OB Exam 1 Past Paper PDF

lOMoARcPSD|40142722 OB exam 1 - ob exam 1 Maternal Health Theory & Application (Arizona College of Nursing) Scan to open on Studocu Studocu is not sponsored or endorsed by any college or university Downloaded by Ja...

lOMoARcPSD|40142722 OB exam 1 - ob exam 1 Maternal Health Theory & Application (Arizona College of Nursing) Scan to open on Studocu Studocu is not sponsored or endorsed by any college or university Downloaded by James Jonez ([email protected])  lOMoARcPSD|40142722 1. Genetic testing includes:  carrier testing  preimplantation testing  prenatal testing  newborn screening 2. Antenatal Testing’s includes:  35 to 36 weeks  carrier testing,  genetic testing 3. Carrier testing does what? identifies individuals who carry one copy of a gene mutation, can provide information about the risk of having a child with a genetic condition 4. Alfa protein: neural tube defect screening. If levels are low can indicate down syndrome for baby 5. Illegal substances:  Marijuana  Cocaine  Heroin  alcohol 6. What are the illegal substances effects on the baby:  may cause low birth weight  fetal demises  mental retardation  cardiac issues 7. Ethical dilemmas: embryos, substance abuse, surrogacy, 500 gram or less baby 8. When would mom feel baby for the first time?  18 – 20 weeks (quickening)  At 12 weeks we can hear the baby’s heartbeat 9. Pitocin: induces labor or strengthens uterine contraction, can also control bleeding after childbirth 10. Mag sulfate: used to prevent seizures with preeclampsia 11. Trexall (methotrexate): folic acid antagonist will cause dissolution of the ectopic mass in order to treat ectopic pregnancy 12. Clomid: stimulates release of FSH and LH which stimulates ovulation (treats anovulatory infertility) Downloaded by James Jonez ([email protected])  lOMoARcPSD|40142722 13. Nifedipine: treats hypertension (Ca channel blocker) 14. Hydralazine: antihypertensive med 15. Betamethasone: antenatal steroid to accelerate fetal lung maturity 16. Ca gluconate: antidote for mag sulfate 17. Valium (diazepam): anticonvulsant 18. Causes of male infertility:  endocrine causes  drugs, infections  systemic illness  prolonged heat exposure to the testes  pesticide exposure, radiation  intercourse disorder, missing or blocked structures o Solution: semen analysis, repair of structures, lifestyle changes 19. Causes of female infertility:  ovulatory dysfunction  tubal and pelvic pathology  cervical mucus factors, infection o solution: hormonal therapy, lifestyle changes, surgery to open the fallopian tubes, removal of uterine fibroids 20. Infertility and how it effects couple: marital strain- especially if one partner blames the other, stress which can lead to sexual dysfunction, self esteem issue o Interventions for infertility (emotional): couseling 21. Infertility meds that help:  Corticosteroids  hormonal therapy  clomiphen citrate  letrozole  gonadotropin releasing hormone pump  bromocriptine 22. Amniocentesis: Downloaded by James Jonez ([email protected])  lOMoARcPSD|40142722  diagnostic procedure where a needle is inserted through the abdominal wall into the placenta to receive amniotic fluid.  Used for genetic testing or assessment of disease, infection, and lung maturity o Amniocentesis interventions before: detailed ultrasound to locate, prep abd, label specimens o Amniocentesis interventions after: assess fetal and maternal well-being and FHR, educate mom not to lift anything heavy for 2 days 23. Naegele’s rule: (LMP – 3 CALENDAR MONTHS + 7 DAYS + 1 YEAR)  add 7 days to the first day of last period and subtract three months 24. GTPAL: gravida, term, para, abortion, living  G: total number of pregnancies  T: term infants born  P: preterm infants born  A: abortions  L: living children 25. Full term = 37 weeks and after 26. Preterm = 6-36 weeks 27. Who is at risk of having maladaptive adaptation to pregnancy? high risk pregnancies 28. Sex during pregnancy is OKAY as long as membranes are intact and there is no hx of premature labor 29. Estrogen: stimulates the enlargement of the breasts and uterus Downloaded by James Jonez ([email protected])  lOMoARcPSD|40142722 30. Progesterone: facilitates implantation and decreases uterine contractility 31. HCG: stimulates the corpus luteum so that it will continue to secrete estrogen and progesterone until the placenta is mature enough to do so 32. HPL: promotes fetal growth by regulating available glucose and stimulates breast development in Preparation for Lactation 33. Levels of HCG:  will rise rapidly during first trimester, and rapidly decline afterward  high levels throughout can indicate trisomy 21 34. Inhibin A levels: high levels can indicate trisomy 21 35. AFP and unconjugated estriol can indicate? abnormality 36. Decreased estriol levels can indicate: NTDs (neural tube defects) 37. How we can prevent or decrease the chance of a preterm birth:  lifestyle changes  resting sufficiently  prenatal care  social support 38. Preeclampsia: multisystem disorder categorized mainly by HTN  Signs and symptoms: HTN, blurry vision, headache, proteinuria  When is it first seen? After 20 weeks of gestation  Intervention: Expedient birth, corticosteroids, magnesium sulfate, antihypertensive meds  Risk for preeclampsia: o Nulliparity o younger than 20 or older than 35 o obesity o multiple gestation o family hx o diabetes, htn, hx 39. Trauma in pregnancy what are we worried about? maternal death and fetal hypoxia 40. Biophysical profile: ultrasound of fetal status along with an NST (non-stress test). it assesses FHR reactivity, fetal movement, tone, breathing and amniotic fluid volume. 41. Gestational diabetes: carbohydrate intolerance leading to hyperglycemia that is first discovered in pregnancy  Gestational diabetes tests: one hour glucose test  if positive pt will come back for 3-hour glucose test Downloaded by James Jonez ([email protected])  lOMoARcPSD|40142722 42. What to avoid during pregnancy?  Torch infections: these diseases can cross the placenta  T: toxoplasmosis: protozoan parasite from raw meat and cat feces  O: other (hep b)  R: rubella  C: cytomegalovirus: Virus of herpes group (droplet)  H: herpes: chronic lifelong viral infection o HIV: antiretroviral therapy prevents and lowers transmission  Teratogenic Drugs: (TERA- TOWAS)  T: Thalidomide  E: Epileptic medications (valproic acid, phenytonin)  R: Retinoid (vit A)  A: Ace inhitors, ARBS  T: Third element (Lithium)  O: Oral contraceptives)  W: Warfarin (coumadin)  A: Alcohol  S: Sulfonamides and sulfones 43. Group B strep: bacteria that can over colonize in genital tract and rectum  Does not affect the mom but effects the baby  Screen during 35-37 weeks  Often the cause for UTI, pyelonephritis, discharge and preterm labor 44. Cystic fibrosis: recessive genetic disease, causes extremely thick mucus secretions that clog up the airway 45. Veracity: being truthful 46. Cervical cerclage: the stitching of the cervix in order to prevent preterm birth due to weakening of the cervix. Stitch comes out during labor 47. Hyperemesis gravitation: severe vomiting that leads to dehydration, electrolyte imbalance, acid-base imbalance, weight loss and starvation ketosis Downloaded by James Jonez ([email protected])  lOMoARcPSD|40142722 48. TOCO transducer: external monitor for uterine contractions which goes above umbilicus 49. Ultrasound transducer: external monitor for fetal heart rate which goes below the umbilicus (with JELLY) 50. Things that can cause intrauterine growth restriction?  smoking, drugs, ACE, Ca channel blockers 51. placenta previa: placenta attaches to the lower uterine segment near or over the internal cervical os 52. Spina Bifida: portion of the neural tube does not close or develop properly, causing problems in the spinal cord. (Spine bulging out of back) 53. Folic acid: decreases risk of neural tube defects 54. Medicines and treatment for HIV during pregnancy and labor? Downloaded by James Jonez ([email protected])  lOMoARcPSD|40142722  antiretroviral meds, avoid instruments and rupture of fetal membranes, avoid fetal scalp, and assisted vaginal delivery 55. LS ratio: 2.0 to 2.5 and is significant for appropriate fetal lung development. 56. Supine hypotension in moms: blood vessels are squished under baby when supine. Place a towel under left side to offset weight and allow blood flow 57. Fundal height and what it means?  after 10-12 weeks fundal height can be used to determine approximately the amount of weeks present up until week 38 58. Quad screen: test done between 15-20 weeks. Checks for AFP, unconjugated estrol, hCG, and inhibin-A 59. Different presumptive signs of pregnancy: amenorrhea, nausea and vomiting, breast changes, fatigue, urinary frequency, quickening (fetal movement) 60. Probable signs of pregnancy:  chadwick's sign (bluish purple coloration of vaginal mucosa and vulva)  goodell's sign (softening of cervix and vagina)  hegars sign (softening of the lower uterine segment)  uterine growth  skin hyperpigmentation  positive pregnancy results 61. Abruptio placentae: partial or complete placental detachment prior to delivery 62. Nutrition for pregnant people: increase protein and fluids 63. How much weight should they gain? 25 – 33 pounds 64. How much caffeine can they drink? 200 mg a day 65. What foods should increase (high in folic acid and iron)?  legumes, beans, meat, spinach, broccoli Downloaded by James Jonez ([email protected])  lOMoARcPSD|40142722 66. Signs of a miscarriage: uterine bleeding, large blood clot, abdominal pain a few hours after bleeding or even days after 67. HELLP syndrome: (variant of preeclampsia life threatening complication)  H: Hemolysis  EL Elevated Liver enzymes  LP: Low Platelets 68. Eclampsia: (Seizures activity or a coma)  Immediate care: interventions o Side lying o Padded side rails with pillows/ blankets o O2 o Suction if needed o Do not restrain o Do not leave 69. placental accreta: describes the clinical condition when part of the placenta or entire placenta invades and is inseparable from the uterine wall. Pregnancy signs and symptoms: Presumptive (subjective): think of mom  P: period absent (amenorrhea)  R: really tired  E: enlarged breast  S: sore breast  U: urination increased (urinary frequency)  M: movement perceived (quickening)  E: emesis and nausea Probable (objective) think of doctor (12 weeks)  P: Positive (+) pregnancy test (high levels of the hormone: HCG)  R: Returning of the fetus when uterus is pushed w/ fingers (ballottement)  O: Objective Downloaded by James Jonez ([email protected])  lOMoARcPSD|40142722  B: Braxton hicks contractions  A: A softened cervix (Goodell’s sign)  B: Bluish color of the Vuvla, Vagina, or cervix (Hadwick’s sign)  L: Lower uterine segment soft (Hegar’s sign)  E: Enlarged uterus Positive (objective) think of baby  F: fetal movement palpated by a doctor or nurse  E: Electronic device detects heart tones  T: The delivery of the baby  U: Ultrasound detects baby  S: Seeing visible movements Downloaded by James Jonez ([email protected])