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4th Quarter : 2
Units 7 - 9
| Question | Answer |
|---|---|
| When teaching patients, what grade level should we be addressing? | The 3rd grade level. |
| Is teen pregnancy rising or declining? | Rising. |
| Abortion: | Any birth at less than 20 weeks. |
| Antepartum: | Pregnancy |
| Ante: | Before |
| Partum: | Birth |
| Ballotement: | When the cervix is tapped, the floating baby moves and taps back. |
| Braxton Hicks: | Contractions of the uterus that are warm-ups. They are not regular or painful and do not open the cervix. |
| Chloasma: | The mask of pregnancy r/t hormones that appears as a darkening of skin similar to the malar rash of lupus. |
| EAB | Elective abortion. |
| EDB, EDC, EDD | Estimated date of birth, confinement, delivery. |
| Gestation: | Dating pregnancy in weeks from LMP. |
| Gravida: | Pregnant woman. |
| Intrapartum: | Labor & delivery. |
| Lightening: | Feeling of baby dropping into pelvis. |
| Linea nigra: | A darkened line from pubis symphisis to the navel. |
| LMP | 1st day of last menstrual period. |
| McDonald's rule: | Measure the uterine height to approximate gestation. Cm = weeks. |
| Fundus: | Top of uterus. |
| What happens to fundal height when lightening occurs? | It goes down. |
| According to McDonald's rule, at what location will 20 wks fall? | At the navel. |
| Multi gravida: | Pregnant more than once. |
| Para: | # of pregnancies carried to the age of viability. |
| Nagele's rule: | LMP minus 3 months + 7 days = due date. |
| Nulligravida: | Never pregnant. |
| Nullipara: | Never pregnant past the age of viability. |
| Post partum: | From delivery to the return of the non-pregnant state. |
| Post term: | Pregnancy of 42 weeks or greater. |
| Pre term: | Pregnancy of 37 weeks or less. |
| Primigravida: | Pregnant for the 1st time. |
| Primipara: | Pregnant for the 1st time past the age of viability. |
| SAB | Spontaneous abortion (miscarriage). |
| Still birth: | a.k.a. fetal demise. Birth of a dead baby after 20 wks. |
| Striae gravidarum: | Stretch marks from pregnancy. |
| TAB: | Therapeutic abortion. |
| What is considered term? | 37 - 42 weeks. |
| TOP | Termination of pregnancy. |
| What is the most common prenatal complication worldwide? | PIH |
| What is the #1 medical cause of maternal mortality? | PIH |
| What is PIH? | Pregnancy induced HTN. |
| When does PIH most often occur? | After 20th week. |
| What causes PIH? | It is unknown. |
| Kidneys are involved with this: | PIH |
| What causes vasospasm in mom & placenta? | PIH |
| How common is PIH? | 5 - 8% |
| Does maternal BP normally increase or decrease during pregnancy? | Decrease d/t vasodilation. |
| What are predisposing factors for PIH? | Obesity, twins, over 35, adolescents, prima gravida, DM, low SES, non-white. |
| PIH can lead to: | Abruption, DIC, fetal demise. |
| IUGR | Intra uterine growth retardation. |
| Women with chronic HTN are at a __ % increased risk of PIH. | 25% |
| Presenting woman with PIH: | HA, visual disturbance, epigastric pain (URQ). |
| How late can PIH occur? | Up to 2 days after delivery. |
| What do we ask all women that come in to L & D? | HA? Visual disturbances? Epigastric pain? |
| What objective signs are present with PIH? | Edema of hands, face, sacrum. HTN 140/90. Proteinuria. |
| What is the BP goal for a diabetic? | 120/80 |
| Is PIH a progressive disease? | Yes |
| What treatments are used for PIH? | Bedrest on left side. Decrease Na+. Increase fluids. Very high fiber diet. Magnesium Sulfate. |
| What side is best to lay on in pregnancy? | The left, it profuses baby the best. |
| Magnesium sulfate | Anticonvulsant, smooth muscle relaxant, IV, monitor blood levels. RISK OF RESPIRATORY DEPRESSION. |
| What is the antagonist of magnesium sulfate? | Calcium gluconate. |
| What are the SE of magnesium sulfate? | Mom flushes, feels hot and gross. |
| What effect does magnesium sulfate have on the baby? | Baby will appear limp & "magged out". |
| What is the cure for PIH? | Delivery. |
| Women with PIH are more prone to what later in life? | Renal disease. |
| HELLP | Hemolysis. Elevate Liver enzymes. Low Platelets. |
| Is HELLP common? | No. |
| HELLP is ___ gone really bad. | PIH |
| Gestational diabetes: | Diabetes diagnosed during pregnancy. |
| Is gestational diabetes similar to DM or DMII? | DMII r/t insulin resistance. |
| Who is at risk for gestational diabetes? | Family hx, obese, sedentary, hispanic, native american. |
| What are the associated complications of gestational diabetes? | PIH, large baby (macrosomia), retarded surfactant development. |
| A baby born to a mom with gestational diabetes will have hyper/hypoglycemia when the cord is cut? | Hypoglycemia. |
| Interventions for gestational diabetes: | Diet & exercise. More frequent visits & tests. Insulin (Lg molecular wt) and orals. |
| When does gestational diabetes manifest? | 2nd half of pregnancy. |
| Gestational diabetes has what effect on the baby's risk for diabetes? | It increases the risk. |
| What is the cure for gestational diabetes? | Delivery, but not all are cured with delivery. |
| What is the #1 cause of neonatal mortality? | Prematurity. |
| What is considered low birth weight? | 2500 g / 5.5 lb |
| Who is at risk of preterm labor? | Smokers, drinkers, drug users, multiples, adolescents, 35 and over, obesity, low SES, anatomcial predisposition (short cervix), mom's with infections, and mom's with pregnancies too close together. |
| Can periodontal disease cause preterm labor? | Yes |
| Symptoms of preterm labor: | Backache, cramping. |
| How long should a woman wait to conceive again? | As long as her prior gestation. |
| How do we treat preterm labor? | Antibiotics (if caused by infection). Smooth muscle relaxants. |
| Terbutaline | Bronchodilator for asthma. Off label use for preterm labor. PO & SubQ. |
| Nifedipine | Ca+ channel blocker. Smooth muscle relaxant. PO. |
| Magnesium Sulfate | Smooth muscle relaxant. Target organ, uterus. |
| Betamethasone | Steroid. Given to mature fetal lungs, develop surfactant. Given more than 24 hr. before delivery. |
| Betamethasone increases risk for: | Infection. |
| When does the clock start ticking? | When membrane rupture occurs. |
| PROM | Before 37 wks. |
| Antibiotics may be used to prevent infection when this occurs: | PROM |
| What is the Fern test? | Amniotic fluid on microscopy appears fern-like. |
| What is the #1 concern with ruptured membranes? | Infection. |
| Why should a vaginal exam be performed after ROM? | Only if absolutely necessary. |
| Rh is _______ recessive trait. | Homozygous. |
| Hydrops fetalis | A condition in which a fetus or newborn baby accumulates fluids, causing swollen arms and legs and impaired breathing. |
| Who receives Rhogam? | All Rh negative moms at 28 wks & after delivery if baby is positive, within 72 hrs. |
| Rhogam is given: | IM |
| ABO incompatibility may lead to the need for what? | Bili lights to treat jaundice. |
| The blood V of a pregnant woman increases 50% and is mostly _____. | Serum |
| Normal Hct goes ____ in pregnancy. | Down to 34 - 38. |
| Moms with anemia are at higher risk for what? | Postpartum hemorrhage. |
| Folic acid anemia may lead to: | Neural tube defects. |
| All women of childbearing age should be on 1 mg of ______ ____ a day. | Folic acid. |
| Sickle cell anemia is characterized by: | Exacerbations and remissions. |
| What prenatal complication increases the risk of placental abruption? | PIH |
| How do we measure abruption? | By % |
| Central abruption: | Stabbing abdominal pain, no bleeding. |
| Marginal abruption: | Bright red blood, no pain. |
| 100% central abruption: | Mass pain. No fetal heart beat within 4 minutes. |
| What are risk factors for abruption? | Cocaine, smoking, trauma. |
| Symptoms of abruption: | Bleeding, pain, no fetal heart tones. |
| This may lead to DIC: | Placental abruption. |
| Treatment for 100% abruption: | Emergency c-section. |
| Placenta previa | Implantation occurs low in the uterus. |
| Can a woman with placenta previa deliver vaginally? | No |
| Sign of placenta previa: | Bleeding |
| Who is at risk of placenta previa? | Elderly, hx, multiple gestation (twins). |
| What prenatal complication will not receive a vaginal exam? | Placenta previa. |
| What is a molar pregnancy? | The tissue around a fertilized egg develops as an abnormal cluster of cells that is incompatible with life. |
| What is a sign of a molar pregnancy? | Prune juice discharge. |
| How will a woman with a molar pregnancy feel? | Pregnant with n/v. |
| Treatment for molar pregnancy: | D & C |
| Ectopic pregnancy | Implantation outside the uterus. |
| Where do most ectopic pregnancies occur? | In the fallopian tubes. |
| What is the leading cause of maternal death in the 1st trimester? | Ectopic pregnancy. |
| Where is pain with ectopic pregnancy? | Low abdomen/pelvic region. |
| What happens with a growing ectopic pregnancy? | The tube may rupture, causing bleeding into the peritoneum, leading to hypovolemic shock. |
| What is used to treat ectopic pregnancy? | Methotrexate |
| Methotrexate | Kills rapidly dividing cells. Dosage calculated based on body surface area. |
| Incompetent cervix | Won't stay closed. Associated with short cervix. |
| Treatment for incompetent cervix: | Cerclage and bedrest. |
| Post-term pregnancy | 42 weeks or greater. |
| What happens to the placenta in a post-term pregnancy? | It can decrease effectiveness or increase it. |
| Postmature syndrome | Wrinkly baby with sunken cheeks, at risk for meconium aspiration. |
| Risk factors for postmature syndrome: | Uteroplacental insufficiency, post-term, PIH, any fetal stressor. |
| Not post term: | Post date. |
| How many babies are being born with HIV to moms with HIV? | Only 2% d/t antiretroviral drugs during pregnancy. |
| When is a c-section performed with an HIV mom? | At 38 weeks. |
| Can HIV moms breastfeed? | No. |
| Hyperemesis | Entire pregnancy to the point of dehydration and fluid & electrolyte imbalance. |
| Treatment for hyperemesis: | Zofran (for n/v r/t chemo), B12, no fat/low fat diet. |
| After MVA how long is the fetus monitored? | 24 hours. |
| This may escalate or begin during pregnancy: | Domestic violence. |
| __% of pregnant teens are victims of domestic violence. | 35% |
| What causes enlargement of the uterus? | Hypertrophy of preexisting myometrial cells. |
| By the end of pregnancy, how much of the total maternal blood is contained within the uterus? | 1/6 |
| At term, the cervix has only ___ of it's prepregnant strength. | 1/12 |
| Goodell's sign | Softening of the cervix. |
| Chadwick's sign | Blue-purple discoloration of the cervix. |
| Do the ovaries continue to produce eggs during pregnancy? | No. |
| How soon may colostrum be manually expressed? | Week 12. |
| Between 16 - 40 weeks, oxygen consumption increases by how much? | 15 - 20%. |
| What causes rhinitis of pregnancy, and epistaxis? | Estrogen-induced edema and vascular congestion. |
| What happens to the heart, anatomically, during pregnancy? | It pushes upward and to the left, rotating forward. |
| At term, blood volume has increased by how much? | 40 - 45% |
| What happens to pulse rate during pregnancy? | It increases. |
| What may cause a marked decrease in BP, dizziness, pallor, and claminess? | The uterus putting pressure on the vena cava when supine. |
| How much does plasma volume increase during pregnancy? | 50% |
| What causes the emptying time of the gallbladder to become prolonged during pregnancy? | Smooth muscle relaxation from progesterone. |
| On what side do dilation of the kidneys and ureter usually occur? | On the right. |
| What stimulates skin changes during pregnancy? | Hormones. |
| What causes stretch marks? | Reduced connective tissue strength. |
| What happens to the rate of hair growth during pregnancy? | It slows down. |
| What happens to the sweat and sebaceous glands during pregnancy? | They become hyperactive. |
| What joints relax during pregnancy? | Sacroiliac, sacrococcygeal, and pubic. |
| What happens to a woman's lumbodorsal spinal curve? | It becomes accentuated. |
| What causes paresthesia's that may occur late in pregnancy? | Pressure on peripheral nerves. |
| What happens to intraocular P during pregnancy? | It decreases. |
| What happens to the cornea? | A slight thickening occurs r/t fluid retention. |
| Do most metabolic functions increase or decrease during pregnancy? | Increase. |
| What accounts for most of the weight gain in pregnancy? | Uterus & it's contents. Breasts. Increased intravascular fluids. |
| What are the maternal reserves? | Extra water, fat, and protein that are stored. |
| Recommended total weight gain: | 25 - 35 lb. for average. |
| Is it normal to retain water during pregnancy? | Yes, d/t an increase in sex hormones. |
| When does the fetus make it's greatest demands for protein and fat? | During the 2nd half of gestation. |
| In what direction does iron transfer at the placenta? | Toward the fetus only. |
| Relaxin | Inhibits uterus activity. |
| Where do prostaglandins occur, in high concentration? | In the female reproductive tract. |
| Hegar's sign | A softening of the isthmus of the cervix. Occurs at 6 - 8 weeks. |
| Which is higher, false positives, or false negatives? | False negatives. |
| How soon should a woman retest if she had a negative result and still has not started her period? | 1 week. |
| Fetal heart rate | 120 - 160 |
| What are risk factors? | Any findings that have been shown to have a negative impact on pregnancy outcome, for mom or baby. |
| What may be the single most important factor for dating pregnancy? | Uterine size. |
| When can fetal heartbeat be heard on doppler? | 8 - 10 weeks. |
| How soon can US visualize pregnancy? | 5 - 6 weeks. |
| Crown to rump measurements are used on US until when? | Until the fetal head can be defined. |
| What can help prevent/reduce back strain, and strengthen abdominal muscle tone? | Pelvic tilt / Pelvic rocking. |
| Pica | The persistent craving & eating of substances such as ice, freezer frost, cornstarch, baby powder, clay, dirt, etc. |
| What causes rheumatic fever? | Untreated strep infections. |
| What is rheumatic fever? | An inflammatory connective tissue disease. |
| What can be affected by rheumatic fever? | Heart, joints, CNS, skin and subcutaneous tissue. |
| Marfan syndrome | Autosomal dominant. May cause disection/rupture of aorta in pregnancy. Maternal mortality as high as 50%. |
| What may decrease heart palpitations in people with mitral valve prolapse? | Decreasing caffeine intake. |
| Is mitral valve prolapse more common in women or men? | Women |
| PIH used to be called: | Toxemia |
| What risks are associated with multiple gestations? | Prematurity, PIH, high % of perinatal mortality & morbidity. |
| What risks are associated with polyhydramnios? | Preterm labor, prolapsed cord. |
| What risks are associated wtih oligohydramnios? | Inadequate protection/cushion of the baby. |
| What type of environment is created by oligohydramnios? | A hostile intrauterine environment. |
| What causes oligohydramnios? | Vasoconstriction. |
| Why is pregnancy a hypercoagulable state? | Due to extra estrogen. |
| Thromboembolic disease increases the risk for what? | DVT |
| What happens if you do Homan's sign on a person with a DVT? | It may dislodge. |
| How do we test for Clonus? | Using Homan's sign. Dorsiflexed foot may beat against hand (hyperreflexivity). |
| When might Clonus be found? | When in preeclampsia. |
| DIC may occur due to: | PIH, HELLP or anything that can cause bleeding. |
| How many women are affected by antepartum depression? | 40% |
| What risk factors are associated with antepartum depression? | Preterm labor. |
| Elevated BP after week 20: | PIH |
| When may magnesium sulfate be used? | During preterm labor and PIH. |
| How does a nurse check the dose of magnesium sulfate? | With another RN. |
| How often is RR checked while on magnesium sulfate? | Every hour. |
| Bleeding is never _____ in pregnancy, until ruled as such. | Normal. |
| Dr. visits: | Every 4 weeks for 28. Every 2 weeks to 36. Then weekly until delivery. |
| What do we do at each visit? | Weight check, edema check, BP, fetal activity, fetal heart tones, Leopold's maneuvers, UA. |
| What type of issue are we monitoring with a fetal movement count? | A chronic one. |
| US in pregnancy is used for: | Guiding instruments, confirming fetal death, and ruling out ectopic pregnancies. |
| NST belt placement: | Top: measure contractions. Bottom: fetal heart rate. |
| What is an excellent test for fetal well being? | NST |
| Who gets an NST? | Anyone at high risk. |
| Reactive NST: | FHR needs to increase >15 bpm for >15 sec over FHRBL, with 2 accelerations in 10 minutes. |
| What is the most common reason for fetal tachycardia? | Maternal fever. |
| What gestation are NST best for? | 32 weeks or greater. |
| What is a biophysical profile? | NST + US |
| What are the target organs of oxytocin? | Breast and uterus. |
| Contraction stress test (CST): | Negative (no bad result). Positive, c-section necessary. |
| Quad screen: | Alpha-feta protein + 3 others. (used to detect neural tube defects) |
| What is a predictor of Down's syndrome? | Low alpha-feta protein. |
| What was the problem with the alpha-feta protein test? | Too many false positives. |
| Who should get the quad test? | All pregnant women, especially those over 35. |
| AFI | Amniotic Fluid Index |
| Amniocentesis can be performed when? | After 14 - 16 weeks. |
| What size needle is used for amniocentesis? | 18 gauge. |
| What is the purpose of amniocentesis? | Test for genetic abnormalities, date the pregnancy. |
| What are the risks of amniocentesis? | Infection & contraction. |
| Who should have an amniocentesis? | Anyone over 35. |
| Tocolytic | Stops contractions. |
| Chorionic villi sampling | Cells taken directly from placenta at 8 - 10 weeks. Results much quicker than amniocentesis. |
| GBS culture | 35 - 37 weeks for all pregnant women. |
| What is the #1 cause of neonatal sepsis, worldwide? | GBS |
| How many women carry GBS, normally. | 30 - 40% |
| What is the main reason for concern of PROM? | GBS |
| If GBS cultures are positive: | Antibiotics will be given during labor. 2 doses, 4 hours apart, prior to delivery. |
| What is fetal fibronectin? | A protein made by the fetus that is shed into the amniotic fluid. |
| When is fetal fibronection made? | Mostly in the 1st 20 weeks. |
| What is a predictor of preterm labor? | The pressence of fetal fibronectin past 20 weeks. |
| When is testing for fetal fibronectin performed? | 22 - 35 weeks. |
| CF screening | Is recommended for all. $800. |
| How is a positive clonus rated? | By beats. The more beats, the worse. Get magnesium sulfate. |
| Leopold's maneuvers: | 4 maneuvers on the outside of the abdomen, used to determine fetal position. |
| Glucose screening: | 24 - 28 weeks. Blood sugar over 140 will do a glucose tolerance test. |
| If glucose is ___ or higher, after the glucose screening, no GTT is necessary, gestational diabetes is assumed. | 200 |
| GTT | Done if glucose screening is greater than 140. |
| If 2 blood draws are ____ from the GTT, gestational diabetes is diagnosed. | High. |
| Bishop score is used to assess: | Cervical readiness. |
| What are we scoring with the Bishop score? | Dilation, effacement, fetal station, consistency and position. |
| What direction do most cervixes face? | Posteriorly |
| Prenatal nutrition requirements: | Additional 200 - 300 calories/day. Iron, Ca+, folic acid, B12. |
| What is the #1 way to control a pregnancy's outcome? | Nutrition |
| B12: | Stabilizes membranes. |
| How much weight should be gained in the 1st trimester? | 1/2 lb a week. |
| How much weight should be gained in the 2nd/3rd trimester? | 1/2 - 1 lb a week. |
| When do we count para? | After delivery. |
| What are the 4 P's of intrapartum? | Passage, Passenger, Powers, Psyche. |
| What effect does squatting have on a pelvis? | It may widen it 1 - 2 cm. |
| What part of the pelvis is the key to whether the baby will fit or not? | The inlet, it is the smallest diameter. |
| What effect can x-rays have on the unborn fetus? | They can increase the risk of childhood leukemia by tenfold. |
| What allows a baby's head to pass through the pelvis? | Suture lines and fontanels. |
| Which fontanel do we associate as the "soft spot"? | The anterior. |
| What is fetal presentation? | The anatomical part of the fetus that enters the pelvis 1st. |
| Which presentation is ideal? | Vertex |
| What is vertex? | The back of head, head down, presentation of the fetus. |
| What is breech? | Butt down presentation of the fetus. |
| What is fetal position? | The presenting part to the maternal pelvis. |
| If a woman is experiencing back labor, what position is the fetus in? | Posterior |
| What are examples of fetal position? | L/R anterior/posterior. |
| Where is the fetal heart rate heard? | Over the back of the fetus. |
| What is lie? | The relation between the axis of the baby and the axix of mom. |
| What is a transverse lie? | When the baby is sideways. This is common with multiples. |
| How soon can lightening occur with a primip? | A couple weeks prior to delivery. |
| Does lightening occur later with a primip or a multip? | A multip. |
| When does engagement occur? | When the biggest part of the fetal head hits the smallest part (diameter) of the maternal pelvis. |
| What is station? | The measure of the progression of labor. Marked from negatives (above the ischial spines) to positives (below the ischial spines) to 0 at the ischial spines. |
| What are powers? | Uterine contractions. |
| What 3 things do we always chart? | Duration, frequency, and intensity. |
| What 2 can be measured via the fetal monitor? | Duration & frequency. |
| How do we measure the duration of a contraction? | From the beginning to the end. |
| How do we measure the frequency of contractions? | From the beginning of one to the beginning of the next one. |
| What is the strongest muscle in the human body? | The uterus. |
| What are the target muscles of epinephrine and norepinephrine? | Large muscles, heart, lungs. |
| What effect do epinephrine and norepinephine have on our system? | They shut down other systems that are not vital for our survival. |
| What is the determination of true labor? | Whether there is dilation or not. |
| When should a woman come to the hospital? | When her contractions are 5 minutes apart. |
| What effect does pushing have on the force of a contraction? | It doubles it. |
| What is the rule of thumb? | Once you hit 4 cm, you should go about 1 cm an hour. |
| Always chart these three things: | Dilation, effacement, station. |
| A primip will ______ before she _______. | Efface, dilates. |
| A multip will efface and dilate _________. | Simultaneously. |
| What happens in the early/latent phase? | 0 - 4 cm. 30 - 45 sec contractions. 20 - 5 min apart. |
| What happens in the active phase? | 5 - 7 cm. 45 - 60 sec contractions. 5 - 3 min apart. |
| When is the best time to have an epidural? | The active phase. |
| What happens in the transitional phase? | 8 - 10 cm. 60 - 90 sec contractions. 3 - 2 min apart. |
| What happens in the 2nd stage of labor? | The baby is pushed out. |
| What happens in the 3rd stage of labor? | The placenta is pushed out. |
| What is an important VS postpartum? | Temperature |
| The twin closest to the cervix is twin _. | A |
| When water ruptures, check the: | FHR |
| What position should the mother be moved to, with a prolapsed cord? | Hands and knees, head down. |
| What is dystocia? | When the uterus is not contracting sufficiently. |
| Hypotonic uterus: | Grandmultips, prolonged labor, twins, polyhydramnios. |
| What medicine is used for a hypotonic uterus? | Pitocin |
| Hypertonic uterus: | Usually iatrogenic. |
| IUPC | Internal monitor of the intensity of UC. |
| Shoulder dystocia: | Head delivers, shoulders get stuck. Measured in minutes. |
| What is a precipitous delivery? | One that occurs in less than 3 hours. |
| What are the risks of precipitous delivery? | Postpartum hemorrhage, tearing, and uterine rupture. |
| What is considered a prolonged labor? | One that lasts for more than 24 hours. |
| What are the risks of a prolonged labor? | Postpartum hemorrhage, infection. |
| Amniotic fluid embolus: | PE d/t amniotic fluid in the maternal circulation. |
| Symptoms of amniotic fluid embolus: | Severe chest pain, SOB. |
| Uterine rupture is most often due to: | Hyperstimulation. |
| Signs of uterine rupture: | Excruciating abdominal pain, bleeding, absent FH tones, hypotension. |
| Macrosomic: | 4000 g / 8.5 lb |
| What is a sign of fetal distress? | Decelerations with contractions. |
| Risk factors with post term: | Meconium aspiration syndrome. Decline in placenta function. |
| Reasons for induction: | Post date, hostile intrauterine environment, macrosomia, PROM r/t infection risk. |
| Reasons to NOT induce: | Malpresentation, cord prolapse. |
| What can we use to establish if it is ok to induce? | Bishop score. |
| P-Gel | Ripens cervix. |
| Cervidil | Sterile gauze tape, with prostaglandins. Ripens cervix. |
| Cytotec | GI drug, protects stomach lining. Category X, only used during labor & delivery. Intravaginal, PO, IV, IM. |
| Cytotec can be given rectally, to stop what? | Postpartum hemorrhage. |
| What hormones are found in amniotic fluid? | Prostaglandins |
| Pitocin is artificial what? | Oxytocin |
| Risks associated with induction: | Hyperstimulation, uterine rupture. |
| Forceps are use on what part of the baby? | Cheekbones |
| Reasons for use of forceps: | Fetal distress, maternal exhaustion. |
| What can be damaged by forceps? | Nerves. (Sylvester Stallone) |
| GBS positive, what antibiotics? | Penicillin. Clindamycin if allergic. |
| Reasons for c-section: | Prolapsed cord, placenta previa, placental abruption, fetal distress, fetal malpresentation, active herpes lesion, PIH, cardiac illness, prior c-section. |
| What is the concern of a TOLAC? | Uterine rupture. |
| TOLAC | Trial Of Labor After Cesaerean. |
| Pain is: | What a patient says it is. |
| Acute pain is associated with: | Anxiety |
| Chronic pain is associated with: | Depression |
| Who monitors I & O during a c-section? | Anesthesiologist |
| Rule 1 | All items in a sterile field must be sterile. |
| Rule 2 | Edges of sterile containers are not considered sterile once the package has been opened. |
| Rule 3 | Gowns are considered sterile in front, from the shoulder to table level. Sleeves are sterile. |
| Rule 4 | Tables are sterile only at table level. |
| Rule 5 | Sterile persons and items contact only sterile areas. Unsterile persons and items contact unsterile areas. |
| Rule 6 | Movement in or around a sterile field must not cause contamination of that field. |
| Rule 7 | Whenever bacterial barriers are penetrated, contamination occurs. |
| Rule 8 | Articles of doubtful sterility are considered unsterile. |
| Fentanyl | Narcotic analgesic. Patch, IV, IM. 1/2 life 30 min. Q 1 hr. Give at port nearest to IV site, during a contraction. |
| Stadol | IV push |
| Ambien | PO, for sleep. |
| Epidural | Regional anesthesia. -caine drugs. Into epidural space, so not as fast. |
| What is the anesthesia of choice for labor? | Epidural |
| Risk factors of epidural: | Maternal hypotension, fetal distress. |
| Prior to an epidura/spinal: | Bolus with warm LR, 1000 - 1500 mL. |
| A woman in late pregnancy should not: | Lie flat on her back. |
| General anesthesia: | Crash c-section. Baby out in 4 minutes. |
| Duramorph | 24 hours of relief after c-section. Can cause itching. |
| Psychoprophylaxis | Relaxation techniques |
| What instrument can give an accurate EKG reading of baby? | IUPC |
| Early decelerations | Beginning of deceleration happens before the beginning of the contraction. D/T head compression. |
| Late decelerations | Beginning of the deceleration occurs after the beginning of the contraction. |
| Variable decelerations | Decelrations not related to contractions. D/T umbilical cord compression. |
| What part of FHR do we chart? | BL, accelerations, decelerations, and variability. |
| Variability in the FHR is a sign of? | Fetal health. |
| 4 things you must do with deceleration: | Turn on L side. If after 30 seconds it doesn't help, turn to right. Call for help. Put oxygen on. |
| What is the average blood loss? | 500 mL or less. |
| Low BP in PP: | Hemorrhage |
| High BP in PP: | PIH |
| High P in PP: | Hemorrhage |
| Where should the uterus be felt PP? | At navel, recessing about 1 cm each day. |
| What should the fundus feel like? | Rock hard. |
| How long does lochia last? | 4 - 6 weeks. |
| What is progression of lochia? | Heavy red with clots, pink, brown, creamy. |
| What size clot is cause for concern? | Golf ball. |
| When is bleeding a concern? | When you soak a pad an hour. |
| Teach the relation between uterus and what? | Bleeding. |
| How long do we ice after delivery? | 24 hr. |
| When can we give sitz baths? | After 24 hr. |
| REEDA | Redness. Edema. Ecchymosis. Discharge. Approximation. |
| Which muscle separates during pregnancy? | Rectus abdominus. |
| Are after-pains harder for primips or multips? | Multips |
| How many extra calories does a breastfeeding mom need? | 500 |
| Is swimming ok with an open cervix? | No |
| What exercises are good PP? | Walking and Kegels. |
| What are the 3 PP stages? | Taking in. Taking hold. Letting go. |
| Taking in: | 1 - 2 days after delivery. May appear passive, dependent. May not be interested in newborn care. Not very teachable. Has desire to replay labor story. |
| Taking hold: | About a week. More energy, more teachable, more independent. |
| Good bonding | In room. Face to face. Looking at baby. |
| Baby blues: | Physiologic psychologic response. Most common in 1st few weeks d/t sudden decline in hormones. |
| Hemorrhage: | > 500 mL vag. > 1000 mL C-section. |
| What is most often the cause of PP hemorrhage? | Uterine atony. |
| If no IV line, what can be given for PP hemorrhage? | Methergine IM, Cytotec rectally. |
| Who gets PP depression more often? | Adolescents |
| What do you always assess PP with a c-section? | Breath sounds and bowel tones. |
Created by:
NataschAnn
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