EXAM 2 OB (NURSING 160)
UPDATED ACTUAL QUESTIONS AND CORRECT
ANSWERS
Question 1.
What are the placenta functions?
ANSWER
Placenta Functions
-Hormone production: Hormones vital to fetal development and survival and maintenance of
pregnancy
-Respiration: Facilitate passage of oxygen from maternal to fetal circulation
-Nutrition: Facilitate passage of nutrition from maternal to fetal circulation
-Elimination: Excretion of waste products (transported back to the mom like CO2 *Anything
that is inside mom that doesn't normally belong to her does not belong to her
*When the placenta comes out moms hormones will change drastically (very high to very low)
*Very important placenta is healthy for pregnancy
*Shiny side fetal side can see all vessels essential for perfusion
*Red "dirty" side maternal
,Question 2.
What are labs and nursing assessment/interventions related to elimination (renal) in patients with
preeclampsia?
ANSWER
Labs
-BUN & Creatinine: Increased (the kidneys ability to filter blood)
-Serum uric acid: Increased (the body's ability to filter blood)
-Serum albumin: decreased
-Urinalysis or Urine dip:
•Specific gravity: Increased (urine becomes more concentrated) (measures the concentration
of the urine; does it have a lot of water or is it very concentrated)
•Protein: Increased (the larger molecules that are able to pass through the capillaries in the
kidneys)
-24 hour urine protein (determines severity of preeclampsia and severity of renal involvement)
(discard first urine)
•300 mg/L to 1000 mg/L
•5 Grams/L in 24 hours
Nursing Assessment/Interventions
-Assess for edema
•Peripheral
•Pitting
•General (facial)
•Daily weights
•Lung sounds
-Urine assessment for protein
-Collect 24 hour urine
-Strict hourly I&O (at least 30ml/hr)
-Monitor serial labs (look at her labs daily to compare differences from day to day)
-NO DIURETICS
*Your head is the highest point away from your heart so if you have facial edema you know
you have some significant edema you dealing with
*For patients with severe preeclampsia we may be monitoring way more frequently for serial
labs possibly every 4-6 hours; these give you a good idea of the direction her condition is going
,Question 3.
What are the maternal and fetal/neonatal risks for premature rupture of membranes?
ANSWER
Maternal Risks:
-Infection
•Chorioamnionitis (infection of the placenta and amniotic fluid)
•Endometritis (an infection that occurs in the inner lining of the uterus) (if an infection does
develop she is at an increased risk of placenta abruptio; placenta prematurity pulls away from
lining of the uterus)
-Placenta abruptio
Fetal/Neonatal Risks:
-Fetal hypoxia/Umbilical cord compression
-Complications of prematurity
•RDS (respiratory distress syndrome)
•NEC (necrotizing enterocolitis)
•IVH (intra-ventricular hemorrhage)
-Neonatal infection/sepsis
-Growth or position defects (no longer has cushion around them; basically sitting on moms
bone structure and can cause soft tissue damage and impair growth because they no longer
have the ability to move around
Question 4.
What is ovarian or adnexal mass?
ANSWER
-70-80% of ovarian masses benign
-No current screen for ovarian cancer (usually not systematic until its gotten to the point where
we can't do anything)
-Still recommend pelvic bimanual examination
-Assess for risk factors:
-BRAC 1 & BRAC 2 genetic mutations (genes protect us from cancers but if there is a mutation
acquired from genetics this can cause cancers (breast or ovarian)
-Family history
-Ovarian cancer is identified as the most fatal cancer in women
-Ovarian cancer the "silent killer" - difficult to diagnose and it has usually spread in the pelvis
before detection
*Most of them are benign
, Question 5.
What are
the different drug withdrawal symptoms affecting the autonomic and interventions?
ANSWER
Assessment
-Nasal stuffiness
•Babies are obligatory nose breathers
-Tachypnea
•RR over 60
-Fever/temp instability
-Diaphoresis (sweating)
•Abnormal in babies
-Mottled skin
Interventions
-Promote oxygenation/circulation
-Pulse, respirations and O2 saturation monitoring
-Promote thermoregulation
-Closely monitor temperature
-Thermo controlled environment
*When babies can't breath out of their noses they get very irritated because they are nose
breather
*Sweating and shivering in babies is abnormal
UPDATED ACTUAL QUESTIONS AND CORRECT
ANSWERS
Question 1.
What are the placenta functions?
ANSWER
Placenta Functions
-Hormone production: Hormones vital to fetal development and survival and maintenance of
pregnancy
-Respiration: Facilitate passage of oxygen from maternal to fetal circulation
-Nutrition: Facilitate passage of nutrition from maternal to fetal circulation
-Elimination: Excretion of waste products (transported back to the mom like CO2 *Anything
that is inside mom that doesn't normally belong to her does not belong to her
*When the placenta comes out moms hormones will change drastically (very high to very low)
*Very important placenta is healthy for pregnancy
*Shiny side fetal side can see all vessels essential for perfusion
*Red "dirty" side maternal
,Question 2.
What are labs and nursing assessment/interventions related to elimination (renal) in patients with
preeclampsia?
ANSWER
Labs
-BUN & Creatinine: Increased (the kidneys ability to filter blood)
-Serum uric acid: Increased (the body's ability to filter blood)
-Serum albumin: decreased
-Urinalysis or Urine dip:
•Specific gravity: Increased (urine becomes more concentrated) (measures the concentration
of the urine; does it have a lot of water or is it very concentrated)
•Protein: Increased (the larger molecules that are able to pass through the capillaries in the
kidneys)
-24 hour urine protein (determines severity of preeclampsia and severity of renal involvement)
(discard first urine)
•300 mg/L to 1000 mg/L
•5 Grams/L in 24 hours
Nursing Assessment/Interventions
-Assess for edema
•Peripheral
•Pitting
•General (facial)
•Daily weights
•Lung sounds
-Urine assessment for protein
-Collect 24 hour urine
-Strict hourly I&O (at least 30ml/hr)
-Monitor serial labs (look at her labs daily to compare differences from day to day)
-NO DIURETICS
*Your head is the highest point away from your heart so if you have facial edema you know
you have some significant edema you dealing with
*For patients with severe preeclampsia we may be monitoring way more frequently for serial
labs possibly every 4-6 hours; these give you a good idea of the direction her condition is going
,Question 3.
What are the maternal and fetal/neonatal risks for premature rupture of membranes?
ANSWER
Maternal Risks:
-Infection
•Chorioamnionitis (infection of the placenta and amniotic fluid)
•Endometritis (an infection that occurs in the inner lining of the uterus) (if an infection does
develop she is at an increased risk of placenta abruptio; placenta prematurity pulls away from
lining of the uterus)
-Placenta abruptio
Fetal/Neonatal Risks:
-Fetal hypoxia/Umbilical cord compression
-Complications of prematurity
•RDS (respiratory distress syndrome)
•NEC (necrotizing enterocolitis)
•IVH (intra-ventricular hemorrhage)
-Neonatal infection/sepsis
-Growth or position defects (no longer has cushion around them; basically sitting on moms
bone structure and can cause soft tissue damage and impair growth because they no longer
have the ability to move around
Question 4.
What is ovarian or adnexal mass?
ANSWER
-70-80% of ovarian masses benign
-No current screen for ovarian cancer (usually not systematic until its gotten to the point where
we can't do anything)
-Still recommend pelvic bimanual examination
-Assess for risk factors:
-BRAC 1 & BRAC 2 genetic mutations (genes protect us from cancers but if there is a mutation
acquired from genetics this can cause cancers (breast or ovarian)
-Family history
-Ovarian cancer is identified as the most fatal cancer in women
-Ovarian cancer the "silent killer" - difficult to diagnose and it has usually spread in the pelvis
before detection
*Most of them are benign
, Question 5.
What are
the different drug withdrawal symptoms affecting the autonomic and interventions?
ANSWER
Assessment
-Nasal stuffiness
•Babies are obligatory nose breathers
-Tachypnea
•RR over 60
-Fever/temp instability
-Diaphoresis (sweating)
•Abnormal in babies
-Mottled skin
Interventions
-Promote oxygenation/circulation
-Pulse, respirations and O2 saturation monitoring
-Promote thermoregulation
-Closely monitor temperature
-Thermo controlled environment
*When babies can't breath out of their noses they get very irritated because they are nose
breather
*Sweating and shivering in babies is abnormal
