OB / Mother & Baby ULTRA NCLEX Mastery Flashcards

Comprehensive vocabulary flashcards covering OB foundations, prenatal care, complications, labor/delivery monitoring, medications, and newborn assessment based on the NCLEX mastery study guide.

NCLEX Priority Rule for OB

Stabilize the birthing parent first because fetal oxygenation depends on maternal oxygenation and uteroplacental perfusion.

First Trimester

Weeks $1$ through $13$; focused on organ formation, pregnancy confirmation, and miscarriage concerns.

Second Trimester

Weeks $14$ through $26$; focused on fetal movement, anatomy scans, and glucose screening at $24$ to $28$ weeks.

Third Trimester

Week $27$ to term; focused on GBS screening, preeclampsia signs, and labor precautions.

hCG (Human Chorionic Gonadotropin)

Maintains the corpus luteum early so progesterone continues; detected in pregnancy tests and associated with nausea/vomiting.

Progesterone

Relaxes smooth muscle and keeps the uterus relaxed; causes constipation, heartburn, and urinary stasis.

Human Placental Lactogen (hPL)

Makes maternal cells more insulin resistant so glucose is available for the fetus; increases gestational diabetes risk.

Relaxin

Softens the cervix and relaxes pelvic ligaments; results in pelvic pressure, back pain, and altered gait.

Umbilical Vein

One vessel that carries oxygenated blood from the placenta to the fetus.

Umbilical Arteries

Two vessels that carry deoxygenated blood and waste from the fetus to the placenta.

Embryonic Period

Weeks $0$ to $8$; the time of organogenesis and highest risk from teratogens.

Presumptive Signs

Subjective signs felt by the client (e.g., amenorrhea, nausea, fatigue, quickening) that cannot confirm pregnancy.

Probable Signs

Objective signs observed by the examiner (e.g., Chadwick sign, Goodell sign, Hegar sign, positive pregnancy test).

Positive Signs

Signs that prove a fetus is present: fetal heartbeat by Doppler, ultrasound visualization, or fetal movement palpated by the examiner.

Gravida

The total number of pregnancies, including the current one.

Para

The number of pregnancies that reached viability/birth, regardless of the number of babies (e.g., twins count as one event).

Naegele Rule

Calculates the Estimated Date of Birth (EDB) by subtracting $3$ months, adding $7$ days, and adding $1$ year to the first day of the last menstrual period.

Normal Fundal Height

From about $20$ to $36$ weeks, the measurement in centimeters roughly equals the gestational weeks.

Severe BP Elevation Range

Systolic pressure $\ge 160$ or diastolic pressure $\ge 110$; considered urgent.

Supine Hypotension

Occurs when the uterus compresses the inferior vena cava; management is to turn the client to a lateral side, especially the left.

Rh Sensitivity Nursing Concideration

Rh-negative unsensitized clients receive Rh immune globulin at $28$ weeks and within $72$ hours postpartum if the newborn is Rh-positive.

Universal GBS Screening

Vaginal-rectal culture performed at $36\,0/7$ to $37\,6/7$ weeks; positive results require intrapartum antibiotics.

Magnesium Sulfate Toxicity Warning

Absent reflexes, respiratory rate less than $12/min$, urine output less than $30\,mL/hr$, and decreased level of consciousness.

Hyperemesis Gravidarum

Severe nausea/vomiting causing dehydration, electrolyte imbalance, weight loss, and ketonuria.

HELLP Syndrome

A severe preeclampsia variant consisting of Hemolysis, Elevated Liver enzymes, and Low Platelets.

Placenta Previa

Placenta covers or is near the cervical os, presenting as painless bright red bleeding after $20$ weeks; vaginal exams are contraindicated.

Placental Abruption

Premature separation of the placenta presenting as painful bleeding and a rigid/tender uterus.

Calcium Gluconate

The medical antidote for magnesium sulfate toxicity.

Methylergonovine

Used for postpartum hemorrhage due to uterine atony; contraindicated in patients with hypertension/preeclampsia.

Carboprost (Hemabate)

Used for postpartum hemorrhage; contraindicated in patients with asthma due to risk of bronchospasm.

Betamethasone

An antenatal corticosteroid used to promote fetal lung maturity when preterm birth is likely.

Variable Decelerations

Abrupt V/U/W shaped fetal heart rate drops caused by cord compression; nursing management is maternal repositioning.

Early Decelerations

Fetal heart rate drops that mirror contractions, caused by head compression; management is to identify labor progress.

Late Decelerations

Fetal heart rate drops that begin after the contraction peak, caused by placental insufficiency; requires executing resuscitation interventions.

Tachysystole

More than $5$ contractions in $10$ minutes averaged over $30$ minutes.

Umbilical Cord Prolapse

A fetal emergency where the nurse must lift the presenting part off the cord with a gloved hand and place the client in knee-chest or Trendelenburg.

Shoulder Dystocia Management

Apply McRoberts position (legs back) and suprapubic pressure; fundal pressure is never performed.

BUBBLE-HE

Postpartum assessment: Breasts, Uterus, Bladder, Bowel, Lochia, Episiotomy, Homan (clots), and Emotional status.

Uterine Atony (Boggy Uterus)

The primary cause of postpartum hemorrhage; priority action is fundal massage.

Newborn Vital Signs (Normal)

HR: $110\text{ to }160/min$; RR: $30\text{ to }60/min$; Axillary Temp: $97.7\text{ to }99.5\,^{\circ}F$ ($36.5\text{ to }37.5\,^{\circ}C$).

Cold Stress (Newborn)

Heat loss that forces the newborn to burn glucose and oxygen, potentially causing hypoglycemia and respiratory distress.

Vitamin K IM

Injected to prevent hemorrhagic disease as newborns lack the gut bacteria to produce it at birth.

Neonatal Abstinence Syndrome (NAS)

Withdrawal from intrauterine substance exposure; signs include high-pitched cry, tremors, and irritability.

Tdap Vaccine

Recommended during each pregnancy, ideally between $27$ and $36$ weeks, to protect the newborn from pertussis.