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DSCC OB
OB section of test #6
| Question | Answer |
|---|---|
| what is PPROM? | Preterm Premature Rupture Of Membranes <37wks gestation |
| although the cause of PPROM is unknown, what are the top 4 things normally associated with it? | 1) infection, 2) prev hx PPROM 3)hydramnios, 4)multiple preg |
| nursing care for PPROM focuses on what? | preventing infection by limiting vaginal exams and changing bedpans frequently |
| what does RDS stand for? | Respiratory Distress Syndrome |
| what is prescribed for premature babies and how does it help reduce r/f RDS? | betamethozone 12mg/day for 2days it helps produce surfactant to help reduce r/f RDS |
| its called preterm labor when pt is how far along? | b/t 20 - 36wks gestation |
| do we check FFN before or after the cervical check? | we check FFN - fetal fibro nectin, BEFORE cervical check |
| abruptio placentae that seperates at the edges with vaginal bleeding is what type? | marginal abruptio placentae |
| abruptio placentae that seperates centrally with concealed bleeding is what type? | Central abruptio placentae |
| abruptio placentae with total seperation and massive vaginal bleeding is what type? | Complete abruptio placentae |
| abruptio placentae is normally indicated with mothers that.... | are cocaine users, experienced trauma, have pre - eclampsia or are diabetic |
| what type of bleeding and condition is the mother typically in? | there is severe painful dark bleeding with a firm and board like fundus |
| what are the nursing interventions for abruptio placentae? | maintain 2 lg bore iv sites, assess fetal status and resting fetal tone q15min, measure abd girth hrly, and assess maternal cardiovascular status q15min, give O2 and deliver. |
| placenta previa; when the internal os is completly covered is called what? | total placenta previa |
| placenta previa; the internal os is partially covered is called what? | partial placenta previa |
| placenta previa; the edge of the os is covered is called what? | marginal placenta previa |
| low lying placenta previa is when... | the placenta is implanted in the lower segment in proximity to the os |
| why is placenta previa like a ninja? | bc placenta previas onsetis quick and sneaky painLESS bleeding, the abd will be soft and pliable |
| what will the monitor look like for a prolapsed cord? | variables with cord compression |
| what does late d cells mean? | uteroplacental insufficiency |
| what does early d cells mean? | normal head compression |
| what are some maternal implications for abruptio placentae? | intrapardum hemmorrhage, DIC, hypo fibro genemia, ruptured uterus from over distention, fatal hemorrhagic shock |
| what are the implications of placenta previa? | maternal psychologic stress, transverse lie common, changes in FHR, meconium staining, fetal hypoxia, c - section birth, neonatal anemia |
| nursing interventions for placenta previa include... | INTERVENE B4 LABS! - lg bore iv, provide emotional support, administer O2 |
| why would we check HGB, complete cell count, RBC with placenta previa? | promote neonatal adaptation and looking for signs of enemia |
| how can you distinguish true from false labor? | ROM, 8contr per hr or 4 in 20min, cervial changes, pain worsens with walking = true labor. |
| what is the correct weight in lbs for a normal preg vs multiples? | normal want to gain b/t 20-35 lbs and w/multiples you want them to gain 40-45 lbs |
| identical twins vs fraturnal twins | identical twins from 1 egg and sperm, genetically identical and same gender. fraturnal twins come from more than one egg and more than one sperm, genetically like any other siblings can be different genders |
| what are some maternal implications of hydramnios? | SOB, edema, larger in size, too much fluid, uterine dysfunction, greatly increased csection rate and abruptio placentae |
| what are some fetal - neonatal implications of hydramnios? | malformations, preterm birth, increased mortality rate, prolapsed cord, malpresentation |
| what are soem conditions commonly associated with hydramnios? | diabetes, rh sensitization, malformations of fetal swallowing, neural tube defects with exposed meninges |
| what are some conditions associated with oligohydramnios? | postmaturity, IUGR, and major renal malformations |
| whata re some implications of oligohydramnios? | fetal deformations defects like adhesions and umbilical cord compression may need a warm fluid amnioinfushion during labor |
| unresolved hypertonic contractions may manifest what? | a prolonged latent phase r/t ineffective cervial dilation |
| frothy sputum, fast HR and lg amount of vaginal bleeding = ... | amniotic fld embolus |
| what are the characteristics of a HYPERtonic labor? | increased contraction freq and uterine resting tone, decresed contraction intensity and prolonged latent phase |
| what are some implications of a HYPERtonic labor? | increased discomfort and prolonged labor, maternal exhaution, dehydration, incresed r/f infection, late d cells |
| prolonged pressure on fetal head results in... | excessive molding, caput succedaneum (fluid), and cephalhemtoma (blood) |
| what is the clinical therapy for a HYPERtonic labor? | stadol (relaxes & reduces pain), oxytocin (strengthen & uniforms contractions, amniotomy (breaks water) |
| what are some causes of hypotonic labor? | fetal macrosomia, multiple gestation, hydramnios, grand multiparity |
| what are some implications of hypotonic labor? | prolonged labor, PP hemorrhage, nonreassuring fetal status |
| what is the clinical therapy for hypotonic labor? | oxytocin infusion, nipple stimulation, amniotomy, iv flds |
| post term gestation is... | 42 wks gestation |
| postdate gestation is... | 40 - 42 wks gestation |
| what is the nursing plan for a hypotonic labor? | assess bladder for distention and empty freq., assess for signs of infection, fetal tachy 160^ >= 10min |
| a baby in OP postion is... | "sunny side up" |
| what can you expect to see with a OP labor? | prolonged labor, extensive perineal laceration, back labor |
| what non medical interventions can we take for a malpresentation labor? | pop lock and drop it like a mad cat!! and lunge = rotation from posterior to anterior |
| what clinical therapy is recommended for breech? | external cephalic version PRIOR to labor 36 to 38 wks |
| fetal macrosomia= | baby more than 4500g |
| what happens to the baby with shoulder dystocia? | fetal shoulder dysplasia |
| top 2 interventions for a prolapsed umbillical cord? | knee/chest trendelenburg position and cut pitocin |
| what will momma look like for amniotic fluid embolism? | gray and gasping |
| what do you administer during external version and why? | tocolytic to relax uterus bc we dont want contractions during! |
| a podalic version is... | an internal version for when the 2ed twin needs to be turned during vaginal birth |
| how many times should the vaccum extracter be attempted b4 stopping and why? | twice to prevent cephalhematoma |
Created by:
tferrari
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