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Labor and Delivery Flashcards

(46 cards)

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1
Q

Uterine contractions and cervical changes that occur between 20 wks and 37 wks

A

Preterm labor

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2
Q

UTI
Vaginal infections
chorioamnionitis
previous preterm birth
multifetal pregnancy
low socioeconomic status
smoking
substance abuse

A

Risk factors for Preterm labor

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3
Q

Cervical changes could include

A

Shortening , softening thinning or dilation of cervix

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4
Q

Mucus plug prevents bacteria if ruptured …

A

have to deliver with in 24 hours d/t risk for infection

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5
Q

domestic violence
DM
HTN
incompetent cervix
placenta previa or abruption
frequent conception
dehydration

A

risk factors for preterm labor

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6
Q

Lower back pain
pressure in pelvis
cramping in abdomen
vaginal discharge (increase or change)
bleeding
cervical dilation

A

Manifestations of Preterm labor

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7
Q

Braxton hicks vs Real labor

A

Braxton hicks go away with water or rest 1-2 hours, lay on left side
Real increases with exercise

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8
Q

Cervical cultures
CBC
UA
Fetal Fibronectin

A

lab test for Pre term labor

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9
Q

Swab of cervical secretions to detect protein that bond amniotic sac to uterus

determine imminent preterm labor and birth

low levels= possible preterm = stop labor and tx underlying issues
hydration, bedrest , tx infection

A

Fetal fibronectin testing

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10
Q

Terbutaline
Magnesium Sulfate
Indomethacin
Betamethasone

A

Preterm labor medications

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11
Q

Relaxes smooth muscle
PO or Subcut

Monitor Pulse + 120 HOLD

not used prior to 24wks or beyond 34wks

A

Terbutaline

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12
Q

Relaxes smooth muscle of the uterus, stopping contractions
IV by RN
Monitor signs of toxicity

CALCIUM GLUCONATE antidote

A

Magnesium sulfate

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13
Q

NSAID, suppress preterm, blocking the production of prostaglandin, stopping contractions

Used LESS than 32wks,
after 32wks affect closure of ductus arteriosus

With food to prevent GI upset

monitor postpartum hemorrhage if delivery while taking drug - reduces platelet aggregation

short term use

Stop if Respirations less than 12 or urine output less than 30

A

Indomethacin

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14
Q

Glucocorticoid IM - Promote fetal lung maturity and surfactant

2 doses given 24 hours apart

A

Betamethasone

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15
Q

spontaneous rupture of membranes ONE hour PRIOR to true labor

A

PROM

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16
Q

Spontaneous rupture of membranes after 20wks or before 37 wks -labor do not have to follow

A

PPROM

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17
Q

Infection

A

Risk factor for PROM and PPROM

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18
Q

Gush of fluid
maternal fever
increase maternal or fetal HR
Foul smelling fluid or vaginal discharge

A

Manifestations of PROM or PPROM

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19
Q

prolapsed cord
placenta abruption
cord compression

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A

With PROM or PPROM clients have a increased risk for

20
Q

activity restrictions
no sex
hydration
s/s of infection
monitor fetal Heart rate and contractions

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A

Nursing care for preterm labor

21
Q

decrease in deep tendon reflexes, changes in mental status and Decreased RR

22
Q

Nitrazine paper test
Amnisure test

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A

lab test for PROM and PPROM

23
Q

asses pH of leaked fluids

vaginal fluids: yellow to light green
Amniotic/cervical mucus: Darker green/blue

False positives with blood, soap, semen, infection or intermittent

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A

Nitrazine Swab

24
Q

Fetal fibronectin in Vag = PROM (present with any disruption)
Alfa fetoprotein in vag fluids suggest rupture
blood may cause false positive

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A

Amnisure test for PROM/ PPROM

25
Prepare for delivery determine cervical dilation assess FHR and contraction pattern maintain bedrest monitor vital signs
Nursing care for PROM/PPROM
26
Confirm gestational age assess fetal well being uterine activity cervical changes monitor temp and vital signs PROM and atleast 36 wks go into labor with in 24 wks of rupture If earlier delivery may be delayed if possible to administer steroid for fetal lung maturity Goal is prevent infection and deliver healthy infant
Nursing care once confirmation of ROM
27
used to treat infections or as prophylaxis
medications with ROM Ampicillin
28
Low constant backache r/t relaxing of pelvic muscles Lightening (dropping of fetal head) usually 2-4 wks prior -cause waddle in walk contractions (mild/irregular similar to menstrual cramps, lower back to abdomen) bloody show (vaginal discharge with thick mucus like with blood tinged streaks) energy burst (nesting) GI changes (N/V) ROM
Client in labor
29
Power Passage Passenger Psyche Position
Components of birth process
30
involuntary uterine contractions that increase in intensity and regularity dilating and thinning (effacement) the cervix Ferguson reflex is the reflex to push upon complete dilation during delivery
Power
31
The clients pelvis
Passage
32
Fetus
passenger
33
mind set of client
psyche
34
assist in dilation and effacement of cervix
Uterine contractions
35
time from beginning of one contraction to the beginning of next
frequency of contraction
36
length of contraction
duration of contraction
37
strength of contraction at peak mild - tip of nose moderate - pushing out chin firm- pushing top of forehead
intensity of contraction
38
tone of the uterus between contraction
Resting Tone of contraction (Soft or Firm)
39
stretching of the cervical OS to allow fetal passage
Cervical dialtion
40
thinning and shortening of the cervix Primigravida = cervix thins then completely dilate multigravida= dilate and thin when the cervix is nearly completely dilated
Cervical Effacement
41
using the ischial spines as ) station, the descent of the fetus can be measured position above the ischial spines is (-) and below is (+)
Fetal station
42
Fetal head is down and presenting part (chin to chest) chin out neck straight brow enters pelvis 1st with neck extended face enters pelvis 1st
cephalic/ vertex sinciput brow facial fetal presentation
43
Feet of the fetus presenting part (fetal feet) one foot presenting both feet present
footling breech single footling double footling fetal presentation
44
buttocks presenting part with hip flexed and feet toward head buttocks with legs crossed
frank breech complete breech fetal presentation
45
shoulder presenting
shoulder presenting
46
the relationship of the presenting part of the maternal pelvis related to the skull and portion of the occipital bone and its position anterior or posterior to the pelvis and direction facing the mothers buttocks described with 3 letters ex. LOA Occiput anterior/posterior
Fetal position

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