Ob Exam 2

Front 1

Ductus venosus

Back 1

Vein that goes from the umbilical cord to the inferior vena cava. Bypasses the liver.

Front 2

Ductus arteriosus

Back 2

Shortcut from pulmonary artery to aorta. Allows blood to bypass the lungs.

Front 3

Foramen ovale

Back 3

Shortcut from R atrium to L atrium.

Front 4

What do the arteries in the umbilical cord carry? Oxygenated or de-oxygenated blood?

Back 4

De-oxygenated.

Front 5

Fetal epithelial cells in the alveoli differentiate into what two types

Back 5

Type 1 - secretory until term. Then switch to sodium absorbing cells.

Type 2 - synthesize and store surfactant, peaking after 35 weeks.

Front 6

How do Type I cells in the alveoli help lung function after birth

Back 6

They switch to sodium absorbing cells. Water follows the sodium, causing water to be taken up out of the lungs and brought into the interstitial space.

Front 7

Three factors that instigate the baby's first breath

Back 7

1. Cold air.

2. Negative intrathoracic pressure at expulsion.

3. Asphyxia from squeezing during birth stimulates respiratory center.

Front 8

Estimates are that Csection should be necessary in ___% of cases

Back 8

15

Front 9

Time that it takes the foramen ovale to close functionally after birth

Back 9

1-2 hours

Front 10

Time that it takes the foramen ovale to close permanently after birth

Back 10

6 months

Front 11

Time that it takes the ductus arteriosisa to close functionally after birth

Back 11

15 hours

Front 12

Time that it takes the ductus arteriosus to close permanently after birth

Back 12

3 weeks

Front 13

Newborn respiration normal range

Back 13

40-60 /min

Front 14

Apnea for a newborn is no breathing for greater than ___________

Back 14

20 seconds

Front 15

How to differentiate TTN (transient tachypnea of newborn) from RDS?

Back 15

TTN is short lived and doesn't get worse. RDS will progressively worsen and takes longer to resolve.

Front 16

Apgar scoring should be done at __ and __ minutes after birth

Back 16

1 and 5

Front 17

If apgar score is less than 7, scoring should continue every ___ minutes

Back 17

5

Front 18

A slow, steady dribble of lochial flow postpartum is likely indicative of what

Back 18

a laceration somewhere along the passage

Front 19

What drugs are often used postpartum to stimulate uterine contractions and decrease hemorrhage?

Back 19

Pitocin most often. Cytotec, Methergine, Hemabate.

Front 20

Methergine

Back 20

Used to stop hemorrhage postpartum. Causes strong uterine contraction, which can be quite painful.

Front 21

Hemorrhage after 24 hours is most commonly causes by what

Back 21

Infection or retained placenta

Front 22

Concern for hemorrhage exists postpartum when a single pad is saturated within ___ minutes

Back 22

10-15

Front 23

What does Rhogam do

Back 23

turn off the mom's production of antibodies to fetus's RBCs

Front 24

Coombs test

Back 24

Used to detect Rh antibodies. Direct tests the fetus. Indirect tests the mother.

Front 25

What can be used to determine how much Rhogam will be needed

Back 25

Coombs test

Front 26

With what moms is Rhogam given?

Back 26

All Rh- moms. Given at 28 weeks prophylactically.

Also given with any invasive or traumatic event.

Front 27

Normal range for fetal heart rate

Back 27

110-160

Front 28

POISON

Back 28

Position (reposition)

O2 (8-10 L)

IV fluids

Stop pitocin

Off contractions (can use terbutaline)

Notify doc

Front 29

If the patient is taken off of their pitocin drip, how long before you'll see reduction in contractions?

Back 29

around 10 minutes

Front 30

What's a more correct series of steps for POISON

Back 30

SOIPON

Front 31

Should you run pitocin if you are unable to assess contractions?

Back 31

Nope

Front 32

Maternal hypotension will often cause what with the FHR?

Back 32

Bradycardia

Front 33

Maternal hypothermia will often cause what with the FHR?

Back 33

Bradycardia

Front 34

Maternal fever will often cause what with the FHR?

Back 34

Tachycardia

Front 35

Recurrent decelerations

Back 35

Occur with equal to or greater than 50% of contractions.

Front 36

Variable decelerations

Back 36

Occur due to cord getting blocked

Front 37

Early decelerations

Back 37

Due to head being squeezed during contractions. Occur along with contraction.

Front 38

Late deceleration.

Back 38

Due to placental problem. Occur later than contraction.

Front 39

Mnemonic for types of decelerations

Back 39

VEAL CHOP

Variable - Cord

Early - Head

Acceleration - OK

Late - Placenta

Front 40

TPAL

Back 40

Term births.

Premature births.

Abortions.

Living children.

Front 41

In TPAL, what is considered to be "term"

Back 41

Fetus makes it to 37 weeks

Front 42

Babies can be expected to lose _____% of their birth weight in the first 24 hours

Back 42

5-7

Front 43

After initially losing some weight in the first day following birth, babies should be back to their birth weight by ____________

Back 43

2 weeks

Front 44

A baby's weight should double in ______________ after birth

Back 44

5 months

Front 45

Average BP of a newborn

Back 45

72/47. Lower in preterm babies.

Front 46

Normal Hgb for a neonate

Back 46

15-20 g/dl

Front 47

How does the baby get IgG

Back 47

From mother during pregnancy

Front 48

How does the baby get IgA

Back 48

through breast milk

Front 49

How does the baby get IgM

Back 49

The baby makes its own