Dressler Module 4 Complications of Labor Flashcards
(213 cards)
1
Q
Prenatal and Antepartum is referring to _____ birth
A
prior to
2
Q
Nutritional Status of newborn is greatly affected with ________ patients
A
overweight
3
Q
What are some Socio-Demographic factors that may affect birth
A
Low income No prenatal care Age (Under 16, Over 40) Parity Support System
4
Q
This fetal status test visualizes fetal & maternal structures
A
Ultrasound
5
Q
This fetal status test can be done transvaginally
A
Ultrasound
6
Q
This fetal status test is to check for abnormalities usually prior to 20 weeks
A
Amniocentesis
7
Q
This test can check for genetic diseases, quadruple screening, and fetal lung maturity
A
Amniocentesis
8
Q
This Fetal Status Test can be done externally referred to as Reactive vs Nonreactive
A
Non-stress test
9
Q
A maternal HGB test can be used to check for _______ levels and ______ levels
A
Blood and Oxygen
10
Q
An indirect coombs test can be used to check for (2)
A
Rh factor and Billy rubin
11
Q
The triple screen tests consists of what three levels and when is it usually done
A
Usually done at 16 weeks
AFP
HCG
Estriol
12
Q
AFP stands for
A
Alpha Fetal Protein
13
Q
HCG stands for
A
Human Choreographic (too much is a problem)
14
Q
Elevated estriol could lead to
A
Down Syndrome
15
Q
Glucose Screening can be used to check for
A
diabetic ketoacidosis
16
Q
Vaginal Culture can be used to check for
A
localized infection
17
Q
Newborn Vital sign norms
A
B/P 60/40
Pulse 110-160
Resp 35-45
18
Q
Excessive & difficult to alleviate N&V, in young obese non-smoker is called
A
Hyperemesis Gravidarum
19
Q
A lot of vomiting during pregnancy is called
A
Hyperemesis Gravidarum
20
Q
Signs and Symptoms of Hyperemesis Gravidarum include
A
Weight loss Dehydration Ketonuria Acetonuria Electrolyte imbalances
21
Q
What is the main difference between morning sickness and Hyperemesis
A
Dehydration
22
Q
PPN stands for
A
Partial Parenteral Nutrition
23
Q
TPN stands for
A
Total Parenteral Nutrition
24
Q
What are some treatments for hyperemesis
A
Rest
IV fluids
Antiemetics
Small Meals
25
Painless, premature dilation of cervix and being at risk for a spontaneous abortion is having an
Incompetent Cervix
26
The main job of the cervix is
stays closed to help maintain pregnancy
27
What is a Cervical Cerclage and when is it needed and when is it usually done
When the cervix is dilated more than 3cm, between 14-26 weeks and it is the SUTURING OF THE CERVIX (ARTIFICIAL PLUG TO KEEP CERVIX FROM DILATING
28
Spontaneous Abortions, Ectopic Pregnancy, Hydatidiform Mole are bleeding disorders during
Early Pregnancy
29
Placenta Previa and Placenta Abruptio are bleeding disorders during
late pregnancy
30
A spontaneous abortion is loss of pregnancy before
20 weeks
31
Abortion is the medical term for
miscarriage
32
Vaginal bleeding, closed cervix, mild cramps where the fetus is in danger is called a _______ spontaneous abortion
threatened
33
Cervical dilation, ruptured membranes, vaginal bleeding, not being able to maintain pregnancy are S&S of a _________ spontaneous abortion
inevitable
34
products of conception expelled, uterine contractions, bleeding are S&S of a ___________ spontaneous abortion
Complete
35
POC stands for
Products of conception
36
Profuse bleeding, and retained tissue parts are S&S of _______ spontaneous abortion
Incomplete
37
Fetus dies but retained, amenorrhea, foul smelling discharge or bleeding (fetus will die in utero, not expelled, becomes necrotic) is an example of a __________ spontaneous abortion
Missed
38
Infection of uterus, not all tissue is expelled is S&S of ________ spontaneous abortion
Septic
39
3 or more consecutive losses becomes to get called a ______ spontaneous abortion and the most frustrating thing is that ...
Habitual
| We don't really know what's going on
40
What is the treatment for spontaneous abortion
IV Oxytocin
Dilation and Curettage
Vacuum evacuation
41
What is the best treatment for Threatened spontaneous abortion
Bedrest
42
What does Oxytocin do
causes contractions so we can expel stuff
43
D+C is when you
scoop everything out after Dilation
44
Vacuum evacuation is ....
attached to cervix to remove products, LESS INVASIVE THAN D+C
45
Provide nursing care for Rhogam is RH
Negative
46
Not occupying uterine cavity, increases with STD's, Endometriosis is the etiology for
Ectopic Pregnancies
47
Abdomen Tenderness, Spotting, Bleeding, decreased H&H, Increased WBC, shoulder pain are S&S of
Ectopic Pregnancies
48
Referred pain is the same is ________ pain
Radiated
49
Main treatment for Ectopic Pregnancy (3)
Trans vaginal ultrasound
Methotrexate
Salpingectomy
50
decreasing production of cells, kills of rapidly growing cells, so no rupturing occurs is called
Methotrexate
51
If rupturing occurs with a Ectopic Pregnancy mom can go into
Shock
52
Removal of fallopian tubes is called
Salpingectomy
53
Nursing care of Ectopic pregnancy would include
```
Pre and post op care
Monitor at risk for shock
Grief counseling
Pregnancy counseling
Monitor HCG levels
```
54
After an ectopic pregnancy resident should wait at least _____ before next pregnancy
1 year
55
Abnormal trophoblastic tissue - avascular vesicles. Instead of layers forming, cells keep multiplying. WILL NOT DEVELOP INTO EMBRYO/FETUS is called a
Hydatidiform Mole
56
Abnormal Uterine growth, PIH, increased HCG levels, excessive N/V, and vaginal bleeding are S&S of
Hydatidiform Mole
57
Treatment for a Hydatidiform Mole would include (3)
Transvaginal Ultrasound
D&C
Rhogam (If Negative)
58
Hydatidiform Mole puts mom at high risk for
Chorionic Carcinoma
59
What is Chorionic Carcinoma
Choriocarcinoma is a quick-growing form of cancer that occurs in a woman's uterus (womb). The abnormal cells start in the tissue that would normally become the placenta, the organ that develops during pregnancy to feed the fetus. Choriocarcinoma is a type of gestational trophoblastic disease.
60
Abnormal placement of the placenta, placenta being misplaced in the uterus is called
Placenta Previa
61
Marginal Placenta Previa means fetus is placed near _____ and there is a ______ chance of c-section
Sidewall
| High
62
Partial Placenta Previa means placenta is located
comes close to cervix
63
Total placenta previa means
Placenta is completely upside down
64
With partial placenta previa, or total placenta previa c section is
guaranteed
65
Placenta Previa can be diagnosed by looking at
a sonogram
66
Painless bleeding in 3rd trimester could be a sign of
Placenta Previa
67
The goal for a resident with placenta previa is to get lots of ______ and reach ____ weeks
Bedrest
| 34
68
What are some Nursing care tactics with Placenta Previa
Monitor FHR
Assess for hemorrhage
Assess FUNDUS
69
PIH stands for
Pregnancy induced hypertension
70
PIH, H/o abruption, smoking, cocaine, PROM are means for diagnosing a
Abruptio Placentae
71
PROM stands for
Premature rupture of membrane
72
Painful bleeding, sudden bleeding, severe pain, fetal distress, hard uterus, maternal shock are S&S of
Abruptio Placentae
73
Best treatment for partial abruption is
Bedrest
74
When a resident is diagnosed with Abruptio Placentae we have about ______ to take baby out
30-45
75
Fetus not getting any circulation is called
Fetal distress
76
In complete abruption mom has a
concealed hemorrhage
77
With abruptio Placentae mom is at risk for
shock or death, Fetal brain damage, Fetal demise (Death)
78
Dysfunctional labor can also be called
Dystocia
79
Friedman curve is used to
graph dilation and descent
80
With Dystocia mom and fetus has a potential for
Infection
Postpartum hemorrhage
Exhaustion to mother
81
Dystocia can be related to
Power Contractions
Position or Presentation of fetus
Size of Fetus
82
Amniotomy is the
breaking of water
83
IV pitocin is given to
speed up contractions
84
Hypotonic Contractions are
unprogressive contractions
85
Treatment for hypotonic contractions are
Amniotomy
IV pitocin
C-section
86
Hypertonic contractions are
Strong uncoordinated contractions
87
We can diagnose Hypertonic Contractions during ______ phase
Latent
88
Hypertonic contractions can be treated with
Sedative or medication to relax uterus
89
Forceps mean to
Pull baby forward
90
Abnormal position is treated with
Forceps
| Trying to rotate to normal position
91
Cephalopelvic Disproportion is a term for saying
Head too large or pelvis too small
| Possible C-section
92
Large baby, frequently due to diabetic mother is called
Macrosomia
93
Linea Terminalis means
100% c-section
94
Precipitous Labor is labor with _____ usually completed within ___
Strong frequent contractions usually completed within 3 hours
95
During precipitous labor is more common in ______ and best thing to do is
Multips
| DO NOT LEAVE MOTHER ALONE
96
Accelerates or helps labor after it has started is called
Augmentation
97
Cervical Gel is also called
Prostaglandins
98
Dried seaweed is used to ________ and is called ______
pulls fluid out of cervix
| Laminaria
99
Nipple stimulation is increasing
secretion of oxytocin from posterior pituitary
100
Walking helps
induce labor
101
Oxytocin does..... and is usually given in
Stimulates uterine contractions
| 10units/1000cc Ringers
102
contractions closer than every 2min, longer than 90sec, rest less than 60, possible fetal distress, rupture of uterus are S&S of
Overstimulation of Oxytocin
103
What are some conditions where we don't want to induce labor
Placental abnormalities, abnormal presentation, prolapsed cord, obstructed cord, fetal distress, prior C-section with classic or low vertical incision.
104
Bikini line incision means
less healing time
105
Sometimes inducing labor can be
dangerous
106
Artificial rupture of membranes to stimulate or augment labor
Amniotomy
107
What are some potential complications of an Amniotomy (3)
Umbilical Cord Prolapse
Infection
Abruption
108
A post term pregnancy is one that lasts longer than
42 weeks
109
Post term pregnancy etiology examples are
Decrease placental perfusion risk of decrease O2 to the fetus
May pass meconium
Decrease in amniotic fluid
Fetus keeps gaining weight
110
PIH after 20 weeks, no proteinuria, Hypertension, INCREASE IN 30mm Systolic, INCREASE in 15mm Diastolic are signs of
Toxemia
111
Treatment for Toxemia includes
low salt diet, rest monitor closely make personal
112
Contractions causes B/P to go
Sky high
113
Any hypertension before 20 weeks is called _________ and is not due to ________
Essential hypertension
| Pregnancy
114
If PIH isn't treated ______ can occur
Pre eclampsia
115
Hypertension after 20 weeks is called _______ and it can be _______ or _______
20 weeks
| Mild or severe
116
Edema of hands and face, H/A, Blurry vision, and DAMAGE TO EPITHELIUM LINING of blood vessels due to low blood supply are S&S of
Pre eclampsia
117
Pre Eclampsia can lead to the __________
HELLP Syndrome / Eclampsia
118
Hemolysis Elevated Liver Enzyme Low Platelets can also be considered the
HELLP Syndrome
119
Pre eclampsia can lead to damage to the _______ causing a decrease of ______ supply
Placenta
| Oxygen
120
Treatment for Mild Pre Eclampsia includes
Limit activity
Possible CBR (complete bed rest) lying on back or left side
Antihypertensive meds
121
Treatment for Severe Pre Eclampsia includes
```
Hospitalization
Antihypertensives
MagSO4/Calcium Gluconate
Lasix
Amniocentesis
```
122
MagSO4 / Calcium Gluconate helps
decrease smooth muscle action in the myometrium
123
Once a pre eclamptic mom has had a seizure she is considered
eclamptic
124
S&S of Preeclampsia w/ a seizure, P/F abruption, Fetal compromise, Fetal death, Maternal Death are etiology examples for
Eclampsia
125
Seizures, proteinuria, DECREASED URINARY OUTPUT, INCREASED BUN & CREATININE, DECREASED PLATELETS, pulmonary edema, visual problems are S&S or
Eclampsia
126
Explain how Eclampsia can affect visual senses
pressure on optic nerve can cause eyesight blockage
127
With an eclamptic mom we might put mom on Dialysis to
Give Kidneys a rest
128
Treatment for Eclampsia includes
```
Antihypertensives
MagSO4
Calcium Gluconate
Lasix
Amniocentesis
```
129
When U/O is less than 30ml/hour mom is going into
Renal Failure
130
A sign of loss in deep tendon reflex, (coming from too much MagSO4 is ______ and we should administer ______
Hands turn out
| Calcium Gluconate
131
Nursing care for mom with Pre eclampsia / Eclampsia include
```
Quiet room
Dim lights
SIDE LYING POSITION
Seizure precautions
Padded side rails
Keep suction machine at bedside
INCREASE PROTEIN
```
132
Mom is still at risk _______ after labor for Pre eclamptic Seizure
48 hours
133
ABO blood incompatibility happens when mom is ____ and Fetus is ____ . This can cause ________ or _______
Mom is O
Fetus is A or B
Jaundice or Hepatosplenomegaly
134
Rh incompatibility happens when Mom is ____ and Fetus is ____ this can cause ______
Mom is RH-
Fetus is RH+
Leakage of antibodies
135
Treatment for blood incompatibility includes
Rhogam (immunoglobulin) 72 hours after delivery
136
In sickle cell moms we might want to administer extra
Oxygen
137
In mothers with a prolapsed cord what are the priorities
Need to decrease compression
138
In mothers with prolapsed cord what position should we put them in
Trendelenburg / Side lying
139
What are some of the things that happen with a Uterine Rupture (3)
Strong contractions with little descent
Fetal distress
Maternal shock
140
With a Uterine rupture a ______ is most likely to happen
Emergency C-section or a Hysterectomy
141
What are some nursing implications for a mom with Uterine Inversion
Fundal Massage
Cord pulled
Surgery to revert uterus
Hysterectomy
142
Define hysterectomy
hysterectomy is an operation to remove a woman's uterus
143
What are the signs and symptoms for Uterine Atony
Boggy Fundus
| Increase lochia with clots
144
No muscle tone with possible loss of contractions is called
Uterine Atony
145
Treatment for a Uterine Atony includes
Fundal massage
| Meds to increase contractions
146
Two main meds that increase contractions are
Oxytocin
| Methergine
147
Possible complications of C-sections (5)
```
Infection
Hemorrhage
Paralytic Ileus
Thrombophlebitis
Dehiscence
```
148
What are priorities for mom post op c-section (5)
```
Empty bladder
Monitor VS
Monitor incision
Asses homans sign
Bowel Sounds
```
149
Mom may develop _______ post op c-section that are very painful where she would not like to move
Gas pockets
150
Near incision post op c-section it is important to make sure ....
there isnt any drainage
151
Locchia should be ..... post op c section
same amount as vaginal delivery
152
VBAC stands for
Vaginal Birth After C-section
153
Major complication for Premature Rupture of membranes
Umbilical cord coming out
154
Premature Rupture of Membranes happens
before 38 weeks
155
What is Chorioamnionitis and what might it cause
Inflammation of Chorion Amniotic Sac, may cause premature rupture of membranes
156
What can we use to check pH of Vagina
Nitrazine Paper
157
Hypertension can
induce labor
158
Temp of 100.5 or more in pregnant mom may call for
C-section, induced labor
159
When baby is at risk for being born immaturely we try our best to
get labor to at least 32 weeks, then 34, then 36 hopefully
160
At 36 weeks baby begins to make its own
Surfactin
161
Premature labor can be caused by (5)
```
Young mother under 17
Incompetent cervix
Decreased blood supply to uterus
Abdominal trauma
Polyhydramnios
```
162
Tocolytics are given to
Relax uterus and stop contractions
163
Betamethasone is given to
hasten fetal maturity and increase surfactant production in fetus
164
Nursing care for Pre term Labor
Give Tocolytics
Give Betamethasone
bed rest
IV hydration
165
Retinal Atrophy of Prematurity is
eyes, oxygen effects optic nerve
166
Blood loss greater than 500cc for NSVD or 1000cc for c/sec is defined as
Hemorrhage
167
Mom is at risk for _______ after labor for Hemorrhage
48 hours
168
NSVD stands for
Normal Delivery
169
Treatment for Hemorrhage is
Blood transfusion
170
Before a blood transfusion we must
stop the bleeding with a vigorous massage
171
Fluid or fetal cells enters mothers venous system is defined as
Amniotic Fluid Embolism
172
Massive clotting, then massive fibrinogen breaks down causes bleeding from all orifices is called
DIC - Disseminated Intravascular Coagulation
173
Possible DIC is
bleeding from IV site
174
Tears to perineum, cervix or both during delivery is called
Perineal Lacerations
175
1st and 2nd degree Lacerations are
tear of perineum not extending to rectal sphincter
176
3rd degree Lacerations are
involves anal sphincter
177
3rd degree Lacerations are bad because
difficult to repair, can have permanent damage
178
4th degree lacerations are
lacerations in the recto vaginal wall
179
Nursing care for lacerations include
Sitz bath
meds
ice pack
180
ball of blood, accumulation of blood under the skin is defined as
Hematomoa
181
Nursing care of Hematoma include
Ice pack to area
| pain management
182
1 egg that separates into 2 fetus
Monozygotic
183
2 sperm fertilize 2 eggs
Dizygotic
184
Vomiting during pregnancy that results in electrolyte imbalance
Hyperemesis
185
Premature dilation of cervix early in pregnancy
Incompetent Cervix
186
Procedure done to keep cervix closed
Cerclage
187
Loss of pregnancy prior to 20 weeks gestations; Can be threatened; inevitable; incomplete; missed; or septic
Spontaneous Abortion
188
defines a woman who has had 3 or more consecutive spontaneous abortions
Habitual Spontaneous Abortions
189
medication given to RH NEGATIVE mothers at 28 weeks of pregnancy and 72 hours after delivery to prevent production of antibodies
Rhogam
190
pregnancy that takes place outside the uterus (tubal pregnancy
Ectopic pregnancy
191
failure of embryo to develop after fertilization; abnormality of the trophoblast
Hydatidiform mole
192
condition in which the placenta is implanted close the the cervical is which impacts delivery, can be marginal, partial, or complete
Placenta Previa
193
sudden separation of the placenta from the uterine wall characterize by severe abdominal pain and bleeding
Placental abruption
194
Pregnancy induced Hypertension or toxemia is known as
PIH
195
PIH with proteinuria
Pre-eclampsia
196
PIH, with proteinuria and seizures
Eclampsia
197
medication given IV to prevent seizures of eclampsia
Magnesium sulfate
198
Antidote for Magnesium Sulfate
Calcium gluconate
199
Difficult labor is defined as
Dystocia
200
contractions that are too weak to effectively progress labor
Hypotonic contrations
201
contractions that are too intense and may put mom and fetus at risk
Hypertonic contractions
202
baby born bigger than average size is known as
Macrosomia
203
the repositioning of a breech or transverse fetus
Version
204
labor that is completed in less than 3 hours
Precipitate labor
205
an intervention to help labor progress
Augmentation
206
an intervention to help labor process start
Induction
207
Drug applied topically to cervix to help increase dilation of cervix
Prostaglandin
208
product applied to cervix that absorbs fluid and hastens labor process
Laminaria
209
Pitocin; medication given IV to induce or augment uterine contractions
Oxytocin
210
artificial rupture of the membranes
Amniotomy
211
the rupture of the uterus due to abnormal strong and frequent contractions requires surgical repair
Uterine rupture
212
the descent of the umbilical cord before the fetus causing pressure and impaired circulation
Prolapsed cord
213
the fundus inverts down into uterus after delivery is called
Uterine inversion
