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RN Spring 2021 > Maternity Ch. 8 > Flashcards

Maternity Ch. 8 Flashcards

(47 cards)

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1
Q

What hormones stimulate contractions?

A

Prostaglandins and oxytocin

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2
Q

What happens as placenta ages?

A

Begins to breakdown, triggering initiation of contractions

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3
Q

Lightening

A

descent of the fetus into true pelvis; normally around 2 weeks before term

-Feels she can breathe better but causes urinary frequency due to bladder pressure

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4
Q

Braxton-Hicks

A

Irregular UC’s and do not cause cervical change

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5
Q

True labor

A

regular UC with cervix dilation and effacement

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6
Q

5 P’s

A 
● Powers (the contractions) 
● Passage (the pelvis and birth canal) 
● Passenger (the fetus) 
● Psyche (the response of the woman) 
● Position (maternal postures and physical positions to facilitate labor)
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7
Q

Frequency

A

● Frequency: Time from beginning of one contraction to the beginning of another. It is recorded in minutes (e.g., occurring every 3 to 4 minutes).

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8
Q

Duration

A

● Duration: Time from the beginning of a contraction to the end of the contraction. It is recorded in seconds (e.g., each contraction lasts 45 to 50 seconds).

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9
Q

Intensity

A

● Intensity: Strength of the contraction

  • Done during a contraction
  • Nose +1
  • Chin +2
  • Forehead +3
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10
Q

What two powers are for external monitoring

A

Frequency and duration

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11
Q

what power is for internal monitoring

A

Intensity

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12
Q

How to place toco?

A

palpate area that has no fetus

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13
Q

What must be done for before internal monitor is used?

A

Membrane must be ruptured

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14
Q

Why do we want to know the intensity of a contraction?

A

b/c we want to see cervical change

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15
Q

What is one purpose of internal monitoring?

A

May need to do an aminoinfusion

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16
Q

Phases of Contractions (Powers): Increment phase

A

Ascending or buildup of the contraction that begins in the fundus and spreads throughout the uterus; the longest part of the contract

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17
Q

Phases of Contractions (Powers): Acme phase

A

Peak of intensity but the shortest part of the contraction

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18
Q

Phases of Contractions (Powers): Decrement phase

A

Descending or relaxation of the uterine muscle

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19
Q

What is dilation and how big is it?

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A
  • enlargement or opening of the cervical os

- 10 cm = cervix can no longer be palpated on vaginal exam

20
Q

What is effacement?

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A

Shortening and thinning of the cervix

21
Q

Longitudinal lie

Study These Flashcards
A

Baby and mom are parallel

-Needed for vaginal birth

22
Q

Transverse lie

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A

Baby is perpendicular

-Can not be delivered vaginally

23
Q

True vs False Labor

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A

True:

  • Contractions bring cervical effacement and dilation
  • UC are regular and increase in frequency and intensity

False:

  • US are irregular with no cervical change
  • Hydration, laying down, or sedation slows or stops contractions
24
Q

SROM/AROM

Study These Flashcards
A

Spontaneous/Artificial rupture of membranes

  • Can occur before but normally during labor
  • With fluids gone = increase risk of infection
  • Need to deliver within 24 hours
  • If at home and this happens go to hospital
  • Go to ER if having intense pain or bloody show
25
TACO
-assessment of rupture of membranes Time/Amount/Color/Odor
26
Techniques to confirm rupture of membranes
- Speculum = rapid test - Ferning = Fluid sample placed on slide - Amnisure = rapid test - Nitrazie = will turn blue (done at bedside)
27
Normal FHR
110-160
28
Fetal Tachycardia
above 160 for 10 mins or longer
29
Fetal Bradycardia
Below 110 for 10 mins or longer
30
Goal of external fetal monitoring
is to interpret and continually assess fetal oxygenation to prevent significant fetal acidemia while minimizing unnecessary interventions and promote family centered-care
31
What to do is baby is bradycadiac?
Check moms radial pulse because could be picking up moms HR (do this before getting water or side laying) ALSO Check mom for vaginal bleeding and abnormal pain because s/s of placenta aburpto
32
Category 1 FHR
= well oxygenated
33
When to use scalp electrode vs when not to
when to use = if baby moves too much or when mom moves too much or is obese When not to use = if mom has gonorherra/ HIV/ herpes/ Group B Strep
34
What to do if FHR is erratic?
Mom and baby will move around so may need to adjust toco to get better reading
35
First stage of labor
onset of labor to complete cervical dilation (10 cm)
36
Second stage of labor
Burst of energy and urge to push
37
Third stage of labor
Delivery of baby to delivery of placenta * Once placenta is delivered give bolus of oxytocin to decrease bleeding * Assess placenta (AVA and completely out; not in pieces/no abnormality)
38
Meds used to prevent PPH?
Oxytocin (pitocin) Methylergonvine (Methergine) Thromethamine (Hemabate) Misoprostol (Cytotec) Given during third stage
39
Fourth stage of labor
Immediate PP - Skin to skin - Assess lochia
40
Phases of First stage of labor
1. Early/latent phase: Excited; mild UCs, up to 5cm 2. Active phase: dilate up to 7 cm; more intense/regular UCs, fatigue 3. Transition phase: 8-10 cm dilated, completely effaced, empty bladder b/c gets in the way of passageway, shortest/most difficult phase
41
What to assess for mom with epidural?
Assess bladder often b/c can't she feels like she has to void
42
Ferguson's Reflex | types?
urge to bear down - Mother instated: mom feels urge to push - Delayed bearing down: let baby come down on own; sitting mom up saves energy - Active direct pushing: nurse letting mom push
43
APGAR
``` Appearance Pulse Grimace Activity Respiratory ```
44
Given to baby after birth
Hep B Vit K Erythromycin ointment on eyes
45
What to do before giving mom epidural?
- Give bolus b/c risk of hypotension - Assess mom (Monitor VS) - Assess baby (Monitor on strip for 20 mins before and after)
46
Basic principles when using analgesia include:
● Labor should be established. ● Medication should provide relief to the woman with minimal risk to the baby. ● Neonatal depression may occur if medication is given within an hour before delivery. ● Women with a history of drug abuse may have a lessened effect from pain medication and require higher doses.
47
Basic principles for anesthesia include:
● Local anesthesia is used at the time of delivery for episiotomy and repair. ● Regional anesthesia is used during labor and at delivery. ● Regional anesthesia includes the pudendal block, epidural block, and spinal block. ● Regional or general anesthesia is used for cesarean deliveries.

RN Spring 2021 (7 decks)

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