RNC-OB flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Naegele's rule

Method for estimating the due date: take the first day of the last menstrual period, subtract 3 months, add 7 days, and add 1 year.

GTPAL

Obstetric history summary standing for gravida, term births, preterm births, abortions before 20 weeks, and living children; gravida counts all pregnancies including the current one.

Physiologic anemia of pregnancy

Plasma volume increases about 40 to 50 percent while red cell mass rises only about 25 percent, so hematocrit falls; values near 32 to 34 percent are expected in the second trimester.

Preeclampsia diagnostic criteria

New blood pressure of 140/90 mmHg or higher after 20 weeks gestation plus proteinuria of 300 mg per 24 hours or more, or end-organ dysfunction such as thrombocytopenia, renal or liver involvement, or pulmonary edema.

Magnesium sulfate toxicity signs

Progressive loss of deep tendon reflexes, respiratory depression below 12 breaths per minute, oliguria, and altered consciousness; calcium gluconate given intravenously is the antidote.

Betamethasone dosing

12 mg intramuscularly, repeated once after 24 hours, given between 24 and 34 weeks gestation to accelerate fetal lung maturity and reduce respiratory distress in the newborn.

Group B strep screening

Vaginal and rectal culture obtained at 36 0/7 to 37 6/7 weeks gestation; a positive result indicates the need for intrapartum penicillin prophylaxis to prevent neonatal sepsis.

Fundal height correlation

Between roughly 20 and 36 weeks, symphysis-to-fundus height in centimeters approximates gestational age in weeks; a difference of 3 cm or more suggests growth or fluid abnormality.

Fetal heart rate baseline

The mean fetal heart rate rounded to the nearest 5 beats per minute, measured over 10 minutes and excluding accelerations and decelerations; normal range is 110 to 160.

Moderate variability

Fluctuation of 6 to 25 beats per minute above and below the baseline; it is the strongest single indicator that the fetus is adequately oxygenated.

Late deceleration

A gradual, symmetric slowing of the fetal heart rate that begins after the peak of a contraction and returns after it ends; it signals uteroplacental insufficiency and requires repositioning, fluids, and provider notification.

Variable deceleration

An abrupt fall in fetal heart rate of at least 15 beats per minute lasting 15 seconds to 2 minutes, caused by umbilical cord compression; treat with position change and consider amnioinfusion.

Category III tracing

A fetal heart pattern with absent variability plus recurrent late or variable decelerations, bradycardia, or a sinusoidal rhythm; it predicts abnormal acid-base status and calls for immediate intervention and preparation for birth.

Tachysystole definition

More than five uterine contractions in 10 minutes, averaged over 30 minutes; management includes repositioning, an intravenous fluid bolus, and reducing or stopping oxytocin.

Shoulder dystocia maneuvers

McRoberts maneuver with suprapubic pressure is attempted first, followed by internal rotational maneuvers or delivery of the posterior arm; fundal pressure is never applied.

Umbilical cord prolapse

Call for help, elevate the presenting part off the cord, place the woman in knee-chest or Trendelenburg position, and prepare for immediate cesarean birth while minimizing cord handling.

Uterine involution

The fundus rests at the umbilicus right after birth, descends about 1 cm per day, and is no longer palpable abdominally by roughly 2 weeks postpartum.

Lochia progression

Lochia rubra, dark red, lasts 1 to 3 days; serosa, pink to brown, lasts 4 to 10 days; alba, yellow to white, continues until about 6 weeks.

Postpartum hemorrhage definition

Cumulative blood loss of 1000 mL or more, or any blood loss accompanied by signs or symptoms of hypovolemia, occurring within 24 hours after birth.

Uterotonic contraindications

Methylergonovine is avoided in hypertension and preeclampsia; carboprost is avoided in asthma; both are second-line agents after oxytocin for uterine atony.

Postpartum endometritis

Temperature of 38 degrees Celsius or higher after the first 24 hours postpartum with uterine tenderness and foul-smelling lochia; treated with intravenous broad-spectrum antibiotics.

Rh immune globulin postpartum

Given within 72 hours of birth to an Rh-negative unsensitized woman who delivered an Rh-positive infant, unless the infant is confirmed Rh-negative.

Apgar components

Heart rate, respiratory effort, muscle tone, reflex irritability, and color, each scored 0 to 2 at 1 and 5 minutes after birth; a total of 7 to 10 is normal.

Normal newborn vital signs

Heart rate 110 to 160 beats per minute, respiratory rate 30 to 60 breaths per minute, axillary temperature 36.5 to 37.5 degrees Celsius, and blood pressure around 60/40 mmHg.

Physiologic jaundice timing

Bilirubin elevation that appears after the first 24 hours and peaks at 3 to 5 days in term infants; visible jaundice within the first 24 hours is always considered pathologic.

Newborn glucose threshold

Screen at-risk infants; values below 25 mg/dL, or below 40 mg/dL with symptoms such as jitteriness or poor feeding, are treated with feeding or intravenous dextrose.

Vitamin K prophylaxis

0.5 to 1 mg given intramuscularly to every newborn within 1 hour of birth to prevent vitamin K deficiency bleeding, formerly called hemorrhagic disease of the newborn.

Newborn screening timing

Heel-stick blood specimen collected after 24 hours of age and before discharge, following adequate feeding, to detect metabolic, endocrine, and hemoglobin disorders.

SBAR communication

A structured handoff format using Situation, Background, Assessment, and Recommendation to convey urgent clinical information clearly and to escalate concerns about a changing patient condition.

Sentinel event

An unexpected occurrence involving death or serious physical or psychological injury that requires a root cause analysis and an organized corrective action plan.

AWHONN active labor staffing

Recommended nurse-to-patient ratio of one registered nurse for each woman in active labor, with one nurse assigned to no more than two women not in active labor.

Just culture

A safety framework that distinguishes human error from at-risk and reckless behavior, encouraging staff to report errors while retaining accountability for unsafe choices.