OB Pediatric FISDAP FINAL EXAM 2022/2023

OB Pediatric FISDAP FINAL EXAM 2022 what is preeclampsia? Correct Answer: A condition of late pregnancy that involves gradual onset of hypertension, headache, visual changes, and swelling of the hands and feet; also called pregnancy-induced hypertension or toxemia of pregnancy. What is eclampsia? Correct Answer: Seizures that result from severe hypertension in a pregnant woman. How do you stop seizures in patients with severe preeclampsia or eclampsia? Correct Answer: Administration of Magnesium sulfate What is abruptio placentae? Correct Answer: A premature separation of the placenta from the wall of the uterus. What are the signs and symptoms of abruptio placenta? Correct Answer: a sudden onset of severe abdominal pain, often radiating into the back; there will also be decreased fetal movement and decreased fetal heart tones. The patient may report vaginal bleeding, although in some cases the blood does not emerge through the cervix and the bleeding may remain concealed within the endometrium. Physical examination may reveal signs of shock, often out of proportion to the apparent volume of blood loss. The abdomen will be tender and the uterus rigid to palpation. Other complications include severe hemorrhaging. If the hemorrhaging cannot be controlled after delivery, a hysterectomy may be necessary. What are the signs and symptoms of Placenta Previa? Correct Answer: The chief complaint of a woman with placenta previa is usually painless vaginal bleeding, with the loss of bright red blood. Because the blood supply to the fetus is not immediately jeopardized, fetal movements continue and fetal heart sounds remain audible. What is Placenta Previa? Correct Answer: In placenta previa, the placenta is implanted low in the uterus and, as it grows, it partially or fully obscures the cervical canal. What is gravidity? Correct Answer: total number of times a woman has been pregnant regardless of those pregnancies' outcomes, including the current pregnancy. What is Parity? Correct Answer: Number of live births What are the stages of labor? Correct Answer: first stage second stage third stage of labor (placental stage) What happens in the first stage of pregnancy? Correct Answer: begins with the onset of labor pains—crampy abdominal pains that may radiate into the small of the back and reflect the contractions of the uterus. What happens in the second stage of pregnancy? Correct Answer: begins as the head of the fetus descends and flexes (chin to chest) to enter the birth canal. What happens in the third stage of pregnancy? Correct Answer: (placental stage) is the period that involves separation of the placenta from the uterine wall. What is crowning? Correct Answer: It is the appearance of the infant's head at the vaginal opening during labor. Indicates that the fetus will be born within the next few minutes. Crowning is considered the beginning of the second stage of labor. What do you do if you see crowning? Correct Answer: place your sterile gloved hand over the emerging bony parts of the head, and by exerting minimal pressure, control the delivery of the head. What is a prolapsed umbilical cord? Correct Answer: When the umbilical cord presents first and gets squeezed between the vaginal wall and the baby's head, cutting off blood supply. How do you treat prolapsed umbilical cord? Correct Answer: Elevate hips Oxygen pant with contraction 2 fingers gently push presenting part (not cord) back up into the vagina until it no longer presses on the cord While you maintain pressure on the presenting part, have your partner cover the exposed portion of the cord with dressings moistened in warmed normal saline Try to maintain that position, with a gloved hand pushing the presenting part away from the cord, throughout urgent transport to the hospital. What is magnesium sulfate used for in pregnancy? Correct Answer: Prevention or treatment of seizures in pregnant patients with preeclampsia or eclampsia. What is placental hypoperfusion? Correct Answer: When the pregnant uterus compresses the inferior vena cava, venous blood return to the heart is diminished or, in some cases, occluded. What's the best position for the babys head during delivery? Correct Answer: Head down, this is called cephalic presentation. How does the baby's head move during delivery? Correct Answer: The babies head will begin to turn in order to make it easier to facilitate birth. What is breach presentation? Correct Answer: In a breech presentation, a part of the body other than the head leads the way. Usually, the buttocks emerges first (the word breech means "buttocks"), but at other times one of the feet comes first. What do you do if you have a breech presentation? Correct Answer: position woman with buttocks at edge of bed Allow lower half of baby to deliver, do not pull Support baby and allow to hang by its weight When you see the hairline of the baby, grasp the ankles and lift towards womans abdomen. What if the baby's head doesn't deliver within 3 minuets of breech presentation? Correct Answer: Suffocation may occur. Push vaginal wall away from babys face Rapid transport. What is Meconium? Correct Answer: A dark green-black material in the amniotic fluid that indicates fetal distress, and that can be aspirated into the fetus's lungs during delivery; the fetus's first bowel movement. What type of baby is at risk of meconium aspiration? Correct Answer: more common in postterm newborns and in those who are small for their gestational age (weighing less than the 10th percentile for their age), and in newborns who are stressed before or during delivery. How to give epinephrine to a baby? Correct Answer: Preferably IV but can be given via ET tube. Umbilical vein can be catheterized. What are hypoglycemic levels for a newborn? Correct Answer: In full-term or preterm newborns, hypoglycemia is a blood glucose level of less than 45 mg/dL. How do you treat hypoglycemia in a newborn? Correct Answer: 2mL/kg 10% dextrose IV bolus. If blood glucose is less than 40 mg/dL and infant is symptomatic. When would you give a newborn Naloxone? Correct Answer: If respiratory depression is the result of the mother being treated acutely with narcotics, and there is no chronic narcotic exposure. When would you not give a newborn Naloxone? Correct Answer: In the case of a drug-addicted mother, may precipitate seizures. What can be the cause of respiratory distress in a premature infant? Correct Answer: Prematurity is the single most common cause of respiratory distress and cyanosis in the neonate. Low Surfactant level Respiratory causes include airway obstruction, aspiration (meconium, amniotic fluid, maternal blood delivery, gastroesophageal reflux, and foreign body), pneumonia, pneumothorax, tracheoesophageal fistula, congenital diaphragmatic hernia, or immature lungs. What is on the neonatal resuscitation pyramid? Correct Answer: Warm, dry, position, suction, stimulate oxygen establish ventilation, BVM, ET tube Chest compressions Medications (Most common at the top, least common in the bottom? What are the most common newborn BVM mistakes? Correct Answer: Inadequate seal of the mask on the face and incorrect head position. Other causes such as copious secretions, pneumothorax, or equipment malfunction need to be considered as well.