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ob module 5

Terms in this set (86)

Misoprostol (Cytotec) can cause chemical abortion in early pregnancy and can be used for cervical ripening and induction of labor in late pregnancy.
true
Misoprostol has no adverse effects on the mother or fetus.
NO can cause teratogenic anomalies early in pregnancy and uterine hyperstimulation.
Oxytocin (Pitocin) is used to induce labor or reinforce labor
true
Possible adverse effects of oxytocin include hyperstimulation of the uterus, fetal hypoxia, water intoxication, uterine rupture, cervical lacerations and hypotension.
true
Women who are positive for HIV are encouraged to breast feed
NO can spread the disease to the infant.
Women who have mastitis are encouraged to breast feed.
true
Pregnancy can precipitate violence toward women or escalate it.
true
Human trafficking is the enslavement of people for profit, particularly immigrants.
true
Ectopic pregnancy is caused by STI's
NO - a risk factor.
Ectopic pregnancy presents with a positive pregnancy test and severe abdominal pain.
true
Dystocia can be caused by problems with any of the5 P's; the passageway, passenger, powers, position and psychological response.
true
Gestational trophoblastic disease (GTD, hydatiform mole, molar pregnancy) are neoplastic disorders originating in the uterus
NO - the placenta. Blast tumors are immature cell tumors.
Women with GTD will have positive pregnancy tests and are at risk for loss of pregnancy and developing choriocarcinoma.
true
GTD treatment consists of immediate evacuation of the uterus to ensure complete removal.
true
For women with GTD serial hCG levels are recommended to be measured for at least 6 months.
NO - 1 year minimum.
Women who are diagnosed with GTD need to use a reliable contraceptive to prevent pregnancy for one year.
true
For women with GTD, tissue samples are sent to the laboratory for biopsy to rule out choriocarcinoma. If diagnosed on biopsy, the woman would start cancer treatment.
true
Placenta previa is treated by assessing maternal and fetal compromise, bedrest, hydration, type and cross for 2 units of blood, identify need to RhoGAM, refraining from vaginal examinations, and maternal avoidance of sex or nipple stimulation.
true
Pregnancy induced hypertension (PIH, preecclampsia) is abnormally high blood pressure with spilling of protein in the urine, mild facial and hand edema and weight gain as a severe form after 20 weeks of gestation.
NO - mild form, severe would include headache, hyperreflexia, oliguria, blurred vision, pulmonary edema, 3+ protein in urine, thrombocytopenia, epigastric or RUQ pain, cerebral dysfunction and HELLP syndrome.
HELLP (hemolysis, elevated liver enzymes, low platelets) syndrome requires analysis of liver enzymes, a CBC with differential, clotting studies and blood and urine testing for renal function.
true
Magnesium sulfate causes vasodilation and blockage of neuromuscular transmission to prevent seizures in severe preeclampsia or ecclampsia women.
true
If a client has too much Magnesium Sulfate, they can stop breathing. The antidote is Calcium Gluconate.
true
Hypertension in pregnancy can be treated with hydralzine (Apresoline), labetalol hydrochloride (Normodyne), nifedipine (procardia) or in severe cases sodium nitroprusside.
true
Furosemide (Lasix) is given with caution in pregnancy. Side effects include bradycardia, hypertension and hypervolemia.
1. NO S/E tachycardia, hypotension and hypovolemia.
The health care provider should be contacted if the pregnant woman gains more than one pound per week.
true
Women with Mitral valve prolapse (MVP) are most often asymptomatic but can worsen during pregnancy due to increased cardiac demand / strain.
true
MVP is treated by decreasing cardiac demand and beta blockers. Antibiotics before any surgical procedure may be used prophylactically.
true
Rheumatic heart disease is treated based on symptomatology, cardiac function and administering antibiotics before any surgical procedure.
true
Heart valve stenosis of the mother can be treated with beta blockers, bedrest or limited activity
true
Amniotic fluid emboli results in hypoxia, hypotension and coagulopathy. It is treated with oxygen, IV fluids and vasopressors to maintain hemodynamic stability. Mortality is 86%.
true
1. DIC is treated with PRBC and / or FFP.
true
Pulmonary emboli are result of clots created by hypercoagulation and venous stasis. S/S C/P, SOB, tachypnea, tachycardia, hypotension, decreased O2 Saturation, confusion. Lung scans confirm the diagnosis.
true
PE treatment is oxygen, fluids, vasopressors, artificial ventilation, and anticoagulants.
true
Prevention of emboli includes keeping the pregnant woman well hydrated and active, eliminating smoking and wearing intermittent compression stockings / devices on her legs.
true
Preexisting diabetes in pregnancy does not require an adjustment in diet or insulin requirements.
1. NO - diet needs to be balanced and insulin needs to be adjusted to client need.
Gestational diabetes is pregnancy induced by pregnancy and is expected to resolve once the fetus / neonate is delivered.
true
Carb counting is the best way to manage gestational diabetes.
NO capillary blood sugars and Carb counting with insulin coverage.
Abruptio placenta is a medical emergency for both mother and fetus. Blood typing and cross matching during prenatal visits assists in providing blood during an emergency.
true
Uterine atony is treated with oxytocin and, if still unresponsive or unimproved in tone, a cesarean section.
true
Placenta accreta or retained placental fragments can cause hemorrhage or infection. Manual removal after delivery is an immediate option, if possible.
true
` Preterm labor is at or before 37 weeks gestation. The goal of treatment is to get the mother and fetus as close to term as possible without complications.
true
23Terbutaline (Brethine) is used to prevent preterm labor.
true
One of the causative factors for an asthma attack is stress and pregnancy can be a stressor.
true
Premature rupture of membranes or membranes ruptured for greater than or equal to 24 hours puts the mother and infant at risk for infection.
true
Neonatal jaundice first becomes evident in the sclera
NO - sclera late, face and forehead first.
Bruising at birth, dehydration and prematurity are risk factors for hyperbilirubinemia.
true
Transcutaneous bilirubin is done for infants suspected to having increased bilirubin levels.
true
1. Phototherapy, hydration and bili-blankets are used to decrease bulirubin levels.
true
Infants under phototherapy need to have skin exposure, eyes covered, perineum covered and frequent temperatures to assess for hyperthermia.
true
Infants may drop their temperatures, become dusky or cyanotic or lose muscle tone in response to septic infection.
true
Infant antibiotics are calculated using weight or body surface area to ensure the proper dose.
true
Infants of substance abuse mothers (ISAM) may be put on morphine or methadone to ease their withdrawal from the drugs.
true
. Infants of diabetic mothers can become pale and hypoglycemic at birth.
true
If an infant is diagnosed with a congenital anomaly, other anomalies are also investigated and rule out. Example - cardiac anomaly will investigate cerebral and renal anomalies.
true
Listen to parent conversations about congenital anomalies and teach about when anomalies occur in utero, if necessary.
true
Infants are at risk for infections due to their immature immune, liver and renal systems.
true
An elevated alpha fetoprotein level diagnoses a neural tube defect.
1. NO - indicates but is not diagnostic.
Cleft palate / lip, Tetrology of Fallot, Hypoplastic heart and spina bifida are congenital anomalies.
true
TORCH infections are intrauterine acquired infections
Yes but not only. TORCH infections can be acquired in utero and cause congenital anomalies- herpes can also be acquired at birth and other infections can be acquired at or after birth.
Infants of substance abuse mothers present with irritability, tremors, high pitched cries, poor feeding, hyperreflexia, tachypnea or apnea.
true
Alcohol is a teratogen.
true
Physiologic jaundice levels peak between 72-96 hours of life (3-4 days)
true
Radiant warmers and warmed isolettes are used to prevent cold stress in infants.
true
Cesarean babies may have moist lung sounds up to 24 hours after birth.
true
Perspiration is a method of heat loss for newborns.
NO Evaporation, convection, conduction and radiation, yes but babies do not perspire.
Hearing screening is done to reassure concerned parents.
NO done to prevent or reduce developmental delays, early identification and treatment, help the child communicate and is recommended by the Joint committee on Infant hearing
1. AGA is between the 10th and 90th percentiles on the growth charts.
true
Twenty four hours after birth, the nurse can gauge the neonate's maturity level by assessing the infant's general appearance.
true
Babies need to void after a circumcision before they can go home.
true
To help a baby clear their airway with feeding the nurse would suction the mouth first.
true
1. Babies should have 6-8 wet diapers per day to be well hydrated and effectively breast fed.
true
Having a baby breast feed every 2 hours may help relieve discomfort in a woman with engorged breasts.
true
Colostrum is high in antibodies, protein vitamins and minerals.
true
Babies want to feed when they make sucking motions.
true
Babies should be burped during and after feedings with breast milk or formula as needed.
true
More long term studies need to be done to determine any lasting effects on infants when mothers have taken or are taking illegal drugs.
true
Macrosomic infants need to have blood glucose levels monitored frequently for signs of hypoglycemia.
true
Parents who come to NICU are often intimidated. It helps to introduce yourself as the nurse, and gently encourage the parents to meet their infant explaining the equipment first and then focusing on the newborn.
true
For infants experiencing drug withdrawal, swaddling the infant snugly and holding the infant tightly may be necessary.
true
Infants who are septic may have low Apgars, be tachypneic, and pale. Before birth they may have been exposed to prolonged rupture of membranes and had accelerations with limited variability.
true
Post term babies are at risk for meconium aspiration, hypoglycemia, and dry, cracked skin.
true
Ceftriaxone is the drug of choice for gonorrhea in pregnant women. Tetracycline can cause bone and teeth disorders in the fetus, neonates and young children.
true
Risk factors for breast cancer are family history, early menarche, race, and nulliparity or first pregnancy after age 30.
true
Chlamydia, syphilis and gonorrhea can be treated and cured.
true
Fibrocystic breast changes are benign and can be painful. Reducing caffeine intake and taking NSAIDS (such as ibuprofen) may reduce the cysts and the discomfort.
true
Measles may cause spontaneous abortions (miscarriages) and preterm labor.
true
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