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NUR 239 > Test #7: OB > Flashcards

Test #7: OB Flashcards

1
Q

What is the largest cause of spontaneous abortion?

A

Congenital problems of the baby

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2
Q

What is a “spontaneous abortion”?

A

The medical term for miscarriage

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3
Q

What is a “threatened abortion”?

A

Bleeding in the first half of pregnancy

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4
Q

Post-miscarriage, what will contents left in the uterus cause?

A

Bleeding and infection

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5
Q

What is a “missed abortion”?

A

Where the mother is unaware that the baby died

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6
Q

What is the only “absolute” sign of pregnancy?

A

Fetal Heart Rate

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7
Q

What should a patient, post-miscarriage be taught?

A

No tampon use or sex until being cleared by the doctor

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8
Q

After a missed-abortion, what will contents left in the uterus cause?

A

Bleeding (DIC) and infection

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9
Q

What is a risk factor for ectopic pregnancy?

A

Pelvic infection or pelvic inflammatory disease

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10
Q

What is the most sensitive test to determine fibrin levels (used in patients with DIC)?

A

D-dimer

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11
Q

How long should a woman who had a molar-pregnancy be monitored for choriocarcinoma?

A

For 1 year

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12
Q

How is a molar pregnancy treated?

A

Vacuum aspiration is used to extract the mole; then IV oxytocin is used to contract the uterus

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13
Q

What is it important not to stimulate uterine contractions before the uterus is evacuated? (in molar pregnancy)

A

Because contractions can cause trophoblastic tissue to be drawn into venous circulation, resulting in embolization of the vesicles

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14
Q

What is the “classic sign” of placenta previa?

A

Painless uterine bleeding in the second half of pregnancy

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15
Q

What assessment should not be done on a patient with placenta previa?

A

Digital examination of the cervical os (can cause serious bleeding)

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16
Q

What 4 things should a patient be taught to monitor for management of placenta previa at home?

A
  1. Assess discharge or bleeding
  2. Count fetal movement
  3. Assess uterine activity (contractions) daily
  4. No sex (to prevent displacement of the placenta)
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17
Q

Why is a pregnant woman positioned on her left side?

A

Because lying flat on her back can cause vena cava compression; side-lying promotes placenta perfusion

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18
Q

What is the main symptom of a concealed abruptio placenta?

A

Rigid, board-like abdomen

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19
Q

What is the primary risk factor for abruptio placenta?

A

Maternal cocain use

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20
Q

What test cannot be used to diagnose abruptio placenta?

A

Ultrasound; because placental seperation and bleeding look similar on ultrasounds

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21
Q

What is the major danger for a woman with abruptio placenta?

A

Hemorrhage, DIC and/or hypovolemic shock

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22
Q

What test cannot be used to diagnose abruptio placenta?

A

Ultrasound; because placental separation and bleeding look similar on ultrasounds

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23
Q

What is “gestational hypertension”?

A

Blood pressure of >140/90 that develops after 20 weeks without proteinuria

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24
Q

What is “pre-eclampsia”?

A

A BP of >140/90 after 20 weeks with significant proteinuria

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25
What is eclampsia?
Progression of preclampsia to seizures
26
What does epigastric pain in a patient with pre-eclampsia indicate?
It is a warning sign of decreased liver perfusion and often indicates that a seizure is imminent
27
What classification in Magnesium Sulfate?
A CNS depressant (tocolytic)
28
What is a warning sign of magnesium toxicity?
Respirations less than 12/min
29
What is the drug to treat magnesium toxicity?
Calcium gluconate
30
What is generally the first sign of eclampsia and/or impending maternal seizure?
Facial twitching
31
What is the advantage of Hydralazine over other antihypertensives?
In addition to vasodilation, it increases cardiac output and placental bloodflow.
32
What is the classic symptom of the HELLP syndrome?
Pain in the right upper quadrant, epigastrium or lower chest.
33
When does an Rh incompatibility occur?
When the Mom is Rh negative and the baby is Rh positive
34
What test is used to predict Rh incompatibility?
Coombs test
35
What complication might a diabetic mother have with amniotic fluid?
They may have an excess of amniotic fluid
36
What intervention is indicated for a prolapsed umbilical cord?
Immediate C-section
37
How much bleeding/lochia is considered "too much" after birth?
More than 1 pad per hour
38
How long should lochia be red?
First 3 days
39
How often should vital signs be checking in the post-partum patient?
Every 15 minutes until stable and then every hour
40
What contraction-inducing medication should not be given to a woman with hypertension?
Methergine
41
What contraction-inducing medication would be given if Pitocin is ineffective?
Prostin E2
42
Any time excessive bright red uterine bleeding is present and the fundus is contracted firmly at expected location, what is suspected as the cause?
lacerations of birth canal
43
What is subinvolution of the uterus?
where the uterus does not return to its normal size
44
How fast does the uterus normally descend?
1 cm per day
45
How often should a newborn be nursed?
Every 2-3 hours
46
What is the technical definition of "preterm" or "premature" baby?
Less than 38 weeks
47
What is the normal respiratory rate of a neonate/newborn?
30-60
48
What respiratory rate is considered tachypnea in a neonate/newborn?
More than 60
49
What 3 things point to infection in the postpartum woman?
fever >100.4 F, pelvic tenderness, or vaginal discharge with a foul odor
50
What is the range of Proteinuria in mild preclampsia?
>0.3 g but
51
What is the range of Proteinuria in severe preclampsia?
>5 g on 24 hour urine; 3+ or higher on dipstick
52
What is the range of Proteinuria in severe preclampsia?
>5 g on 24 hour urine; 3+ or higher on dipstick
53
What is the therapeutic range of Magnesium?
4-8
54
What is the antidote for Magnesium?
Calcium gluconate
55
What is the antidote for Magnesium?
Calcium gluconate
56
Why does the nurse have to be cautious when administering Magnesium and anti-hypertensives together to a woman in severe preclampsia?
Because signs of magnesium toxicity includes hypotension
57
Why does the nurse have to be cautious when administering Magnesium and anti-hypertensives together to a woman in severe preclampsia?
Because signs of magnesium toxicity includes hypotension
58
What does "HELLP" stand for?
Hemolysis Elevated Liver enzymes Low Platelet count
59
What is the first sign of HELLP syndrome?
Pain in right upper quadrant, lower chest, or epigastric area
60
What is the first sign of HELLP syndrome?
Pain in right upper quadrant, lower chest, or epigastric area
61
What should the nurse keep in mind with administering Methyldopa to a pregnant patient with hypertension?
It may cause a positive Coombs test
62
What should the nurse keep in mind with administering Methyldopa to a pregnant patient with hypertension?
It may cause a positive Coombs test
63
What is the purpose of a Coombs test?
To detect detect maternal antibodies to Rh positive blood
64
What is the purpose of a Coombs test?
To detect detect maternal antibodies to Rh positive blood
65
When should RhoGam be administered?
At 28 weeks and within 72 hours of delivery
66
When should RhoGam be administered?
At 28 weeks and within 72 hours of delivery
67
When should RhoGam be administered?
At 28 weeks and within 72 hours of delivery
68
What is Procardia (Nifedipine)?
A calcium channel blocker; used in pregnancy to relax smooth muscle (as a Tocolytic)
69
In the event of premature birth, what intervention will decrease the risk/severity of hyperbilireubinemia?
Clamping the cord immediately rather than letting it pulsate
70
What is the treatment for HELLP syndrome?
FFP, mag and hydralazine (and birth the baby)
71
What is the treatment for HELLP syndrome?
FFP, mag and hydralazine (and birth the baby)
72
What effects does gestational diabetes have on the baby?
Hypoglycemia, hypocalcemia and hyperbilireubinemia
73
What effects does gestational diabetes have on the baby?
Hypoglycemia, hypocalcemia and hyperbilireubinemia
74
How does an ectopic pregnancy often present?
Sudden, sharp, stabbing pain in the lower abdominal quadrant--referred pain the neck or shoulder
75
Why is it important for Mom to void every 1-2 hours during labor?
Soft tissue obstruction; can keep labor from progressing
76
Why is it important for Mom to void every 1-2 hours during labor?
Soft tissue obstruction; can keep labor from progressing
77
What fetal heart rate is indicative of infection?
greater than 160
78
What fetal heart rate is indicative of infection?
greater than 160
79
In the event of premature rupture of membranes, what will the nitrazine paper show?
pH greater than 6.5, alkaline and paper will turn blue
80
In the event of premature rupture of membranes, what will the nitrazine paper show?
pH greater than 6.5, alkaline and paper will turn blue
81
When are corticosteriods used to mature the baby's lungs?
Most effective given between 24 and 34 weeks gestation
82
How long do corticosteroids need to take effect?
Birth must be halted for 24-48 hours for the drug to take effect
83
How long do corticosteroids need to take effect?
Birth must be halted for 24-48 hours for the drug to take effect
84
How long do corticosteroids need to take effect?
Birth must be halted for 24-48 hours for the drug to take effect
85
What complication may be seen in a mother that goes over her due date?
Cord compression due to oligohydramnios, decreased placental function and meconium aspiration
86
What complication may be seen in a mother that goes over her due at date?
Cord compression due to oligohydramnios, decreased placental function and meconium aspiration
87
What is done to pt in prolonged labor?
if cervix is ripened (soft, dilate, and slight effacement) ten labor is induced. if not prostaglandin gel applied to the cervix
88
What is a hypertonic contraction?
Longer than 90 seconds, less than 2 minutes between contractions or less than 30 seconds rest between contractions,
89
What is a hypertonic contraction?
Longer than 90 seconds, less than 2 minutes between contractions or less than 30 seconds rest between contractions,
90
manifestations of uterine atony after birth
fundus difficult to locate, uterus relaxes when massage stop, vaginal bleeding - pad every 15 is excessive
91
management for uterine atony
regular fundal message, pitocin, metergine and hysterectomy for extreme atonia
92
management for uterine atony
regular fundal message, pitocin, metergine and hysterectomy for extreme atonia
93
management for uterine atony
regular fundal message, pitocin, metergine and hysterectomy for extreme atonia
94
How long after birth until the uterus is not palpable anymore?
2 weeks
95
What assessment finding indicates PKU?
musty urine
96
what test detects PKU?
Guthrie blood test
97
what typically results if PKU goes untreated?
mental retardation, musty body odor or urine, and seizures (trt includes low protein diet)
98
What is Kernicterus?
it is the toxic accumulation of bilirubin in the brain and may cause severe brain damage.
99
what is the most common cause of hyperbilirubinemia and kernicterus?
Rh and ABO inccompatibility
100
what at some indications of a hopycalcemic newborn d/t diabetic mother
irritability, tremors, and high pitched cry
101
the test used to screen for gestational diabetes is the?
oral glucose tolerance test
102
a woman has shoulder dystocia when giving birth. the RN should expect which intervention
suprapublic pressure
103
a mother has excess lochia 2 hours after delivering an 8lb baby, what should be the RN's priority
assess the firmness of her uterus
104
the best position for a women who has postpartum endometritis is?
Fowler's
105
what intervention would be expected in the first 8-12 hours after a post-term birth
blood glucose determination

NUR 239 (8 decks)

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