RNC-OB Swilley Exam with all Correct & 100% Verified
Answers |Actual Complete Update |Already Graded A+
1. Nutrition 75 G protein daily
during increase 300 kcal/day in 2nd trimester, double for
pregnancy
twins Folic acid for neural tube defects
normal weight gain is 25-35 lbs, if overweight 15-25
2. MTHFR gene product in autosomal-recessive disorder, associated with decencies
in folate metabolism
-detectable by PCR
BLOOD IS PRONE TO CLOT, SO HIGH RISK FOR PRE-E
3. TIDM & T2DM (fe- -leads to congenital heart and neural tube defects
tal affects) -can lead to fetal acidosis (b/c vascular flow issues in dm pts means that is
will also inhibit flow to vascular placenta, so decreased oxygenation
leads to acidosis
-if maternal a1c> 8.5, 40% chance baby will have cardiac defect
-standard for well controlled dm is to induce at 38-39 weeks
-macrosomia >4000 gms
-polyhydramnios (b/c excess urination gets to baby too)
4. FETAL MECHA-
NISMS IN
-glucose crosses placenta but insulin doesnt
T1DM,
-excess glucose means that fetus will respond by producing more insulin
T2 Pts.
-when born, glucose is cut ott, but baby is left with excess insulin-->
5. Glucose vs. hypoglycemia
Sur-factant
Think surfactant = soapy, glucose = sticky
-Excess glucose causes a delay in surfactant production
-Lack of surfactant makes the alveoli sticky, unable to open
-high risk of RDS in neonates born to uncontrolled DM moms
6. DKA -diabetic ketoacidosis
-seen in type 1 mostly, bg >250
-Metabolic acidosis (lack on insulin to transport excess glucose out of
vascular space into cells, so body starts breaking down fat for energy
1/
29
,RNC-OB Swilley Exam with all Correct & 100% Verified
Answers |Actual Complete Update |Already Graded A+
instead)
-fruity breath b/c of ketones
-Kussmaul Respirations
2/
29
, RNC-OB Swilley Exam with all Correct & 100% Verified
Answers |Actual Complete Update |Already Graded A+
7. Kussmaul -Seen in dka
respi-rations
-lungs will compensate for the metabolic acidosis, create a lot of CO2 in
order to blow ott the acid
-will blow it ott fast
8. Type II DM -no acidosis
-rarely see DKA
9. Tx for T1 AND -give IV fluids fast to treat for polyuria (NS/Isotonic) RISK FOR SHOCK
T2DM
-IV insulin
(maternal)
-watch out for hypokalemia
-Insulin carries glucose AND potassium into the cells, so when insulin is
low, potassium is low
-also polyuria means that they are excreting a lot of potassium
10. 3 P's of diabetes polyuria, polydipsia, polyphagia
11. Maternal 13.
Risks with
Diabetes
12. Screening
for GDM
3/
29
Answers |Actual Complete Update |Already Graded A+
1. Nutrition 75 G protein daily
during increase 300 kcal/day in 2nd trimester, double for
pregnancy
twins Folic acid for neural tube defects
normal weight gain is 25-35 lbs, if overweight 15-25
2. MTHFR gene product in autosomal-recessive disorder, associated with decencies
in folate metabolism
-detectable by PCR
BLOOD IS PRONE TO CLOT, SO HIGH RISK FOR PRE-E
3. TIDM & T2DM (fe- -leads to congenital heart and neural tube defects
tal affects) -can lead to fetal acidosis (b/c vascular flow issues in dm pts means that is
will also inhibit flow to vascular placenta, so decreased oxygenation
leads to acidosis
-if maternal a1c> 8.5, 40% chance baby will have cardiac defect
-standard for well controlled dm is to induce at 38-39 weeks
-macrosomia >4000 gms
-polyhydramnios (b/c excess urination gets to baby too)
4. FETAL MECHA-
NISMS IN
-glucose crosses placenta but insulin doesnt
T1DM,
-excess glucose means that fetus will respond by producing more insulin
T2 Pts.
-when born, glucose is cut ott, but baby is left with excess insulin-->
5. Glucose vs. hypoglycemia
Sur-factant
Think surfactant = soapy, glucose = sticky
-Excess glucose causes a delay in surfactant production
-Lack of surfactant makes the alveoli sticky, unable to open
-high risk of RDS in neonates born to uncontrolled DM moms
6. DKA -diabetic ketoacidosis
-seen in type 1 mostly, bg >250
-Metabolic acidosis (lack on insulin to transport excess glucose out of
vascular space into cells, so body starts breaking down fat for energy
1/
29
,RNC-OB Swilley Exam with all Correct & 100% Verified
Answers |Actual Complete Update |Already Graded A+
instead)
-fruity breath b/c of ketones
-Kussmaul Respirations
2/
29
, RNC-OB Swilley Exam with all Correct & 100% Verified
Answers |Actual Complete Update |Already Graded A+
7. Kussmaul -Seen in dka
respi-rations
-lungs will compensate for the metabolic acidosis, create a lot of CO2 in
order to blow ott the acid
-will blow it ott fast
8. Type II DM -no acidosis
-rarely see DKA
9. Tx for T1 AND -give IV fluids fast to treat for polyuria (NS/Isotonic) RISK FOR SHOCK
T2DM
-IV insulin
(maternal)
-watch out for hypokalemia
-Insulin carries glucose AND potassium into the cells, so when insulin is
low, potassium is low
-also polyuria means that they are excreting a lot of potassium
10. 3 P's of diabetes polyuria, polydipsia, polyphagia
11. Maternal 13.
Risks with
Diabetes
12. Screening
for GDM
3/
29
