Fast Stream OB Scenarios Questions and Answers 2023

Fast Stream OB Scenarios Questions and Answers 2023 An inpatient procedure whereby preexisting labor is assisted in its progress in strength and frequency of uterine contractions and/or dilation and effacement in the cervix by Artificial Rupture of the Amniotic Membranes (AROM), and/or cervical ripening agents and/or IV oxytocin." Augmentation of Labor "An antepartum fetal surveillance procedure carried out after 28 weeks gestational age exam. By fetal heart rate monitoring and the mother marking the movements of the fetus, this exam detects fetal well-being by recording movement, heart rate and reactivity of the heart rate of the fetus. Abnormal results lead to immediate further exploration of the fetal condition." Nonstress Test "A pregnancy-related complication of unknown cause that is characterized by high blood pressure (when pre-pregnancy BP's were normal) and signs of damage to other organ systems such as the kidneys, leading to a condition known as proteinuria. Usually begins after 20 weeks of pregnancy and if left untreated can lead to serious, even fatal, complications for the mother and the baby." Preeclampsia "A condition of glucose intolerance, with no pre-existing occurrence, that begins and is diagnosed during pregnancy only. This condition is diagnosed between 24-28 weeks gestational age by an oral 50-gram glucose challenge test (GCT) during prenatal care. If results are abnormal, a 100-gram oral glucose tolerance test (OGTT) is carried out for confirmation of the diagnosis. Classifications of this disorder include A1-(diet control) and A2 (insulin control with diet). Maternal treatments include self-glucose monitoring, diet, exercise and close maternal and fetal surveillance. This condition can lead to fetal macrosomia or large for gestational age fetus (LGA), cephalopelvic disproportion (CPD), Cesarean Section and hypoglycemia, hyperbilirubinemia (Jaundice), respiratory distress syndrome (RDS) or hypocalcemia of the newborn." Gestational Diabetes Mellitus (GDM) "Amniotic fluid that contains products of the fetus's first bowel movement in utero. The presence of this in the fluid is not harmful to the fetus in utero; however, aspiration of the fluid by the infant at or after delivery may result in respiratory complications, infection and/or other serious complications. Careful assessment of the time, amount, color and odor of the amniotic fluid is of high priority, prior to birth." Meconium Staining "An antepartum diagnostic examination to determine fetal well-being in utero. Stimulation of the uterus is accomplished by either nipple stimulation or use of IV Pitocin if spontaneous "rhythmic uterine tightenings" are not already present. Fetal monitoring is done to assess tolerance of the Fetus during and after these "rhythmic uterine tightenings" , and whether signs of fetal hypoxia are present as evidenced by fetal heart rate changes." Contraction Stress Test (CST) "A condition in pregnancy associated with preeclampsia whereby the pregnant patient experiences a critical hemolysis, elevated liver enzymes and low platelet count." HELLP Syndrome "An inpatient procedure whereby contractions of the uterus and/or cervical dilation are initiated in the absence of natural labor by artificial rupture of amniotic membranes (AROM), and/or cervical ripening agents and/or IV oxytocin." Induction of Labor "A complication that occurs prior to, or during, delivery of the baby. This condition occurs when the "pulsing life-line" which connects the placenta to the fetus drops through the open cervix into the vagina ahead of the baby becoming trapped and totally or partially occluded against the baby's body during delivery. This complication occurs in one in every 300 births and presents a great danger to the fetus. It can result in hypoxia or death to the fetus if intervention is not initiated immediately." Umbilical Cord Prolapse KarenScott A G1P0 is admitted to the Antepartum holding area as an outpatient to be monitored for complaints of regular moderately uncomfortable uterine contractions lasting 60-80 seconds occurring every 2-5 minutes. Her cervix was examined for dilation and effacement and found to be 2-3 centimeters and 100% effaced. The patient complains of a "sudden large gush" of warm amniotic fluid between her legs following the vaginal exam. When the nurse is cleaning up the fluid on the bed and changing the waterproof pad a protrusion is visualized coming out of the patient's vagina. The fetal heart rate has dropped suddenly to 40 beats per minute. The nurse quickly repositions the patient, does a vaginal examination and pushes the fetal presenting part away from the protrusion. Umbilical Cord Prolapse A G1P0 is admitted to the Antepartum holding area as an outpatient to be monitored for complaints of regular moderately uncomfortable uterine contractions lasting 60-80 seconds occurring every 2-5 minutes. Her cervix was examined for dilation and effacement and found to be 2-3 centimeters and 100% effaced. The patient complains of a "sudden large gush" of warm amniotic fluid between her legs following the vaginal exam. When the nurse is cleaning up the fluid on the bed and changing the waterproof pad a protrusion is visualized coming out of the patient's vagina. The fetal heart rate has dropped suddenly to 40 beats per minute. The nurse quickly repositions the patient, does a vaginal examination and pushes the fetal presenting part away from the protrusion. Prepare for Surgical Intervention or Cesarean Section A G1P0 at 38 weeks gestation presents to the OB triage with complaints of no fetal movements for 12 hours. She states she is contracting irregularly without discomfort and denies spontaneous rupture of membranes. Contraction Stress Test (CST) A G1P0 at 38 weeks gestation presents to the OB triage with complaints of no fetal movements for 12 hours. She states she is contracting irregularly without discomfort and denies spontaneous rupture of membranes. Select action Admit to Antepartum testing/holding center as an outpatient". Jennifer Holly A G3P2 at 42 2/7 weeks gestational age presents to labor and delivery from her obstetrician's office. She has had no signs of labor. She has not been sleeping well and states she "is exhausted". She has noticed a decrease in fetal movements over the last 24 hours and she was concerned. Monitoring in the office resulted in a non-reactive nonstress test. An ultrasound was done that showed a decrease in amniotic fluid or oligohydramnios. Currently, she denies any signs of labor or vaginal discharge or fluid. Select term Post Term Pregnancy Jennifer Holly A G3P2 at 42 2/7 weeks gestational age presents to labor and delivery from her obstetrician's office. She has had no signs of labor. She has not been sleeping well and states she "is exhausted". She has noticed a decrease in fetal movements over the last 24 hours and she was concerned. Monitoring in the office resulted in a non-reactive nonstress test. An ultrasound was done that showed a decrease in amniotic fluid or oligohydramnios. Currently, she denies any signs of labor or vaginal discharge or fluid. Admit to Labor and Delivery Unit Joey Kelly A G1P0 was admitted to the high-risk antepartum unit due to signs and symptoms of Preeclampsia yesterday. She has received Magnesium Sulfate IV and her blood pressure and reflexes have decreased. She is 41 weeks gestational age and an ultrasound has shown that the infant has intrauterine growth restriction. A nonstress test was done and the fetus is reactive, and movements are regular. Induction of Labor Joey Kelly A G1P0 was admitted to the high-risk antepartum unit due to signs and symptoms of Preeclampsia yesterday. She has received Magnesium Sulfate IV and her blood pressure and reflexes have decreased. She is 41 weeks gestational age and an ultrasound has shown that the infant has intrauterine growth restriction. A nonstress test was done and the fetus is reactive, and movements are regular. Admit to Labor and Delivery Unit Rosie Holloway A G1P0 at 38 weeks is transferred to the Antepartum holding/testing area from her doctor's office for monitoring and evaluation. In the office her cervix was 2-3 cm and 50% effaced. Earlier in the day, on admission, she had complained of irregular contractions and a persistent headache for the last 24 hours and decreased fetal movements as well as complaints of heart burn that had not been relieved with the OTC Tums. Blood pressures are 160-180/90-100. After 2 hours on the monitor the uterine activity monitor shows regular uterine contractions every 2-5 minutes apart, with the patient complaining of pain with a 7 out of 10 pain scale. The fetal heart rate of 130 has minimal to moderate variability and an absence of accelerations. Non-reassuring decelerations are currently ABSENT. Many of the patient's blood tests are pending; however, the labs that have been received are showing a low platelet count, elevated (ALT, AST) liver enzymes. Urine test is 2+ for protein. The patient's cervix is examined again and is now 3-4 cm dilated and 80%. HELLP Syndrome Rosie Holloway A G1P0 at 38 weeks is transferred to the Antepartum holding/testing area from her doctor's office for monitoring and evaluation. In the office her cervix was 2-3 cm and 50% effaced. Earlier in the day, on admission, she had complained of irregular contractions and a persistent headache for the last 24 hours and decreased fetal movements as well as complaints of heart burn that had not been relieved with the OTC Tums. Blood pressures are 160-180/90-100. After 2 hours on the monitor the uterine activity monitor shows regular uterine contractions every 2-5 minutes apart, with the patient complaining of pain with a 7 out of 10 pain scale. The fetal heart rate of 130 has minimal to moderate variability and an absence of accelerations. Non-reassuring decelerations are currently ABSENT. Many of the patient's blood tests are pending; however, the labs that have been received are showing a low platelet count, elevated (ALT, AST) liver enzymes. Urine test is 2+ for protein. The patient's cervix is examined again and is now 3-4 cm dilated and 80%. Admit to Labor and Delivery Unit Linda Hunter A G1P0 at 41 1/7 weeks gestational age presents to the OB triage desk with complaints of active labor that has lasted for the last 20 hours. Her doctor has sent her over from the office and when checking the cervix noted that the patient had an intact bulging bag of amniotic membrane and a cervical exam of 3-4 cm. dilation and 80% effacement. The patient states active fetal movements and FHR of 120's in the doctor's office. This report was confirmed by the physician over the phone. Augmentation of Labor