High risk intrapartum Flashcards
(32 cards)
What is:
-Spontaneous tearing of the uterus that may result in the fetus being expelled into the peritoneal cavity
A-Placental abruption
B-Fundus death
C-Uterine rupture
D-Prolapsed cord
C
Risk factors for uterine rupture (select all)
A-Previous uterine scar
B-Forceps assisted birth
C-Previous C section
D-UTI during labor
E-Excessive use of pitocin or cytotec
A
B
E
S/S of uterine rupture (select all)
A-Variable decelerations
B-Fetal tachycardia
C-Severe, constant abdominal pain
D-BP over 140/90
E-Contractions suddenly stop
A
C
E
If the uterus ruptures, how long do you have to intervene before the fetus dies?
A-5-15 minuets
B-10-37 minuets
C-10-25 minuets
D-15-45 minuets
B
What should you do if the uterus suddenly ruptures?
A-Monitor FHR Q5 minuets
B-Prepare mom to push
C-Prepare for C-section + possible hysterectomy
D- Insert internal fetal monitor
C
What is:
-The anterior shoulder of the fetus becomes impacted on the maternal pubic symphysis or the posterior shoulder becomes impacted on the sacral promontory
A-Shoulder dislocation
B-Fractured clavicle
C-Breech position
D-Shoulder dystocia
D
Risk factors for shoulder dystocia (select all)
A-Macrosomia (diabetes)
B-Prolonged labor
C-Maternal BMI >30
D-Rapid labor
A
C
D
Which s/s of shoulder dystocia is:
-The fetal head remains in the occipital-anterior position after delivery by extension and therefore does not turn to look to the side
A-Turtle neck sign
B-Failure of restitution
B
Which s/s of shoulder dystocia is:
-The fetal head retracts slightly back into the pelvis, so that the neck is no longer visible
A-Turtle neck sign
B-Failure of restitution
A
What are some warning signs of shoulder dystocia? (Select all)
A-Fat cheeks
B-Breech position
C-Slow crowning
D-Excessive bleeding
A
C
management for shoulder dystocia? (Select all)
A-Prepare for stat C-section
B-Advise the mom to stop pushing
C-Consider episiotomy
D-Hand Mag
B
C
How do you perform McRoberts’s maneuver?
A-Hyperextend hips + tell stop pushing + apply pressure behind the anterior shoulder
B-Adduct hips + continue pushing + apply pressure behind the anterior shoulder
C-Adduct hips + stop pushing + apply pressure behind the anterior shoulder
D-Hyperflex hips + stop pushing + apply pressure behind the anterior shoulder
D
Which maneuver is:
- Apply pressure simultaneously in front of one shoulder and behind the other to move the baby 180 degrees or oblique position
A-Symphysiotomy
B-Zavenelli
C-Internal rotation (Corkscrew maneuver)
D-Cleidotomy
C
Which maneuver is:
-Fracturing the fetal clavicle
A-Symphysiotomy
B-Zavenelli
C-Internal rotation (Corkscrew maneuver)
D-Cleidotomy
D
Which maneuver is:
-Cutting the pubic symphysis
A-Symphysiotomy
B-Zavenelli
C-Internal rotation (Corkscrew maneuver)
D-Cleidotomy
A
Which maneuver is:
- Returning the fetal head to the pelvis for delivery of the baby via caesarean section
A-Symphysiotomy
B-Zavenelli
C-Internal rotation (Corkscrew maneuver)
D-Cleidotomy
B
What are some risks for instrument assisted birth? (Select all)
A-Placental abruption
B-Bladder or rectal trauma
C-Lacerations
D-Cradle cap
E-Hemorrhage
B
C
E
What does the nurse need to do during instrument assisted birth?
A-Use the instrument to deliver the baby
B-Verbally announce & record how many & time of pulls, vacuums, or pull-offs
C-Hold the mother’s legs and assist her in breathing techniques
D-Closely monitor FHR during procedure
B
What complication is:
-Presence of the umbilical cord between the fetal presenting part & the cervix, regardless of membrane status
A-Placenta previa
B-True knot
C-Cord prolapse
C
S/S of prolapsed cord (select all)
A-Abnormal FHR tracings
B-Sudden onset of pain
C-UC coming out of the vagina
D-Contractions suddenly stop
A
C
Managment of prolapsed cord (Select all)
A- Immediate delivery by CS
B-Wrap the cord in warm cloths
C-insert foley cath & fill bladder
D-Tell mom to continue to push
E-Steep Trendelenburg
A
C
E
Indications for induction (Select all)
A-Mother elects before 40wks due to being uncomfortable
B-Gestational diabetes
C-Premature ROM
D-HCG drops
E-Preeclampsia
B
C
E
Contradictions for induction (Select all)
A-Vasa previa/ placenta previa
B-Pregnancy past 40wks
C-Active genital herpes/cervical cancer
D-Pelvis structural deformities
E-Multiple gestations
A
C
D
Risks for induction (Select all)
A-Uterine hyperstimulation/rupture
B-Infection
C-Increased risk for C-section
D-Declarations in FHR
A
C
