Ob Test 2/ Amy

Front 1

Where should fundus be 1 hour after delivery:
Day 2:

Back 1

Umbilicus-
2 cm below umbilcus, should correspond with postpartum days.

Front 2

At which day should it return to normal/symphysis pubis:

Back 2

Post partum day 9

Front 3

Postion of uterus is called:

Back 3

Involution

Front 4

Who is at more of a risk to have afterpains:

Back 4

Multipara's, increases with breast feeding, multifetal gestation or large baby. (overextension of uterus)

Front 5

Muscles of abdomen may seperate( diastasis recti abdominis) can cause loose skin:

Back 5

Mom will have to rebuild muscle tone through exercise.

Front 6

Mom will lose weight postpartum related to:

Back 6

Postpartum diuresis, caused by decrease in estogen levels, aids in ridding body of excess fluid NORMAL finding

Front 7

For engorgement of non-breast feeding mother:

Back 7

Ice to breasts, fitted bra 24 hours a day and no nipple stimulation. Avoid warm showers on breast-

Front 8

Mother postpartum may have what VS:

Back 8

Normal BP or Orthostatic hypotension OR Gest hypertension. Varies on person. Assess frequently,note changes.

Front 9

Why does the mom have fever post-partum:

Back 9

Dehydration. Should not last longer than 24 hours and should not be greater than 100.4.

Front 10

Hemabate, Cytotec, Methergine and Pitocfin are all what kind of drugs:

Back 10

ERGOT- contraindicated with Hypertension- is vasoconstrictive.

Front 11

Baby has decreased muscle tone, tremors and is jittery test him for what:

Back 11

Hypoglycemia

Front 12

Treat hypoglycemia with baby:

Back 12

Breastfeed asap OR D5W if baby is lethargic give IV( baby could aspirate)

Front 13

When mom has IDM, baby is more prone to:

Back 13

birth trauma because of large size of baby-internal organs may be enlarged as well.

Front 14

Baby that is born with fetal alcohol syndrome, what can be done to decrease stimuli:

Back 14

Swaddle, dark room, quiet area.

Front 15

These infections are caused by maternal virus/infection contracted during pregnancy:

Back 15

TORCH
Toxoplasmosis
Hep,syphylis, gonorrhea,varicella
CMV
Herpes Simplex 2

Front 16

This is caused by sushi and cat litter exposure:
S/S:

Back 16

Toxoplasmosis
Blindness, deafness,severely retarted,convulsions, coma and death.

Front 17

GC can cause:

Back 17

Blindness and microcephaly

Front 18

Most frequent virus that affects teenagers that can cause hydrocephaly,CP,mental retardation:

Back 18

CMV

Front 19

If mom has open lesions of HSV 2 what will have to happen:

Back 19

C-section

Front 20

Can HSV cross placenta:

Back 20

Yes, it can! It can cause congential anomalies or miscarriage in 1st trimester
Late tri it can cause pre term labor, SGA and infection

Front 21

With this STD men will have urethritis:
Women will have:

Back 21

Chlamydia
Cervicitis

Front 22

Mostly asymptomatic and is transmitted by contact, chlamydia is dangerous because:

Back 22

It spreads in an ascending fashion if not treated.

Front 23

Where can chlamydia spread to:

Back 23

Rectum, lining of eye, throat. Increases risk for cervical cancer and epididmitis

Front 24

ERGOT medications have to be closely monitored with pt's that have:

Back 24

HTN

Front 25

If baby is a hyperstimulated baby from addict mother, what intervention can nurse provide:

Back 25

Swaddle and do not stimulate.

Front 26

What are ERGOT medications:

Back 26

Hemobate/Methergine/Cytotec/Pitocin

Front 27

What is the main reason mother had postpartum temp:

Back 27

Dehydration-

Front 28

How long must mother wait to breastfeed after alcohol:

Back 28

2 hours

Front 29

What are risk factors for DVT and BCP:

Back 29

Over 35, smoking, overweight

Front 30

How do you apply a condom:

Back 30

Roll it down over erect penis, shaft to bottom, leave space /bubble at end. Check expiration/no heat/latex allergy

Front 31

With a vasectomy, what is post op instructions for care and follow up:

Back 31

Ice pack to scrotal area, must have 2 sperm samples with no motile sperm prior to relying on procedure for birthcontrol. Use alternate bc for 10-12 weeks.

Front 32

What iud does not have hormones in it, it causes egg not to implant in uterus:

Back 32

Copper IUD

Front 33

When should mother void after delivery:

Back 33

Kirby 3-4 hours
Book within 6-8 hours

Front 34

Subinvolution can be caused by:
S/S:

Back 34

Placental fragments, pelvic infection
Prolonged lochial discharge,larger than normal uterus, hemorrhage.

Front 35

Best way to prevent inversion of uterus:

Back 35

Prevention- do not pull on cord until placenta has seperated.
Uterine inversion is a medical emergency.

Front 36

If placental fragments cannot be removed manually,what will pt have done:

Back 36

D and C, possible hysterectomy

Front 37

Most common post partum infection:

Back 37

Endometritis, Fever, nausea,tachy,chills, pelvic pain, fould smelling profuse lochia.

Front 38

For mastitis treat:

Back 38

Continue breastfeeding unless infection, then pump and dump. Warm compresses. Analgesics. Keep nipples moist with breast milk.

Front 39

For engorgment of non-breastfeeding mother:

Back 39

Cool compresses, ICE avoid nipple stimulation and warm showers on breasts.

Front 40

Pt's pulse after delivery may be :

Back 40

Brady which is normal, if elevated above baseline suspect hemorrhage.

Front 41

Post partum in first 24 hours:

Late hemorrahge is considered:

Back 41

Acute hemorrhage within 24 hrs.
After 24 hours up to 6 weeks.

Front 42

Severe pain, despite analgesia and discolored bulging mass:

Back 42

Perineal hematoma- evacuate clot

Front 43

Lochia rubra is and lasts:

Back 43

dk red, fleshy, musty and last 1-3 days( per Kirby)

Front 44

This is a pink/brown discharge that is odorless and lasts 4-10 days:

Back 44

Lochia serosa

Front 45

Stale odor, yellow or white discharge :

Back 45

Lochia alba, last 11-21 days but can last 6 weeks.

Front 46

Scant drainage:
Lochia light:
If peri-pad saturates more than _ hour this is serious:

Back 46

scant amount
less than 2 cm
1 peripad an hour

Front 47

First 24 hours postpartum apply this :

Back 47

Ice-20 minutes on, 10 off
for 12-24 hours
after 24 hours use sitz bath, 3x daily.

Front 48

Apply peri-pad to :

Back 48

Front and back

Front 49

How many feedings a day shoudl newborn get in:

Back 49

8 feedings a day
every 2-3 hours or on demand
Feed baby prior to crying. crying is a late sign of hunger.

Front 50

If bottle feeding, baby will last longer between feeding:

Back 50

3-4 hours for bottle feeding, breast milk has protein that is easier to digest than formula.

Front 51

What are atony manifestations:

Back 51

Increased lochia
Increase clots
Boggy uterus
S/S shock
Decreased urine output

Front 52

Best time to breast feed baby:

Back 52

Alert stage, within 30 minutes after brith.

Front 53

Risks for postpartum hemorrhage:

Back 53

Multiparity
Large baby
prolonged labor
shoulder dystocia

Front 54

Risk factors for DVT:

Back 54

Anemia, clotting factors,hx of dvt, increased maternal age,prolonged bedrest, obese, high parilty

Front 55

What nursing interventions should be done with pt with DVT:

Back 55

Bedrest, elevation, warm moist packs. Anti-coagulants

Front 56

10 Days of mild sadness and mild depression with some happy feelings:

Back 56

Baby blues

Front 57

Sadness, crying, lack of interest in baby starts at 4 weeks:

Back 57

Post partum depression which can last up to one year- treat SSRI'S

Front 58

Evident 3 months after postpartum, pt will have delusions, irrational:

Back 58

Postpartum psychosis- mood disorder usually associated with it.

Front 59

Palpitations, rapid breathing, impending doom, when this affects tyour everyday life:

Back 59

Panic/ovewhelming emotion

Front 60

No sex, nothing in vagina after baby for:

Back 60

6 weeks

Front 61

How is endometriosis diagnosed:
S/S

Back 61

Laparoscopy-
Heavy bleeding, heavy cramps, GI/GU upset/infertility

Front 62

S/S of polycystic ovarian disease:

Back 62

Painful ovulation,menses, infertility, hiritsuism, linked to endometrial ca. Use metformin to decrease insulin resistance.

Front 63

What are s/s of PID:

Back 63

pain with sex, discharge, infertility

Front 64

This STD can cross into the brain:

Back 64

syphlis

Front 65

If fundus is firm and pt is passing bright red blood,no clots like a trickle of blood think:

Back 65

Laceration bleed- from cervix,vulva,vagina or perineum

Front 66

HSV can be transmitted through:

Back 66

Contact- meticulous handwashing.Can cause fetal anomalies- can be fatal and cause neurological damage.

Front 67

HSV is diagnosed and treated with:

Back 67

Acyclovir and diagnosed with culture.. NO sexual contact during outbreaks. (mild symptoms may go unnoticed)

Front 68

How many stages of syphlis are there and which shows no s/s:

Back 68

4 stages
Primary-chancre
Secondary- systemic (fever,rash)
Latent- NO signs
Third/Tertiary nodules in all major organs

Front 69

Syphilis can cross over to placenta at what week:

Back 69

10 week (through intercourse of contact with chancres)

Front 70

Gonorrhea/chlamydia is dangerous to have because it travels:
Can effect:

Back 70

ascends through body, it can infect tubes/uterus/PID
Gential tract, mout, rectum

Front 71

Gonorrhea is easier to detect in men and is painful, s/s:

Back 71

green/yellow pus from penis.burning with urination.
Treat with pcn

Front 72

PCOS S/S:
Caused by:

Back 72

amenorrhea, obesity, hirsutism,
ovarian/pituitary imnbalance
too much estrogen,testosterone and LH, hyperinsulin

Front 73

These symptoms occur in luteal phase and resolve in a few days and are sympom free in follicular phase:

Back 73

PMS

Front 74

Thes symptoms have 5 or more physical symptoms and occur week prior to menses and are absent in follicular phase of cycle:

Back 74

PMDD

Front 75

Coital pain after intercourse:

Back 75

Dyspareunia

Front 76

If fundus is firm and 1 cm above umbilicus and right of midline:

Back 76

Pt has full bladder, have pt void and massage uterus.

Front 77

Most frequent cause of pp hemorrhage:

Back 77

Uterine atony

Front 78

Coombs negative woman would receive Rhogham:
True or False

Back 78

True- if mom is rh negative and baby is rh positive.

Front 79

Phase of maternal adjustment that occurs during theh first 24 hours, woman focus on herself.

Back 79

Taking In Phase

Front 80

Phase when mom adjusts on 2nd day and lasts 10 days and focus on baby/may have some blues:

Back 80

Taking Hold

Front 81

Woman learns and accepts new skills of being mother is increased in confidence and reasserts her relationship with partner:

Back 81

Letting Go phase

Front 82

Turning of the uterus inside out and after birth:

Back 82

Inversion

Front 83

Infection of lining of uterus, postpartum infection/placenta site:

Back 83

Endometritis

Front 84

Forceps delvivery can cause a :

Back 84

Vaginal hematoma

Front 85

Most common type of hematoma is a:

Back 85

Vulvar hematoma

Front 86

Newborn characteristics:
Temp:
HR:
Resp:

Back 86

97.9-99.0 (first temp rectal check for patent)
120-160
30-60

Front 87

Newborn baby BP:
Blood glucose:

Back 87

sbp- 60-80
dbp- 40-50
45-65

Front 88

Baby weight:

Back 88

5.8-9.7 pounds
2500-4300 grams

Front 89

Length of baby:

Back 89

17-21 inches
45-55 cm

Front 90

Head circumfrence:

Back 90

13-15 inches
35-38 cm

Front 91

Chest circumfrence:

Back 91

12-13 inches
30-33 cm

Front 92

Baby heart rate can go up to what when crying:
Baby sleeping:

Back 92

180

80-100

Front 93

Murmur is caused by what:

Back 93

Closing of foramen ovale and ductus arteriosis- first 24 hours normal to have murmur,after 48 hours not normal-

Front 94

Apgar score on what 5 characteristics:

Back 94

Heart rate
Respirations
Muscle tone
Reflex
Color

Front 95

Apgar score of less than this indicates severe trauma:

Back 95

3

Front 96

What is a late sign of baby resp distress:
Subtle sign of resp distress:

Back 96

retractions-
nasal flaring

Front 97

First 30 minutes of baby life what is administered:

Back 97

Erythromycin ointment, Vit K

Front 98

Baby cannot regulate temp, no sweat glands lose heat though these sources:

Back 98

Convection
Radiation
Evaporation
Conduction

Front 99

If you place baby near window or door, baby will lose heat:

Back 99

Radiation

Front 100

Baby loses heat from cold table:

Back 100

Conduction

Front 101

Baby loses heat form moisture skin:

Back 101

Evaporation

Front 102

If baby warms up to rapidly what can occur:

Back 102

Acidosis and apnea- warm up baby slowly

Front 103

To clear airway from baby use bulb syringe :

Back 103

Suction mouth and then nose

Front 104

What scale is used to monitor babys gestational age:

Back 104

Ballard scale
Score of 35 equals 38 weeks
Score of 25 equals 34 weeks
Score of 15 equals 30 weeks

Front 105

Jaundice that occurs within 24 hours of birth:

Back 105

Pathologic jaundice

Front 106

Increased bilirubin at birth, during 1st week of life, RBC's continue to breakdown, increasing bilirubin

Back 106

Physicological jaundice

Front 107

Bilirubin normalizes usually on:

Back 107

7th day- it increases up to day 6 then decreases by day 7

Front 108

What causes hyperbilirubin:

Back 108

Immatrue liver,RH/ABO imcompatiability
Infection/Bleeding
Maternal diabetes
Hypothermia

Front 109

Brain damage caused by elevated bilirubin:

Back 109

Kernicterus

Front 110

Normal cord bilirubin level:

Back 110

2 (normal bili is less than 2)

Front 111

If baby is over oxygenated what can it lead to :
What should PAO2 be:

Back 111

Blindeness (retinopathy)
50-70

Front 112

Dry skin, decreased SQ fat, long nails,no vernix, no lanugo, what kind or baby is this:
Baby at risk for:

Back 112

Post date baby

Hypoglycemia

Front 113

Baby born less than 10% percentile:
Baby looks like:

Back 113

SGA
Loose skin, little hair, weak cry, hypoglycemia

Front 114

If baby is born prior to 3rd trimester, what does the baby not receive:

Back 114

Moms' immunogloblins- baby will have high risk for infections.

Front 115

Baby can be LGA and still be born pre-term, what are LGA babies at risk for:

Back 115

Preterm LGA-RDS
Post- Meconium aspiration,hyperbilirubinemia

Front 116

Bilirubin that is bound to fat:

Not bound to fat:

Back 116

Indirect -unconjugated-harder to eliminate
Direct-water soluble, easier to get out via stool.

Front 117

These babies are born with mature lungs and are at less risk for RDS (think cultural)

Back 117

African American baby- baby lungs mature faster.

Front 118

Who is at more of a risk for RDS:

Back 118

Caucasian male, mother with htn, ama,2nd born twin, perinatal aphyxia

Front 119

Coombs test
Indirect is:
Direct is:

Back 119

Maternal
Fetal blood

Front 120

If baby is exposed with Hep B how is it treated:

Back 120

Hep B globulin within 12 hours of life

Front 121

With HIV, antibodies can form up to how many months:

Back 121

15 months

Front 122

Hypoglycemia in a baby is considered what:

Back 122

30-35 in term infant

Front 123

C-section baby place in what position :

Back 123

Side lying to help with drainage.

Front 124

Baby may have alterations in breathing ( grunt,flaring,crackles) but should clear in :

Back 124

within 1 hour, if not NICU will come and get baby

Front 125

Weight of baby within norms:

Back 125

5.8-9.7

Front 126

Baby is born with large clitoris or undescended testes, transluscent skin and ears that are down (no recoil)

Back 126

premature baby

Front 127

Desquamation, leathery skin, cracked, no lanugo:

Back 127

post date baby

Front 128

If baby has heart murmur after 24 hours, nurse should check what:

Back 128

BP in all extremities, will provide critical info for pediatrician.

Front 129

Dark pigmentation on baby that resemble brusie:

Back 129

Mongolian spots- normal

Front 130

Red, scattered rash may indicate:

Back 130

Plethora- Increase RBC-hyperanemia

Front 131

If baby has blue hands and feet, what if this called and is it normal:

Back 131

Acrocyanosis and it is normal

Front 132

If baby is born with hypospadias can they have circumcision:

Back 132

No, the extra skin will be used to surgically create urethra.

Front 133

If baby cannot move arms, it could be caused by:

Back 133

Shoulder dysotica- Erbs'palsy

Front 134

If baby has menigocele, what is important for nurse to know:

Back 134

Baby will be paralized at site of sac.

Front 135

How long does baby have passive immunity for:

Back 135

first 6 months

Front 136

Nurse strokes infants palate and baby begins to suck:

Back 136

Sucking reflex

Front 137

Infants cheek is stroked and baby turns head:

Back 137

Rooting

Front 138

Infants toes flare outward and big toe dorsiflexes when nurse strokes the lateral sole of foot:

Back 138

Babinski

Front 139

Nurse raises the infant and allows head and trunk to drop back 30 degrees, infants arm and legs extend and abduct, forefingers form a "c"

Back 139

Moro

Front 140

When lying on back with head to one side, infant extends the arm and leg, same side flexes:

Back 140

Tonic- neck

Front 141

A generalized, easily, identifiable, edematous area of scalp that extends across suture lines, resolves in 3-4 days:

Back 141

Caput Succedaneum- usually caused by forceps

Front 142

Collection of blood between skull/periosteum, does not cross cranial suture line:

Back 142

Cephalhematoma

Front 143

When does cephalhematoma occur:

Back 143

Several hours after birth, is largest on 2nd or 3rd day- it may increase jaundice as RBC's hemolysis

Front 144

Baby should void within:

Back 144

First 24 hours, then add a diaper a day- by day 6 ,6-10 times daily