NURS 629 Exam 3 (OB/GYN) questions and answers(scores 100%)

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NURS 629 Exam 3 (OB/GYN) What antibiotics are safe for UTI during pregnancy? Correct Answer: Macrobid, Ampicillin, Keflex, Pyridium What antibiotic is unsafe during preganancy? Correct Answer: ... Bactrim (<13 w or >36 w) Are oral hypoglycemics okay in pregnancy? Correct Answer: NO!!! What medication do you use to treat DM during pregnancy? Correct Answer: Insulin Name the 5 infant risk factors for an infant with a DM mother Correct Answer: 1. NTD 2. Cardiac Defects 3. Macrosomia 4. Intra-Uterine Growth Restrictions 5. Hyperbili What complications can Macrosomia cause to an infant? Correct Answer: Truncal Fat, Shoulder Dystocia, Hypoglycemia, Hyperglycemia (Delay in lung maturation), Hypoxia (Cerebal Palsy) How is the 1 hour glucose test performed? Correct Answer: 24-28 weeks drink 50G of glucose (BS >140) How is the 3 hour glucose test performed? Correct Answer: High carb 2 day diet, NPO after midnight, FBS then drink 100G of glucose (FBS >105 or 2 of the following: 190 at 1 hr, 165 at 2 hr, 145 at 3 hr) What is the treatment of PIH or chronic HTN during pregnancy? Correct Answer: ACE contraindicated, Betablockers can cause low birth weight the safest (Lobateolol) Name the classic TRIad for Preeclampsia Correct Answer: 1. HTN 2. Edema 3. Proteinuria What do you see in MILD Preeclampsia? Correct Answer: BP >140/>90 1+ Proteinuria No HA How do you treat MILD Preeclampsia? Correct Answer: Increase protein, document fetal activity, weekly NST What do you see in SEVERE Preeclampsia? Correct Answer: BP >160/>110 3+ Proteinuria HA Decreased output Visual disturbances Thrombocytopenia How do you treat SEVERE Preeclampsia? Correct Answer: Deliver the baby, rest, decrease stimuli, mag sulfate, medications (Apresoline) What are visual signs and symptoms of Eclampsia? Correct Answer: Facial twitching, tonic clonic seizures, pulmonary edema, circulatory/renal failure What are signs and symptoms of HELLP syndrome? Correct Answer: RUQ pain, N/V, edema, increased liver enzymes, decreased H&H & platelets What is the treatment of HELLP and Eclampsia? Correct Answer: Deliver the baby, bed rest, mag sulfate (Valium or Phenobarb if mg is not effective after 2 hrs), Steriods (Fetal lung maturity), Hydralazine (SEVERE) What is the treatment of Hyperemesis Gravidarum? Correct Answer: IV fluids, tpn, antiemetics (B6, unisom, antihestamines), diet as tolerated What education do you need to give about quad screening? Correct Answer: It is not a diagnostic. It is an assessment tool and will be referred to a specialist if positive. What can early bleeding indicate? Correct Answer: Miscarriage, ectopic pregnancy, incompetent cervix Explain the 3 types of spontaneous abortions Correct Answer: 1. Threatened - Vaginal bleeding occurs 2. Inevitable - Membranes rupture and cervix dilates 3. Incomplete - Some products of conception have remained How do you manage a THREATENED abortion? Correct Answer: Check fetus by ultrasound, bed rest, no sex for 2 weeks after bleeding stops, no false reassurance of outcome Treatment for an INEVITABLE abortion Correct Answer: Check for complete vs incomplete via ultrasound, analgesia for d&c, RhoGAM if negative blood type (avoid future issues with future preganancy) Treatment for an INCOMPLETE (Missed) abortion Correct Answer: Hospitalization, d&c or IV pitocin for 14 weeks, after 14 weeks give pitocin or prostaglandins, wait 3-5 weeks for spont abortion if does not want medical treatment, monitor for DIC or excessive prolonged bleeding What education do you need to give someone who is having an abortion? Correct Answer: Bleeding and cramping last 1-2 weeks, vaginal rest for 1 week, check temp bid, f/u in 2 weeks, may take 6w for cycle to return, can try to get pregnant after 1 cycle What are the signs and symptoms of an INCOMPETENT cervix? Correct Answer: Advanced cervical dilation, low abd pressure, bloody show, urinary frequency Treatment for INCOMPETENT cervix Correct Answer: Cerclage (by ob cervical stitch), do not check cervix manually use u/s only Risk factors to have an ectopic pregnancy? Correct Answer: Hx of salpingitis, prior ectopic, assisted reproduction, smoker, current IUD use, hx of STD or STI Signs of symptoms of ectopic pregnancy? Correct Answer: Missed period, bilateral lower abd pain, vaginal spotting, rupture (severe abdominal pain), low hCG and progesterone levels, no gestational sac on U/S Treatment for ectopic pregnancy? Correct Answer: Ruptured: Surgical- Salpingectomy Methotrexate if unruptured tube, early on, no cardiac activity If there is bleeding in 2nd or 3rd what might it mean? Correct Answer: Placenta Previa (covers the cervix) Abruptio Placenta (Premature separation of placenta) Risk factors for placenta previa? Correct Answer: Advanced maternal age, HTN, cocaine use, history of c/s, multifetal pregnancy, african american or asian Signs and symptoms of placenta previa? Correct Answer: Bleeding after 24 weeks, abdomen soft and nontender, dx by u/s Treatment for placenta previa? Correct Answer: Avoid pelvic exam unless done in OR, bed rest till week 36, antenatal testing: u/s, NST, BPP, L/S ratio prior to early delivery, c-section Risk factors for abruptio placenta? Correct Answer: HTN, dm, poor nutrition, cocaine or tobacco use, blunt trauma to abdomen, graded 1, 2 or 3 u/s What are the grades of 1-3 of abruptio placenta mean? Correct Answer: 1. Partial separation (concealed) 2. Partial (apparent hemorrhage) 3. Complete (concealed) Signs and symptoms of abruptio placenta Correct Answer: Sudden onset of intense pain, bleeding, hard/board-like abdomen, decreased FHR and movement, shock (due to bleeding) Management of placenta abruption? Correct Answer: Grade 1: Hospital and monitor Grade 2 & 3: Delivery and manage shock What do you do if there are no fetal movements for 12 hours? Correct Answer: NST 2+ episodes of acceleration (>15 bpm/20 min at least 15 seconds long associated with fetal movement), perform weekly or twice a week What is the purpose of first trimester u/s? Correct Answer: Confirm pregancy, confirm viability, determine gestational age, r/o ectopic, visualization for genetic testing What is the purpose of the second trimester u/s ? Correct Answer: Estimate or confirm due date, confirm viability, detect polydraminos or oligohydraminos, visualization during amino, can see gender at this point [Show More]

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