OB MATERNITY VERSION GUIDE WITH QUESTIONS AND VERIFIED ANSWERS

OB MATERNITY VERSION GUIDE WITH QUESTIONS AND VERIFIED ANSWERS What position does the Pavlik harness put infants with developmental dysplasia of the hip stay in? - ANSWER The Pavlik harness keeps the infant in an abducted position allowing the hips and knees flexed Proteinuria and preeclampsia - ANSWER Higher protein levels suggest greater leaking of protein secondary to glomerular damage with worsening preeclampsia LOC & magnesium - ANSWER -Drowsiness or dulled sensorium indicates therapeutic effects of magnesium; -No responsive behavior or muscle weakness is associated with magnesium excess Cerebral edema - ANSWER vasospasm of cerebral vessels, and liver edema. Eclampsia may develop quickly. Carboprost Tromethamine (Hemabate) - ANSWER prostaglandin; oxytocic uses: - reduce postpartum bleeding secondary to uterine atony Adverse effects and contraindications a. Can cause headache, nausea, vomiting, diarrhea, fever, tachycardia, and hypertension b. Contraindicated if the client has asthma (other uses:) -pregnancy termination -induce labor in intrauterine fetal death and hydatidiform mole Oxytocin (Pitocin) - ANSWER class: oxytocics Indication: labor induction, postpartum bleeding Action: stimulates uterine smooth muscle Nursing Considerations: - can cause ICH in fetus - can cause asphyxia in fetus - may cause coma and seizures in mother - may cause painful contractions - assess fetus - assess contractions - monitor blood pressure - assess maternal electrolytes - may cause uterine tetany Assessing the uterine fundus - ANSWER -supine position with her knees slightly flexed to relax the abdominal muscles and to permit accurate location of the fundus. -Place your nondominant hand above the woman's symphysis pubis to support and anchor the lower uterine segment during palpation or massage of the fundus. placenta previa - ANSWER implantation of the placenta over the cervical opening or in the lower region of the uterus Ultrasound examination placenta abruption - ANSWER the premature detachment of the placenta placenta previa s/s placental abrution s/s - ANSWER previa - there is no pain, but there is bleeding abrution - there is pain, but no bleeding (board like abd) threatened abortion - ANSWER bleeding with the threat of miscarriage spontaneous abortion - ANSWER naturally occurring termination of pregnancy; also known as a miscarriage(before 24-28th week) Types of abortions include - ANSWER Threatened; Inevitable; Incomplete; Complete; Missed Inevitable abortion - ANSWER Uterine bleeding at 18 weeks' gestation; no products expelled; membranes ruptured; cervical os open. incomplete abortion - ANSWER incomplete expulsion of the products of conception complete abortion - ANSWER all products of conception are expelled threatened abortion management - ANSWER -Conservative supportive treatment -Possible reduction in activity in conjunction with nutritious diet and adequate hydration incomplete abortion management - ANSWER -may be allowed to finish -D&E after 1st (D&C in 1st) -pitocin -RhoGAM if indicated inevitable abortion management - ANSWER -dilation and evacuation (D&E) in 2nd trimester -suction curettage in 1st trimester -RhoGAM if indicated When should jaundice in a newborn be concerning? - ANSWER If jaundice is present less than 24 hours of delivery, it may indicate excess bilirubin What is the action of terbutaline sulfate (Brethine)? - ANSWER Stop labor contractions Ovulation occurs how many days before the next menstrual period? (AKA between ovulation & beginning of next menstrual cycle, there are how many days?) - ANSWER 14 To prevent pregnancy, a couple must avoid unprotected sex for ______days before anticipated ovulation & for ___ days after ovulation to prevent pregnancy - ANSWER Several days before antcipated ovulation & 3 days after ovulation ---sperm live approx 3 days ---eggs live about 24 hrs Because some women experience _____ or _____, they do not know they are pregnant - ANSWER implantation bleeding OR spotting Signs of maternal-fetal bonding in utero? - ANSWER talking to fetus in utero massaging abdomen nicknaming fetus For women, battering (emotional/physcial abuse) begins during preg. How should women be assessed for abuse? - ANSWER In private, away from male partner, by nurse who is familiar w/ local resources & knows how to determine safety of the client A women who is 6 wks preg has the following maternal history: -healthy 2 yo daughter -miscarriage at 10 wks -elective abortion at 6 weeks -5 years earlier (what is her GTPAL?) - ANSWER 4-1-0-2-1 gravida 4, para 1 (only 1 delivery after 20 wks gestation) What is EBD using Nagele's rule? --Woman's last menstrual period Oct. 17 - ANSWER Count back 3 months +7 days --July 24 When does plasma volume increase during preg? - ANSWER At approx 28 to 32 weeks, plasma volume increase 25-40%, resulting in hemodilution of Hct values 32-42% --High Hct values may look good, BUT in reality they represent a gestational HTN disorder & depleted vascular space Foods high in iron - ANSWER -fish & red meats -cereals & yellow vegetables -green leafy vegetables & citrus fruits -egg yolks and dried fruits What position increases perfusion to uterus, placenta, and fetus? - ANSWER L side-lying Changes in ______ are the 1st & most important indicators of compromised blood flow to fetus, & these changes require action! - ANSWER changes in FHR --fetal well-being determined by fundal height, fetal heart tones & rate, and uterine activity (contractions)