OB COMPREHENSIVE - glenn copy

What is reproduction?

The biological process by which a fertilized ovum develops into a fetus and eventually results in the birth of a newborn.

What is gravidity?

The total number of pregnancies a woman has had.

What does parity refer to?

The number of pregnancies carried to a viable gestational age.

What physiological changes occur in the uterus during pregnancy?

The uterus enlarges and the endometrium thickens to accommodate fetal growth.

How does the cardiovascular system change during pregnancy?

There is an increase in blood volume and cardiac output to meet the metabolic demands of the mother and fetus.

What respiratory changes occur during pregnancy?

Increased tidal volume and oxygen consumption to provide sufficient oxygen for both mother and baby.

How does renal function change during pregnancy?

Renal blood flow and glomerular filtration rate rise to excrete maternal and fetal waste products.

What gastrointestinal changes may occur during pregnancy?

Slowed motility, which promotes nutrient absorption but may cause constipation and heartburn.

What hormonal changes support pregnancy?

Increased levels of progesterone, estrogen, and human chorionic gonadotropin support uterine growth and maintain the pregnancy.

What are some antepartum complications?

Hypertensive disorders, gestational diabetes, placental problems, hyperemesis gravidarum, preterm labor, and premature rupture of membranes.

What is gestational hypertension?

Blood pressure greater than 140/90 after 20 weeks of pregnancy without proteinuria.

What characterizes preeclampsia?

Hypertension with proteinuria or organ dysfunction, such as elevated liver enzymes or low platelets.

What is eclampsia?

Preeclampsia accompanied by seizures.

What is the management for preeclampsia?

Quiet environment, antihypertensives, magnesium sulfate for seizure prophylaxis, and monitoring.

What is HELLP syndrome?

Hemolysis, Elevated Liver enzymes, Low Platelets, requiring immediate delivery.

What defines preterm labor?

Contractions and cervical change between 20-36 6/7 weeks of pregnancy.

What are risk factors for preterm labor?

Infection, multiple gestation, advanced maternal age, substance use, hypertension, and placental issues.

What is the screening for gestational diabetes?

1 hour glucose tolerance test at 24-28 weeks; if >135-140 mg/dL, a 3-hour test is done.

What are the risks associated with gestational diabetes?

Macrosomia, neonatal hypoglycemia, hyperbilirubinemia, and shoulder dystocia.

What is included in prenatal maternal assessment and care?

Collecting comprehensive health, obstetric, and social history, and assessing for medical conditions and lifestyle factors.

What is a nonstress test?

A test that assesses fetal heart rate patterns in response to fetal movement to determine adequate oxygenation.

What does a biophysical profile combine?

A nonstress test with ultrasound assessment of fetal breathing, movement, tone, and amniotic fluid volume.

What is amniocentesis used for?

To obtain amniotic fluid for genetic testing or to determine fetal lung maturity.

What infections can affect maternal and fetal health during pregnancy?

Parvovirus B19, rubella, cytomegalovirus, toxoplasmosis, and sexually transmitted infections.

What can parvovirus B19 cause during pregnancy?

Fetal anemia, hydrops fetalis, or fetal death, especially if infection occurs before twenty weeks of gestation.

What is Naegele's Rule used for?

To calculate the Estimated Date of Delivery (EDD).

What does GTPAL stand for?

Gravida, Term, Preterm, Abortions, Living children.

What is the routine laboratory test for syphilis?

VDRL/RPR.

What is the visit schedule for prenatal care until 28 weeks?

Monthly visits.

How often should prenatal visits occur from 28 to 36 weeks?

Biweekly.

What assessments are performed at each prenatal visit?

Weight, BP, urine dipstick, fundal height, fetal heart tones, edema, and symptoms review.

When should fetal movement counting (kick counts) begin?

28 weeks

What test is performed at 26-28 weeks for glucose screening?

One hour glucose tolerance test.

What is the purpose of RhoGAM for Rh-negative mothers?

To prevent Rh incompatibility.

What does a positive Group B Streptococcus (GBS) culture require?

Intrapartum antibiotics.

What is the difference between placenta previa and placental abruption?

Previa: painless bright red bleeding; Abruption: painful bleeding with a tender/rigid abdomen.

What is the definition of PPROM?

Preterm Premature Rupture of Membranes before 37 weeks.

What are the warning signs to assess during prenatal care?

Vaginal bleeding, headache, vision changes, contractions.

What is the recommended prenatal vitamin to prevent neural tube defects?

Folic acid.

What are the goals of antepartum care?

Promote health, detect complications early, provide education, and build trust.

What is the schedule for prenatal visits after the initial visit?

Every 4 weeks until 28 weeks, every 2 weeks from 28 to 36 weeks, and weekly from 36 weeks until birth.

What assessments are included in routine maternal assessments?

Vital signs, urine dipstick, fundal height, fetal heart tones, fetal movement, and edema monitoring.

What is the purpose of the Non-Stress Test (NST)?

To monitor fetal heart rate in response to movement.

What does a Biophysical Profile (BPP) assess?

Fetal well-being through movement, tone, breathing, amniotic fluid, and NST.

What indicates fetal tachycardia?

A baseline heart rate above 160 beats per minute.

What are early decelerations associated with?

Fetal head compression, usually benign.

What do late decelerations indicate?

Uteroplacental insufficiency, indicating impaired fetal oxygenation.

What is the normal baseline fetal heart rate range?

110 to 160 beats per minute.

What is moderate variability in fetal heart rate?

Fluctuations of 6 - 25 beats per minute.

What is the expected number of fetal movements in 2 hours?

At least 10 movements.

What are the risks associated with PPROM?

Neonatal sepsis, preterm birth, cord compression.

What nursing actions are indicated for PPROM?

Avoid vaginal exams, monitor for infection, administer antibiotics and betamethasone if indicated.

What are the three categories of fetal heart rate patterns according to NICHD?

Category 1 (normal/reassuring), Category 2 (indeterminate), Category 3 (abnormal)

What characterizes Category 1 fetal heart rate patterns?

Moderate variability with no concerning decelerations

What does Category 3 fetal heart rate patterns indicate?

Absent variability with recurrent decelerations or bradycardia, requiring immediate intervention

What are the four stages of labor?

First Stage (Dilation), Second Stage (Expulsion), Third Stage (Placental Delivery), Fourth Stage (Recovery)

What occurs during the First Stage of labor?

Begins with regular uterine contractions and ends with full cervical dilation at 10 cm, consisting of Latent, Active, and Transition phases.

What happens during the Second Stage of labor?

Begins with full dilation and ends with the birth of the newborn, where the woman actively pushes.

What is the duration of the Third Stage of labor?

Typically lasts 5 to 30 minutes after the birth of the infant until the placenta is expelled.

What is the focus during the Fourth Stage of labor?

Maternal stabilization and monitoring of vital signs, bleeding, and uterine tone.

What is dystocia?

Difficult or prolonged labor due to issues with contractions, fetus, or pelvis.

What is precipitous labor?

Labor and delivery occurring in under 3 hours, increasing risks of maternal lacerations and fetal distress.

What is shoulder dystocia?

When the fetal shoulders become lodged behind the maternal symphysis pubis after the head is delivered.

What is umbilical cord prolapse?

When the cord slips ahead of the presenting part, leading to fetal hypoxia.

What is uterine rupture?

A rare but life-threatening event involving tearing of the uterine wall.

What is amniotic fluid embolism?

Occurs when amniotic fluid enters maternal circulation, causing sudden cardiovascular collapse.

What defines uterine tachysystole?

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

What are late decelerations in fetal heart rate?

Indicate uteroplacental insufficiency and require urgent intervention.

What are variable decelerations caused by?

Often caused by cord compression.

What is bradycardia in fetal heart rate?

A heart rate of less than 110 bpm, which may indicate cord prolapse or maternal hypotension.

What is tachycardia in fetal heart rate?

A heart rate greater than 160 bpm, potentially due to maternal fever or fetal distress.

What are the nursing interventions for late decelerations?

Repositioning, administering oxygen, IV bolus, stopping Pitocin, and considering amnioinfusion.

What is the McRoberts maneuver used for?

To relieve shoulder dystocia by hyperflexing the maternal hips.

What is the definition of breech presentation?

When the fetal buttocks or feet present first instead of the head.

What is the role of nonpharmacologic pain management during labor?

To promote comfort, reduce anxiety, and support patient control during the birth process.

What are common systemic analgesics used during active labor?

Opioids such as fentanyl, butorphanol, and morphine.

What are the risks associated with systemic analgesia?

Maternal sedation, nausea, or respiratory depression.

What is the goal of pain management during labor?

To promote comfort and facilitate labor progress while minimizing stress.

What interventions are needed for umbilical cord prolapse?

Call for help, elevate the presenting part, reposition the patient, administer oxygen, and prepare for emergency C-section.

What can cross the placenta and affect the newborn?

Medications, such as opioids, can cross the placenta and may cause respiratory depression at birth.

What are the nursing responsibilities before administering opioids?

Assess maternal vital signs, pain level, and fetal heart rate (FHR) pattern before and after administration.

Why should naloxone be available during labor?

Naloxone should be available for neonatal reversal in case of opioid-induced respiratory depression.

What is regional analgesia in labor?

Regional analgesia, such as an epidural, is the most common form of pain relief in active labor.

What are the benefits of an epidural?

Excellent pain relief, patient remains awake and alert, and can participate in pushing.

What are the risks associated with epidural analgesia?

Risks include hypotension, decreased fetal heart rate from reduced placental perfusion, urinary retention, and headache.

What nursing interventions are required before placing an epidural?

Baseline vital signs and fetal heart rate should be assessed, and a pre-epidural fluid bolus should be administered to reduce hypotension.

What is a local or pudendal block used for?

It is used for pain relief during the second stage of labor, episiotomy, or operative vaginal delivery.

What is the purpose of general anesthesia in labor?

General anesthesia is reserved for emergencies or when regional anesthesia is contraindicated.

What are the risks of general anesthesia during labor?

Higher risk of maternal aspiration and neonatal respiratory depression, requiring airway management and close monitoring.

What should be included in patient education regarding pain relief options?

Explain pain relief options early, including benefits and risks, and respect the patient's birth plan while maintaining safety.

What are the stages of labor?

First Stage: Onset to 10 cm; Second Stage: 10 cm to delivery; Third Stage: Delivery of placenta; Fourth Stage: Immediate postpartum recovery.

What defines the second stage of labor?

It begins at complete cervical dilation (10 cm) and ends with the birth of the baby.

What are nursing responsibilities during the delivery of the newborn?

Support maternal pushing efforts, position the patient appropriately, monitor fetal heart rate, and prepare for delivery.

What is the Apgar score and when is it assessed?

The Apgar score evaluates appearance, pulse, grimace, activity, and respiration at 1 and 5 minutes after birth.

What are the signs of placental separation?

Signs include sudden gush of blood, lengthening of the umbilical cord, a firm fundus, and increased cramping.

What medications are typically administered to the newborn after delivery?

Vitamin K IM, erythromycin ointment, and hepatitis B vaccine (with consent).

What is the importance of thermoregulation for the newborn?

Thermoregulation is crucial to prevent cold stress; newborns should be dried, warmed, and placed skin-to-skin with the mother.

What should be avoided during the third stage of labor?

Do not apply fundal pressure during the delivery of the placenta.

What is the purpose of fetal electronic monitoring (EFM)?

To assess fetal well-being during labor by tracking fetal heart rate (FHR) and uterine activity.

What is the normal baseline fetal heart rate (FHR)?

110-160 bpm, averaged over 10 minutes.