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1538 - Test 2 (Reproduction + Human Development) > Labor & Delivery + Labor Pain > Flashcards

Labor & Delivery + Labor Pain Flashcards

(58 cards)

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1
Q

V > C
E > H
A > O
L > P

A

V = variable decelerations > C = cord compressions
NOT OK

E=early decelerations > H = Head compressions
OK!!

A= accelerations > O= OK

L= late decelerations > P= placental insufficiency
NEVER OK!!! EMERGENCY

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2
Q

Ongoing nursing care in the _____ of intrapartum includes:

  • *every 30 min >
  • vital signs
  • *every 15-30 min >
  • FHR pattern
  • uterine activity & show
  • maternal mood & affect

**vaginal exams for cervical change

A

Ongoing nursing care in the ACTIVE PHASE of intrapartum includes:

  • *every 30 min >
  • vital signs
  • *every 15-30 min >
  • FHR pattern
  • uterine activity & show
  • maternal mood & affect

**vaginal exams for cervical change

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3
Q

_____ is infusion of room-temperature isotonic fluid (usually normal saline or lactated Ringer’s solution) into the uterine cavity if the volume of amniotic fluid is too little.

A

AMNIOFUSION is infusion of room-temperature isotonic fluid (usually normal saline or lactated Ringer’s solution) into the uterine cavity if the volume of amniotic fluid is too little.

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4
Q

What is amniotic fluid embolism (Anaphylactoid syndrome of pregnancy)

A

Amniotic fluid embolism is when fetal debris enters maternal circulation

  • *causes 5-10% maternal deaths
  • *22-61% of mothers die; 80% of fetus’ die
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5
Q

What are the FRIST S/S of Amniotic Fluid Embolism?

A

What are the FRIST S/S of Amniotic Fluid Embolism?

DYSPNEA + SEVERE HTN

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6
Q

Amniotic Fluid Evaluation:

A

amniotic fluid is very BASIC
if membranes are intact, the swab will be YELLOW
if membranes are ruptured, the swab will be BLUE

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7
Q

_____ or ____ can both cause a FALSE + on an amniotic fluid evaluation swab.

A

BLOOD or SEMEN can both cause a FALSE + on an amniotic fluid evaluation swab.

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8
Q

Causes of FETAL BRADYCARDIA include:

A
  • atrioventricular dissociation (heart block)
  • structural defects
  • viral infections
  • medications
  • fetal heart failure
  • maternal hypoglycemia
  • maternal hypothermia
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9
Q

What methods are used for cervical ripening?

A

CYTOTEC which cannot be removed
CERVADIL which can be removed
COOK DOUBLE BUBBLE CATH with can be removed

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10
Q

Hypoxemia causes the FHR to _____

A

Hypoxemia causes the FHR to DROP

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11
Q

When is the best time to administer a narcotic analgesic via IV to the patient in the labor and delivery unit?

  • during the latent phase of labor
  • during the active phase of labor
  • just before delivery
  • upon admission to the unit
A

When is the best time to administer a narcotic analgesic via IV to the patient in the labor and delivery unit?

-during the active phase of labor

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12
Q

____ __ ____ means difficult labor abnormally slow progress of labor.

A

DYSTOCIA OF LABOR means difficult labor abnormally slow progress of labor.

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13
Q

What nursing interventions are required for early decelerations?

A

NONE! Early decelerations are OK and expected because of the contraction compressing the fetal head.

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14
Q

What can cause early decelerations?

A

Causes of early decelerations include:

  • *head compression resulting from the following:
  • uterine contractions
  • vaginal examination
  • fundal pressure
  • placement of internal mode of monitoring
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15
Q

When is ECV not used/contraindicated

A
  • uterine abnormalities
  • 3rd trimester bleeding
  • multifetal gestation
  • oligohydraminos
  • nuchal cord
  • previous C/S
  • obvious cephalopelvic disproportion
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16
Q

Is lightening the maternal sensation of fetal movement in the abdomen?

A

NO - FALSE:

Lightening is the dropping of the fetus into the birth canal, only occurs during a woman’s first pregnancy!

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17
Q

Can an external uterine TOCO monitor accurately reflect the pressure of uterine contractions in mmHg which can be calculated into MVU’s?

A

NO!!! TOCO monitors can only track the duration of the contractions NOT the pressure/strength

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18
Q

Is external cephalic version is an option for all breech pregnancies?

A

NO! there are many contraindications for ECV!

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19
Q

What is the FERGUSON REFLEX?

A

FERGUSON REFLEX is the uncontrollable urge to push!

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20
Q

What is the FETAL ATTITUDE?

A

FETAL ATTITUDE is the relationship of fetal parts to the fetus itself.

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21
Q

What is considered fetal bradycardia?

A

Fetal bradycardia is a FHR with less than 100 BPM

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22
Q

What is FETAL LIE?

A

FETAL LIE is the relationship of fetal axis to the maternal axis

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23
Q

What is considered fetal tachycardia?

A

Fetal tachycardia is a FHR with more than 160 BPM

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24
Q

What causes late decelerations?

Study These Flashcards
A
  • uterine tachysystole
  • maternal supine HTN
  • epidural or spinal anesthesia
  • placental previa
  • placental abruption
25
What causes late decelerations?
- uterine tachysystole - maternal supine HTN - epidural or spinal anesthesia - placental previa - placental abruption - hypertension disorders - postterm gestation - intrauterine growth restriction - diabetes - intraamnioic infection
26
What is the clinical significance of LATE DECELERATIONS?
- abnormal pattern associated with fetal hypoxemia - acidemia - low APGAR scores - considered ominous if persistent and uncorrected
27
nursing interventions for LATE DECELERATIONS
Nursing interventions for LATE DECELERATIONS: - discontinue oxytocin if infusing - assist women to lateral position (side lying) - administer oxygen at 10L/min by nonrebreather mask - correct maternal hypotension by elevating legs
28
In a shoulder presentation, the ______ is closest to the cervical opening.
In a shoulder presentation, the SCAPULA is closest to the cervical opening.
29
Ongoing nursing care in the _____ of intrapartum includes: * *every 5-30 min > - vital signs * *every 5-15 min > - FHR pattern * *every 10-15 min> - uterine activity & show - maternal mood & affect * *vaginal exams for cervical change * *assess each contraction and bearing down effort
Ongoing nursing care in the SECOND STAGE of intrapartum includes: * *every 5-30 min > - vital signs * *every 5-15 min > - FHR pattern * *every 10-15 min> - uterine activity & show - maternal mood & affect * *vaginal exams for cervical change * *assess each contraction and bearing down effort
30
What is shoulder dystocia?
SHOULDER DYSTOCIA is when the shoulder cannot pass through the pelvic arch **THIS IS AN EMERGENCY!
31
What are treatments for shoulder dystocia?
Treatment for shoulder dystocia include: - suprapubic pressure - McRoberts maneuver - knees to chest * ***DO NOT APPLY FUNDAL PRESSURE
32
What is a S/S of shoulder dystocia?
S/S of shoulder dystocia include: - the turtle sign - no external rotation
33
What is UTERINE TACHYSYSTOLE?
Uterine tachysystole is when the uterus contracts MORE THAN 5 times in 10 minutes
34
What does expected uterine activity look like?
- Contractions every TWO - FIVE minutes - Contractions lasting less than NINTY SECONDS - MORE THAN THIRTY SECONDS between contractions - FIVE or fever contractions in TEN MINUTES averaged over a THIRTY minute window
35
What is considered the first stage of active labor?
The FIRST STAGE of active labor is 4-7CM DILATED!
36
What is considered the transition phase of the first stage of labor?
The TRANSITION PHASE of labor is 8-10CM DILATED!
37
When do the fontanels of the fetal head close?
Anterior closes at 18 MONTHS | Posterior closes at 6-8 WEEKS
38
What is closest to the cervical opening with a breech presentation?
In a BREECH PRESENTATION the SACRUM is the closest to the cervical opening!
39
What types of fetal presentations are there?
- Cephalic (head) - Breech (butt) - Shoulder (shoulder)
40
Once the bag of waters is ruptured, the FIRST thing you do is_______ **Plummeting ___ indicates ___
Once the bag of waters is ruptured, the FIRST thing you do is CHECK FHR!!! **Plummeting FHR indicates CORD PROLAPSE!! **THIS IS THE #1 PRIORITY!!!
41
What to do if the cord prolapses?
CALL FOR HELP! NOTIFY THE HCP!!!!
42
What are the 3 phases of the 1st stage of labor!?
early (latent) active transition
43
Mechanisms of labor happen in this EXACT order:
- engagement - descent - flexion - internal rotation - extension - restitution and external rotation - expulsion
44
In fetal attitude, ___ is when everything is stretched out. This is common in ___ babies!
In fetal attitude, EXTENSION is when everything is stretched out. This is common in PRETERM babies!
45
First Stage Second Stage Third Stage Fourth Stage
First stage: ends with full cervical effacement + dilation Second stage: ends with fetal expulsion Third stage: ends with placental expulsion Fourth stage: return to maternal homeostasis
46
In fetal attitude, ___ is when everything on the fetus is flexed except for the chin.
In fetal attitude, FLEXION is when everything on the fetus is flexed except for the chin.
47
What are the 4 sutures of the fetal head > front to back
Frontal, Coronal, Sagittal, Lamboid | FCSL
48
What are the types of fetal attitude?
General flexion Flexion Extension
49
What to know about epidurals?
Frequently HYPOTENSION with epidural; so a bolus of IV FLUIDS are given 30 MINUTES before administration
50
What is the landmark in determining the station of the fetus?
ISCHIAL SPINES
51
Leopold's maneuver #1
TOP OF MATERNAL BELLY
52
Leopold's maneuver #2
SIDES OF MATERNAL BELLY
53
Leopold's maneuver #3
BOTTOM OF MATERNAL BELLY
54
Leopold's maneuver #4
BABIES HEAD
55
_____ help you determine what position the baby is in and where to put the FHR monitor
Leopold's maneuver help you determine what position the baby is in and where to put the FHR monitor
56
In terms of fetal position, ____ is the easiest delivery?
In terms of fetal position, LOA is the easiest delivery | LOA = baby head down, occipital bone presenting, babies spine facing left
57
Early (latent) phase of the 1st stage of labor is
Early (latent) phase of the 1st stage of labor is UP TO 3 CM
58
In a _____ _____ the back of the head is closest to the cervical opening
In a VERTEX PRESENTATION the back of the head is closest to the cervical opening

1538 - Test 2 (Reproduction + Human Development) (14 decks)

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