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OBtest
Obstetrics test november
| Question | Answer |
|---|---|
| Signs of ectopic pregnancy | Sharp unilateral pain, syncope, referred shoulder pain, lower abd pain,vaginal pain. |
| Tx of ectopic pregnancy | Salpingostomy or salpingectomy. |
| What is an incompetent cervix | Cervix is weak and begins to open before baby is ready to be born |
| Risk of incompetent cervix | miscarriage, premature birth |
| tx of incompetent cervix | cerclage. Purse stringing the cervix closed |
| Possible causes of incompetent cervix | cervical trauma, infection, congenital abnormalities, increased uterine volume (twins). |
| what is premature rupture of membranes | water breaking too early |
| What can preemie ruptures cause | Infection, abrupto placentae, fetal sepsis, malpresentation of fetus. |
| tx of preemie rupture | Bedrest with br privileges, monitor temp and pulse every 4 hours, watch fetal movement and chart it. |
| S/S of pre eclampsia | Protein in urine, Rising BP, Edema.. P R E. Eclampsia = grand mal convulsion. |
| tx of pre eclampsia | monitor bp, weight, urine tests for protein daily, Stress tests. |
| Tx of eclampsia | Anticonvulsants, sedation like dilantin, diuretics for edema. Didge. I&O |
| RH factor. what is it? what does it mean? | Rh negative woman carries an rh positive fetus. Womans body will attack the second baby with this, the first is usually not affected |
| rh factor effects on newborn | anemia, jaundice, CHF. |
| tx of rh factor | screen for it. Coombs test. Give rh immune globulin 300 mg. |
| What is a precipitous birth | occurs rapidly without a doctor or midwife present. |
| what to do in precipitous birth | nurse scrubs in if she has time. When infant crowns mom should pant. Gentle pressure on fetal head to prevent rapid birth. |
| When is precipitous baby born .. before, after, during or between contractions | between with support on perineum. |
| What is stage 1 pregnancy | begins to dialate, cervix starts to thin effacement starts. |
| What is stage 2 | Finish dialating, ends with the birth of the infant. may feel out of control. scared, irritable. Pushing and pressure on perineum |
| what is stage 3 | placental separation and delivery, may feel releif, focused on welfare of baby |
| what is stage 4 | increased pulse decreased blood pressure due to redistribution. Uterus contracts between unbilicus and symphysis pubis. Euphoria energy and thirst/hunger |
| what is frequency | How often they are coming.. From the start of one to the start of another. |
| Intensity? | how strong they are |
| Duration | Time from beginning to end of one contraction |
| what is leopold maneuver | feeling the position of baby through abdomen and pelvis. Feel for position, presentation and lie. |
| fetal baseline heart rate | 120-160bpm |
| tach is? | above 160 |
| brady is ? | below 120 |
| what is fetal malpresentation | presentation of the fetal parts in inappropriate positions for the easiest passage through the cervix |
| Transverse | Sideways risks cord prolapse |
| Frank breech | Folded in half |
| Footling breech | feet first |
| facial | face first |
| breech | sacrum first |
| vertex | chin to chest. occiput first. |
| military | straight head top of head first |
| brow | head tipped back sinciput first |
| what is station | relationship of presenting part to imaginary line drawn between ischial spines of maternal pelvis |
| dystocia | difficult or abnormal labor |
| latent phase cm's | less than 4 |
| active phase cms | more than 4 |
| 4 shapes of pelvis | gynecoid, platypoid, anthropoid, android |
| shape of gynecoid | wide oval |
| shape of platypoid | thin oval |
| shape of athropoid | long oval.. up and down not side to side |
| shape of android | triangular |
| best pelvic shape for delivery | gynecoid |
| worst pelvic shape for delivery | android |
| what is station +5 | crowning, pelvic outlet is +4 |
| what is station -5 | pelvic inlet |
| what is fetal station | degree of fetal head engagement as it travels through birth canal |
| what is molding | the adjusting of the shape and size of the fetal head to the birth canal during labor. |
| fetal attitude | relationship of head to spine. Flexed, neutral or extended. |
| What is presentation? | What part is lowest in uterus. Head (vertex), butt (breech) Neither (transverse) |
| how to determine presentation | Leopolds maneuver |
| station 0 | level of ischial spines |
| what is lochia | The fluid that weeps from the vagina for a week or so after delivery of a baby. At first the lochia is primarily blood, followed by a more mucousy fluid containing dried blood, and finally a clear-to-yellow discharge. |
| what are the presenting parts | cephalic, breech or shoulders |
| Normal lochia value | 225ml decreasing day by day |
| what is TORCH | T- Toxoplasmosis O- Other infections R- Rubella C- Cytomegavirus H- Herpes Simplex |
| Effects of T on mom | Flu like symptoms |
| Effects of T on baby | miscarriage, neuro defects, seizures |
| Effects of O on mom | liver issues, fever, malaise , abd pain |
| Effects of O on baby | Death, hepatitis, preterm birth possible |
| Effects of R on mom | rash fever lymphedema |
| Effects of R on baby | miscarriage IUGR Congenital abnormalities hepatospleenomegaly mental retardation and death are possible |
| Effects of C on mom | no symptoms, cervical discharge, mono |
| Effects of C on baby | death, anemia, jaundice, pneumonitis, cerebal palsy, deaf, retardation |
| Effects of H on mom | rash, blisters, malaise, fever, nausea, vomiting |
| Effects of H on baby | miscarriage, preterm birth, stillbirth, IUGR, retardation, microencephally, seizures, coma. |
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