MC OB Exam 3 Word Scramble
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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
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