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NUR 332 > Intrapartum complications > Flashcards

Intrapartum complications Flashcards

1
Q

Nursing, Care, PPROM

A

determine duration
Assess gestational age
Observe for infection
Assess fetal status
Maternal corticosteroid

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2
Q

Preterm labor

A

20–36 weeks

Uterine contractions, 4/20 minutes, 8/1 hour
Cervical change, dilation
ROM

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3
Q

Tocolytic meds

A

used to stop contractions

nifedipine
Magnesium sulfate
Terbutaline
Progesterone

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4
Q

What are corticosteroids used for in pregnancy?

A

to improve fetal lung development

Betamethasone

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5
Q

Cervical insufficiency

A

incompetent cervix
Painless, dilation of cervix without contractions
<25 mm before term

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6
Q

cerclage

A

Surgical option for closure of cervix with stitches

Prophylactic in multiple pregnancies

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7
Q

warning, signs of birth

A

Lower back pain
Pelvic pressure
Changes in discharge
Bleeding

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8
Q

Placenta previa

A

placental implantation in lower, uterine segment
Placental villi are torn from uterine wall
Painless, bleeding

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9
Q

Types of placenta previa

A

complete – placenta covers, full cervix
Partial – partial coverage
Marginal – near cervix
Low lying now on cervix

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10
Q

what is the main difference between placenta, previa and placenta abruption?

A

Placenta previa has soft, relaxed, uterine tone

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11
Q

T/F vaginal exams can be conducted with placenta previa

A

False

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12
Q

Placenta abruption

A

Premature separation of a center from uterine wall

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13
Q

types of placenta abruption’s

A

Marginal – placenta, separate at edges, vaginal bleeding
Central – separates centrally, concealed bleeding
Complete – total, separation, massive, bleeding

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14
Q

How is the severity of placenta abruption measured?

A

Grades one through three

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15
Q

What is the uterine tone with placenta abruption’s?

A

firm, board like

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16
Q

Normal weight gain for multiple gestation’s

A

40–45 pounds total
24 pounds x 24 weeks

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17
Q

amniotic fluid complications

A

hydramnios > 2000 ML

Oligohydramnios < 500

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18
Q

What’s the normal amount of amniotic fluid?

A

600–1000 ML

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19
Q

amniotic fluid embolism

A

Amniotic fluid leaks into maternal circulation through small tear of the uterus during placental separation or through cervical tears

Blocks vessels of lungs

High mortality

20
Q

sx AF embolism

A

Chest pain
Dyspnea
Cyanosis
Frothy sputum
Tachycardia, hypotension

21
Q

what is a key step to complete during CPR?

A

Displace the uterus

22
Q

dystocia

A

Hypertonic contractions – tachysystole
> 5/10 minutes

Hypotonic, low intensity – <2-3/10 minutes

23
Q

Nursing care for tachysystole

A

turn off Pitocin
Administer tocolytic
Change positions

24
Q

nursing care for hypotonic

A

Consider CPD
Rule out malpresentation
Stimulate contractions – oxytocin augmentation

25
Q

how many weeks is considered post term?

A

Greater than or equal to 42 weeks
Greater than estimated delivery date

26
Q

Malposition care

A

mother rotate side to side
Knee to chest
Hands to knees
Rotate fetal head during labor

27
Q

Malpresentation

A

shoulder, brow or face
Breach

28
Q

Version

A

Turning fetus counterclockwise in utero

29
Q

nursing care for version

A

Consent
ultrasound
IV access
Terbutaline
NPO eight hours
Reactive, NST
RhoGAM if negative

30
Q

Examples of non-reassuring fetal status

A

meconium stained AF
Persistent late decelerations
Bradycardia, tachycardia
Decrease movement

31
Q

Umbilical cord prolapse

A

Umbilical cord proceeds presenting fetal part and is compressed against the pelvis

32
Q

Nursing care for umbilical cord prolapse

A

bedrest
Keep gloves, fingers in vagina to relieve pressure during vaginal exam
Position for gravity
02 if needed

33
Q

cephalic, disproportion, maternal risks

A

Prolonged labor
Risk of rupture
Risk of forceps assisted or vacuum assisted delivery
Risk for C/S

34
Q

cephalic disproportion fetal risks

A

Cord prolapse
Excessive molding
Bruising
Head nerve trauma

35
Q

what should be done if true cephalic disproportion is occurring

A

C-section

36
Q

Macrosomia

A

Large fetus greater than 4000 g

37
Q

Shoulder dystocia

A

Shoulders and trapped behind, super pubic bone

38
Q

What should be done to care for shoulder dystocia?

A

Superpubic pressure downward

39
Q

T/F fundal pressure should be applied in shoulder dystocia

A

False

40
Q

how long is considered retained placenta?

A

Greater than 30 minutes post delivery

41
Q

lacerations

A

Spontaneous, tearing of perineal area, despite firm fundus
Bright red blood persists

42
Q

placenta accreta

A

Chorionic villi attached directly to uterine myometrium
Attaches

43
Q

placenta increta

A

Myometrium invaded

44
Q

placenta percreta

A

Myometrium penetrated, sometimes attaches to other organs

45
Q

What delivery or procedure method should be completed during the different types of placenta adherences

A

hysterectomy
Deliver less than 38 weeks

NUR 332 (14 decks)

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