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Maternal Child > Labor > Flashcards

Labor Flashcards

(46 cards)

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0
Q

Latent stage

A
  • Contraction last 30 40 sec with increasing intensity
  • 0-3cm dilation
  • bloody show
  • usually unable to walk/talk
  • use diversion
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1
Q

First stage of labor

A

Dilating stage
Behind with the 1st true labor contraction and end with complete dilation of the cervix 10 cm
3 phases
Latent, active, transitional

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2
Q

Active stage

A
  • contraction are stronger, 45-60 sec, Q3-5 minutes
  • cervix dilates 4-7cm
  • not able to walk, mother tends to withdraw from the surrounding environment but desire companionship and encouragement
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3
Q

Transient

A
  • Sharp contraction, more intensified lasting 60-90sec, frequency is 2-3min
  • dilation 8-10cm
  • increase in bloody show
  • mother unregenerate to push or having a BM
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4
Q

2nd stage of labor

A

Delivery/expulsive stage: from complete dilation to the birth of baby (where almost everything happens)

  • crowning
  • delivery of the baby
  • clamping and cutting umbilical cord
  • increase bloody show
  • desire to bear down
  • nausea, irritability, uncooperative, severe discomfort, pleas for relief
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5
Q

3rd stage of labor

A

Placental stage: from baby delivery to placental expulsion

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6
Q

4th stage of labor

A

Recovery and stabilization phase

  • from placental delivery and uterus tends to relax
  • goal is to prevent hemorrhage
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7
Q

What is engagement, descent, flexion?

A

When the widest part of the baby’s head passes the ischial spines as as the head is flexed onto the chest

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8
Q

Mechanism of labor

A 
Engagement
Internal rotation
Extension
External rotation
Expulsion
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9
Q

What is LOA presentation?

A

Fetal occiput (back of the head) is facing towards the left side of the maternal pelvis and towards the front
LOA
(Left occiput anterior)

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10
Q

Full term fetal heart rate

A

120-160bpm baseline
Brady< 120
Tachy> 160

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11
Q

What FHR during contraction should do?

A

May increase or decrease by 30bpm and return to baseline immediately after

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12
Q

What to do if FHR does not vary with contraction?

A
  • assist woman to change position

- notify physician/ certified unreserved midwife

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13
Q

What generalized edema indicate?

A

Preeclampsia or pregnancy induced hypertension

Especially edema is face and hands

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14
Q

What is fetal station?

A

The relationship between the presenting part of the baby with the mother pelvis
(Presenting part/pelvis)

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15
Q

What is fetal lie?

A

Relationship between the head to tail bone axis for both the fetus and the mother
(Lie/alignment)

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16
Q

What is fetal attitude

A

The relationship of the fetal body parts to one another

Posture

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17
Q

What is fetal presentation?

A

Portion of the baby that enters the pelvis first (cephalic, breech, shoulder)

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18
Q

Lab test

Study These Flashcards
A
  • urinalysis for protein
  • antibody screen at 28weeks if client is Rh negative
  • cervical culture for group B strep at 34-36 weeks gestation
  • hemoglobin/Hct
19
Q

When do you give rhogam?

Study These Flashcards
A
  • To Rh negative female @ 28-30 weeks during pregnancy
  • after any possible mixing of fetal blood (ectopic pregnancy,miscarriage, MVA, amniocentesis, abortion….)
  • within 72h of giving birth
  • After the birth of a Rh positive newborn
  • after a negative or normal Coombs test
20
Q

How long the latent phase of the 1st stage of labor last?

Study These Flashcards
A

Approximately 8hour for the primipara and 4-5hours for the multipara

21
Q

How long is the active phase of the 1st phase of labor?

Study These Flashcards
A

About 4h for primipara and 2h for multipara

22
Q

What are nursing responsibilities before administration of epidural?

Study These Flashcards
A

Take vs
Record FHR
Encourage to empty bladder or insert Foley catheter

23
Q

How often should the nurse monitor FHR and BP after epidural?

Study These Flashcards
A

Every 5 min for 30 minutes!!
- then if stable Q15 to 30 min

If hypotension, or fetal bradycardia occur, turn the woman to her left side

24
Serious side effect of epidural anesthesia
Headache Shivering Backaches Nausea
25
Postpartum endocrine adaptation
- estrogen drop at birth, lowest in 1week - Progesterone drop at birth, undetectable in 72h - Oxytocin stimulate uterine contraction and milk letdown reflex - Progestin stimulates milk production
26
When is loch is supposed to be pink to brown?
On days 3 to 7 Rubra (red) from day 1-3 Serosa (pink) 3-7 Alba (creamy white) on or around day 10
27
During teaching about breast feeding the nurse should tell the mom to....?
Baby should nurse 10-15 min on each side Q2- 3hours Encourage 8 oz of fluid with each feeding and 500calories extra per day Suggest warm compress or shower prior to breast feeding to assist the let down reflex Baby should be fed Q2-3 hours during day and night Start with the breast last fed on Avoid using soap and water on nipple
28
What are postpartum warning signs for the mother to report?
- Temperature >100.4F (38C) - Continued mood swing or depression - Appetite loss - Sleep disturbance - Elimination problems (GI/GU) - increased lochia clots or foul odor - Perineal pain or swelling - Calf tenderness
29
Newborn warning sign to report?
- temperature>100.4F - Inconsolable crying - Poor effort feeding - Inability to arouse (exceedingly sleepy) - No wet diaper in 8hours - vomiting or diarrhea - Yellowing of the skin
30
What is colostrum?
The first milk which is high in protein and fat soluble vitamins and has anti-infective properties.
31
What is Depo-provera?
An injection of progestin hormone (IM) Each shot prevents pregnancy for three month May delay conception for up to 2 years after discontinuation of the product
32
When do we Never administer Rhogam?
To a Rh positive mother Someone with a positive Coombs test A Rh negative woman wha has just given birth to an RH negative baby To the father of the child
33
What is apgar score?
Rating of respiration, crying, reflexes, irritability, pulse,heart rate and skin color of the newborn Score from 0 -10 given at 1 and 5 min from birth.
34
What does an apgar score of 6 means?
Mean this the baby has some mild depression (5-7= mild depression) - The neonate may require some stimulation (gently but firmly slappy the sole of the frets or runnin the back/ spine. - This kids may require oxygen
35
APGAR score
8-10= normal 5- 7= mild depression (need some stimulation, may need O2) 3- 4= moderate depression (baby will need O2 and may need insertion of feeding tune to decompress stomach) 0- 2= severe depression requiring immediate life support
36
Why do we instill erythromycin eye drop to new born within the few first hour of birth?
To prevent and protect the child against chlamidial conjunctivitis
37
Newborn vitals sign?
Temp: 97.9- 99.7 axial lark Apical HR: 110-160bpm BP: 50-75 mm hg Resp: 30-60 resp per minute
38
Hyperbillirubinemia for newborn
15mg/dL or greater (term baby) 10mg/dL or greater (preterm) Persistent elevated of bilirubin in the body place the infant at risk for neurotoxicity or BIND (bilirubin induced neurological dysfunction)
39
When do we screen the baby for PKU (Phenylketonuria)?
After 48 h of age and after adequate protein intake
40
The 4th stage of labor is the placental separation and expulsion True or false?
False The 3rd stage of labor is the placental separation and last about 5-30 min. The 4th stage of labor is maternal adaptation!!! Occurring 1 to 2 hour after birth.
41
When the fetus is active the FHR should increase by 15 bps True or false?
True | When the fetus is active the HR will increase by 15 bpm above baseline
42
What is chloasma?
Discoloration of the skin during pregnancy
43
A gravida 3, para 3 woman should be rush to the delivery room once engagement has occurred True or false?
False Engagement just means that the head of the baby is no longer free floating, but has dropped into the pelvis. In a multipara, engagement normally occurs about 2 weeks before birth!
44
The safest time for the fetus is to give the mother analgesia when her cervix is dilated 8- 10cm True or false?
False! | The safest time to give analgesia is when dilation is between 4-7 cm
45
What is the glabella reflex?
The baby will close his eyes when tapping on the glabella (flat bone between the eyebrows)

Maternal Child (3 decks)

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