Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
MC OB Exam 3
Collins Spring 2013
| Question | Answer |
|---|---|
| Antidote for Magnesium Sulfate | calcium gluconate |
| Side effects of Yutopar | hypotension, cardiac arrhythmia, tachycardia, palpitations, MI, pulmonary edema, hyperglycemia |
| action of Betamethasone | induce pulmonary maturation & decrease incidence of RDS |
| Initial weight loss postpartum | 15-18 lbs |
| temp is increased for 24 hrs AFTER milk comes in | 100.4 & below |
| uterus palpable where | midline contracted size of grapfruit |
| lochia alba | days 10-12 white light WBC & D/C |
| lochia serosa | days 3-10 cell component decreases=serosanguous |
| lochia rubra | 1st 2-3 days increased with activity/breastfeeding, no odor or clots |
| 1st period occurs when | breastfeeding 36 weeks or 3 months nonbreastfeeding 6-10 weeks |
| striae | take on different colors based on moms skin tone |
| what can delay elimination? | pain d/t episiotomy/laceration/hemorrhoids |
| after pain help with breastfeeding | NSAID prior to breastfeeding |
| taking in | dependent mom expresses need for food & rest |
| taking hold | focus on newborn, independence for self & newborn |
| letting go | end of 1st postpartum phase, realize what REALLY happens |
| postpartum blues | 1st 10 days, spontaneous recovery & self limiting |
| postpartum depression | anytime in the 1st year, affective mood disorder, & requires MEDICAL Interventions |
| BUBBLEHE | breasts uterus bowel bladder lochia episiotomy/laceration homan's/hemorrhoids emotional |
| prevent UTI | front to back wiping & change frequent pads |
| REEDA | redness, edema, ecchymosis, discharge, approximation |
| ice when | 1st 24 hrs |
| heat when | after 1st 24 hrs |
| rubella vaccine given do not become pregnant for how long? | 3 months |
| threatened abortion | pt has slight bleeding, decrease uterine pain, no dilation/effacement |
| Treatment for threatened abortion | bedrest |
| total placenta previa | completely covers cervical opening |
| why not to do a cervical exam | placenta previa |
| abruptio placentae bleeding | dark port wine, no clot, quick shock state or can be conceeled |
| typical location for ectopic pregnancy | falllopian tubes |
| treatment for ectopic pregnancy | methotrexate 1-2 doses to prevent cells from rapidly dividing OR surgical |
| Pt with gestational trophoblastic disease is told what | DO NOT become Pregnant |
| PUBS | under US guide, removes blood form cord for testing |
| PUBS tests for what | hemophilia, hemoglobinopathies, fetal infections, chrom. abnormalities, nonimmune hydrops |
| CVS | early genetic testing |
| CVS detects what | genetic, metabolic & DNA abnormalities |
| Amniocentesis | 15-20 weeks removes fluid for genetic testing |
| Amniocentesis can detect what | enzyme analysis, AFP, NTD, blood typing, cytogenic (metabolic/DNA testing) |
| LS Ratio | determines RDS 2:1 unlikely |
| PG | 2nd most abundant phopholipid in surfactant |
| PG detects | PROM, vascular disease, severe preeclampsia before 35 weeks |
| Quad Marker Screening | AFP, HCG, diameric inhibin A, & estriol |
| Quad Marker Screening detects | NTD, trisomy 21, downs syndrom & trisomy 18 |
| Preterm | labor that begins between 20 & 37 weeks |
| diagnosis of preterm labor | uterine contractions every 5 mins ofr 20 mins OR 8 contractions in 60 mins AND documented cervical change or cervical effacement of 80% or more OR dilation greater than 1 cm |
| weaned from open crib | 1500 g, 5 days wt gain, respiratory & cardiac stability, & PO feeds |
| Mild preeclampsia dx | BP 140 systolic or 90 diastolic proteinuria 3 g/L or greater in 24 hr urine +1 or +2 dipstick |
| epigastric or RUQ pain | severe preeclampsia S & S |
| eclampsia main symptoms | seizures |
| only cure for PIH | delivery |
| during a seizure | nothing in mouth, stay with pt, call for help, O2 via facemask 8-10 L/min, protect from harm, side-lying, suction |
| glucose challenge test | 130-140 |
| main complication of gestational diabetes in infant | macrosomia (large tissue growth) |
| newborn caloric need | 110-130 kcal/kg/day |
| blood loss from delivery | approximately 5 lbs vaginal 500cc C-section 1000cc |
| prepregnancy weight by | 6-8ths week post delivery |
| if lochia doesn't follow the one way flow pattern what is suspected & should be done? | hemorrhage & call the doctor |
| NI for constipation & bowel issues | walking, drinking H2O, stool softner, dietary fiber (roughage) |
| afterpains | cramping experienced as the uterus contracts down. gives pt contraction sensation |
| pulmonary thrombi alerts | sudden chest pain & + Homan's sign |
| 3+ or 4+ Deep Tendon Reflex indicates | PIH |
| care for breast for breast feeding | heat, no restrictive bra or clothing, face water in shower. |
| care for breast for bottle feeding | cold, tight bra, back to water in shower, cabbage leaves |
| Nipple care | lanolin & vitamin E cream. cleansed off prior to breastfeeding. |
| hemorrhage signs | saturates 1 pad in 15 mins or less |
| heavy bleeding signs | saturates 1 pad in every 2 hrs |
| when to resume sexual activity | once episiotomy healed & lochia has stopped |
| symptoms to report | depression, increased bleeding, fever over 100.4, D/V, dizziness, unrelived HA, swelling, breast tenderness, mastitis, abd pain |
| Spontaneous Abortion occurs when | before 16 weeks |
| incomplete abortion | fetus partially expelled surgery done to scrape uterus |
| complete abortion | everything comes out pain & bleeding STOP |
| missed abortion | fetus dies enutero & all remains in uterus. pregnancy symptoms stop. increased risk for infection. surgery treatment. |
| placenta previa | placenta implants & develops in the low uterine area & covers cervical opening |
| partial (marginal) | partially covers cervical opening |
| low-lying | close to covering cervical opening |
| S&S for placenta previa & treatment | S&S: painless vaginal bleeding after 24 weeks that will stop spontaneously. Tx: 36 week planned c-section until then monitor H&H & Bedrest |
| Placenta previa is a risk for | bleeding |
| abruptio placentae | placenta prematurely separates from the uterine wall after 20 weeks gestation |
| S&S for abruptio placentae | uterus hard, constant contractions, decreased perfusion, board like abd |
| Placenta previa is a risk for | sudden massive bleeding |
| ectopic pregnancy | tubal pregnancy implantation outside the uterus |
| S&S of ectopic pregnancy | doubled over in pain, syncope, referred shoulder pain |
| intrauterine fetal demise | fetus dies enutero after 20 weeks |
| complete gestational trophoblastic disease | sperm meets egg with no neucleus 23+ chromosomes |
| partial gestational trophoblastic disease | normal ovum fertilized by 2 sperms 69 chromosomes |
| invasive gestational trophoblastic disease | same as complete but invades the uterus |
| carcinoma gestational trophoblastic disease | malignant highly treatable if found early |
| S&S of gestational trophoblastic disease | vaginal bleeding @ 4 weeks, dark bleeding, uterine size larger than gestation, increased HcG, N/V, manifest PIH symptoms, cause hyperthyroidism |
| after removal gestational trophoblastic disease | weekly HcG levels until prepregnancy than monthly for 1 yr |
| transabdominal ultrasound needs what | FULL bladder 1-2Quarts |
| fetal surveillance occurs because | PIH, GDM, DM, decreased fetal movements, chronic medical conditions |
| NST | reactive (HR of 15 beats up for 15 secs from baseline) is wanted nonreactive (none in 40 mins) |
| CST | negative is wanted positive is where late decelerations are present in 50% of contractions |
| BPP checks for | FHR acceleration, FHR breathing, fetal movements, fetal tone, amniotic fluid volume |
| BPP results to induce | 6/10 or lower |
| Quad marker screening is done when | around 15-18 weeks |
| S&S of preterm labor | change in DC, vaginal bleeding, ROM, D, fetal engagement prior to 32 weeks, UTI, low back pain that is different, pelvic/thigh pressure, sensation of uterine tightening, lower abd cramping |
| treatment for Inpatient preterm labor | fetal/uterine monitoring, bedrest, side-lying, tocolytics, evaluate fetal lung maturity |
| treatment for outpatient preterm labor | uterine monitoring, modified bedrest, side-lying, tocolytics, non-caffeinated fluids, empty bladder, no heavy lifting, no sexual activity |
| preterm neonate kidneys immaturity increases risk for | metabolic acidosis so avoid & caution meds due to nephrotoxicity |
| if preterm neonate is stressed due to things like touch, noise, & light reacts by | decreasing HR & O2 |
| severe preeclampsia | 160 systolic or 110 diastolic proteinuria 5g/L or more in 24 hr urine |
| S&S of severe preeclampsia | cereral/visual disturbances (HA, altered concsiousness, blurred vision), pulmonary edema or cyanosis, epigastric or RUQ pain, thrombocytopenia or impaired liver funciton, oliguria (<500cc/24hrs) |
| pathophysiology of PIH | exaggerated response to angiotensins & thromboxane increases. arteriolar vasospasm, endothelial damage, stimulates platelet & fibrinogen use. systemic vasospasm, vascular damage & fluid shifts. |
| in normal pregnancy patho | normal pregnancy blunts response to angiotensin II (increase BP/decreases fluid) thromboxane (increases BP & promotes platelet aggreagation) |
| Treatment for Mild PIH | IP/OP, rest, NST, BPP, fetal movement, assessment of BP, monitor for advancement |
| treatment for severe PIH | IP seizure precautions, continous fetal monitoring, DTR every hr, BP monitoring, rest & quiet, daily wt, proteinuria, end organ changes, amniocentesis, betamethasone & dexamethasone, mag sulfate |
| treatment for eclampsia | mag sulfate, Na amobarbitol, observe for precipitous labor/delivery & placental abruption, seizure safety |
| S&S for GDM | vary none to coma 3 P's glucosuria |
| Screening criteria for GDM | prior GDM, LGA infant, marked obesity, dx of polycystic ovarian syndrome, glycosuria, family hx of diabetes |
| if at risk random test | HbA1c >6.5% or fasting glucose >126 |
| if not high risk GDM is screened at | 24-28 weeks |
| maternal complications from GDM | infection, HTN, polyhydramnios, postpartum hemorrhage, premature delviery, over distended uterus |
| infant complications from GDM | macrosomia, IUGR, congenital abnormalities, IUFD, birth asphyxia, birth injury, RDS, hypoglycemia |
| self glucose monitoring of GDM | pre below 95, 1 hr post below 130-140, & 2 hrs post below 120 |
| nutrition GDM | 3 meals & 3 snacks. 40-50% complex carbs, 15-20% protein, 20-30% fat |
| why is oral hypoglycemics rarely used | crosses the placenta |
| Mag sulfate | neuromuscular relaxation given IV SE: flushing, warmth, HA, N, nystagmus, dry mouth, dizzy, lethargy, & sluggish NI: monitor BP, resp, mag levels, DTR, urinary output infant SE: hypotonia, lethargy, hypoglycemia, hypocalcemia |
| ritodrine hcl (Yutopar) | beta blocker SE: hypotension, cardiac arrhythmia, tachycardia, palpitations, MI, pumonary edema, hyperglycemia NI: IV, IM, SQ, oral |
| betamethasone (Celestone Solusapn) | induce pulmonary maturation & decrease incidence of RDS SE: increase infection, hyperglycemia, pylmonary edema, Na & fluid retention, N, impaired wound healing infant SE: decrease cortisol levels @ birth, hypoglycemia, increased risk for sepsis |
| NI for betamethasone (Celestone Solusapn) | assess for contraindications, deep in gluteal muscle, monitor BP, HR, wt, & edema, assess lab values for electrolytes & blood glucose |
| Contraindications for betamethasone (Celestone Solusapn) | cant delay birth, adequate L/S ratio, maternal bleeding, maternal infection, DM, more than 34 weeks, Cushing syndrome |
| Terbutaline | same as yutopar beta blocker |
| Nifedipine | reduces flow of extracellular Ca ions into intracellular space=inhibits contractile activity SE: hypotension, tachycardia, facial flushing, HA NI: assess BP, HR, & resp CI: heart disease, cardio compromise, intrauterine infection, multiple pregnancy, H |
| increases risk for preeclampsia | primigravida <20 yrs old, chronic HTN, low SES, >35 yrs old, & multiple gestation |
| increases risk for GDM | prior GDM, LGA infant, marked obesity, polycystic ovarian disease, glycosuria, history of DM type 2 |
| increases risk for preterm | OB complications, poor uterine blood flow, maternal employment, stress, history of Preterm labor |
| increases risk for abruptio placentae | increased parity (multiple gestation), low SES, PIH, increased maternal age, cocaine use, smoking alcohol, history of it |
| increases risk for ectopic pregnancy | damaged fallopian tubes or history of surgery on , pelvic inflammatory disease, increased age |
| increases risk for IUFD | DM especially type 1, PIH, Rh incomptabilities, abruption of the placenta, cord compression, illegal drugs, anything that decreases perfusion to the baby |
| which procedures should you have a full bladder? | abdominal ultrasound & CVS. Not amniocentesis. |
Created by:
midnight1854
Popular Nursing sets