labor and birth (unit 1) Flashcards Preview

OB > labor and birth (unit 1) > Flashcards

Flashcards in labor and birth (unit 1) Deck (119)
Loading flashcards...
1

cardiovascular changes during labor

•during ctx 400 mL blood emptied from uterus into maternal system
•mom CO, BP, HR increase
•blood flow to placenta decrease

2

cardiovascular NSG Imp during labor

•check VS b/t ctx
•discourage Valsava maneuver
•keep off back
•monitor BP hourly

3

respiratory changes during labor

•> O2 consumption
•depth/rate respirations inc. w/ pain
•hyperventilate (risk for alkalosis)

4

respiratory NSG imp during labor

•monitor for tingling, numbness, dizziness (resp. alkalosis)
•have pt breathe into cupped hands

5

GI changes during labor

•GI motility dec.
•thirst/dry mouth
•N/V; belching @ full dilation

6

GI NSG imp during labor

•admin anti-emetic (Phenergan)
•keep NPO (exc. ice chips)
•monitor for Mendelson's syndrome

7

Mendelson's Syndrome

•aspiration of food or acidic gastric contents leads to pneumonia
•prevented by keeping women in labor NPO in case general anesthesia required

8

renal/GU changes during labor

•spontaneous voiding difficult
-tissue edema after birth
-regional anesthesia (epidural)
•proteinuria 1+ normal b/c breakdown of muscle tissue

9

renal NSG imp during labor

•maybe cath
•encourage void q2h
•swollen bladder makes it difficult for baby to progress

10

blood changes during labor

•H&H of >11g/dL and 33% will prevent complications
•WBC inc
•clotting factor inc
•SVD: lose 500 cc blood
•C/S: lose 1000 cc blood

11

NSG Imp blood changes during labor

•know admission H&H to compare w/ PP
•monitor blood loss
***1st sign of hypovolemia is tachycardia

12

fetal circulation during labor

•during ctx, blood to placenta from mom dec.
•placental exchange occurs b/t ctx to supply enough for fetus
*why resting phase is important

13

NSG Imp fetal circulation during labor

•ensure ctx not too close or last too long

14

fetal pulmonary system

•lungs filled w/ fluid as fetus
•labor prepares fetus for respirations
-PO2 dec
-CO2 inc
-pH changes
-temp changes

15

vaginal squeeze

•during birth, fetal thorax is squeezed and fld is expelled into upper airway
-surfactant prevents alveoli from sticking
•c/s baby will have more difficulty breathing

16

doulas

•female labor attendant
•one on one physical/emotional care
•DONT provide medical care
•don't leave at shift change
•act as advocate

17

what starts birth

•no single cause
-distention of uterus
-cervix ripen
-pit release oxytocin
-fetal/maternal hormone inc
-aging placenta
*changes take place days-weeks before labor begins

18

pitocin

•drug derivative of oxytocin
•ctxs the uterus
•given to mom after delivery

19

lightening

•preceding labor sign
•baby descends into pelvis

20

bloody show

•preceding labor sign
•capillaries in cx break, so blood mixed w/ mucous
•pink (bright red is concerning)

21

mucous plug

•preceding labor sign
•up to 2 weeks prior
•"wine cork" that comes out of os when cervix ripens

22

other signs preceding labor

•braxton hicks ctx
•increased energy
•nesting instinct
•wt loss
•GI s/sx

23

7 cardinal movements

•position changes fetus undergoes to move thru birth canal
1. engagement
2. descent
3. flexion
4. internal rotation
5. extension
6. restitution
7. expulsion

24

engagement

•widest part of fetal head passes pelvic inlet into station 0 or lower (in line of maternal pelvis)
•primips: 2-3 wks prior to birth (dropped)
•multips: occurs during labor

25

descent

•head progresses thru pelvis
•accelerates after 5-7 cm

26

flexion

•head becomes maximally flexed b/c meeting resistance w/ cervix/pelvic floor
•chin to chest makes smaller diameter that has to pass thru cervix

27

internal rotation

•fetal occiput rotates to lateral anterior position as it progresses to lower pelvis in corkscrew motion

28

extension

•fetus extends neck as passes thru symphysis
•head deflected anteriorly and born by extension of chin away from chest

29

restitution

•head turns 45 degrees back to position it occupied as it entered pelvic inlet to realign w/ shoulders

30

expulsion

•first anterior, then posterior shoulders are born (down then up)
•followed by the rest of the body