OB test 2 set 4

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Author:
kbryant86
ID:
249174
Filename:
OB test 2 set 4
Updated:
2013-11-26 11:10:28
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OB high risk II
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OB test 2
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  1. vertical (peri-natal) infection transmission

    (1-3)
    from parent to offspring

    • transplacentally
    • transvaginally
    • breast milk
  2. transplacentally

    transvaginally

    breast milk
    tp= TORCH infections

    • tv= contact with body fluids and vaginal secretions after ROM and during delivery
    •   = sti's, HIV, GBS

    bm= HIV and TB and CMV
  3. TORCH acronym
    • Toxoplamosis
    • Other infections: Hep B, HIV
    • Rubella
    • Cytomegalovirus (CMV)
    • Herpes Simplex Virus: types 1 and 2 (HSV)
  4. Toxoplasmosis

    mode of trans
    sources
    • flu like symptoms, can cause preterm labor or miscarriage
    • baby effects= IUGR, microcephaly, neurological

    trans= Transplacental

    • sources= CAT FECES
    •  = raw meat
  5. Hep B
    can cause liver disease in baby in unTx

    • mom w/ active Hep B: State mandated Hep B immunoglobulin w/n 12 hrs after birth AND Hep B vaccine series
    • causes jaundice, fever, rash
    • can result in stillbirth or miscarriage

    trans= tp, tv
  6. antepartum Hep B testing
    • std of care
    • HBsAg: blood test for Hep B surface antigen

    ON ALL Women
  7. Recombinvax / Energix-B
    • Hep B vaccine
    • series of 3
    • -birth
    • -1 month
    • -4 months

    • IM vastus lateralis
    • requires maternal consent
  8. Rubella:
    mode of trans
    testing
    maternal effects
    trans= tp

    test= IgM titre for immunity

    effect= 3 day rash, fever, HA
  9. rubella:
    1st vs 2nd vs 3rd trimester
    • 1st= teratogenic
    • = congenital anomalies (cataracts, deaf, heart defects)
    • =microcephaly
    • =MR
    • =cerebral palsy

    • 2nd= deaf
    • =systemic infections
    • =IUGR
    • =rash

    3rd= NO teratogenic effects
  10. instruct mom to avoid pregnancy for 1 month after receiving the Rubella vaccine
    instruct mom to avoid pregnancy for 1 month after receiving the Rubella vaccine
  11. Cytomegalovirus CMV
    trans= all 3

    • causes mono like symptoms in mom
    • may have cervical discharge
    • miscarriage or stillbirth

    • baby:
    • IUGR
    • microcephaly
    • rash
    • jaundice
    • hearing and learning disabilities
  12. CMV prevention
    • safe sex
    • early dx and tx
  13. Herpes Simplex Virus
    trans= tv and tp

    miscarriage, stillbirth, PTL, sequela of virus
  14. delivery of mom w/ active and non-active Herpes
    active= C/D

    • non= vaginal possible if NO open lesions
    •  = NO ARTIFICIAL rupture, scalpe electrodes, etc.
  15. HIV

    transmission
    maternal effects
    trans= all 3

    • mom= prego can inc progression rate of disease
    •  = inc risk for infects
  16. HIV Dx and Tx
    • Dx= initial screen for HIV antibodies
    • Western Blot or immunofluorescence assay

    Mom Tx= Zidovudine / AZT = DOC

    • Baby Tx= AZT severely dec. risk of HIV+
    •  = repeat antibody testing every few months through 2yrs old
    •  = infants will seroconvert (-) w/n 15 months
  17. Listeriosis
    get from eating soft cheezes

    • causes fever, ms aches, n/diarrhea
    • can cause miscarriage, stillbirth, PTL, infection in newborn

    Prego women 20X's more likely to get List. b/c of change in immune system

    Tx= antibiotics
  18. signs of hypovolemia after trauma may not be present until loss exceeds 1500 mL
    signs of hypovolemia after trauma may not be present until loss exceeds 1500 mL
  19. nursing actions in trauma
    • focus on maternal stabilization
    • assess FHR, movement, and uterine contractions
    • position women on side

    fetal tachycardia is 1st sign on infection
  20. Hydatidiform molar pregnancy
    abnl development of placental cells overgrow in uterus

    no viable fetus

    severe abd pain

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