OB-Maternity Exam Updated questions and answers graded A 2024

Presumptive Signs of Pregnancy - Amenorrhea, Nausea and Vomiting, Fatigue, Urinary Frequency, Breast and Skin Changes, Vaginal and cervical color changes, and Fetal Movement. Probable Signs of Pregnancy - Abdominal Enlargement, Cervical Softening, Uterine Changes, and Pregnancy Tests Positive Signs of Pregnancy - Auscultation of Fetal Heart Sounds, Fetal Movements felt by examiner, Visualization of Fetus. Leukocytes (WBC) during pregnancy... - 12,000 cells/mm3 to 15,000 cells/mm3 Leukocytes (WBC) during labor and early postpartum... - 25,000 cells/mm3 to 30,000 cells/mm3 Magnesium Sulfate - This depresses the CNS acting as an anticonvulsant by decreasing acetylcholine released by motor nerve impulses blocking neuromuscular transmission. This medication is used to prevent and control seizures in severe preeclampsia and helps to prevent uterine contractions during preterm labor. Also can cause respiratory depression. (4 to 6 grams) External Version - This is more common and promotes vaginal birth by changing the fetal presentation from a breech or transverse lie (shoulder) to a cephalic lie (head). This helps to avoid a cesarian birth. Internal Version - This is used to change the presentation of the second twin after birth of the first twin in hopes for a vaginal birth of second twin rather than a cesarian. Pitocin - Used for the induction of labor and control of postpartum bleeding. Stimulates the uterine smooth muscle producing uterine contractions and has vasoactive and antidiuretic effects. Also known as Oxytocin. Precautions for Pitocin administration... - Give this as a piggyback infusion so it may be stopped if complications occur, insert into primary line as close to the venipuncture site as possible, monitor FHR and patterns before administration to determine baseline and after, start medication slowly and increase gradually as regulated by an infusion pump. Actual Nursing Diagnoses... - Imbalanced Nutrition: Less than Body Requirements or Ineffective Breastfeeding Risk Nursing Diagnoses... - Risk for Imbalanced Nutrition: Less than Body Requirements or Risk for Ineffective Breastfeeding Wellness Nursing Diagnoses... - Readiness for Enhanced Self-Health Management or Readiness for Enhanced Nutrition Calcium Gluconate - This acts as an antidote for Magnesium Sulfate. Folic Acid - This can help decrease the amount of neural tube deficits such as spina bifida and is especially important to take before conception and during the first trimester. Products containing enriched flour, breads or cereals can help adequate intake. (G) GTPAL - Pregnancies or Gravida (How many times pregnant) (T) GTPAL - Term Pregnancies delivered (How many delivered to full term 37+ weeks) (P) GTPAL - Pre-Term delivered (How many delivered pre-term 20 to 36 6/7 weeks) (A) GTPAL - Abortions (How many abortions, under 20 weeks, etopic?) (L) GTPAL - Living Children (How many kids do you have?) Nagele's Rule - Used to establish estimated delivery date (EDD) by subtracting 3 months since the last normal menstrual period (LNMP) then adding 7 days, then correcting year if needed. Polyhydramnios - Excessive volume of amniotic fluid usually associated with fetal abnormalities. Can be caused by gestational diabetes. Usually in excess of 2000 ml. Oligohydramnios - Abnormally small quantity of amniotic fluid usually associated with placental insufficiency or fetal urinary tract abnormalities. Usually less than 700-800 ml Cytotec - Used for gastric ulcers but also used forcervical ripening and induction of labor and is not to be given to a woman with a previous cesarian birth. Also known as Misoprostol. Usual dose 25 mcg vaginally. Amniotomy - Artifical rupture of the amniotic sac usually performed in conjunction with an augmentation of labor and to allow fetal monitoring. Performed by a physician or nurse-midwife. Chorioamnionitis - Inflammation of the amniotic sac caused by bacterial or viral infections