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OB Middle Chapters/Part 1 Flashcards | StudBud
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OB Middle Chapters/Part 1
OB Middle Chapters/Part 1
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Answers
1
Late pregnancy bleeding?
Placenta previa
SAB
Ectopic pregnancy
Abrutio placentae
2
Lungs require ___, a soap-like substance, to lower the ___ ___ of the ___ in the lungs.
Surfactant, surface pressure, alveoli
Pleura, surface pressure, bronchioles
Pleura, surface pressure, alveolar sac
Surfactant, density, bronchioles
3
Which of the following are risk factors for ectopic pregnancy? (*Implanted ovum outside of uterus*)
Use of condoms as birth control
Pelvic inflammatory disease
Use of IUD as birth control
ART (antiretroviral therapy)
4
Methergine is contraindicated with hypertension
False
True
5
S/S of Hydatidiform mole/Molar pregnancy (Complete/No Fetus or Partial/Some Fetal Tissue)
Early preeclampsia
High hcG levels, Excess N/V
Dark "prune colored" vaginal bleeding
Rapid growing uterus
6
G1P0 client at 37 weeks gestation is admitted to ER after vehicular collision. Nurse should monitor closely for:
Placental abruption
Preeclampsia
Placenta previa
Preterm labor
7
A blood glucose of 40-60 mg/dL is within range of a newborn less than 24 hours old
True
False
8
Marginal placenta previa-> You may still be able to deliver baby vaginally.
False
True
9
30 week gestation client w/ limited prenatal care arrives at ED w/ bright red bleeding. Next actions by nurse?
Assess for pain
Ultrasound to confirm placental placement
If placental previa is confirmed, perform sterile vaginal exam
Reassure that this is an expected finding at 30 weeks
10
Placenta previa interventions?
C-Section delivery
Start a bolus IV
Fluid restriction
Assess s/s of hypovolemic shock
11
An L:S ratio between 1.5:1 and 1.9:1 means:
The baby has suffered fetal death.
The baby has a birth defect.
The baby has mature lungs and is ready for delivery.
The baby is at risk for immature lungs/breathing problems.
12
AFP is done at 16-18 weeks.
False
True
13
HIGH levels of alpha-fetoprotein (AFP) may indicate:
Ectopic pregnancy
Neural tube defect
Down syndrome
Molar pregnancy
14
Client reports of "abrupt, sharp, right-sided lower quadrant pain and bright red vaginal bleeding". She has an IUD.
Ectopic pregnancy
Missed abortion
Severe preeclampsia
Hyatidiform mole
15
Which of the following are
matched correctly
regarding assessment of diastolic flow using the Color Doppler?
BLUE-> blood flow toward transducer
RED-> blood flow away
BLUE-> blood flow away
RED-> blood flow toward transducer
16
Which variables are monitored during BPP?
Placental position, Movement, Amniotic fluid volume, Fetal position
Breathing, Movements, Tone, Amniotic fluid volume, Accelerations
Cervix effacement, Movement, Tone, Amniotic fluid volume, Decelerations
Breathing, Fetal Kick count, Umbilical cord position, Urinalysis
17
Miscarriage/Spontaneous abortion (SAB) is any fetal demise that occurs < 20 weeks gestation
False
True
18
Nurse is educating pregnant client regarding an amniocentesis. Which statement is best?
You will lay on your right side during procedure
You should not eat anything for 24 hours prior to the procedure
The test is done to determine gestational age
You should empty your bladder prior to the procedure
19
carboprost (Hemabate) is contraindicated with asthma
True
False
20
Mother experiences precipitous delivery and gives birth to baby in the car. Priority?
Perform first APGAR score of baby
Assess babinski reflex
Determine serum glucose of baby
Establish airway of newborn
21
Complete placenta previa-> Placenta is partially covering cervix
False
True
22
Which of the following are accurate regarding Oligiohydraminos
AFI < 5 cm
IUGR
Fetal Distress
Congenital anomalies
23
CST Negative
-> No decels. (
Normal
finding) THAT IS GOOD.
CST Positive
-> Decels noted. (
Abnormal
finding) THAT IS BAD.
True
False
24
Pregnant client at 32 weeks gestation has placenta previa and is actively bleeding. Which med should be administered?
Methylergonovine
Betamethasone
Nifedipine
Indomethacin
25
What should the nurse ensure is readily available prior to the administration of IV magnesium sulfate?
Betamethasone
Calcium gluconate
Indocin
A sword
26
Which of the following are accurate regarding the amniocentesis procedure?
Preterm labor or infection
Obtains amniotic fluid
Hemorrhage
Direct injury to fetus or fetal death
27
APGAR: Activity, Pulse, Grimace, Appearance, Respiration (Assess 1 min, again at 5, IF SCORE IS <7 assess at 10 min)
True
False
28
An L:S ratio of more than 2:1 means:
The baby has suffered fetal death.
The baby has a birth defect.
The baby is at risk for immature lungs/breathing problems.
The baby has mature lungs and is ready for delivery.
29
L:S ratio (Lecithin–sphingomyelin ratio) is a:
Test of placental tissue to assess for birth defects
Test of fetal amniotic fluid to assess for birth defects
Test of placental tissue to assess for fetal lung immaturity
Test of fetal amniotic fluid to assess for fetal lung immaturity
30
What moms might need this done? (*Color Doppler*)
History of problems with perfusion
IUGR (Baby at risk for low birth weight)
Hypertension
Chronic DM
31
You will have pain with placental abruption. You will not have pain with placenta previa.
False
True
32
Nursing interventions for Incompetent cervix? (*Premature dilation of cervix... Recurrent SABS*)
Perform CERCLAGE (Cervix is sutured closed until birth)
Restricted from sexual relations
Determine psych needs, frequently assess emotional status
Prophylactic antibiotics and Rhogam administration for Rh – mother
33
32 week pregnant client is scheduled for amniocentesis. Nurse should evaluate which test to assess fetal lung maturity?
Lethicin/ sphingomyelin (L:S ratio)
Alfa-fetoprotein (AFP)
Kleihauer-Betke test
Non stress test (NST)
34
A bilirubin of 2- 6 mg/dL is within range of a newborn less than 24 hours old
True
False
35
Normal fetal kick count: 6-10 kicks per min. You can utilize
Vibro-Acoustic stimulation
to help initiate
fetal activity
.
False
True
36
Client is contracting less than every 2 min lasting up to 60-90 seconds. Is this normal?
No. Hyperstimulation of uterus. TOOND.
No. Hyperstimulation of uterus. Stop pitcocin! TOONDA! Give terbutaline.
Yes. Client is in active labor. Offer pain relief/palliative measures.
Yes. Client is in transition. Monitor contractions and FHR.
37
Client diagnosed with marginal abruption placentae. Nurse is aware that the following findings are risk factors:
Blunt abdominal trauma
Cocaine use
Maternal age
Cigarette smoking
38
Primipara mother only interacts with baby when it cries. Next interventions by nurse
Assess for previous experience caring for babies
Judge her harshly
Offer education
Call DCFS
39
Fetal non-stress test (NST) normal findings: Reactive (Reassuring) >2 accels, 15 bpm > secs in 20 mins
True
False
40
EMPTY BLADDER BEFORE AMNIOCENTESIS PROCEDURE TO PREVENT INJURY!
False
True
41
Nurse is educating pregnant client regarding an acoustic vibration device. Which statement is best?
It stimulates uterine contractions
It lulls the fetus to sleep
It awakens a sleeping fetus
It decreases the incidence of uterine contractions
42
What test is done in the first trimester and requires a sample of placental tissue?
CVS
CST
Amniocentesis
NST
43
S/S of ectopic pregnancy? (*Implanted ovum outside of uterus*)
Vaginal bleeding “spotting”
Cullen’s sign- Abdominal bruising around umbilicus
Missed period, + pregnancy test
Abdominal pain
44
Routine prenatal assessment: Measure fundal height. If fundal height is small for gestational age, do a doppler.
False
True
45
Educate client to NOT VOID prior to ultrasound. Must have full bladder during external ultrasound.
True
False
46
You should encourage deep breathing and leg exercises for a client who had a C-section
True
False
47
After an amniocentesis, the client should notify HCP it they experience fever or leaking of fluid
False
True
48
Fetal non-stress test (NST): Moderate variability is good. Done in 3
rd
Trimester. More frequently for high-risk clients.
False
True
49
2
nd
Trimester amniocentesis is to confirm fetal abnormalities. 3
rd
Trimester amniocentesis is to confirm L:S ratio.
False
True
50
Nursing interventions for SABs?
Use of name for infant
Grief assessment and mementos for bereavement
Preparation, Counseling, Support system, Grief support group
Encourage viewing, holding, and then thoughtful separating from baby
51
Postpartum client's uterus is soft/boggy. Next action by nurse?
Administer oxytocin
Administer vitamin K
Continuous massage of fundus
Bop it. Twist it. Pull it.
52
Client has partial placenta previa. Best method of delivery?
Vaginal delivery
DO NOT DELIVER. Administer tocolytics.
Cesarean delivery (C-section)
Operative vaginal delivery
53
What are benefits of CVS over amniocentesis? What are benefits of amniocentesis over CVS?
There is higher risk to the fetus with CVS than w/ amniocentesis
CVS has earlier diagnosis (10-12 weeks), rapid results
There is higher risk to the fetus with amniocentesis than w/ CVS
Amniocentesis has earlier diagnosis (10-12 weeks), rapid results
54
Treatment of Hydatidiform mole/Molar pregnancy?
Emotional care, educate to avoid pregnancy x 1 year
D&C
Serum BhCH levels q 2 weeks
Oral contraceptives
55
LOW levels of alpha-fetoprotein (AFP) may indicate:
Down syndrome
Ectopic pregnancy
Neural tube defect
Molar pregnancy
56
Always know if mother is Rh - or Rh + prior to amniocentesis. If Rh -, she will need Rhogam after the procedure.
False
True
57
Bladder must be full prior to amniocentesis procedure.
False
True
58
Which of the following will you determine during the
first trimester
of pregnancy?
Confirmation of pregnancy
Assess viability of fetus
Assess location of fetus
LMP to deterime EDD
59
Client at 4 months gestation reports constant n/v and prune colored discharge. Fundal height longer than expected.
Preterm labor
Threatened abortion
Hydatidiform mole
Hyperemesis gravidarum
60
Non-reactive NST is observed. Next action?
Encourage ambulation and then resume monitoring
Notify HCP and administer pitocin
Utilize vibroacoustic device
Reschedule NST
61
Which of the following are potential complications of an amniocentesis?
Miscarriage
Rh sensitization
Infection
Fetal injury
62
Which of the following is accurate regarding Biophysical profile (BPP) score?
Anything less than a score of 12 is not good
Anything less than a score of 8 is not good
Anything less than a score of 10 is not good
Anything less than a score of 9 is not good
63
G2P0 client comes in for 6 week ultrasound. What type of ultrasound will be used and what will be assessed?
Color doppler. Diastolic flow.
3-D ultrasound. Width, height, and depth of the fetus.
Endoscopic ultrasound. Location of fetus, Age, markers.
Transvaginal ultrasound. Location/ # of fetus(es), Age/EDD, markers.
64
Which of the following is accurate regarding Abruptio placentae?(*prematurely detached placenta*)
S/SX Sudden onset, severe pain, rigid abdomen,bleeding, signs of shock
Immediate delivery via C-section
Blunt external abdominal trauma and previous abruption are risk factors
Maternal HTN and cocaine use are risk factors
65
Clients with an ectopic pregnancy commonly present with unilateral pain
True
False
66
An alpha-fetoprotein (AFP) test is a
____
for pregnant women. If levels are out of normal range, this may indicate ____.
Placental biopsy, respiratory depression
Amniotic fluid test, hyperbilirubinemia
Blood test, birth defect
Urine test, hypoglycemia
67
ASSESS: Confirm presence/location of fetus. Confirm viability, EDD. Ultrasound. Beta HCG. Progesterone. CVS.
During Third trimester (29-40 weeks)
During First trimester (1-12 weeks)
During Second trimester (13-28 weeks)
68
Baby is floppy. Pulse 120. No grimace. Acrocyanosis. Irregular cry. APGAR score?
9
7
4
6
69
No variability, minimal or absent variability: You determine fetal condition is not stable. Next interventions?
Feed client
Reassess
Position changes
Encourage fluids, give orange juice
70
Gestational trophoblastic disease (Molar pregnancy) -> Primary goal is to remove w/ D&C, evacuate uterus.
False
True
71
The purpose of the doppler ultrasound blood flow assessment is to identify problems in diastolic flow.
True
False
72
G2P0 client at 41 weeks gestation had an NST. Which of the following should be identified as a reactive test?
Maternal HR accels to 130 bpm for > 20 sec
Baseline 110 bpm, 2 bpm variability, no fetal movement
Baseline 160 bpm and a few drops of FHR after contractions
Baseline 125 bpm, 2 accels of 15 bpm, lasts > 15 sec
73
Which of the following are accurate regarding Polyhydraminos
Fetal hydrops or neural tube defects
AFI > 25 cm
Multiples
Obstruction of GI tract
74
Which of the following are indications for a CST?
Decreased fetal movement
IUGR
Postmaturity
Prematurity
75
36 year old client is 16 weeks pregnant. MSAFP came back low. What could this mean? What interventions should be done?
Could be neural tube defect.
Ultrasound to look for abnormalities. Amniocentesis to confirm.
Could be down syndrome, trisomy 21, or normal fetus w/ overestimated age.
D&C.
76
NST abnormal findings: Non-Reactive (Non-Reassuring) 0 accels
True
False
77
Client w/ Hx of HTN. At 20 week appointment, client's fundus is found 15 cm above the symphysis pubis. Is this normal?
Yes. Baby is normal size for this gestational age.
No. By 20 weeks, fundus should be at umbilicus (20 cm). IUGR. Use doppler.
Yes. HTN will decrease perfusion to baby. This is expected. Will resolve.
No. By 20 weeks, fundus should be two fingerbreadths above umbilicus. LGA.
78
Which of the following factors can influence the health of a pregnancy?
Social status, economics, cultural beliefs
Previous births, abortions, etc
Diabetes, hypertension
Depression, cardiomyopathy
79
beta hCG (β-hCG) measures the amount of hCG present in the blood. It may be used to CONFIRM pregnancy.
False
True
80
Fetal Movement. Nonstress test. Vibroacoustic. Stimulation. Biophysical Profile. Contraction. Stress Test.
During First trimester (1-12 weeks)
During Second trimester (13-28 weeks)
During Third trimester (29-40 weeks)
81
Nurse is reviewing client's BPP. Nurse should expect which of the following variables to be included in this test?
Fetal tone
Amniotic fluid volume
Fetal position
Fetal breathing movement
82
CST is contraindicated with which of the following?
Ectopic pregnancy
Placenta previa
Molar pregnancy
Preeclampsia
83
HCP performs this at ___ with ultrasound to guide the ___ to prevent direct injury to fetus. Place in ___ position.
bedside, needle, supine
OR, needle, supine
bedside, ultrasound wand, prone
OR, needle, side-lying
84
False pregnancy can occur with progesterone increases.
True
False
85
Which of the following are accurate regarding the Chorionic Villi Sampling (CVS) procedure?
Technique for genetic studies
Earlier diagnosis, rapid results, increased risk of abortion
Performed between 10-13 weeks of gestation
Obtains tissue specimen from fetal portion of placenta
86
Biophysical profile (BPP) will help to determine:
Amniotic fluid index
Fetal movement
Oxygenation of fetus
Ensure fetal condition is stable
87
Baby is placed on cold scale to be weighed, what type of heat loss?
Evaporation
Conduction
Radiation
Convection
88
Nurse is caring for a client with ruptured ectopic pregnancy. Which of the following would be seen with this condition?
Serum progesterone greater than the expected reference range
Report of severe shoulder pain
Transvaginal ultrasound indicating a fetus in the uterus
No alteration in menses
89
With ruptured ectopic pregnancy, you will likely observe LOW serum progesterone and referred pain.
False
True
90
Monitor age/growth. Ultrasound. AFP. Amniocentesis. PUBS.
During Third trimester (29-40 weeks)
During First trimester (1-12 weeks)
During Second trimester (13-28 weeks)
91
Client's with a previous history of fetal demise do not need to be monitored more frequently. (*BPP*)
True
False
