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MATERNITY AND OBS BY RICCI |
(MIDTERM)
patient who has been prescribed Procardia and magnesium sulfate should be closely assesed for what? - Correct Answers -increased hypotension Endometrium: - Correct Answers -innermost laye; Lines the uterine cavity in nonpregnant women Myometrium: - Correct Answers -muscular middle layer; Makes up the major portion of the uterus; Composed of smooth muscle linked by connective tissue Perimetrium: - Correct Answers -outer serosal layer; Covers the body of the uterus Follicular phase - Correct Answers -(day 1 through ovulation, approximately days 10 to
Ovulation - Correct Answers -(day 14 of a 28-day cycle) Luteal phase - Correct Answers -(day 15 through day 28 of a 28-day cycle) Gonadotropin-releasing hormone (GnRH) - Correct Answers -released from hypothymaus, stimulates release of FSH AND LH Who is affected by Klinefleter syndrome? - Correct Answers -only males What is cri-du-chat? - Correct Answers -cause by a missing piece of chromosome 5, high pitched cry due to laryngeal defect What types of disease is Hungtington's? - Correct Answers -autosomal dominant inheritance What is the chances of a parent who has an autosomal dominant inheritance disorder passing it onto their child? - Correct Answers -50% How is down syndrome diagnosed? - Correct Answers -Alpha-fetoprotein, wk 15 and 18 of gestation and Chorionic villus sampling 15 to 20 weeks
Follicle-stimulating hormone (FSH) - Correct Answers -Anterior piturity; most important during first week, maturation of ovarian Luteinizing hormone (LH) - Correct Answers -Anterior piturity; maturation of preovulatory follicles Estrogen - Correct Answers -secrets by ovaries; causes uterus size to increase Progesterone - Correct Answers -corpus lute; sweeping and increased secretions of he endometrium Prostaglandins - Correct Answers -freeing the ovum inside the graafian follicle What stage lasts fertilization to second week? - Correct Answers -pre embryonic stage What stage lasts second week.... - Correct Answers -? What fish should a pregnant woman avoid? - Correct Answers -shark, swordfish, king markel, orange roughy, ahi tuna and tile fish What fish are okay for pregnant woman? - Correct Answers -shrimp, canned light tuna, slamon, pollock and catfish How much iron does a pregnant women need? - Correct Answers -18 to 27 g/day How much folic acid does a pregnant women need? - Correct Answers -400 to 800 mcg/day How many calories does a pregnant women need extra? - Correct Answers - calories How much weight should an underweight pregnant women gain? - Correct Answers - to 40 pounds How much weight should a normal pregnant women gain? - Correct Answers -25 to 35 pounds How much weight should an overweight pregnant women gain? - Correct Answers - to 25 pounds How much weight should an obese pregnant women gain? - Correct Answers -11 to 20 pounds In the first trimester, an underweight woman should gain? - Correct Answers -5 pounds
What are the classic clinical triad of ectopic pregnancy? - Correct Answers -abdominal pain, amenorrhea and vaginal bleeding A patient with spotting and abdominal pain should be assessed for what? - Correct Answers -ectopic pregnancy What is the medical treatment of a patient with ectopic pregnancy? - Correct Answers - methotrexate What are some adverse effects of methotrexate? - Correct Answers -nausea, vomiting, stomatitis, diarrhea, gastric upset, increased abdominal pain andizziness A patient after a ectopic pregnancy should follow up how often with MD? - Correct Answers -weekly until HCG levels are down What are the two common types of gestational trophoblastic disease? - Correct Answers -hydatidiform mole (partial and complete) and choriocarcinoma What is a begin neoplasm of the chorion in which chronic villa denigrate? - Correct Answers -hydatidiform mole How would a woman with complete hydroform mole present? - Correct Answers - vaginal bleeding, anemia, excessively enlarged uterus, preeclampsia and hyeremesis How would a women with partial hydroform mole present? - Correct Answers -missed or incomplete abortion, vaginal bleeding and small or normal size or date uterus A patient with brownish vaginal discharge and expulsion of grape-like vesicleswould be assessed for what? - Correct Answers -GTD (gestational trophoblastic disease) A patient with pink-tinged vaginal discharge and an increased in lower pelvic pressure would be assessed for what? - Correct Answers -cervical insufficiency A patient with bright red painless bleeding would be assessed for what? - Correct Answers -placenta previa A patient with sudden, dark bleeding would be assessed for? - Correct Answers -abrupt placentae A patient who presents with abrupt placentae, what would the nurse expect to do? - Correct Answers -emergency measures such as two large bore IV, NS, located ringers What are the classical manifastions of abruptio placentae? - Correct Answers -painful, dark red bleed, knife-like pain
When a woman arrives with abruptio placentae, what position would she be placed in? - Correct Answers -left lateral What are promethazine and prochlorperazine used for? - Correct Answers -antimetics What is the first sign of preeclampsia? - Correct Answers -headache What medication is used to treat seizures? - Correct Answers -magnesium sulfate What is the antidote for magnesium sulfate? - Correct Answers -calcium glucontae What is the first sign of eclampsia? - Correct Answers -facial twitching What does HELLP stand for? - Correct Answers -hemolysis, elevated liver enzymes and low platelet count; hypertension What test is used in prenatal testing of pregnant women and in testing prior to a blood transfusion? - Correct Answers -indirect Coombs Fasting blood glucose level should be what? - Correct Answers -less than 92 mg/dL Postprandial levels, at 1 hour should be? - Correct Answers -180 mg/dL Postprandial levels at 2 hour should be? - Correct Answers -153 mg/dL Postprandial levels at 3 hours should be? - Correct Answers -140 mg/dL A patient with A.FIB is planning on getting pregnant, what medication would the nurse expect the patient to come off of? - Correct Answers -Warfarin At what week does the heart now beat i a regular rhythm? - Correct Answers -week 5 At what week can a fetal heart beat be heard? - Correct Answers -week 7 At what week can fetal gender be revealed? - Correct Answers -week 12 At what week do lungs start to produce surfactant? - Correct Answers -week 21- What are autosomal dominant inheritance disorders? - Correct Answers -Huntington diseases What are autosomal recessive inheritance disorders? - Correct Answers -cystic fibrosis, phenylketonuria, Tay-Sach diseases, sickle cell Hegar's sign - Correct Answers -softening lower uterine segment or isthmus
determine the fluids' ph. Vagina is acidic, amniotic fluid is alkaline this swabs turns blue/deep blue. What is the FERN test used for? - Correct Answers -amniotic applied to slide once dried can detect if amniotic fluid. pg What color will nitrazine paper turn if amniotic fluid is present? - Correct Answers - blue/deep blue What is the pH of normal amniotic fluid? - Correct Answers -between 7.1 to 7.3, alkaline What are the major complications of dystocia? - Correct Answers -Postpartum hemorrhage, secondary to uterine atony or vaginal lacerations, is the major complication to the mother. Transient Erb's or Duchenne's brachial plexus palsies and clavicular or humeral fractures are the most common fetal injuries encountered with shoulder dystocia. What position is used in shoulder dystocia? - Correct Answers -McRobert's maneuver or suprapubic pressure What position is the woman placed in for McRobert;s maneuver? - Correct Answers - knee-chest Does Epidural analgesia does increase the du-ration of the second stage of labor? - Correct Answers -No, it does not What is a local anesthetic agent used for birth? - Correct Answers -lidocaine or bupivacaine What is an opioid analgesic agent used for birth? - Correct Answers -morphine or fentanyl into the lumbar epidural space Where is the epidural space that is typically entered through? - Correct Answers -third and fourth lumbar vertebrae What are complications of epidural? - Correct Answers -nausea and vomiting, hypo- tension, fever, pruritus, intravascular injection, maternal fever, allergic reaction, and respiratory depression. What should the nurse ensuring that the woman avoids to stop hypotension? - Correct Answers -a supine position What are tocolytic drugs? - Correct Answers -slow contractions. They do not typically prevent preterm birth, but they may delay it.
What medication most commonly used include? - Correct Answers -magnesium sulfate(which reduces the muscle's ability to contract), terbutaline,indomethacin and nifedipine (procardia, a calcium channel blocker) What does Magnesium Sulfate do? - Correct Answers -Relaxes uterine muscles to stop irritability and contractions, to arrest uterine contractions for preterm labor. Used for seizure prophylaxis and tx of preeclamptic and eclamptic clients. What should the nurse assess with Magnesium sulfate? - Correct Answers -Assess vital signs, deep tendon reflexes (DTRs) hourly and report any hypotension or DTRs, Monitor LOC, blurred vision, headaches, dizziness and altered LOC. Monitor urine output, Must be 30 ML or more per hour, Respiratory rate should be > 12 BPM, assess for pulmonary edema; Watch for Nausea, Flushing, vomiting, dry mouth, lethargy, blurred vision and headache A patient with headache, hypotension, RR of 9, urine output of 20 ml/hr and blurred vision should be assessed for what? - Correct Answers -magnesium sulfate toxicty What are signs of Toxicity signs for Magnesium Sulfate? - Correct Answers -Decreased level of consciousness, depressed respiration, and DTRs, slurred speech, weakness and respiratory and/or cardiac arrest. What major assessment must the nurse make before giving Terbutaline? - Correct Answers -maternal heart remains less than 130 BPM What complications shoult the nurse look for with Terbutaline? - Correct Answers - Closely assess for jitteriness, flushing, hypotension, nervousness, anxiety, restlessness, nausea and tachycardia. Assess fetus for tachycardia, hypotension, and hypoglycemia. What is Indomethacin? - Correct Answers -inhibits PROSTAGLANDINS which stimulate contractions. What would be a contradindciation fo Indomenthacin? - Correct Answers - Contraindicated in women with peptic ulcer What are the Nursing Implications for Indomenthacin? - Correct Answers -Continual assessment of vital signs, uterine activity, and FHR, administer with food; Be alert for vomiting, nausea, heartburn, rash, prolonged bleeding time, oligohydramnios, and hypertension. What parameters should the nurse look for with procardia? - Correct Answers -Monitor blood pressure hourly and report pulse of >110 bpm What is Nifedipine (Procardia)? - Correct Answers -Blocks calcium movement into the muscles cells, inhibits uterine activity to arrest (stop) preterm labor
What is the longest stage of labor? - Correct Answers -first stage A patient with caput succedanuem should be informed this will naturally go away in how many days? - Correct Answers -3-4 days A patient with cephalohematoma should be informed this will naturally go away in how many days? - Correct Answers -6-8 weeks What is a priority assessment after the membrane breaks? - Correct Answers -fetal heart rate and assessment Signs of intrauterine infection includes - Correct Answers -maternal fever, fetal and maternal tachycardia, foul odor of vaginal discharge, increase WBC count A nurse preforming Leopold's Manuever feels a soft and irregular body shape, the nurse would document this as what presentation? - Correct Answers -vertex (head) as you are feeling the buttocks What is engagement? - Correct Answers -occurs when the greatest transverse diameter of the fetal head in vertex passes through the pelvic inlet (0-station)
- Correct Answers - Why is affected by Turner Syndrome? - Correct Answers -only females What are presumptive signs of pregnancy? - Correct Answers -Fatigue, Breast tenderness, Nausea &vomiting, Amenorrhea, Urinary frequency, Hyper pigmentation of the skin, Fetal movements(quickening), Uterine enlargement, Breast enlargement
- Correct Answers - What type of sign of pregnancy is a pregnancy test? - Correct Answers -probable What education is provided to a patient with varicose veins? - Correct Answers -walk daily, legs avobe heart, don't wear constrictive stockings, support stockings above the knee Which two emtion responses are in the first trimester? - Correct Answers -ambivalance and introversion What emotional response is in the second trimester? - Correct Answers -acceptance What drugs are recommended during pregnancy for the asthmatic pregnat women? - Correct Answers -Three recommended drugs to be used during pregnancy?
budesonide (inhaled corticosteroid), albuterol (short acting beta2 agonist) and salmeterol (long acting beta2 agonist) When can you hear fetal heartbeat? - Correct Answers -12 weeks How to measure contractions duration? - Correct Answers -begin to end of same How to measure frequency? - Correct Answers -begin of one contraction to beginning of next Side effects of Zofran: - Correct Answers -Confusion, dizziness, fever, headache, shortness of breath and weakness What causes Varicose veins IN women? - Correct Answers -Distention, instability, and poor circulation secondary to prolonged standing or sitting and the heavy gravid uterus placing pressure on the pelvic veins What can be used to assess fetal heart beat? - Correct Answers -fetoscope (a modified stethoscope attached to a headpiece) or a Doppler (ultrasound) device, or continuously with an electronic fetal monitor applied externally or internally What is Biophysical Profile score that is normal? - Correct Answers -8 to 10 What is Biophysical Profile score that is suspicious? - Correct Answers -6 or below; further investigation of fetal well-being is needed What is a BPP (Biophysical Profile)? - Correct Answers -Uses a real-time ultrasound and NST to allow assessment of various parameters of fetal well-being
