Pregnancy and prenatal development

The maternal side of the placenta is known as what?

(Dirty) Duncan

The amniotic fetal membrane side of the placenta is known as what?

(Shiny) Schultz

What medication has the following indication? ~ *Acceleration of fetal lung maturity to reduce* the incidence and severity of *respiratory distress syndrome (RDS)* ~ Studies suggest that antenatal steroids can reduce the incidence of intraventricular hemorrhage (IVH) and neonatal death in the preterm infant ~ Greatest benefits accrue if at least 24 hours elapse between the initial dose and birth of the preterm infant, but the drug is indicated if birth is not imminent ~ *12 mg intramuscular (IM) for two doses, 24 hours apart*

*Betamethasone* (Dexamethasone)

What occurs when the largest diameter of the fetal presenting part *(normally the head)* has passed the pelvic inlet and entered the pelvic cavity? (Hint: Presumed to have occurred when the station of the presenting part is zero or lower)

*Engagement*

What is the purpose of *amniotic fluid*? (Name at least 2)

*Protects the growing fetus by the following:* ~ *Cushioning against impacts* to the maternal abdomen ~ *Maintaining a stable temperature* ~ Allowing symmetric development as the major body surfaces fold toward the midline ~ Preventing the membranes from adhering to developing fetal parts ~ Allowing room & buoyancy for fetal movement

What drug is administered to mom's who are RH negative after of the following? ~ Abortion ~ Ectopic pregnancy ~ Chorionic villus sampling ~ Amniocentesis ~ Birth of an Rh-positive infant

*RhoGAM*

What is the *normal range* for a mothers fetal heart rate? (Note: Include fluctuation range)

110-160 beats/min with 6-25 beat fluctuations

How long should ice packs be applied to the perineum to reduce pain, bruising, and edema before switching to heat to promote healing and blood flow?

12 hours

When does *ovulation approximately occur*?

14 days before a woman's next menstrual cycle

The *blood glucose level is screened at 24 to 28 weeks* of gestation with a 1-hour glucose challenge test where no diet restrictions are required, *what does the BG level need to be below* in order to NOT receive a 3-hour Oral Glucose Tolerance Test to determine if she has gestational diabetes? *(Note: 50mL of glucose solution is taken for test)*

140 mg/dL

How often should vital signs be assessed postpartum for a patient on *Oxytocin (Pitocin)*?

15min or according to protocol for the recovery period

Are *Transvaginal ultrasounds* used for the 1st, 2nd, or 3rd trimester?

1st trimester

The umbilical cord is the lifeline between the placenta and the fetus that normally contain how many arteries and veins? (Note: Has no pain receptors)

2 arteries and one vein

How long does the ovum survive after it is released at ovulation?

24hrs

How long do sperm survive in the female reproductive tract?

24hrs (few may last for 80hrs)

Are Transabdominal ultrasounds used for the 1st, 2nd, or 3rd trimester?

2nd and 3rd trimesters

When does the zygote become a embryo aka *embryonic period*?

3rd week to 8th week of development

At how many *cm must a women be dilated* in order to receive an epidural?

4-7cm (active phase of dilation)

When should insulin lispro be taken?

5-15min AC

At what week are the 4 chambers of the heart complete?

6 weeks

What do we want the amniotic fluid to be at 40 weeks into pregnancy?

700-800mL

At what week does the embryo become a fetus and while Teratogens may damage already formed structures they are less likely to cause major structural alterations now?

9th week until birth

Who is the only person that can *translate for a Spanish speaking only patient*?

A Terp

What should be given to a patient with *type 2 diabetes* during pregnancy if insulin is not available?

A form of glucose (like orange juice)

The following match what? ~ *Loss of pregnancy before the fetus is viable*, or capable of living outside the uterus ~ Fetus less than 20 weeks gestation or one weighing less than 500 g is not viable

Abortion

Premature separation of a normally implanted placenta from the uterine wall and can be caused by the following is known as what? ~ Chronic hypertension or PIH ~ Cocaine use (leading cause) ~ Premature rupture of the membranes ~ Blunt external ABD trauma ~ Short umbilical cord ~ Cigarette smoking ~ Prior HX of this complication ~ Maternal age <20 or >35 ~ Three times greater risk in multigravida greater than five

Abruptio Placentae

In terms of variability, undetectable to less than or equal to a variation in FHR of < 5 beats per min is known as which of the following? ~ Absent/Minimal ~ Moderate ~ Marked variability

Absent/Minimal

An abrupt temporary increase in the FHR that peaks at least 15 beats above the baseline and lasts at least 15 seconds is known as what? (Hint: Are normally reassuring and require no intervention)

Acceleration

What should not be consumed during pregnancy due to it having the following effects? ~ Prenatal and postnatal growth restrictions ~ CNS impairment ~ Recognizable combination of facial features

Alcohol

What diagnostic test matches the following? ~ The aspiration of amniotic fluid from the amniotic sac for examination ~ Tests Amniotic fluid contains cast-off fetal cells and various other fetal products ~ Best performed between *15 and 20 weeks gestation*

Amniocentesis

What occurs when amniotic fluid, with its particles such as vernix, fetal hair, and sometimes meconium, enters the maternal circulation and obstructs pulmonary vessels causing failure of the right ventricle and can lead to hypoxemia, depressed cardiac function, and circulatory collapse?

Amniotic Fluid Embolism

An artificial rupture of the membranes (amniotic sac) by using a disposable plastic hook (Amnihook) is known as what?

Amniotomy

Before pregnancy can be referred to as what?

Antepartum

The following are examples of what medication classification? ~ promethazine (Phenergan) ~ diphenhydramine (Benadryl) ~ *metoclopramide (Reglan)* ~ ondansetron (Zofran)

Antiemetics (Note: Can treat Hyperemesis Gravidarum)

The following are examples of what medication classification? ~ Histamine-Receptor Antagonist -famotidine (Pepcid) -ranitidine (Zantac) ~ Gastric Acid Inhibitors -esomeprazole (Nexium) -omeprazole (Prilosec) ~ Corticosteroids: -methylprednisolone

Antiulcer (Note: Can treat Hyperemesis Gravidarum)

Do veins or arteries carry deoxygenated blood back & waste products away from the fetus to the placenta?

Arteries

During postpartum management of severe preeclampsia, magnesium sulfate is continued for at least 24hrs, how long should the PT be monitored for?

At least 48hrs

What is *Oxytocin (Pitocin)* used for before during and after labor?

Before - Induce labor During - Help contractions After- Expel the placenta, uterine tone, and *stop bleeding*

What diagnostic profile is a group of the following five fetal assessments; used to determine how the fetal central nervous system reacts to hypoxemia and fetal acidosis: ~ Fetal heart rate and reactivity (interpreted from the NST) ~ Fetal breathing movements ~ Gross fetal body movements ~ Fetal muscle tone (closure of the hand) ~ Volume of amniotic fluid

Biophysical Profile

*Mixture of cervical mucus and blood* from ruptured capillaries in the cervix; often precedes labor and increases with cervical dilation is known as what?

Bloody Show

What type of *fetal presentation* would be described as the bottom showing first? (Hint: Cephalic, vertex, or breech)

Breech

What does a "3" mean on the Deep Tendon Reflex Rating Scale?

Brisker than average reflex

What is the *antidote* for magnesium sulfate toxicity?

Calcium Gluconate

Sperm are not immediately ready to fertilize the ovum. They undergo changes that enable one of them to penetrate the protective layers surrounding the ovum in a process called what?

Capacitation

What FDA Pregnancy Risk Category can be classified by the following? ~ No evidence of risk to the fetus exists

Category A

What FDA Pregnancy Risk Category can be classified by the following? ~ Animal reproduction studies have not demonstrated a risk to the fetus. No adequate and well-controlled studies have been done in pregnant women.

Category B

What FDA Pregnancy Risk Category can be classified by the following? ~ Animal reproduction studies have shown an adverse effect on the fetus, but no adequate, well-controlled studies have been done in humans. Potential benefits may warrant use of drug in pregnant women despite fetal risks.

Category C

What FDA Pregnancy Risk Category can be classified by the following? ~ Positive evidence of human fetal risk based on adverse reaction data, but potential benefits may warrant use of drug despite fetal risks.

Category D

What FDA Pregnancy Risk Category can be classified by the following? ~ Positive evidence of human fetal risk based on animal or human studies and/or adverse reaction date. Risks of using drug clearly outweigh potential benefits

Category X

The *enlargement or widening of the opening of the cervix* and the cervical canal is known as what? (Hint: It increases from less than 1 cm to 10 cms)

Cervical Dilation

*Thinning of the cervix* and is described as a percentage of the Original length of the cervix is known as what?

Cervical Effacement

What diagnostic test matches the following? ~ Fetal tissue is analyzed to diagnose chromosomal, metabolic, or DNA abnormalities ~ Performed 10-12 weeks gestation ~ Can be done Transcervical or Transabdominal

Chorionic Villus Sampling

What form of hypertension matches the following? ~ High BP known to exist before pregnancy ~ Diagnosed if gestational HTN persists after birth ~ Relatively common ~ Major cause of perinatal death ~ Associated with IUGR

Chronic hypertension

When mixing insulin should you draw *clear or cloudy first*?

Clear before cloudy

Which of the following is *NOT a schedule 1 drug*? ~ Heroin ~ LSD ~ Cocaine ~ Marijuana ~ MDMA

Cocaine

What is it called when all products of conception are expelled from the uterus?

Complete abortion

When is the *Pre-embryonic Period*?

Consists of the first 2 weeks after conception

What type of fetal monitoring matches the following? ~ Allows the nurse to collect more data about the fetus than intermittent auscultation ~ Written recording that becomes part of the mother's chart ~ A disadvantage is that it hampers ambulation ~ Show how fetus responds in labor ~ Allows one nurse to observe two laboring women

Continuous Electronic Fetal Monitoring (EFM)

What diagnostic test matches the following? ~ Evaluation of the fetal heart rate response to mild uterine contractions ~ Done after 32 weeks gestation

Contraction Stress Test

Appearance of the *fetal scalp or presenting part* at the vaginal opening is known as what?

Crowning

When the blastocyst contains approximately 100 cells, it enters the uterus. It lingers in the uterus another *2 to 4 days before beginning implantations*. What is the *endometrium called* when it secretes rich fluids to nourish the zygote before placental circulation is established?

Decidua

Which of the following three forms of childbirth education was the first to be called natural childbirth and focused on preventing the fear-tension-pain cycle, he developed a method of slow abdominal breathing in early labor and rapid chest breathing in advanced labor. ~ Dick-Read Childbirth Education ~ Bradley Childbirth Education ~ Lamaze Childbirth Education

Dick-Read Childbirth Education

Which *classification of twin* matches the following? ~ Same or different gender ~ May not have similar physical traits ~ These twins have a separate placenta, and the sex and genetic makeup can vary Membranes and placentas are separate but may fuse if close ~ Women who conceive after age 40 increase

Dizygotic twins

Select which following that should be checked for clonus? ~ Brachial reflexes ~ Radial reflexes ~ Patellar reflexes ~ Dorsiflexing the woman's foot sharply and then releasing it while her knee is held in a flexed position

Dorsiflexing the woman's foot sharply and then releasing it while her knee is held in a flexed position

Which fetal circulatory structure is responsible for allowing blood to bypass the liver and enter the inferior vena cava?

Ductus Venosus

Which of the following types of deceleration are caused by head compressions and occur with contractions when the FHR returns to baseline by the end of the contraction? ~ Early ~ Late ~ Variable

Early

What *phase of dilation* matches the following? ~ Cervix is at 0 - 3 cm dilated ~ Contractions mild and infrequent ~ Gradually increased strength & intensity ~ *Woman sociable & excited; cooperative but anxious* ~ Pain is usually mild at this phase ~ Duration 30 to 40 seconds

Early Latent Phase

What *hypertensive disorder* can be identified by the following? ~ Occurring after 20 weeks of pregnancy ~ Progression hypertension to generalized seizures ~ Tonic-clonic movements ~ Breathing stops ~ Unlikely to recall event ~ FHR pattern ~ Magnesium sulfate is drug of choice

Eclampsia

Implantation of a fertilized ovum outside the uterus in which more than 98% of the time occur in fallopian tube due to scarring/abnormality is known as what? (Hint: Methotrexate or surgery are used if unruptured)

Ectopic Pregnancy

The following are s/s of what pregnancy complication? ~ Abdominal pain ~ Vaginal spotting ~ Missed period ~ Ruptured tube symptoms ~ Sudden, sever pain in one of the lower quadrants ~ Profuse bleeding (hypovolemic shock) ~ Radiating scapula pain

Ectopic Pregnancy

What is the disease that occurs when *anti-Rh antibodies cross the placenta* and destroy fetal erythrocytes?

Erythroblastosis fetalis

Externally rotating the fetus after 37 weeks gestation with ultrasonography so that it will have a cephalic presentation is known as what? (Hint: *Terbutaline* is used to relax the uterus)

External Cephalic Version

The Doppler transducer and toco-transducer are examples of internal or external devices used for continuous electronic fetal monitoring?

External devices

*True or false*: If non-reassuring fetal signs are present, the External Cephalic Version is performed to allow emergency cesarean delivery if necessary.

False (Reasoning: While it is most commonly used to prepare for a possible C-section, a ECV would add stress to the fetus, who already is functioning with reduced physiologic reserve)

Do the following match *true or false labor*? ~ Contractions Rarely follow a pattern ~ Contractions Vary in length and intensity ~ Contractions frequently stop with ambulation and position changes and eventually stop with relaxation interventions ~ Discomfort in abdomen and groin ~ *Cervix does not change* ~ There is no significant change in fetal position

False Labor

What occurs when one spermatozoon enters the ovum and the two nuclei containing the parents' chromosomes merge?

Fertilization (turning the ovum unto a zygote)

The relationship of fetal body parts to one another is known as what?

Fetal Attitude

The following are danger signs for what? ~ FHR outside range of *110 to 160 bpm* ~ Meconium-stained (greenish) amniotic fluid ~ Cloudy, yellowish, or foul-smelling amniotic fluid ~ Excessive frequency or duration of contractions ~ Incomplete uterine relaxation and intervals shorter than 30 seconds between contractions ~ Maternal hypotension ~ Maternal hypertension ~ Maternal fever *(38°C [100.4°F] or higher)*

Fetal Distress

The relationship of the fetal head and buttocks axis to that of the mother is known as what?

Fetal Lie

The part of the fetus that lies closest to or has entered the true pelvis is known as what?

Fetal Presentation

The measurement of the descent of the fetal presenting part in relation to the level of the ischial spines of the maternal pelvis is known as what?

Fetal Station

What mechanical disruption results from tears in the inner sac (amnion) of the fetal membranes and can result in fetal deformations or intrauterine limb amputations?

Fibrous amniotic bands

What *stage of labor* matches the following? ~ Begins with the onset of contractions until full dilation of the cervix (10cm). ~ This is the longest stage for both the nullipara and multipara ~ *Contains 3 Phases*: Early Latent, Mild/Active, Transitional

First Stage: Dilation

What type of anemia can be classified by the following? ~ Maternal needs double during pregnancy ~ A deficiency results in a decrease in rate of DNA synthesis resulting in the presence of large immature RBCs (megaloblasts) ~ Spontaneous abortions can result ~ Abruption placentae can result ~ Fetal anomalies can result ~ Neural tube defects can result

Folic Acid Deficiency Anemia (Note: The best dietary sources of folic acid are liver, kidney beans, lima beans and fresh dark green leafy vegetables)

What *stage of labor* matches the following? ~ 1-4 hours following birth ~ *Monitor physiologic changes closely* ~ Vital signs, uterine tone, vaginal drainage and assessing perineal tissue are important during this time ~ Assess bladder for fullness ~ Assess for s/s of hemorrhage by assessing lochia (normal vaginal discharge after birth) ~ Promote comfort and administer analgesics as ordered ~ Ideal bonding time for new family

Fourth Stage: stabilization

What *childbirth setting* can be classified by the following? ~ Designed to provide maternity care to low-risk women outside the hospital setting ~ Provide gynecologic services and counseling ~ Birth often done by certified nurse midwife ~ Advantage: less expensive, safe and home-like setting for the low risk women ~ Disadvantage: *Not equipped for major obstetric emergencies*

Freestanding Birth Centers

What does *GTPAL* stand for in terms of pregnancy Hx?

G- Gravida (# pregnancies) T- Term pregnancies (40 weeks) P- Preterm pregnancies (before 38 weeks) A- Aborted pregnancies L- Living children now

The *development* of ova in the woman and sperm in the man is known as what?

Gametogenesis

What disorder can be classified by the following? ~ Disorder of carbohydrate metabolism caused by partial or complete lack of insulin secretion by the beta cells of the pancreas ~ Without insulin, glucose accumulates in the blood ~ Body metabolizes proteins and fat to compensate and meet energy needs ~ Thirst increases (polydipsia) ~ Fluid moves from tissue into blood resulting in dehydration, polyuria, glycosuria

Gestational Diabetes Mellitus (GDM)

What form of hypertension matches the following? ~ BP elevation after 20 weeks that is *NOT accompanied by proteinuria* ~ May progress to preeclampsia

Gestational Hypertension

The number of pregnancies can be referred to as what?

Gravida

Use the following to fill in the "?", *Gravida(?), Para(????)*? Sue had two children at 40 weeks, one child at 32 weeks, no abortions or miscarriages and all three children are living. G- Gravida (# pregnancies) T- Term pregnancies (40 weeks) P- Preterm pregnancies (before 38 weeks) A- Aborted pregnancies L- Living children now

Gravida(3), Para(2103)

The following are s/s of what cardiovascular condition? ~ Dyspnea ~ Syncope with exertion ~ Hemoptysis ~ Paroxysmal nocturnal dyspnea ~ Chest pain with exertion ~ Cyanosis ~ Clubbing ~ Diastolic, presystolic or continuous heart murmur ~ Cardiac enlargement ~ Loud, harsh systolic murmur associated with a thrill ~ Serious dysrhythmias

Heart Disease

What virus can be classified by the following? ~ Can be transmitted by blood, saliva, vaginal secretion, semen, breast milk, and it readily crosses the placenta ~ The infant is at risk for developing many infections at birth due to contact the disease by blood or vaginal secretions ~ Prematurity, low birth weight, chronic liver disease and neonatal death are common effects ~ The infant is likely to become a chronic carrier and a continuing source of infection

Hepatitis B

What childbirth setting can be classified by the following? ~ Advantage: keeps family together in own environment ~ Disadvantage: Long transfer time to hospital in an emergency

Home Births

What does a "4" mean on the Deep Tendon Reflex Rating Scale?

Hyperactive reflex; clonus may also be present (Note: Clonus is rapidly alternating muscle contraction and relaxation)

Persistent, uncontrollable vomiting during pregnancy is known as what?

Hyperemesis Gravidarum

Are the following s/s of hypoglycemia or hyperglycemia in a newborn? ~ Fatigue ~ Flushed, hot skin ~ Dry mouth, excessive thirst ~ Frequent urination ~ Rapid, deep respirations ~ Drowsiness, headache ~ Depressed reflexes

Hyperglycemia

What type of contraction can be classified by the following? ~ Shorter intervals less than 2 mins apart ~ Longer than 90-120 secs ~ Incomplete relaxation of the uterus ~ Report immediately

Hypertonic (tachysystole) contractions

Contractions that are uncoordinated and erratic in their frequency, duration and intensity is known as what?

Hypertonic Labor Dysfunction

Are the following s/s of hypoglycemia or hyperglycemia in a newborn? ~ Shakiness ~ Sweating ~ Pallor, cold, clammy skin ~ Disorientation ~ Headache ~ Hunger ~ Blurred vision

Hypoglycemia

When antihypertensive meds are given to a woman receiving magnesium sulfate, what can result, reducing placental perfusion?

Hypotension

What type of problem with powers of labor matches the following? ~ Uterine contractions are too weak to be effective during labor ~ Most likely to occur in women with an over-distended uterus

Hypotonic Labor Dysfunction

The following are s/s of what? ~ Fetal heart changes ~ Rising weak pulse ~ Rising respiratory rate ~ Shallow irregular respirations ~ Falling blood pressure ~ Decreased urine output ~ Pale skin ~ Cold clammy skin ~ Faintness ~ Thirst

Hypovolemic Shock

What intervention needs to be done immediately if hypovolemia or fetal compromise occurs in a pt with *placenta previa*?

Immediate delivery via stat C/section

The following are signs of what? ~ Increased vaginal discharge ~ Bloody show ~ Rupture of membranes ~ Energy spurt ~ Small weight loss

Impending Labor

Why would you place a pregnant PT on her left side while on bed rest? (Note: NEVER place in supine position)

Improves the blood flow to the placenta and more effectively providing oxygen and nutrients to the fetus

What is the number one thing you want to do for the *father or co-parent*?

Include the individual

What type of fetal monitoring matches the following? ~ Allows the mother greater freedom of movement ~ It is the only method possible if the mother is using a whirlpool or shower during labor, and is the method used with home deliveries ~ Used to collect data about the fetus during a small part of labor

Intermittent Auscultation

What type of version technique would be used in an emergency procedure, for example during the birth of twins to change the fetal presentation of the second twin?

Internal Version

The Fetal Spiral Electrode where membranes must be ruptured/cervix dilated and the intrauterine pressure catheter (IUPC) are examples of internal or external devices?

Internal devices

What can cause the following? ~ Multiple injury sites, particularly of the abdomen, face, and breast ~ Increased risk of contracting STDs and HIV ~ Prenatal care started late ~ Missed appointments ~ Vaginal bleeding ~ Severe nausea and vomiting ~ Kidney or urinary tract infections ~ Low weight gain ~ Anemia ~ Use of alcohol and illicit drugs are increased ~ Infants have higher risk of prematurity, low birth weight, admission to neonatal ICU, and neonatal deaths

Intimate partner violence (IPV)

The following are *s/s of what type of anemia* in pregnancy? ~ *Pallor/paleness* ~ Fatigue ~ Lethargy ~ Pica ~ RBCs are microcytic and hypochromic ~ Reduces fetal oxygen supplies ~ Tachycardia ~ Inflammation on the lips and tongue (Hint: 1000 mg/day is recommended or Ferrous Sulfate treatment)

Iron Deficiency Anemia

What intervention should take place if the umbilical cord is looped around the infant's neck and is too tight to slip it over the head (aka nuchal cord).

It must be clamped in 2 places and cut

What childbirth setting can be classified by the following? ~ Similar to LDR ~ Not transferred to a postpartum unit after recovery ~ Advantage: support person encouraged stays with the mother and infant, sleeping equipment may be provided

Labor, Delivery, Recovery, and Postpartum Rooms (LDRP)

What childbirth setting can be classified by the following? ~ One setting for labor, delivery and recovery ~ Advantage: home-like and comfortable, healthy infant remains with mother throughout stay ~ Disadvantage: Family may regard technologic components as disadvantages

Labor, Delivery, and Recovery Rooms (LDR)

Which of the following three forms of childbirth education is the most popular method used today and was often called psychoprophylaxis because it uses the mind to prevent pain. It involves concentration and conditioning to help the woman respond to contractions with relaxation and various techniques to decrease pain. ~ Dick-Read Childbirth Education ~ Bradley Childbirth Education ~ Lamaze Childbirth Education

Lamaze Childbirth Education

Which of the following types of deceleration are caused by uterus placental insufficiency and occurs with the peak of contractions when FHR returns to baseline after the end of the contraction? ~ Early ~ Late ~ Variable (Hint: Give 10L O2, IV fluid bolus of NS or LR, and reposition)

Late

Where should you avoid messaging during pregnancy due to DVT?

Legs

What position should a women be in during delivery?

Lithotomy

The following are examples of what medication classification that does not cross the placenta? ~ dalteparin (Fragmin) ~ enoxaparin (Lovenox) ~ fondaparinux (Arixtra) ~ tinzaparin (Innohep)

Low molecular weight Heparins

A large fetus, generally weighing over 4000 gm (8 lb 13 oz) is known as what?

Macrosomia

What is the most common anticonvulsant for pregnant women that acts as a CNS depressant relaxing smooth muscle and can cause *Hyporeflexia* if taken in excess?

Magnesium sulfate *(Note: IM can be used but is painful so IVPB is preferred)*

In terms of variability, a variation in FHR > 25 bpm is known as which of the following? ~ Absent/Minimal ~ Moderate ~ Marked variability

Marked variability

What is it called when the mother counts the number of fetal movements in a prescribed period of time?

Maternal Assessment of Fetal Movement (Kick Counts)

The process in which cells divide to form gametes (from 46 chromosomes to 23) is known as what?

Meiosis

What should you use to *clean the perineal area*?

Mild soap and warm water

What *phase of dilation* matches the following? ~ Cervix is 4 - 7 cm dilated ~ Complete effacement ~ Contractions moderate to firm every 2-5 mins ~ Duration 40-60 seconds. ~ Contraction intensity & frequency increase ~ *Woman less sociable, turns inward* ~ May ask for pain medication *aka epidural*

Mild/Active Phase

In terms of variability, a variation in FHR of 6-25 beats per min is known as which of the following? ~ Absent/Minimal ~ Moderate ~ Marked variability

Moderate

Which *classification of twin* matches the following? ~ The twins carry the same genetic code and are the same sex ~ May have two amnions (inner membranes) but a single chorion (outer membrane) or may have two amnions and two chorions ~ They share a placenta, or have two placentas that may fuse and appear as one at birth

Monozygotic twins

The following are *common complications* to what type of pregnancy? ~ Hypertension ~ Preterm labor ~ Placental abruption ~ Placenta previa ~ Gestational diabetes ~ Congenital anomalies ~ Low birth weight ~ Postpartum hemorrhage

Multifetal pregnancies

Someone who has been pregnant multiple times can be referred to as what?

Multigravida

A woman who has had more than one pregnancy progress after viability (pregnancies that progress from 20 weeks on) can be referred to as what?

Multipara

Do maternal and fetal blood share the same flow?

No

What *diagnostic test* matches the following? ~ Noninvasive, 20 - 40 min test ~ HOB 45 degrees with pt tilted to one side ~ Consists of monitoring only ~ Identifies how fetal heart rate responds to fetal movement showing oxygenation ~ Adequate accelerations (with or without movement) are reassuring ~ Uses tocotransducer (movement) and ultrasound transducer (FHR)

Non-Stress Test

What does a "2" mean on the Deep Tendon Reflex Rating Scale?

Normal reflex

Someone who has had a pregnancy progress to 20 weeks can be referred to as what?

Nullipara

What should be observed/recorded for a ruptured membrane via spontaneous or artificial?

Observe time, amount, color and odor. (Note: Confirmation is done with Nitrazine paper or fern test)

An abnormally small volume of amniotic fluid reduces the cushion surrounding the fetus and may result in deformations and can interfere with fetal lung development is known as what? (Hint: Mechanical Disruption)

Oligohydramnios

*Formation of female gamete* is known as what?

Oogenesis

What type of birth is performed when awaiting vaginal birth would compromise mom or fetus, or both such as the following? ~ Persistent non reassuring FHR ~ *Prolapse umbilical cord* ~ Fetal malpresentation ~ Hemorrhagic conditions ~ Dystocia ~ Cephalopelvic disproportion ~ Hypertension ~ Maternal disease ~ Active genital herpes ~ Some previous uterine surgery

Operative Cesarean Birth

What diagnostic test matches the following? ~ The gold standard for diagnosing diabetes ~ BG must be <95 mg/dL after fasting from midnight ~ 100 g of oral glucose solution taken ~ After 1h BG must be <180 mg/dL ~ After 2h BG must be 155 mg/dL ~ After 3h BG must be 140 mg/dL

Oral Glucose Tolerance Test

The number of deliveries after viability (pregnancies that progress from 20 weeks on) can be referred to as what?

Para

The following can be classified as which of the four P's for the Birth Process? ~ Bony pelvis and the soft tissues of the pelvis and perineum ~ Uterus: During labor the walls of the upper uterus thicken while those of the lower uterus become thinner ~ Cervix: Dilates in response to the contractions. ~ Vagina: Capable of stretching to allow passage of the fetus ~ Perineum: The muscles are stretched and thinned by the pressure of the fetus

Passage

The following can be classified as which of the four P's for the Birth Process? ~ Includes the fetus along with the placenta and membranes ~ Usually enters the pelvis head first ~ The bones in the skull are not fused allowing the boney plates to move and overlap as they go through the birth canal *(Molding)*

Passenger

What diagnostic test consists of aspirating fetal blood from the umbilical cord for prenatal diagnosis or therapy?

Percutaneous Umbilical Blood Sampling

*Implantation of the placenta in the lower uterus*; as a result the placenta is closer to the internal cervical os than the presenting part of the fetus is known as what?

Placenta Previa

The *following are s/s* of what pregnancy complication? ~ *Painless, profuse, bright red vaginal bleeding* ~ Bleeding results from tearing of the placental villi ~ Bleeding may not occur until labor starts (Note: NO manual vaginal exam, use ultrasonography to confirm)

Placenta Previa

Immediately following a delivery can be referred to as what?

Postpartum

Involuntary uterine contractions which cause the cervix to open, that propel the fetus downward through the birth canal and matches the following is which of the four P's for the Birth Process? ~ Primary: Responsible for effacement and dilation of the cervix ~ Secondary: Bearing down efforts of the woman which add to the power of the expulsive forces but have no effect on cervical dilation

Powers

What type of birth occurs unexpectedly, with no trained birth attendant present after a labor of any duration?

Precipitous Birth

What type of labor can be classified by the following? ~ Completed in less than 3 hours ~ Labor begins abruptly and intensifies quickly ~ Contractions may be frequent and intense

Precipitous Labor

The following can lead to what *hypertensive disorder*? ~ First pregnancy ~ Age > 35 ~ African American ~ Anemia ~ Family history of PIH ~ Inadequate prenatal care ~ Chronic HTN ~ *Chronic renal disease* ~ Obesity ~ Diabetes mellitus ~ Antiphospholipid Syndrome ~ *Multifetal pregnancy* ~ Angiotensin gene T235 ~ Family Hx of the same condition

Preeclampsia

What form of *hypertension matches the following*? ~ *Occurring after 20 weeks of pregnancy* ~ SBP > or = 140 ~ DBP > or = 90 ~ Significant proteinuria

Preeclampsia

The following are danger signs for what? ~ Vaginal bleeding ~ Fluid from vagina ~ *Swelling/edema of fingers or puffiness of face & eyes* ~ Persistent headache ~ Visual disturbances ~ Severe abdominal or epigastric pain ~ Chills or fever ~ Pain or burning with urination ~ *Persistent vomiting* ~ Lack of fetal movement ~ Signs or symptoms of preterm labor ~ Uterine contractions ~ Cramps ~ Constant or irregular low backaches ~ Pelvic pressure ~ Watery vaginal discharge

Pregnancy

Woman's membranes rupture at term, 38 weeks or more gestation, before the labor contractions begin is known as what?

Premature Rupture of Membranes (PROM)

What type of labor occurs after 20 and before end of the 37th week (38 weeks) gestation?

Preterm Labor (PTL)

Woman's membranes rupture before term, the end of the 37th week (38 weeks) or less, with or without contractions is known as what?

Preterm, premature rupture of the membranes PPROM

A women who is pregnant for the first time can be referred to as what?

Primigravida

Someone who has had one delivery progress after viability (pregnancies that progress from 20 weeks on) can be referred to as what?

Primipara

Why is general anesthesia not recommended for uncomplicated vaginal births?

Produces respiratory depression in both mother and fetus

What is it called when the cord slips downward after the membranes rupture, subjecting it to compression between the fetus and pelvis? (Hint: Requires C-Section)

Prolapsed Umbilical Cord

What type of pregnancy lasts longer than 42 weeks and commonly causes hypoglycemia in the baby?

Prolonged Pregnancy

Name four key nutrients in pregnancy.

Protein - 25 g/day Calcium - 1000mg/day Iron - 18 mg/day Folic Acid - 600 mcg

The following are what type of insulin? ~ insulin aspart (Novolog) ~ *insulin lispro* (Humalog) ~ insulin glulisine (Apidra)

Rapid Acting

Are the following signs *presented at 34 weeks* reassuring or non-reassuring for a NST? ~ At least two fetal heart accelerations, with or without *fetal movement (although with is preferred)* ~ Occur within a 20-minute period, peak at least 15 beats per minute (beats/min) above the baseline, and last 15 seconds ("15 by 15" from baseline to baseline)

Reassuring

What does a "0" mean on the Deep Tendon Reflex Rating Scale?

Reflex absent

What does a "1" mean on the Deep Tendon Reflex Rating Scale?

Reflex present, hypoactive

What *stage of labor* matches the following? ~ Full dilation to birth ~ Contractions firm; slightly less frequent & shorter duration ~ Urge to push with each contraction ~ *Women regains control*

Second Stage: delivery

What mostly occurs during labor or the first 24hrs after birth that requires continuous monitoring of the mother and fetus if severe preeclampsia is present? (Hint: Intrapartum)

Seizures

Formation of male gamete is known as what?

Spermatogenesis

*Termination of pregnancy without action* by the woman or another person and can cause the following is known as what? ~ Maternal infections ~ Maternal endocrine disorders ~ Abnormalities of the reproductive organs

Spontaneous abortion aka miscarriage

*Mild to moderate exercise* is normally encouraged as long as there are no predisposing conditions, which of the following would NOT be recommended to a pregnant patient? ~ Stationary bike ~ Yoga ~ Walking ~ Supine Inner Tubing

Supine Inner Tubing

What agent in the fetal environment can either cause or increase the likelihood that a birth defect will occur such as the following examples? ~ Infections ~ Ionizing Radiation (x ray) ~ Drugs and other substances ~ Maternal Hyperthermia (sauna) ~ Pollutants ~ Diabetes mellitus and PKU (Hint: Most agents cross the placenta and affect the developing fetus)

Teratogens

By the end of what week are all major organ systems in place?

The 8th week

Chorioamnionitis is infection of what?

The Amniotic Sac

Which fetal circulatory structure is responsible for the majority of the blood from the right ventricle to join the oxygenated blood in the aorta?

The Ductus Ateriosus

A sac made up of the chorion and the amnion that contains the fetus and amniotic fluid is known as what?

The amniotic sac

Why are pregnant mothers going into labor often given a *foley catheter*?

The bladder is the most common soft tissue obstruction and there is a high risk of lacerating it during a C-section

Which fetal circulatory structure is responsible for *blood entering the heart from the vena cava* & directed across the right atrium to the left atrium?

The foramen ovale

Why are teenagers *more likely to have complications* during pregnancy?

They are not physically mature yet

What *stage of labor* matches the following? ~ Begins with delivery of baby and ends with delivery of the placenta ~ Average time is 5 to 30 minutes ~ Uterine contraction controls bleeding ~ *Oxytocin & breastfeeding stimulate contractions* ~ Minimal pain; cramping

Third Stage: Delivery of the placenta

What childbirth setting can be classified by the following? ~ Small functional room for labor ~ Moved to delivery area ~ Transferred to recovery area ~ To postpartum unit ~ Advantage: safe ~ Disadvantage: impersonal, multiple moves, uncomfortable for mother, disrupts family's time together, separate parents and infant

Traditional

What *phase of dilation* matches the following? ~ Cervix is 8 - 10 cm dilated ~ Shortest phase ~ Contractions firm; q 1.5 to 2 min. & lasting 60 to 90 seconds ~ *Woman may become uncooperative & hostile; feeling of losing control*

Transitional Phase

If the maternal pelvis is adequate and the soft tissues yield easily to fetal descent, little maternal injury is likely during a precipitous birth, what can occur if he soft tissues are firm and resist stretching?

Trauma (uterine rupture, cervical lacerations, and hematoma) of the vagina or vulva may occur

True or false: ~ The inner cell mass develops in the fetus. ~ The outer layer of cells develops as the placenta and fetal membranes.

True

Do the following match *true or false labor*? ~ Contractions: Regular, closer together, stronger, last longer ~ Contractions start in lower back and then lower abdomen ~ Contractions cannot be stopped ~ *Cervix softens, effaces and dilates* ~ Fetus descends into the pelvis

True Labor

During the second stage of labor (full cervical dilation to birth of the baby) the woman feels an urge to push and bear down as the fetus distends her vagina and puts pressure on her rectum, what other factor contributes to the propelling of the fetus through the pelvis? *(Hint: Blatantly obvious)*

Uterine Contractions

What occurs when the uterus completely or partly turns inside out, usually during the 3rd stage of labor and is uncommon but potentially fatal?

Uterine Inversion

*A tear in the uterine wall* that occurs if the uterine muscle cannot withstand the pressure against it that may precede labor's onset and has the following s/s is known as what? ~ May have no symptoms ~ Shock due to bleeding into the abdomen ~ Abdominal pain ~ Pain in the chest, between the scapulae, or with inspiration ~ Cessation of contractions ~ Abnormal or absent fetal heart rates ~ Palpation of the fetus outside the uterus

Uterine Rupture

Which of the following types of deceleration are caused by cord compression and occurs during or between contractions with their shape, duration, depth varying (as well as falling and rising abruptly)? ~ Early ~ Late ~ Variable (Hint: Amnioinfusion or reposition to help)

Variable

Do veins or arteries carry freshly oxygenated & nutrient-laden blood to the fetus?

Vein

In what diagnostic test is the fetus stimulated with sound; expected response is acceleration of fetal heart rate?

Vibroacoustic Stimulation Test

How often should the FHR be monitored for the *Second-Stage Labor* for a women without risk factors?

q15min

How often should the FHR be monitored for the *Active First-Stage Labor* for women with risk factors?

q15min after a contraction

How often should the FHR be monitored for the *Active First-Stage Labor* for women without risk factors?

q30min after a contraction

How often should the FHR be monitored for the *Second-Stage Labor* for a women with risk factors?

q5min

When should anticoagulants *NOT be taken*? (Name at least 2)

~ *Coagulation disorders* ~ *Ulcer disease* ~ *Malignancy* ~ Recent surgery ~ Active bleeding ~ Imminent labor

Explain if the level of insulin required is normally decreased, increased, or maintained during the following time periods: ~ First Trimester ~ Second/Third Trimester ~ During Labor ~ Postpartum

~ *Decreased* during First Trimester ~ *Increased* during Second/Third Trimester ~ *Maintained* During Labor ~ *Decreased* Postpartum

What is most common purpose for *midtrimester amniocentesis*?

~ *Detecting chromosomal abnormalities is the most common* ~ Evaluate the fetal condition when the woman is sensitized to Rh-positive blood ~ Diagnose intrauterine infections ~ Investigate amniotic fluid Alpha-fetoprotein (AFP)

What are some nursing interventions that can treat *heartburn* in pregnant patients? (Name at least 3)

~ *Eat small meals every 2 to 3 hours* and avoid fatty, acidic, or spicy foods ~ Eliminate smoking, coffee, and carbonated beverages ~ Avoid citrus fruits, juices, tomato based products, chocolate, and peppermint ~ Try chewing gum ~ Avoid bending over or lying flat ~ Wear loose-fitting clothes ~ Take deep breaths and sip water to help relieve the burning sensation. ~ Take calcium-magnesium based antacids after meals and at bedtime ~ *Remain upright for 1 to 2 hours* after eating ~ Avoid eating or drinking for 2 to 3 hours before bedtime ~ Sleep with an extra pillow to elevate your head

How should leaking vaginal fluid be observed/examined?

~ *External Vaginal Exam* ~ Color, consistency, odor, and amount

Contractions are evaluated for what *four main traits*?

~ *Frequency* (5 contractions in 10 min) ~ *Intensity* ~ *Duration* (<90sec) ~ Uterine resting tone (<20 resting tone)

Name a nursing intervention that can be provided to a person with hyperemesis gravidarum? (Name at least 2)

~ *Meals every 2-3 hours* ~ Encourage bland low fat diet with K & Mg rich foods (*electrolytes and fluids*) ~ *Intake & output* ~ *Daily weights* ~ Monitor urine for ketones ~ Sitting upright after meals reduces gastric reflux ~ Monitor skin turgor & mucus membranes

When can *gender* be determined in a fetus and which parent is responsible for the sex of the child?

~ 12 weeks of gestational age ~ Father is responsible for the sex

How often should contractions occur for first and second pregnancies before they should go to a birthing facility?

~ 5 minutes apart for 1 hour for first labor (pregnancy) ~ 10 minutes apart for 1 hour for second and subsequent labors (pregnancies)

What is the normal blood loss for a vaginal birth and C-section?

~ 500mL for vaginal ~ 1000mL for c-section

What are some forms of medical management for Hypotonic Labor Dysfunction?

~ Amniotomy ~ IV or oral fluids ~ Emotional support ~ Change positions ~ Have PT ambulate to enhance contractions

What two main medication classifications could be used to treat *Hyperemesis Gravidarum* that should be administered at the lowest effective does possible?

~ Antiemetics ~ Antiulcer

What are the two most common indication for an amniocentesis during the third trimester?

~ Assess if fetal lungs are mature enough to adapt to extrauterine life ~ Evaluate the fetal condition when the woman has Rh isoimmunization

What should *BP and temperature* be below for maternal patients?

~ BP <140/90 ~ T <100.4 F

If an epidural or subarachnoid block is given, how often should a nurse take vitals and what should be administered beforehand?

~ Baseline set of vitals (BP q2min) ~ 1000cc bolus before

What *two main actions* must be done before administering insulin?

~ Blood glucose test ~ Two licensed practitioners must verify

Select which of the following DTR's should be checked for hyperreflexia: ~ Brachial reflexes ~ Radial reflexes ~ Patellar reflexes ~ Dorsiflexing the woman's foot sharply and then releasing it while her knee is held in a flexed position

~ Brachial reflexes ~ Radial reflexes ~ Patellar reflexes

Which of the following three forms of childbirth education was the first to include the father as a support person for "husband-coached childbirth? ~ Dick-Read Childbirth Education ~ Bradley Childbirth Education ~ Lamaze Childbirth Education

~ Bradley Childbirth Education

Out of the following forms of *Nonpharmacological Pain Management*, which one is most commonly used? ~ Hydrotherapy ~ Mental Stimulation (have a focus point) ~ Breathing Techniques (deep breaths followed by shorter breaths) ~ Relaxation (TV, soft music) ~ Environmental (dim light, no loud noises) ~ Cutaneous (message, reposition, warm packs)

~ Breathing Techniques (or gate control theory)

Name four categories of hypertensive disorders for pregnancy.

~ Chronic Hypertension ~ Gestational Hypertension ~ Preeclampsia ~ Eclampsia

What are the *four signs* of hyper toxicity for magnesium sulfate?

~ Decreased respirations <12 ~ Decreased urinary output <30mL/hr ~ *Decreased tendon reflexes* ~ Decreased LOC (alert, drowsy, confused, blurred vision)

What are the *three shunts* that allow most blood from the placenta to bypass the fetal lungs and liver?

~ Ductus Venosus ~ *Foramen Ovale* ~ Ductus Arteriosus

What are some examples of regional pain management? (Name at least 2)

~ Epidural Block ~ Intrathecal Opioids Analgesics ~ Subarachnoid (spinal) Block (SAB) ~ Systemic Drugs

What are the only *3 positive signs* of pregnancy?

~ Fetal Heartbeat ~ Fetal Movements ~ Visualization of Fetus

The Hepatitis B vaccine can be given to the mother at *any time during pregnancy*, however, when should it be administered to the newborn? (Hint: *Three separate doses*)

~ First dose before discharge ~ Second dose given 1 to 2 months later ~ Third dose given at 6 to 18 months

Which of the following would you not want a pregnant women to do? ~ Rest/Sleep ~ Moderate Activity/Exercise ~ Employment Planning ~ Bathing ~ Sex ~ Hot Tubs/Saunas ~ Douching ~ Tight Fitting Clothing ~ Travel to remote locations during 3rd Trimester

~ Hot Tubs/Saunas ~ Douching ~ Tight Fitting Clothing ~ Travel to remote locations during 3rd Trimester

Which of the following *complications of Gestational Diabetes Mellitus (GDM)*, are the most common in newborns? ~ Spontaneous abortions ~ Hypoglycemia ~ Preeclampsia is two to three times more likely UTIs ~ Premature rupture of membranes ~ Hypocalcemia ~ Shoulder dystocia (wide shoulders) ~ Injury to the birth canal ~ Hyperbilirubinemia ~ Increased Cesarean birth rate ~ Postpartum hemorrhage ~ Hypoglycemia ~ Respiratory Distress Syndrome ~ Neural tube defects ~ Caudal regression syndrome ~ Variations in fetal size

~ Hypoglycemia ~ Hypocalcemia ~ Hyperbilirubinemia ~ Respiratory Distress Syndrome

What are four types of Problems with Powers of Labor where the contractions or pushing efforts are not adequate to expel the fetus?

~ Hypotonic labor dysfunction ~ Hypertonic labor dysfunction ~ Ineffective maternal pushing ~ Weak abdominal wall

How do you use *Nagele's Rule* to determine the duration of pregnancy?

~ Identify the first day of the last normal menstrual period ~ Count backward 3 months ~ Add 7 days

Fill in the blanks: During pregnancy, clotting factors normally ________ and thrombolytic activity __________. These changes predispose the pregnant woman to thrombus formation.

~ Increase ~ Decrease

Why is an ultrasound useful in pregnancy?

~ It can visualize structures in the body ~ *Confirm pregnancy* ~ Detect most fetal anomalies

What are some ways that *pregnancy pain* differs from other forms of pain? (Name at least 2)

~ It is part of a normal process ~ Preparation time exists ~ It is self-limiting ~ Labor pain is not constant, but intermittent ~ Labor ends with the birth of a baby

What are some *treatments* that should be used for a pregnant mother with *heart disease*? (Name at least 3)

~ Limit physical activity ~ *Avoid excessive weight gain by limiting sodium and good diet* ~ *Prevent anemia with good iron intake* ~ *Prevent infection with immunizations* ~ Frequent antepartum visits ~ Monitor weight gain ~ Frequent rest ~ O2 is administered during labor ~ Antiarrhythmics, diuretics, heparin and prophylactic antibiotics and Stool softeners may be ordered ~ Vaginal delivery is recommended with use of forceps

What are some nursing interventions for *Intimate Partner Violence*? (Name at least 2)

~ Listening ~ Developing a Personal Safety Plan ~ Affirming She Is Not to Blame ~ Providing Education ~ Providing Referrals ~ Evaluation

What are some forms of medical management for Hypertonic Labor Dysfunction?

~ Mild sedation ~ Warm showers and baths ~ Tocolytic drugs (terbutaline) may be ordered ~ Provide comfort measures ~ Emotional support

What are the *two classifications of twins*?

~ Monozygotic ~ Dizygotic

Fill in the blanks: ~ Mature ovum is released on the surface of the ______ where it is picked up by the fallopian tube and transported through the tube and awaits fertilization. ~ The ovum fertilized or not, enters the uterus approximately _____ days after its release from the ovary.

~ Ovary ~ 3 to 4

What are some reasons as to why you would not want to induce labor? (Name at least 2)

~ Placenta previa, vasa previa ~ Umbilical cord prolapsed ~ High station of the fetus ~ Active herpes ~ Abnormal size or structure of the mother's pelvis ~ Abnormal fetal presentation ~ Previous classic cesarean incision

What are the four P's for the Birth Process?

~ Powers ~ Passage ~ Passenger ~ Psyche

The placenta produces what four hormones?

~ Progesterone ~ Estrogen ~ hCG (Human chorionic gonadotropin) ~ hPL (human placental lactogen)

What are *two main side effects* of magnesium sulfate on the fetus if administered to the mother during preterm labor?

~ Reduced fetal heart rate (FHR) variability ~ Hypotonia (sluggish, floppy, or rag-doll like)

Adolescents need more calcium, phosphorus, magnesium, and zinc to meet their own growth needs, why would a teenager require more *patient teaching on nutrition* than a middle aged women?

~ Reliant on food in house ~ Body image causes reduced calorie intake ~ Normal diet is high in fast food and low in nutrition

Why is it preferred to have the zygote implant, *aka nidation*, at fundus of the uterus on the posterior wall?

~ Richly supplied with blood for optimal fetal gas exchange, nutrition, and waste elimination ~ The uterine lining is thick in the upper uterus ~ Limits blood loss after birth

Besides contractions, what are some reasons for a pregnant mother to be sent to a birthing facility? (Name at least 2)

~ Ruptured membranes ~ Bleeding other than bloody show ~ Decreased fetal movements ~ Other concerns (burning on urination, hypertension, blurred vision, etc)

Along with increased fluid intake, what is the calorie increase that a pregnant women should attain during her second and third trimester?

~ Second Trimester increase calories by 340 ~ Third Trimester increase calories by 452

Name some nursing interventions for abruption placenta? (Name at least 2)

~ Side lying position with wedge under right hip for uterine placental perfusion ~ Preparation for *immediate cesarean delivery* ~ Blood/fluid replacement (2 large-bore IV lines should be placed) ~ Foley catheter ~ Continuous external FHM ~ Frequent monitoring of vital signs, hemodynamic status ~ Oxygen via mask ~ Emotional support for pt and family ~ Patient/family teaching about medical treatment ~ Provide support for grieving family if fetus dies

Is a women's first child or subsequent rh-positive fetuses affected more by erythroblastosis fetalis and *why*?

~ Subsequent rh-positive fetuses ~ Antibodies are formed after the birth of the infant

*Flying* is generally safe for up to 36 weeks in the absence of complications of pregnancy, what are some patient teaching points you would want to give for the prevention of a PE before the trip since it is a common complication from flying?

~ Support stockings ~ Periodic movement of the legs and ambulation ~ Avoidance of restrictive clothing ~ Adequate hydration ~ Walk at least every hour

Oxytocin (Pitocin) is used to stimulate contractions, what medications can be ordered to reduce uterine activity? (Name 2)

~ Terbutaline ~ Magnesium sulfate

What *specific type of hypertension* can be classified by the following and where would it be treated? ~ Systolic BP >160 x two readings, 6 hours apart, while on bedrest ~ Diastolic BP >110 ~ Proteinuria 3+ or higher ~ Elevated *renal labs* and liver enzymes ~ Low platelets Headache ~ RUQ pain ~ Visual disturbances may or may not be present

~ Treated impatient ~ Severe Preeclampsia

While the *following are all forms of medical management* for mild preeclampsia where would it be treated and what is the only way to cure it? ~ Activity restrictions ~ BP checked in same arm 2-4 times/day ~ Daily weight: use same scale ~ Urinalysis ~ Fetal assessment (Note: Systolic BP >140 but <160; Diastolic BP >90 but <110; Proteinuria 1+)

~ Use home care ~ Only cure is delivery of the baby