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OB > Unit 3 exam > Flashcards

Unit 3 exam Flashcards

1
Q

infants of diabetic mothers r/o

A
  • congenital anomalies
  • cardiac anomalies
  • IUGR
  • respiratory distress
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2
Q

neonate hypoglycemia onset

A 
•BS < 40 in term
•BS < 25 in preterm
•jittery
•RDS
•lethargy
•poor suck
•seizures
*w/in 1-3 hrs after birth
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3
Q

polycythemia

A
  • Hct > 65%
  • inc. blood viscosity -> poor O2
  • inc. RBC hemolysis -> jaundice
  • inc. r/o cephalhematoma/bruising
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4
Q

early onset neonate bacterial infection

A
  • congenital
  • rapid progression (1-2 days)
  • hypothermia common s/sx
  • GBS most common
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5
Q

late onset neonate bacterial infection

A
  • acquired

* late progression (1-2 wk)

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6
Q

drug/etoh neonate effects

A
  • pre-term
  • placental abruption
  • LBW
  • small head
  • high pitched cry
  • IUGR/UPI
  • exaggerated reflexes
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7
Q

pathologic jaundice

A 
•appears w/in first 24 hrs
•r/t excessive RBC destruction
-blood incompatibility
•bill high and stay high
*get stat bill if suspected
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8
Q

physiologic jaundice

A
  • appears after first 24 hrs
  • benign
  • resolves by day 4
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9
Q

omphalocele

A

•intestines stick out of umbilicus are COVERED by thin layer of tissue

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10
Q

gastroschisis

A

•intestines stick out of umbilicus UNCOVERED

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11
Q

when is suck-swallow-breath reflex mature

A

•34 wks

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12
Q

readiness to PO feed

A
  • rooting
  • sucking
    • gag
  • RR < 60
  • tolerate being held
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13
Q

preterm expected UOP

A

•1-3 mL/kg/hr

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14
Q

assessing preterm renal fxn

A
  • UOP
  • Na, hct, BUN, SG
  • weight
  • turgor/edema
  • anterior fontanelle
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15
Q

preterm hematologic issues

A
  • inc. cap friability
  • inc. clotting time
  • dec. erythropoiesis
  • dec. RBC life
  • dec. blood vol.
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16
Q

bronchopulmonary dysplasia

A

•O2 still required 28 hrs after birth or 36 wks post conceptual age

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17
Q

necrotizing enterocolitis (NEC)

A

•accumulation of gas in submucosal layers of bowel wall
•causes necrosis, perforation, and sepsis
•abd. distension, bloody stool, feed retention
*2 wks after birth

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18
Q

post-mature characteristics

A
  • old placenta -> dec. O2/nutrients
  • meconium aspiration
  • polycythemia
  • hairy
  • long nails
  • dry, peeling skin
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19
Q

small for gestational age (SGA)

A

•< 5.5 lbs in term

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20
Q

asymmetric growth restriction

A

•head and length unaffected
•weight disproportional
•recover w/ nourishment
*r/t MID PG complications

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21
Q

symmetric growth restriction

A

•weight, length, head all affected
•may have long-term growth issues
*r/t EARLY PG complications

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22
Q

NIPS

A

•neonatal infant pain scale

  • facial expression
  • crying
  • arm movement
  • leg movement
  • state of arousal
  • hormone levels
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23
Q

CRIES

A 
•neonatal pain scale
Crying
Requires oxygen 
Increased VS
Expression
Sleepless
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24
Q

diagnostic testing

A

•evaluates for and tells of there IS a genetic/congenital issue

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25
Q

screening

A

•evaluates RISK FOR an issue

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26
Q

antepartum testing

A
  • evaluates fetus AFTER problem is detected

* Ex: NST, kicks, U/S

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27
Q

1st trimester U/S

A 
•TV or TA
•dates (CRL)
•# fetus
•heart activity
*1-12
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28
Q

2nd trimester U/S

A 
•TA
•fetal anatomy/viability
•sex @ 18 wk
•PTL assessment
*13-27
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29
Q

3rd trimester U/S

A 
•fetal well being
•BPP
•AFI
•placental location/grading
•growth (IUGR)
•presentation 
•PTL assessment
*28-birth
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30
Q

nuchal translucency

A
  • 1st tri screening done 10.5-13.5 wks
  • assessing for downs
  • contra: pt refuse; past dates
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31
Q

quad screen

A
  1. MSAFP
  2. hCG
  3. Estriol
  4. Inhibin A
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32
Q

maternal serum feroprotein screening (MSAFP)

A 
•2nd tri screening done 16-20 wks
•high = ONTD
•low = downs
*requires followup (don't repeat)
*false + if multiple gest, dates off
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33
Q

amniocentesis in 2nd tri

A
  • after 14 wk

* detects karyotype

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34
Q

amniocentesis in late 3rd tri

A
  • detects fetal lung maturity (2:1)

* detects Rh incompatibilities

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35
Q

amniocentesis risks

A
  • SAB
  • stillbirth
  • ROM
  • PTL
  • abruption
  • fetal injury
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36
Q

chronic villus sampling

A
  • 1st tri alternative to amniocentesis
  • test fetal portion of placenta
  • genetic testing @ 10-12 wks
  • r/o SAB/limb loss
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37
Q

percutaneous umbilical blood sampling (PUBS)

A

•18 wks = genetics
•3rd tri= blood tranfusion for hemolytic dz
•r/o cord lac/hematoma/ROM/PTL/infection
*often in OR b/c may have to get baby out ASAP

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38
Q

reactive NST

A

•< 32 wk = 10x10
•> 32 wk= 15x15
•mod. variation and NO decals
*indicates CNS fxn

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39
Q

non reactive NST

A 
•minimal variation 
•no accels
•+ decels
•requires CST or BPP
*may have to induce
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40
Q

CST

A
  • induction of ctx to assess FHR in response to stress
  • more invasive (IV) than NST and BPP
  • contra in preterm and anything that would lead to PTL
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41
Q

negative CST

A

•no decels
•3 ctx in 10 min
•reassurance that fetus will survive labor
*normal

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42
Q

postive CST

A

•late decels in > 50% ctx
•indicates UPI
•requires induction or C/S ASAP
*abnormal

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43
Q

biophysical profile (BPP)

A

•U/S and EFM to assess

  1. FHT
  2. breathing
  3. amnio vol.
  4. movement
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44
Q

normal BPP scorring

A

•8/8 = normal (didn’t do NST)
•8/10 = normal and non-reactive NST
•10/10 = normal and reactive NST
*no evidence of UPI

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45
Q

equivocal BPP

A
  • 6

* repeat in 24 hr

46
Q

abnormal BPP

A
  • < 6

* induce/C-section ASAP

47
Q

polyhydramnios

A 
•AFI > 25
•d/t 
-NTD
-GI obstruction
-twins
-hydrops
-DM
-congenital anomalies
48
Q

risks r/t polyhydramnios

A
  • cord prolapse
  • PROM
  • unsuccessful labor
49
Q

oligohyramnios

A 
•AFI < 5
•d/t
-renal issue
-PROM
-post-dates
-UPI
50
Q

risks r/t oligohyramnios

A
  • cord accident
  • fetal malformation
  • hypoplastic lungs
51
Q

fetal kick count instructions

A
  • eat/relax
  • should feel 10 movements in 2 hrs
  • if no move in 12 hrs -> further testing
52
Q

PTL clinical characteristics

A
  • b/t 27-37 wks GA
  • > 6 ctx/hr
  • cervical change
  • vag bleeding/discharge
53
Q

PTL interventions

A
  • prevention/early detection key
  • tocolytic
  • steroids
  • bed/pelvic rest
54
Q

tocolytic drugs

A 
•MgSO4
•terbutaline
•nifedipine
•indomethacin 
*promote uterine relaxation
55
Q

low birth weight (LBW)

A
  • ANY baby born < 2500 g, regardless of GA

* usually caused by IUGR

56
Q

PROM

A

•premature rupture of membrane 1+ hr before onset of labor

57
Q

PPROM

A

•premature rupture of membrane 1+ hr before onset of labor AND GA < 37 wks

58
Q

risks r/t PPROM and PROM

A
  • infection
  • cord prolapse
  • fetal abnormalities (skeletal; lung)
59
Q

s/sx cord prolapse

A

•severe variable decels
•fetal bradycardia
•see cord
*ALWAYS vag exam if suspected

60
Q

hypotonic labor vs. hypertonic labor

A

•hypo is no fetal distress
•hypo may require augmentation
•hyper may require uterine resuscitation
*both involve NO cervical change

61
Q

causes of passageway (tissue) obstruction

A

•full bladder (#1)
•cervical edema
•HPV
*avoided by emptying bladder and not pushing until 10 cm

62
Q

shoulder dystocia interventions

A
  • McRoberts- knees to chest
  • Gaskin- all 4s
  • Zavanelli- push head in & C/S
63
Q

uterine rupture vs. uterine dehiscence

A
  • dehiscence is incomplete rupture w/ no pain or fetal distress
  • rupture is complete and requires resuscitation & C/S
64
Q

uterine resuscitation

A
  • pt on side
  • stop pit
  • open main fld. line
  • O2 @ 10L
  • vag exam (r/o prolapse)
  • Brethine (uterine rlx)
65
Q

tachysystole

A

•hyper stimulation of uterus
•ctx > 90 sec
•> 5 ctx in 10 min
*causes late decel; loss of variability

66
Q

when uterine resuscitation may be necessary

A
  • tachysystole
  • uterine rupture
  • hypertonic ctx
67
Q

pitocin admin

A
  • ALWAYS IVPB on pump
  • attach close to insertion site
  • start low and slow
68
Q

Bishop score

A 
•estimates how successfully labor can be induced
•based on:
-dilation
-effacement
-station
-consistency
-position
69
Q

readiness for induction

A

•Bishop of 9+ for nulls
•Bishop of 5+ for multip
*if not ready (low score) may have to cervical ripen

70
Q

amniotomy

A

•AROM
•fetal station MUST be low
*WONT shorten labor

71
Q

excessive fld following amniotomy indicates…

A
  • polyhydramnios

* high fetal station (DONT ambulate)

72
Q

important after episiotomy

A

•NEVER give enema/suppository

*do give PO stool softeners

73
Q

fibrocystic changes

A
  • benign breast d/o
  • bilateral pain/tenderness
  • occurs prior to menopause
  • tx: diuretics; NSAIDs; no caffeine; reduce Na+
74
Q

tamoxifen

A
  • selective estrogen receptor modulator (SERM)
  • breast cancer hormone adjuvant
  • blocks estrogen
  • ONLY works on estrogen-receptive tumors
  • SE similar to menopause
75
Q

candidiasis

A
  • vaginal yeast infection
  • white, thick, curdy d/c
  • no odor
  • itching
76
Q

bacterial vaginosis

A
  • thin, gray/white or yellow/green d/c
  • malodorous
  • profuse
77
Q

gonorrhea

A

•green d/c
•dyspareunia; dysuria
*r/o PROM

78
Q

chlamydia

A
  • yellow d/c
  • asymptomatic in women
  • no abx tx -> PID
79
Q

trichomoniasis

A 
•thin green/yellow d/c
•malodorous
•itching, redness, edema
•looks like sperm
*both partners need abx and refrain from sex
80
Q

syphilis

A
  • painless chancre (male ID)
  • primary, secondary, tertiary
  • PCN ONLY tx
81
Q

herpes

A
  • blisters
  • severe vulvular pain; dyspareunia
  • no cure
82
Q

toxic shock syndrome

A
  • caused by staph
  • leads to hypovolemia, hypotension, shock
  • s/sx: flu-like, hypotension, rash
83
Q

best indicator of endometrial cancer

A

•bleeding after menopause
•hypertensive
*most common malignancy of reproductive system

84
Q

primary amenorrhea

A
  • menarche after 16
  • menarche 1 yr later than mom
  • menarche same age as sister
85
Q

secondary amenorrhea

A
  • absence of 3 menstruation cycles after regular established

* most common cause is PG

86
Q

primary vs. secondary dysmenorrhea

A
  • primary has unkind cause
  • secondary d/t dz (fibroids, endometriosis, PID)
  • tx: OCPs; NSAIDs
87
Q

endometriosis

A

•endometrial cells grow outside of uterus
•often leads to infertility b/c of tube/ovary occlusion
•laparoscopic dx
•no tx necessary if no pain or PG desire
•surgery if s/sx severe
*hyoestrogenism bone loss r/t med tx reversible after stop med

88
Q

basal body temp and ovulation

A
  • decreases right before
  • increases during
  • stays high if PG
89
Q

physical changes of menopause

A 
•cessation of estrogen/progesterone
-dry
-hot flashes
-insomnia
•bladder, vag, urethra atrophy
90
Q

diaphragm

A

•6 hrs before sex
•leave in 6-8 hrs
•refit q2-3yr or if 10 lb change
*r/o toxic shock

91
Q

cervical cap

A

•30 min before sex
•leave in 6-8 after
*r/o toxic shock

92
Q

spermicide

A
  • 15-30 min before sex

* reapply q1h or each encounter

93
Q

female condom

A

•8 hrs before sex

94
Q

PAINS

A 
•IUD warning signs
Period late/abnormal
Abd pain
Infection
Not feeling well
String length change
95
Q

combined oral contraceptive (COC) fxn

A
  • suppress ovulation
  • thicken cervical mucous
  • effect endometrial lining
96
Q

ACHES

A 
•COC AE (call MD)
Abd pain
Chest pain; cough
HA; dizzy
Eye problems
Severe leg pain
*don't stop pill abruptly
97
Q

progestin-only pill (mini pill)

A
  • changes endometrium and cervical mucous
  • best if lactating or > 40 y/o
  • MUST take @ same time
98
Q

most likely spot to have atypical cervical (cancer) cells

A
  • transformation zone

* where changes from cervical cells to endocervical cells

99
Q

Peau de’ orange

A

•abnormal breast tissue texture that indicates inflammatory breast cancer

100
Q

when is COC contraindicated

A
  • > 35 AND smoke, HTN, migraine

* hx of thrombolytic complication

101
Q

induction via oxytocin contraindicated if…

A
  • late decelerations

* positive CST b/c ctx put fetus in distress

102
Q

health risks associated w/ menopause

A
  • osteoporosis
  • obesity
  • heart dz
103
Q

when are PMS s/sx present

A
  • week before menstruation

* resolve w/in couple day of menses onset

104
Q

what test helps dx IUGR

A

•doppler blood flow

105
Q

possible neonate condition d/t steroid admin in utero…

A

•hypoglycemia

106
Q

MgSO4 classification

A

•CNS depressant

*neonate r/o resp. suppression

107
Q

normal respiration findings of preterm

A

•5-10 sec of respiratory pauses followed by 10-15 sec of rapid compensatory respirations

108
Q

RN intervention shoulder dystocia

A

•suprapubic pressure

109
Q

RN interventions for FHR decels and hypertonic ctx

A
  • turn pt on side FIRST

* discontinue oxytocin

110
Q

first intervention if pt reports no fetal movement

A

•auscultate for FHR

OB (17 decks)

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