NURS 629 Exam 3 (OB/GYN) Questions With Verified Answers

What antibiotics are safe for UTI during pregnancy? - Answer Macrobid, Ampicillin, Keflex, Pyridium What antibiotic is unsafe during preganancy? - Answer Bactrim (<13 w or >36 w) Are oral hypoglycemics okay in pregnancy? - Answer NO!!! What medication do you use to treat DM during pregnancy? - Answer Insulin Name the 5 infant risk factors for an infant with a DM mother - Answer 1. NTD 2. Cardiac Defects 3. Macrosomia 4. Intra-Uterine Growth Restrictions 5. Hyperbili What complications can Macrosomia cause to an infant? - Answer Truncal Fat, Shoulder Dystocia, Hypoglycemia, Hyperglycemia (Delay in lung maturation), Hypoxia (Cerebal Palsy) How is the 1 hour glucose test performed? - Answer 24-28 weeks drink 50G of glucose (BS >140) How is the 3 hour glucose test performed? - Answer High carb 2 day diet, NPO after midnight, FBS then drink 100G of glucose (FBS >105 or 2 of the following: 190 at 1 hr, 165 at 2 hr, 145 at 3 hr) What is the treatment of PIH or chronic HTN during pregnancy? - Answer ACE contraindicated, Betablockers can cause low birth weight the safest (Lobateolol) Name the classic TRIad for Preeclampsia - Answer 1. HTN 2. Edema 3. Proteinuria What do you see in MILD Preeclampsia? - Answer BP >140/>90 1+ Proteinuria No HA How do you treat MILD Preeclampsia? - Answer Increase protein, document fetal activity, weekly NST What do you see in SEVERE Preeclampsia? - Answer BP >160/>110 3+ Proteinuria HA Decreased output Visual disturbances Thrombocytopenia How do you treat SEVERE Preeclampsia? - Answer Deliver the baby, rest, decrease stimuli, mag sulfate, medications (Apresoline) What are visual signs and symptoms of Eclampsia? - Answer Facial twitching, tonic clonic seizures, pulmonary edema, circulatory/renal failure What are signs and symptoms of HELLP syndrome? - Answer RUQ pain, N/V, edema, increased liver enzymes, decreased H&H & platelets What is the treatment of HELLP and Eclampsia? - Answer Deliver the baby, bed rest, mag sulfate (Valium or Phenobarb if mg is not effective after 2 hrs), Steriods (Fetal lung maturity), Hydralazine (SEVERE) What is the treatment of Hyperemesis Gravidarum? - Answer IV fluids, tpn, antiemetics (B6, unisom, antihestamines), diet as tolerated What education do you need to give about quad screening? - Answer It is not a diagnostic. It is an assessment tool and will be referred to a specialist if positive. What can early bleeding indicate? - Answer Miscarriage, ectopic pregnancy, incompetent cervix Explain the 3 types of spontaneous abortions - Answer 1. Threatened - Vaginal bleeding occurs 2. Inevitable - Membranes rupture and cervix dilates 3. Incomplete - Some products of conception have remained How do you manage a THREATENED abortion? - Answer Check fetus by ultrasound, bed rest, no sex for 2 weeks after bleeding stops, no false reassurance of outcome Treatment for an INEVITABLE abortion - Answer Check for complete vs incomplete via ultrasound, analgesia for d&c, RhoGAM if negative blood type (avoid future issues with future preganancy) Treatment for an INCOMPLETE (Missed) abortion - Answer Hospitalization, d&c or IV pitocin for 14 weeks, after 14 weeks give pitocin or prostaglandins, wait 3-5 weeks for spont abortion if does not want medical treatment, monitor for DIC or excessive prolonged bleeding What education do you need to give someone who is having an abortion? - Answer Bleeding and cramping last 1-2 weeks, vaginal rest for 1 week, check temp bid, f/u in 2 weeks, may take 6w for cycle to return, can try to get pregnant after 1 cycle What are the signs and symptoms of an INCOMPETENT cervix? - Answer Advanced cervical dilation, low abd pressure, bloody show, urinary frequency Treatment for INCOMPETENT cervix - Answer Cerclage (by ob cervical stitch), do not check cervix manually use u/s only Risk factors to have an ectopic pregnancy? - Answer Hx of salpingitis, prior ectopic, assisted reproduction, smoker, current IUD use, hx of STD or STI Signs of symptoms of ectopic pregnancy? - Answer Missed period, bilateral lower abd pain, vaginal spotting, rupture (severe abdominal pain), low hCG and progesterone levels, no gestational sac on U/S