OB Meds
Fetal Monitoring
Labor Emergencies
PPH
Previa/Abruption
100

This medication is administered IM in two doses, 24 hours apart, to accelerate fetal lung maturity before 34 weeks' gestation.

What is...?

Betamethasone

100

This type of fetal monitoring uses an ultrasound transducer to measure fetal heart rate and a tocodynamometer to measure contractions.

What is...?

External fetal monitoring

100

This fetal heart rate pattern is most commonly seen with an umbilical cord prolapse.

What are...?

Variable decelerations

100

A postpartum client saturates a perineal pad in less than this amount of time. The nurse should notify the healthcare provider immediately.

What is...?

15 minutes

100

This placental disorder presents with bright red, painless vaginal bleeding.

What is...?

Placenta previa

200

This medication is contraindicated after 32 weeks because it may prematurely close the fetal ductus arteriosus.

Indomethacin

200

This invasive monitoring method requires ruptured membranes and at least 2 cm cervical dilation.

What is...?

Internal fetal monitoring

200

The nurse discovers a prolapsed umbilical cord after spontaneous rupture of membranes. What is the nurse's first priority?

What is...?

Lift the fetal presenting part off the cord using a sterile gloved hand.

200

Postpartum hemorrhage is defined as cumulative blood loss of at least this amount or blood loss with signs of hypovolemia.

What is...?

≥ 1,000 mL

200

This placental disorder presents with dark red, painful vaginal bleeding.

What is...?

Placental abruption

300

This medication is contraindicated in clients with asthma.

What is...?

Carboprost

300

When minimal variability may be due to fetal sleep, the nurse uses this device to stimulate the fetus.

What is...?

: Vibroacoustic stimulator

300

After relieving cord compression, which two maternal positions improve fetal oxygenation?

What are...?

  • Knee-chest position
  • Trendelenburg position
300

Name four signs of hypovolemic shock seen with postpartum hemorrhage.

What are...?

  • Tachycardia
  • Hypotension
  • Dizziness
  • Pallor (or decreased urine output/altered mental status) 
300

This nursing intervention is contraindicated in placenta previa because it may disrupt placental vessels.

What is...?

Vaginal examination

400

This obstetric emergency may occur if misoprostol is used in a client with a previous cesarean birth.

What is...?

Uterine rupture

400

A laboring client is receiving oxytocin.

Assessment:

  • Contractions every 90 seconds
  • Six contractions in 10 minutes
  • Late decelerations
  • Moderate variability
  • Cervix 5 cm

List the nurse's priority actions in order.

  • Stop the oxytocin infusion.
  • Reposition the client to the left lateral position.
  • Increase the IV fluid rate.
  • Administer oxygen if maternal hypoxemia is present or per provider/institution protocol.
  • Notify the healthcare provider.
  • Anticipate a tocolytic (e.g., terbutaline) if uterine tachysystole persists.
  • Continue continuous fetal heart rate monitoring and prepare for possible emergent delivery if the fetal status does not improve.
400

Name four priority nursing interventions for amniotic fluid embolism.

What are...?

  • Call rapid response/start CPR if needed
  • Administer 100% oxygen
  • Prepare for intubation
  • IV fluids/vasopressors
  • Prepare for emergency cesarean
  • Administer blood products if DIC develops
400

Normally, the uterine fundus descends approximately this amount every 24 hours postpartum.

What is...?

One fingerbreadth

400

Name three things included in pelvic rest.

What are...?

  • No vaginal exams
  • No sexual intercourse
  • No labor induction/oxytocin
500

A 31-week pregnant client is admitted with preterm labor. She receives betamethasone, nifedipine, and magnesium sulfate.

Explain the purpose of each medication.

  • Betamethasone: Promotes fetal lung maturity by increasing surfactant production.
  • Nifedipine: Tocolytic that suppresses uterine contractions to delay delivery.
  • Magnesium sulfate: Suppresses contractions, provides fetal neuroprotection, and helps delay birth long enough for corticosteroids to become effective.
500

State the VEAL CHOP mnemonic.

What is...?

  • Variable = Cord compression
  • Early = Head compression
  • Accelerations = Okay
  • Late = Placental insufficiency
500

Besides abdominal pain, name three additional assessment findings of uterine rupture.

What are...?

  • Vaginal bleeding
  • Maternal shock (tachycardia, hypotension)
  • Fetal bradycardia or late decelerations
  • Palpable fetal parts through the abdomen
500

A nurse is caring for a client who delivered 20 minutes ago.

Assessment:

  • Saturated two pads within 10 minutes
  • Large clots
  • Fundus boggy and deviated to the right
  • BP 82/48 mm Hg
  • HR 138/min

Identify the most likely cause of the hemorrhage and list the nurse's priority interventions in order.

Cause: Uterine atony due to a distended bladder

Priority Interventions:

  1. Call for assistance and notify the provider.
  2. Massage the fundus while supporting the lower uterine segment.
  3. Assist the client to empty the bladder or insert a urinary catheter if necessary.
  4. Administer oxytocin and additional uterotonics as prescribed (consider methylergonovine if normotensive or carboprost if no asthma).
  5. Increase IV fluids, administer oxygen as indicated, and prepare for blood transfusion if bleeding persists.
  6. Continue frequent assessment of vital signs, uterine tone, and blood loss.
500

A 32-week pregnant client presents with:

  • Sudden onset of severe abdominal pain
  • Dark red vaginal bleeding
  • Rigid, board-like abdomen
  • BP 82/48 mm Hg
  • HR 132/min
  • Recurrent late decelerations

Identify the diagnosis and list the nurse's first five priority interventions.

Diagnosis: Placental abruption

Priority Actions

  1. Call the provider and activate the obstetric emergency response.
  2. Apply continuous external fetal monitoring.
  3. Position the client in the left lateral position.
  4. Start or increase IV fluids using large-bore IV access and obtain blood for type and screen/CBC.
  5. Prepare for an emergency cesarean delivery; anticipate blood transfusion if needed. 
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