OB Test 2

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Author:
haip50
ID:
207536
Filename:
OB Test 2
Updated:
2013-03-16 20:35:39
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OB
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Test 2 for OB
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  1. What is the Tx for Pyrosis?
    • Small, frequent meals
    • Antacids
    • Proton pump inhibitors or H2 inhibitors
  2. What is Tx for Ptyalism (excessive saliva)?
    • Astringent mouthwash
    • Chewing gum or hard candy
  3. What are risks for pregnancy over 35?
    • Down syndrome
    • Autism
    • Cesarean birth
    • Fetal death
  4. What are maternal and fetal effects of alcohol?
    • Maternal: malnutrition
    • Bone marrow suppression
    • Infections
    • Liver disease
    • Fetal: fetal alcohol syndrome
  5. What are S/sx of fetal alcohol syndrome?
    • SGA
    • Small eyes
    • Short or upturned nose
    • Flat cheeks
    • Abnormal organs
  6. What are maternal effects of cocaine?
    • Seizures, hallucinations
    • Pulmonary edema
    • Respiratory failure
    • Cardiac problems
  7. What are fetal effects of cocaine?
    • 1st trimester abortion
    • Abruptio placentae
    • IUGR
    • Preterm birth
    • Stillbirth
  8. What are maternal risks of diabetes?
    • Hydramnios
    • Preeclampsia/eclampsia
    • Hyperglycemia/ketoacidosis
    • Dystocia
    • Infections
    • Retinopathy
  9. What are fetal risks of diabetes?
    • Mortality
    • Congenital abnormalities
    • Macrosomia
    • IUGR
    • RDS
    • Polycythemia
    • Hyperbilirubinemia
    • Hypocalcemia
  10. What are maternal risks of sickle cell anemia?
    • Vaso-occlusive crisis
    • Infections
  11. What are fetal risks of sickle cell anemia?
    • IUGR
    • Prematurity
    • Fetal death
  12. What does rheumatic heart disease do?
    • Strep B infection
    • Stenosis of mitral valve
    • Aortic insufficiency
    • S/sx: dsypnea, orthopnea, pulmonary edema
  13. What is Marfan syndrome?
    • Autosomal dominant
    • Dissection or rupture of aorta
  14. What is peripartum cardiomyopathy?
    • Left ventricle dysfunction during 5 months postpartum
    • S/sx related to CHF
  15. What is Eisenmenger syndrome?
    • Left to right shunting
    • Pulmonary hypertension
    • High mortality
  16. What are effects of asthma on pregnancy?
    • Maternal: preeclampsia, IUGR, preterm
    • Fetal: prematurity, LBW, hypoxia
  17. What are effects of epilepsy on pregnancy?
    • Seizure meds cause congenital anomalies
    • Cleft lip
    • Heart defects
  18. What are indicators of abortion?
    • Pelvic cramping
    • Backache
    • Vaginal bleeding
  19. What are risk factors for ectopic pregnancy?
    • Tubal damage
    • Endometriosis
    • IUD (intrauterine device)
    • High progesterone
    • Ovulation drugs
    • Infertility
    • Smoking
    • Age
  20. What are some s/sx of ectopic pregnancy?
    • One-sided lower abd pain
    • Fainting or dizziness
    • Usually not obvious
  21. What is Methotrexate?
    Folic acid antagonist for ectopic pregnancy
  22. What are s/sx of gestational trophoblastic disease?
    • Vaginal bleeding
    • Anemia
    • Hydropic vesicles
    • Uterus larger than expected
    • Absence of fetal heart sounds
  23. What are complications of GTD?
    • Anemia
    • Hyperthyroidism
    • Infection
    • DIC
    • Embolization of lung
    • Ovarian cysts
  24. What are s/sx of severe preeclampsia?
    • BP: 160/110
    • Proteinuria > 5
    • Oliguria
    • Cerebral or visual disturbances
    • Pulmonary edema or cyanosis
    • Epigastric pain
    • Impaired liver function
    • Thrombocytopenia
    • Fetal growth restriction
    • Scotomata
  25. What are s/sx of preeclampsia?
    • Increased BP after 20 weeks gestation
    • Proteinuria: 300-1 for mild
    • More sensitive to pressor agents
  26. What are risk factors for preeclampsia?
    • Donor eggs
    • First pregnancy
    • Teen pregnancy
    • Conception with new partner
  27. What is HELLP?
    • Hemolysis
    • Elevated liver enzymes
    • Low platelets
    • S/sx: n&v, malaise, epigastric pain
  28. What are some medications for preeclampsia?
    • Magnesium sulfate
    • Methyldopa
    • Labetalol
    • Oral nifedipine
    • Sodium nitroprusside
  29. What are Tx for preeclampsia?
    • BR
    • Diet: high protein, moderate Na
    • Anticonvulsants: Mg sulfate
    • Corticosteroids: fetal lung maturity
    • Fluid and electrolyte replacement
    • Antihypertensives
  30. What are some nursing interventions during surgery?
    • Shield fetus from radiation
    • Insert NG tube prior to surgery
    • Insert catheter
    • Encourage support stockings
  31. What are complications of infection during pregnancy?
    • 1st semester: organ development
    • Later: IUGR, neurologic disturbance
  32. What are complications of Rh incompatibility?
    • Erythroblastosis fetalis: destruction of fetal RBCs
    • Hydrops fetalis: fetal edema
    • CHF
    • Hyperbilirubinemia
    • Jaundice
  33. Discuss Toxoplasmosis
    • Cat feces
    • Dx: Serologic testing
    • Tx: spiramycin, PSF acid after 18 weeks
    • Complications: fetal damage, abortion
    • Highest rate of infection during last month of pregnancy
  34. Discuss Rubella
    • Virus
    • 1st semester risk
    • Risks: cataracts, sensorineural deafness, heart defects, retardation, CP, rubella syndrome
  35. Discuss Cytomegalovirus
    • Herpes
    • Risks: fetal death, microcephaly, hydrocephaly, CP, retardation, SGA
    • No treatment
  36. Discuss Herpes
    • Risks: spontaneous abortion
    • Preterm
    • IUGR
    • Tx: antiviral after 36 weeks
  37. Discuss Group B Strep (GBS)
    • GI, urogenital tracts
    • Maternal morbidity
    • Intrapartum stillbirth
    • Meningitis
    • Tx: antibiotics prophylatically
  38. Discuss Human Parvovirus
    • Erythema infectiosum
    • Abortion
    • Stillbirth
    • Fetal hydrops
    • Dx: velocity of middle cerebral artery (MCA)
    • Fetal death 4-12 weeks post infection
  39. How is viability tested?
    • hCG testing: accurate marker
    • Progesterone
    • Ultrasound
  40. What is the second/third trimester ultrasound for?
    • Sex of fetus
    • Gestational age: crown-rump, femur, abd circumference, biparietal diameter
    • Placental evaluation
    • Fetal number, presentation, viability
    • Amniotic fluid volume
  41. What is the first trimester ultrasound for?
    • Crown to rump length: 6-10 weeks
    • Nuchal translucency: chromosomal disorders, 11-16 weeks
    • Confirm pregnancy
    • Verify location
    • Gestational age
    • Viability
  42. What is a nonstress test?
    • Accelerations after fetal movement
    • 2 or more accelerations within 20 minutes
  43. What is contraction stress test?
    Fetal heart rate deccelerations after contractions: hypoxia
  44. What is the amniotic fluid index?
    • Decreased uteroplacental perfusion = oligohydramnios
    • Fluid determined by urine output, fetal swallowing
    • 5 or less requires evaluation
  45. What is a biophysical profile?
    • Fetal HR acceleration (NST)
    • Fetal breathing
    • Fetal movements
    • Fetal tone
    • Amniotic fluid volume
    • 10 is perfect score
  46. What is maternal alpha-fetoprotein?
    • Neural tube defects
    • Down syndrome
    • Trisomy 18
  47. What are chorionic villi sampling risks?
    • Abortion
    • Limb reduction
    • Failure to get tissue
    • ROM
    • Leakage
    • Bleeding
    • Chorioamnionitis
    • Infection
  48. What is fetal fibronectin?
    • 20-34 weeks
    • Absence: no preterm or premature birth
    • Presence: birth within 2 weeks
  49. How do you evaluate fetal lung maturity?
    • Lecithin/sphingomyelin ratio: 2:1
    • Phosphatidyglycerol (PG): presence = low risk of RDS
    • Flurorescence Polarization: > 55 = mature
  50. What are indications for amniocentesis?
    • Over 35
    • Previous defects
    • Abnormal results
  51. What is cordocentesis for?
    • Fetal karyotyping and genotyping
    • Dx fetal infection
    • Platelet disorders
    • Blood grouping
    • Other disorders

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