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OB Final review 2009
| Question | Answer |
|---|---|
| A nurse is working in a OB clinic and wants to implement an intervention to help with lowering infant mortality among her patients. How would she accomplish this? | Stress the importance of regular prenatal care |
| A nurse practitioner cares for many patients that are of lower SES. She is assessing when her patients seek health care. A patient statement that would reflect how they seek health care would be: | They go to ER, their actions are reactive, not preventative. |
| Katie is a multigravida, pregnant for the third time, (3-1-0-1-2). She is currently 18 weeks pregnant and her health has been good, as determined during regular prenatal visit. Explain the 5-digit system used to describe Kate's obstetric history | GTPAL G3T1P0A1L2 |
| Katie’s states her last menstrual period was November 13, 2008. Using Nagele’s Rule, what is her EDC? | -3 +7 +1 8/20/09 |
| Katie is in for her visit and asks why she has to urinate in a cup every time. The nurse practitioner’s response would be: | Check pts sugar and for protein |
| What are the normal ranges for protein and glucose? | trace or +1 proteins 300mg/24 hours and no sugars |
| Outline the components of the history/interview for routine prenatal visits. What systems would the practitioner want to know about and Why? | Last Menstrual period, OB history, usage of drugs and alcohol, nutrition, and urinary system. |
| The Ductus Arterious | bypasses lungs to liver |
| The Ductus Venous | blood goes to inferior vena cava |
| The Foramen ovale | Blood from fetus legs and abd go to right atrium to the left atrium |
| Healthy family characteristics | A good support system, There is agreement about parenting strategies, Open communication. |
| What to do about Nausea and Vomiting | Crackers in the AM before getting out of bed, 6 small meals, fluid separate from food, don’t lie down after eating |
| What to make sure about urinary frequency | no painful urination |
| What to do about heartburn | tums, avoid spicy foods |
| What to do about leg cramps | increase your calcium intake, dorsiflex the foot |
| What you need to know about breathing during pregnancy | Don’t over do it! Nasal congestion is common, nosebleeds are ok, accompanied by a headache is not ok |
| What to do about backaches | pelvic rock, or the “cat” maneuver |
| What to do about constipation | push the fluids and the fiber |
| Where do you get folic acids? | Green Leafy vegs |
| Katie is 38 y.o. and her midwife asks her if she wants to have what test? | CVS 6-8weeks Amnio 14-16 weeks |
| Constant lump in throat is? | Heartburn |
| CST= | contraction stress test |
| You have a CST when? | after a negative NST |
| A positive CST is what? | late decells, that’s bad |
| First Stage of Labor is | where cervical effacement and dilation occur. Starts with the onset of true labor and ends with complete dilatation. |
| Second stage of labor is | begins when the patient is 10cm. |
| Third stage of labor is | the separation of the placenta from the uterine wall, uterus becomes globular, and cord lengthens, then expulsion. |
| Early Phase is | up to 3 cm, mother is sociable and excited |
| Active phase is | cervix is 4-7cm effacement is cervix is 100% serious and inward, discomfort increases |
| Transition phase | cervix goes from 8-10cm and fetus descends further. Urge to push, leg tremors, nausea and vomiting are common, woman may be irritable and loose control |
| Diet allowed during labor | clear liquids maybe a soft diet |
| Signs and symptoms that would make the nurse not give the patient her pain medication? | Feeling like there is pressure, needs to be checked |
| How would the nurse assess the patients pushing? | high fowlers, open glottis, push at the urge. |
| What should you check if there is increased bleeding after delivery? | Uterine atony, uterus location, if it’s to the right look at bladder distention. |
| APGAR scoring | heart rate, respiration rate, tone, reflex, color |
| Katie’s Blood Type is O neg and Joshua’s Blood type is B neg. What condition does this place Joshua at risk for? | ABO incompatibility, and hemolytic disease |
| What complications can occur when hemolytic disease is not controlled? | Karitonitus of the brain. |
| The taking in phase is | all about her and the birth |
| The taking hold phase is | learning |
| The letting go phase is | letting go of the life before the baby goes |
| The Blues is | normal. Found in the first 7-10 days crying, but still caring for self |
| PP Depression | more than 10 days, needs meds |
| Bubble Heart- | Breast, Uterus, Bladder, Bowel, Lochia, Epis, Homans, Emotion, Attach, Reflexes, Teaching |
| Breast assessment | not breast feeding- need to have a tight bra on, no stimulation. Breastfeeding5-7 days milk comes in, check for mastitis (red warm flu like) |
| Uterus | - location in relation of umbilicus, down one finger breath a day, if lochia increases or smells rotten go to Dr. |
| Bladder | needs to void every couple hours, know s/s of uti |
| Bowel | look for constipation |
| Lochia | look for decreasing, no clots |
| Janice is AFA who is 20 weeks gestation and has sickle cell anemia. What would the care during the pregnancy and postpartum involve? | thicker blood, more blood, stay hydrated, prevent clots in legs, wear Ted hose, and elevate feet |
| Pre-conceptual counseling is very important with Type I diabetics for what reason? | prevent malformations of neurotubes and cardiac |
| Signs and symptoms of cardiac decomposition | Edema weak pulses, irregular pulses, sob, crackels |
| OB emergency situations (10)- | hemorrhage/abruption. Lates, cord prolapse, uterine rupture, eclamptic seizures, Hellp syndrom, DIC, bradycardia |
| CBC with diff results are what with PIH | Low Platlets |
Created by:
jwingett@gmail.com
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