OB ATI

  1. How do you teach the woman to calculate the calendar method
    subtract 18 days from shortest and longest cycle
  2. How do you instruct the woman to take basal body temperature
    Take oral temp before getting out of bed each morning (should see slight decrease)
  3. What do you teach the woman who is using cervical mucus method of birth control
    • Good hand hygiene prior
    • Exam mucus on last day of menstrual cycle
    • Don't douche prior
  4. Benefit of condom
    Prevent STI and pregnancy
  5. What do you educate the woman on using a diaphragm
    • Fitted by provider q 2 years
    • Put in prior to sex with spermacide gel EACH time
    • Leave in for 6 hours after sex
    • Empty bladder prior to using diaphragm
    • Increases risk for toxic shock
  6. What do you educate woman on about the minipill for contraception
    • TAKE AT SAME TIME EACH DAY
    • Cannot miss a pill
    • Need another birth control method for first month
  7. Number one thing to worry about with oral contraceptives!! 2 symptoms!
    chest pain and SOB
  8. What time frame is required for a woman to be labeled infertile
    12 months
  9. What is a major contraindication of a woman about to have a hysterosalpingography
    allergy to seafood (shrimp)
  10. When investigating reasons for infertility where will the doctor start
    with the man because its easier
  11. Name presumptive signs of pregnancy
    • amenorrhea
    • fatigue
    • n/v
    • urinary frequency
    • Breast changes
    • Quickening
  12. Name probable signs of pregnancy
    • Abdominal enlargement
    • Hegar
    • Chadwick
    • Goodell
    • Ballotement
    • Braxton hicks
    • positive pregnancy test
    • fetal outline felt by provider
  13. Name positive signs of pregnancy
    • Fetal heart sounds
    • Ultrasound
    • Fetal movement felt by provider
  14. What is softening and compressibility of the uterus
    Hegar
  15. What is deepened violet-bluish color of cervix
    Chadwick
  16. What is softening of the cervical tip
    Goodell
  17. When is measurement of the fundal height most accurate
    18-32 weeks
  18. GTPAL acronym
    • Gravidity
    • Term
    • Preterm
    • Abortion
    • Live
  19. When is GBS obtained
    35-37 weeks
  20. How many pounds should a woman gave her whole pregnancy
    25-35 lbs
  21. How many lbs should a woman gain in first trimester
    2.2-4.4 lbs
  22. How many pounds should woman gain in 2nd and 3rd trimester
    1 lb/week
  23. How many extra calories should a woman eat in the second trimester
    340
  24. How man calories should a woman eat in the third trimester
    452
  25. What types of food should be avoided for PKU
    foods high in protein
  26. How many mg should caffeine be limited to per day
    300
  27. What is the purpose of a doppler US blood flow analysis
    IUGR, poor placental perfusion
  28. What do u instruct the woman to do before US
    drink 1-2 quarts of water
  29. What 5 things does the BPP include
    • Reactive FHR
    • Fetal breathing movements
    • Gross body movements
    • Fetal tone
    • Qualitative amniotic fluid
  30. What does an Apgar score of <4 indicate
    fetal asphyxia
  31. What does a reactive NST mean
    • FHR normal baseline rate
    • Moderate variability
    • Accelerations 15 beats/min for 15 sec occurring 2x/20 min
  32. What is indicated for a nonreactive NST
    further evaluation (BPP or CST)
  33. What does a negative CST mean
    3 uterine contractions with no late decels in 10 min
  34. When is AFP done
    16-18 weeks
  35. High levels of AFP mean what? Low levels?
    • neural tube defects
    • Chromosomal abnormalities
  36. What indicates fetal lung maturity for L/S ration
    2:1 or (2.5:1-3:1 if diabetic)
  37. What does the absence of PG indicate
    respiratory distress
  38. What does Kleihauer-Betke detect
    If there is fetal blood in mom's circulation
  39. What are the risks of CVS
    • spontaneous abortion
    • fetal limb loss
    • chorioamnionitis or ROM
  40. When can CVS sampling be done
    10-12 weeks
  41. What is AFP
    protein produced by fetus
  42. What is Hcg
    Hormone produced by placenta
  43. What is estriol
    protein produced by fetus and placenta
  44. What is Inhibitin A
    Protein produced by ovaries and placenta
  45. Name 4 things in the QUAD screen
    • AFP
    • Hcg
    • estriol
    • Inhibitin A
  46. When is a QUAD screen done
    16-18 weeks
  47. 2 common causes of bleeding during 1st trimester pregnancy
    • ectopic
    • spontaneous abortion
  48. cause of bleeding during 2nd trimester of pregnancy
    hydatiform mole
  49. 2 causes of bleeding in 3rd trimester
    • abruption
    • previa
  50. What should be done prior to any procedures for a possible aids baby
    bath
  51. When should retovir be administered for aids
    • 14 weeks-pregnancy
    • baby at birth and 6 weeks
  52. symptoms of hyperemesis gravidum
    • elevated hcg >12 weeks
    • 5% weight loss
    • electrolyte imbalance
    • acetonuria
    • KETOSIS
  53. Criteria of gestational HTN? Mild Preeclampsia? Severe preeclampsia? Eclampsia?
    • BP 140/90
    • >+1 protein plus BP
    • 160/100, +3 protein, oliguria, creatinine >1.2, epigastric pain
    • seizure, coma
  54. What do labs look like for severe eclampsia with hepatic dysfunction (HEELP)
    • Hemolysis (jaundice, anemia)
    • Elevated liver enzymes
    • Low platelets
  55. what is scotoma
    absent spot in vision
  56. Sign of Magnesium toxicity
    • Absent DTR
    • UO <30
    • RR >12
    • decreased LOC
    • cardiac dysrhytmias
  57. Two tests indicating ROM
    • Nitrazine: blue
    • Positive Fernig
  58. What are the 5 P's that affect labor
    • Passenger
    • Passageway
    • Position
    • Powers
    • Psychoological
  59. Part of fetus entering pelvic inlet first
    Presentation
  60. 4 types of presentations
    • Mentum
    • Occiput
    • Scapula
    • Breech
  61. relationship of maternal longitudinal axis to fetal longitudinal axis
    lie
  62. relationship of fetus body parts to each other
    Attitude
  63. Most common fetal attitude
    general flexion
  64. abdominal palpitation of number of fetus, presenting part, lie, attitude, descent, and probably location of fetal heart
    Leopold maneuver
  65. What does external monitor NOT tell
    intensity of contractions
  66. How often does nurse check temperature after ROM
    q 1-2 hr
  67. Occurs when presenting part usually biparietal (largest) diameter of fetal head passes pelvic inlet at level of ischial spine (STATION 0)
    engagement
  68. Dilation, frequency, and duration of contractions: latent
    • 0-3 cm
    • 5-30 min
    • 30-45 sec
  69. Dilation, frequency, and duration of contractions: active
    • 4-7 cm
    • 3-5 min
    • 40-70 sec
  70. Dilation, frequency, and duration of contractions: Transition
    • 8-10 cm
    • 2-3 min
    • 45-90 sec
  71. Dilation, frequency, and duration of contractions: second
    • 10 cm
    • 1-2 min
    • >100 sec
  72. What is the shiny surface of placenta? dull?
    • Schultz
    • Duncan
  73. What stage of labor does mom feel tired, restless, irritable, out of control, "can't continue," urge to push
    Transition
  74. What should nurse educate client to do if tingling in fingers or light-headedness occurs with hyperventilation
    brown paper bag
  75. What are some rules when using opioid for pain managament during labor
    • Don't give is 12-24 hrs till birth
    • Monitor for fetal respiratory depression
    • Labor well established >4cm with fetus engaged
  76. what do u instruct the woman to do before leopold maneuver assessment
    • pee
    • supine, head under pillow, knees flexed with wedge under right hip
  77. How often should nurse monitor FHR pattern and uterine contraction?
    • latent: 60
    • Active: 30
    • Second: 15
  78. Normal FHR
    110-160
  79. What does nurse want FHR variability to be
    moderate 6-25
  80. What to do if fetal bradycardia (<110 for 10 min)
    • Stop oxytocin
    • side lying
    • O2 8-10L by mask
    • Tocolytic
    • Notify PCP
  81. Most likely cause of fetal tachycardia
    maternal fever
  82. Loss of FHR variability
    • Stimulate fetal scalp
    • scalp electrode
    • left lying
  83. Late decel interventions
    • side lying
    • increase IV fluids
    • Stop oxytocin
    • O2
    • Notify PCP
    • Prepare for emergent birth
  84. Variable decel interventions
    • side to side or knee to chest
    • Stop oxytocin
    • O2
    • Vag exam
    • Amnioinfusion
  85. Disadvantages of Internal fetal monitoring
    • ROM has to be present
    • Dilated 2-3 cm
    • Provider has to place it
    • Risk for infection
  86. During leopold manevuer what determines fetal lie
    palpating fundus
  87. What is single most important indicator of progress of labor
    cervix dilation
  88. Culture care during labor: hispanic
    mother not partner
  89. Culture care during labor: African American
    female family present
  90. Culture care during labor: Asian
    • Mom
    • partner not active
    • labor in silence
  91. Culture care during labor: Native american
    • Female nurse
    • Family involved
    • Herbs during labor
    • Squatting position
  92. Culture care during labor: European
    • Partner involved
    • PCP head of healthcare team
  93. What should the nurse do FIRST if ROM suspected
    CHECK FHR
  94. When should teaching occur
    latent first stage
  95. How often should woman be encouraged to void during latent, active, and transition of labor
    q 2 hr to prevent bladder distention which blocks fetus descent
  96. 5 things to do to preset at delivery in care of neonate resuscitation
    • check O2 flow and tank on warmer
    • Preheat radiant warmer
    • NB stethoscope and bulb syringe
    • Bag/laryngoscope, emergency meds
    • Check suction apparatus
  97. 4 signs of placental separation
    • fundus firmly contracting
    • swift gush of dark blood
    • umbilical cord lengthens
    • vaginal fullness on exam
  98. 5 factors included in bishop score
    • cervix dilation
    • cervix effacement
    • cervix consistency
    • cervix position
    • Station of presenting part
  99. what bishop score indicates readiness for labor induction
    • 39 weeks:
    • Multparity->8
    • Nullparity->10
  100. Med used for cervical ripening
    misoprostol
  101. Med used for labor induction
    Oxytocin
  102. when should oxytocin be administered in relation to cervical ripening agent (misoprostol)
    6-12 hours after
  103. If on oxytocin how often should maternal assessments be done? FHR?
    • q 30 min and with dose changes
    • q 15 min
  104. Maintain oxytocin dose if? 6 reasons
    • Freq q 2-3 min
    • Duration q 60-90 sec
    • Intensity 40-90
    • Resting tone 10-15
    • Dilation 1cm/hr
    • Reassuring FHR 110-160
  105. 5 reasons to discontinue oxytocin
    • freq > q 2 min
    • Dur >90
    • Intensity >90
    • Resting tone >20
    • No relaxation of uterus between contractions
  106. steps nurses should take following cord prolapse discovery
    • ask for assistance
    • Notify PCP
    • Sterile gloved hand pressure
    • Knee-chest, trendelenberg, side lying
    • warm sterile, soaked saline towel to visible cord
  107. What to do if meconium aspiration leads to depressed respirations, decreased muscle tone, and HR <100 and no spontaneous breath
    endotrach tube and suction
  108. What maternal position help rotate fetus from posterior to anterior
    hands and knees
  109. Ideal apgar score (no distress)
    Moderate? Severe?
    • 7-10
    • 4-6
    • 0-3
  110. 0 on Apgar includes:
    • no HR, RR, reflex
    • Flaccid
    • Blue, pale
  111. 1 on Apgar includes:
    • HR <100
    • slow, weak cry
    • some flexion
    • Grimace
    • Pink with acryanocyanosis
  112. 2 on Apgar includes:
    • HR >100
    • Good cry (RR)
    • Well-flexed
    • baby cries
    • all pink
  113. Average weight? length? HC? CC?
    • 2500-4000g
    • 18-22 in
    • 32-36.8 cm
    • 30-33 cm
  114. What score on new ballard indicates maturity weeks gestation
    35 = 38 weeks
  115. RR of infant? BP?
    • 30-60
    • 60-80/40-50
  116. collection of blood between periosteum and skull (doesnt cross sutures) goes away when?
    • cephalohematoma
    • 2-3 weeks
  117. what can excess saliva in infant indicate
    tracheoesophageal fistula
  118. Reflexes present birth-4 months
    • sucking/rooting
    • moro
    • startle
    • tonic neck
  119. reflexes birth-6mo? birth-8 mo?
    • Palmar
    • Plantar
  120. Birth to 4 week reflex
    stepping
  121. birth to 1 year reflex
    babinski
  122. hgb and hct value
    • 14-24
    • 44-64%
  123. WBC count Baby? Glucose?
    • 9,000-30,000
    • 40-60
  124. Billi baby
    • 0-6 day 1
    • <8 day 2
    • <12 day 3
  125. When should metabolic screening be done? how do we make it most accurate
    feed before, wait 24 hrs
  126. how much does baby gain each week for first 3 months
    110-200 g
  127. Fluid intake requirement for baby
    100-140 ml/kg/day
  128. how long will baby feed on each breast? total per feeding?
    • 15-20/breast
    • 30-40 min
  129. how many voids/stools does infant have per day with adequate nutrition
    • 6-8 void
    • 3-4 stool
  130. how far apart should crib slats be
    <2.25 in
Author
jwhughes
ID
312632
Card Set
OB ATI
Description
AHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH
Updated