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.
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.
4. T or F: you cannot test for TORCH diseases until after the
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
6. Station ___ is when fetal head @ ischial spines.
7. T or F: the HR of the baby slows as it becomes more mature?
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
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
* 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
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
14. T or F: the advantage to internal fetal monitoring includes
accurate FHR, beat to beat variability, and allows movement of mother
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
17. T or F: as soon as contraction is over we want FHR to return
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
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
25. ____is used for thinning meconium in utero, oligohydraminos, relieves pressure on cord, and for a IUPC.
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.
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)
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.
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.
34. PIH is hypertension that occurs after ___Wks and etiology is unknown, associated w/ vasospasm and vascular
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,
37. T or F: PIH will cause upper extremity swelling because fluid
leaving CBV and heart left w/ “sludge: to pump out (RBC)
38. Women at risk for PIH include those over ___years old and under 18, multiple gestation, chronic disease,
39. The ___ panel I and II evals liver changes and increase in blood clotting as well as fibrin levels for
40. Chronic HTN is HTN that occurs before __wks, no edema and no proteinuria.
41. ____ is associated w/ HTN 30/15, proteinuria, edema of UE, weight gain (4-5lbs in 1 week).
42. T or F: ecclampsia is when women begins to convulse
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
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.
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)
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.
53. The big indicator of HELLP is ____ pain, HELLP may occur 2 wks after delivery and is more frequent in older
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
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
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.
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
* 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.
63. T or F: if baby > 9lbs than at risk for GD w/ next pregnancy
64. T or F: diabetes can cause premature aging of placenta
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
* abruptio placenta
68. T or F: the fetus can liver w/ only 50% of the placenta attached
69. T or F: Abruption always w/ pain, and placenta previa always
w/ bleeding and no pain
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.
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
75. T or F: delivery w/ placenta previa usually occurs when amniocentesis
shows lung maturity
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.
77. T or F: the posterior position causes severe back pain in
78. ___positions are the best positions for labor.
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)
82. ___ manuever helps eliminate tears and need for episiotomy w/ gentle lifting of baby over perineum
83. Baby is going thru cardinal movements during stage ___, this includes engagement, descent, felxion, extention,
crowning, internal and external rotation.
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”
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.
91. T or F: labor may be augmented w/ use of blue or black cohosh,
primrose oil, red raspberry tea leaves
92. T or F: the use of forceps can help baby w/ rotation
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
95. T or F: it is better to give mom medication at beginning of
contraction so baby gets less
96. T or F: increase risk of pulmonary aspiration due to woman
eating before labor begins
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.
101. Intravenous narcotics include IV ____ which gives relief in 1-2min and last 1-2hrs.
102. Another intravenous narcotic given is ___ , may be given in first stage, rapid onset, short duration, may
103. T or F: agonist-antagonist are never given to clients w/ dependency
problems or if mom has already taken a narcotic.
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.
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.
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.
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.
110. T or F: spinal is good for end of stage I and stage II, whereas epidural better for stage
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.
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
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
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
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
119. The pudendal block is given for stage __ labor and helps w/ tears, episiotomy, and big shoulders, forceps
and vaccuum delivery, lasts one hour.
120. Local infiltration is given during stage ___ and can give as much meds as you want, baby already out, last
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.
123. ___ is when the uterus goes thru autolysis (self-destruction), fundus descends one finger breadth/day for about 7-10 days.
124. Involution ends in ___wks, the uterus will descend slower in multipara and c-section moms.
125. ___ a form of oral oxytocin may be give (q4hrs x 6 doses) to clean out uterus and help clamp it down and
126. Lochia rubra lasts __-__days, serosa __-___ days, and alba __-__ days.
* 1-3, 4-10,
127. ___ is an astringent made of witch hazel that shrinks hemorrhoids.
128. T or F” the cervix is permanently changed, changes to
a dimple like opening to a slit appearance
129. The cervix is open while shedding lochia, change of infection for first 6wks, the cells are easy to damage
130. T or F: uterus contracting is more painful for multipara and
131. Low ___ after delivery and breastfeeding may cause decreased lubrication.
132. T or F: rugae in the vagina return 2-4 wks after birth and
take longer in breast feeders
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.
135. T or F: WBC may increase for a day or two after delivery
136. Menstruation resumes in __-__wks for non-lactating moms and longer for breast feeders.
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.
140. ___ is an infection around pelvic reproductive organs.
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
143. The ___ phase is when mom talks openly about her birth experience, usually immediately after birth.
144. ___ is when it is hard to bond w/ more than one child at a time (twins, triplets)
145. REEDA stands for?
* redness, edema, ecchymosed, discharge, approximation
146. T or F: this is a lot of damn questions?