1. T or F: If your rubella titer is negative or low you a given
a post-partum injection to avoid hearing problems in your next child.
* T
2. Name the TORCH diseases?
* toxoplasmosis, others (syphilis), rubella, cytomegaly virus, herpes II
3. A pregnant women can get ____from uncooked meat, soil, or cat feces.
* toxoplasmosis
4. T or F: you cannot test for TORCH diseases until after the
delivery
* T
5. T or F: If baby is suspected to be hypoxic a fetal scalp blood sampling is obtained to identify
acid-base balance to determine fetal hypoxia occurring during birth
* T
6. Station ___ is when fetal head @ ischial spines.
* 0
7. T or F: the HR of the baby slows as it becomes more mature?
* T
8. T or F: external fetal heart monitoring has limitations such as frequent adjustments needed, limit mobility,
not good for variability, an obesity a problem
* T
9. A ___ ___ ___ is done for at risk mothers (PIH, diabetic, epilepsy) and shows FHR increase w/ movements;
looking to see if baby can recover from increased HR.
* non stress test
10. Results of the non stress test are ____ which means a good result, and ___ which means CNS problem or placental
problem.
* reactive, non-reactive
11. T or F: if non-stress test comes out non-reactive further
tests are done such as the OCT and biophysical profile
* T
12. What are the two easiest positions to deliver fetus?
* LOA and ROA
13. T or F: internal fetal monitoring is done on high risk moms
and whom are in active labor
* T
14. T or F: the advantage to internal fetal monitoring includes
accurate FHR, beat to beat variability, and allows movement of mother
* T
15. The primary cause of fetal tachycardia is a maternal ____ and primary cause of bradycardia is _______.
* fever, hypoxia
16. T or F: we want constant variability (shows CNS can handle
stress)
* T
17. T or F: as soon as contraction is over we want FHR to return
to baseline
* T
18. The autonomic nervous system controls the heart rate, the ____ accelerates the heart where as the ____slows
the heart rate and regulates the heart as we mature.
* sympathetic, parasympathetic
19. T or F: Down’s syndrome or CNS damage will show little
variability
* T
20. ___term variability shows beat to beat changes, where as ___ term variability shows changes from 1 contraction
to the next
* short, long
21. Factors that affect variability include?
* drugs, prematurely, fetal sleep cycle, CNS anomalies, hypoxia
22. ___changes refer to changes during a contraction where as ___ changes occur outside of a contraction, accelerations
usually fetal movement.
* periodic, non-periodic
23. Early decelerations
can be caused by ___ ___, variable decelerations caused by ____ ___ and late decelerations caused by ______ _____.
* head compression, cord compression, utero-placental insufficiency
24. T or F: late decelerations are always ominous, Interventions
include lay mom on side, give her O2 to 8-10L, increase IV (increase BV to baby), turn off pitocin (give baby time to recover)
and call MD
* T
25. ____is used for thinning meconium in utero, oligohydraminos, relieves pressure on cord, and for a IUPC.
* amnioinfusion
26. An ____ is a catheter placed into the uterus to insert LR into the uterus, LR will float around cord so
it is not depressed
* intrauterine pressure catheter (IUPC)
27. ____ means you are giving something to stop contractions.
* tocolysis
28. ____ ___ is excessive vomiting during pregnancy that can cause dehydration, weight loss, and electrolyte
imbalance; may be caused by ___ imbalance or could be psychological.
* hyperemesis gravidarum, hcg
29. T or F: Hyperemesis gravidarum puts the fetus at risk for abnormal development, IUGR, hypoxia,
and lack of nutrition and could also cause maternal ketoacidosis (using fat stores---ketones)
* T
30. T or F: When ketones are passed to baby it can cause IUGR
and baby must start breaking down own fat stores which it does not have.
* T
31. Tx of hyperemesis gravidarum includes daily weights, I/O, IV fluids, hyper alimentation, antiemetic meds
such as ______ and ______ and B6 pyridoxine stabilize the placenta.
* antihistamines, phenothiazines
32. ____ ___ ____ occurs when membranes break before 38 wks, due to infection, incompetent cervix and trauma; at
risk for cord prolapse.
* premature ruptured membranes
33. ___ is a steroid used to help increase lung maturity for preterm labor, side effects include weakens immune
system and mask infection.
* betamethazone
34. PIH is hypertension that occurs after ___Wks and etiology is unknown, associated w/ vasospasm and vascular
endothelial damage.
* 20
35. PIH causes activation of the coagulation system which causes ______ profusion to the placenta, and a ____
in CBV and ___ in platelet aggregation.
* decrease, decrease, increase
36. T or F: risk of PIH to fetus include LBW and prematurity,
and IUGR
* T
37. T or F: PIH will cause upper extremity swelling because fluid
leaving CBV and heart left w/ “sludge: to pump out (RBC)
* T
38. Women at risk for PIH include those over ___years old and under 18, multiple gestation, chronic disease,
poor nutrition.
* 35
39. The ___ panel I and II evals liver changes and increase in blood clotting as well as fibrin levels for
PIH sufferers
* PES
40. Chronic HTN is HTN that occurs before __wks, no edema and no proteinuria.
* 20
41. ____ is associated w/ HTN 30/15, proteinuria, edema of UE, weight gain (4-5lbs in 1 week).
* preeclampisa
42. T or F: ecclampsia is when women begins to convulse
* T
43. Mild PIH is tx w/ bedrest, increase protein in diet w/ no salt restriction, increase calcium, and antihypertensive
such ____ ___ ____.
* methyldopa, hydrolazine, and nifedipine
44. T or F: bedrest is the only way we know how to get more nutrients
and O2 to the fetus
* T
45. Severe PIH symptoms include the __ __ reflexes, edema, H/A, visual changes, N/V, upper gastric pain (liver
involved), CNS irritation
46. ___ refers to deep tendon reflexes (+4 hyper flex) means ready to go into convulsions.
* clonus
47. Severe PIH is tx w/ ___ ___ via IV, this helps prevent ecclampsia.
* magnesium sulfate
48. T or F: Magnesium sulfate prevents excitability of muscles,
sedative-like action, decrease respiratory rate, highly absorbed in fetus (affects babies tone)
* T
49. To reverse effects of low respirations __ ___ is given
* calcium gluconate
50. When a mom goes into ecclampsia a c-section is needed and she may be given ___ or ___.
* valium or dilantin
51. If PIH gets
worse you need “HELLP” this stands for?
* hemolytic anemia, elevated liver enzymes, low platelet count
52. T or F: Symptoms of HELLP include N/V, malaise, flu-like symptoms, epigastric pain, it effects
every system, and increases BP.
* T
53. The big indicator of HELLP is ____ pain, HELLP may occur 2 wks after delivery and is more frequent in older
white women.
* epigastric
54. Premature onset of labor (POL) occurs after __wks and before __wks, it is stimulated by UTI, diarrhea,
dehydration, any infection, and s/s include cramps or contractions, and increased d/c.
* 20, 37
55. POL is diagnosed when women has 4 contractions w/in 20minutes, __% effaced and __cm dilated and ROM, we
cannot do much to stop labor at this point.
* 80%, 4cm
56. T or F: POL management includes bedrest, oral hydration, sedation,
and FHR monitoring
* T
57. POL can be tx w/ tocolysis agents such as homecare w/ _____ and in the hospital w/ IV___ ____.
* turbutaline, magnesium sulfate
58. T or F: turbutaline is the best homecare drug stop contractions, may cause mom to be uncomfortable
* T
59. A test done on urine to check for POL is the fetal ____ test, this is the glue that holds the amnion and
uterine lining together, will be found in urine if + POL.
* fibrinectin
60. ____ ___is abnormal CHO metabolism and insulin resistance, the placental hormones create insulin resistance.
* gestational diabetes
61. ___ ___ increases the breakdown of insulin, and increased ___ from adrenals causes increased ____ to be
released.
* placental insulin-ase, cortical, glycogen
62. Plasma glucose after 1 hr should be < ___mg/dl, if result high a 3 hr glucose is done, if this is abnormal
than mom has gestational diabetes.
* 140
63. T or F: if baby > 9lbs than at risk for GD w/ next pregnancy
* T
64. T or F: diabetes can cause premature aging of placenta
* T
65. GD puts the fetus at risk for ___ ___ __.
* hypoglycemia after birth, hyperbilirubinemia, macrosomia
66. Post-term pregnancy can cause several problems such as umbilical cord compression due to drying of the
___ ___, decreased amniotic fluid, and macrosomia which could cause shoulder dystocia at birth.
* whartons jelly
67. ___ ____is a premature seperation of the placenta, the number 1 symptom is a painful abdomen w/ or w/out
bleeding.
* abruptio placenta
68. T or F: the fetus can liver w/ only 50% of the placenta attached
* T
69. T or F: Abruption always w/ pain, and placenta previa always
w/ bleeding and no pain
* T
70. The causes of abruption include ___ ___ ____ and the different types of abruption are ___ which is around
the edges, ___ in the middle, and ____.
* HTN, trauma, anemia, marginal, central, complete
71. Abruptio placenta and placenta previa dx w/ ___, pre-natal care is a must.
* ultrasound
72. Abruptio placenta is treated w/ an emergency c-section, hemorrhage or DIC __ __ ___ can occur which is
when the body loses the ability to clot and all the fibrin bleeds out (hypofibrinogenemia).
* disseminated intravascular coagulation
73. ___ ___ is the improper placement of the placenta and can be total, partial, marginal, and low-lying, always
associated w/ bleeding and no pain.
* placenta previa
74. T or F: placenta previa is caused by inadequate endometrial
lining, increased risk is missed periods and irregular cycles
* T
75. T or F: delivery w/ placenta previa usually occurs when amniocentesis
shows lung maturity
* T
76. Placenta___ is when placenta grows thru myometrium, more common in under nourished and low hemoglobin mothers,
has a possibility of uterus turning inside out.
* accreta
77. T or F: the posterior position causes severe back pain in
labor
* T
78. ___positions are the best positions for labor.
* anterior
79. Types of presentation include __ ___ ___, the fetal part that is presenting at cervix.
* cephalic, vertex, breech
80. Three types of breech?
* frank, complete, single footling
81. A ____score is given for cervical changes (thin and dilate)
* bishops
82. ___ manuever helps eliminate tears and need for episiotomy w/ gentle lifting of baby over perineum
* ritgens
83. Baby is going thru cardinal movements during stage ___, this includes engagement, descent, felxion, extention,
crowning, internal and external rotation.
* II
84. Hypotonic contractions are helped w/ use of ____, and hypertonic contractions slowed down w/ ____(baby
cannot recover between contractions).
* oxytocin, stadol
85. T or F: when the placenta comes out fetal side first it is
more intact, may still have fragments left in mom when comes out “dirty Duncan”
* T
86. CPD is ____ ___ and is biggest reason for C-section, results in long stage II, back labor; head does not
fit thru pelvis.
* cephalopelvic disproportion
87. ___ ___is when hands are put on abdomen to turn baby who is in breech position.
* external version
88. When doing external version ____ may be used IV to help relax uterus, once baby turned administer___ to
help cause contractions.
* Terbutaline, oxytocin
89. Labor is induced w/ _____ gel-dinoprostone or w/ ___ or ___ via catheter and diaphragm or ___ as cervical insert
* prostaglandin, prepidil, cervidil, cytotec
90. ___ means to strip the membranes.
* amniotomy
91. T or F: labor may be augmented w/ use of blue or black cohosh,
primrose oil, red raspberry tea leaves
* T
92. T or F: the use of forceps can help baby w/ rotation
* T
93. The typical uterine incision is the ____ incision, the ____ incision is done in emergent situations and
scare does not stretch as well.
* transverse, classical
94. T or F: pregnancy increase sensitivity to all drugs making
overdose more likely
* T
95. T or F: it is better to give mom medication at beginning of
contraction so baby gets less
* T
96. T or F: increase risk of pulmonary aspiration due to woman
eating before labor begins
* T
97. Wait until primipara dilated ___-___cm before giving pain meds, and __-__cm for multipara.
* 5-6, 3-4
98. ___ is the relief of pain usually w/ medication (generalized pain decreased) whereas __ is the absence
of pain from certain area.
* analgesia, anesthesia
99. ___pain is more localized and to surface (stage II) whereas ___ pain is deep (stage I).
* somatic, visceral
100. T or F: early administration of analgesics may prolong labor
whereas late administration may cause respiratory depression in neonate w/ little pain relief to mom.
* T
101. Intravenous narcotics include IV ____ which gives relief in 1-2min and last 1-2hrs.
* stadol
102. Another intravenous narcotic given is ___ , may be given in first stage, rapid onset, short duration, may
prolong labor
* nubain
103. T or F: agonist-antagonist are never given to clients w/ dependency
problems or if mom has already taken a narcotic.
* T
104. ___ has both a narcotic agonist and antagonist properties, it is an analgesic 7 times more potent than
morphine, overdose tx w/ ____. Morphine not given during labor b/c increased respiratory depression.
* Demerol, narcan
105. A ___ is an injection of med into subarchnoid space, injection only given once whereas an epidural uses
a catheter for continuous administration.
* spinal
106. Intrathecal narcotics can be given as an epidural or spinal, these include ____ which is long-acting, used
for spinal or stage II and c-sections.
* duramorph
107. The other intrathecal narcotic is ___ which is short-acting
and does not pass the blood-brain barrier and given via epidural for stage 1 and into stage II.
* fentanyl
108. T or F: The advantage of a spinal is immediate onset,
small drug volume, fully awake, do not feel any pressure, good relief for 1hour
109. To avoid spinal H/A give pt bolus of 1000-1500 cc ___ before epidural or spinal, a defining symptom of
a spinal H/A is skull crushing pain when sits up, ok when lay down again, H/A is caused by leaking of spinal fluid.
* LR
110. T or F: spinal is good for end of stage I and stage II, whereas epidural better for stage
I
* T
111. A ___ ___ is method to repair tear in dura mater around spinal cord; injection of sterile blood into epidural
space to cause a clot for repair.
* blood patch
112. T or F: A lumbar epidural is used for stage I and can extend
into stage II as long as the catheter is still in, once out cannot do anything except for a spinal.
* T
113. A lumbar epidural uses a local anesthetic such as ___ or ___ and an opiod such as ____.
* bupivacaine, marcaine, fentanyl
114. T or F: disadvantages of epidurals include undesirable for
rapid labor, eliminates urge to push, hypotension, purities, and urinary retention
* T
115. T or F: may give a bolus before pull out epidural cath such
as fentanyl, duramorph or demeral that will last up to 24-48hrs after delivery for pain relief
* T
116. The epidural injection site is between the ____ and the _____.
* ligamentum flavum and dura mater
117. Regional anesthesia does not have systemic effects or side effects and includes the ____which is given
into the cervix on both sides, the ___ ___ which given on either side of ischial spines and the ____ ____ which is best anesthesia
for stage 2 for an episiotomy.
* paracervical, pudendal block, local infiltration
118. Paracervical
is only used in stage 1, ___ or ___ used as anesthetic agent, good for 1hr, in that time cervix dilates, once wears off pain
is more intense, associated w/ respiratory depression of neonate
* paracervical
119. The pudendal block is given for stage __ labor and helps w/ tears, episiotomy, and big shoulders, forceps
and vaccuum delivery, lasts one hour.
* 2
120. Local infiltration is given during stage ___ and can give as much meds as you want, baby already out, last
one hour.
* 2
121. General anesthesia is given during emergency c-sections, given amnesia such as ___ ___ and analgesia such
as ___, muscle relaxation with___ ___.
* sodium pentothal, fentanyl, nitrous oxide
122. Intubations done to prevent aspiration, ___ is drug used to paralyze the gag reflex.
* curare
123. ___ is when the uterus goes thru autolysis (self-destruction), fundus descends one finger breadth/day for about 7-10 days.
* involution
124. Involution ends in ___wks, the uterus will descend slower in multipara and c-section moms.
* 6
125. ___ a form of oral oxytocin may be give (q4hrs x 6 doses) to clean out uterus and help clamp it down and
contract.
* methergine
126. Lochia rubra lasts __-__days, serosa __-___ days, and alba __-__ days.
* 1-3, 4-10,
11-21
127. ___ is an astringent made of witch hazel that shrinks hemorrhoids.
* TUCKS
128. T or F” the cervix is permanently changed, changes to
a dimple like opening to a slit appearance
* T
129. The cervix is open while shedding lochia, change of infection for first 6wks, the cells are easy to damage
“_____.”
* friable
130. T or F: uterus contracting is more painful for multipara and
breast feeders.
* T
131. Low ___ after delivery and breastfeeding may cause decreased lubrication.
* estrogen
132. T or F: rugae in the vagina return 2-4 wks after birth and
take longer in breast feeders
* T
133. Mom’s HR slows immediately after birth, tachycardia related to ___ ____.
* blood losss
134. T or F: Fibrinogen levels increase for 1wk increasing risk of thrombophlebitis and mom in
a hypercoaguability state for 6wks.
* T
135. T or F: WBC may increase for a day or two after delivery
* T
136. Menstruation resumes in __-__wks for non-lactating moms and longer for breast feeders.
* 6-8
137. ____ is when uterus will not progress to lower abdomen, stays elevated, usually due to retained placental
tissue or loss of muscle tone.
* sub involution
138. Complications of 4th degree laceration?
* cytokine, rectocele, uterine prolapse, infection from e.coli
139. ___ is a plastic device put into vagina to hold uterus in place.
* pessary
140. ___ is an infection around pelvic reproductive organs.
* parametritis
141. The 3 phases of psychosocial changes in post-partum ?
* taking in , taking hold, letting go
142. ___ is when the infant moves toward the parents voice
* entrainment
143. The ___ phase is when mom talks openly about her birth experience, usually immediately after birth.
* honeymoon
144. ___ is when it is hard to bond w/ more than one child at a time (twins, triplets)
* monotrophy
145. REEDA stands for?
* redness, edema, ecchymosed, discharge, approximation
146. T or F: this is a lot of damn questions?
T
ENJOY!!!!!!!!
