MCN 4F Flashcards
(162 cards)
1
Q
Use of stainless instruments or vacuum extraction
A
Mechanical
2
Q
use of medications
A
Chemical Procedures
3
Q
Labor has started artificially
Administration of medicines
A
Induction of Labor
4
Q
Total absence of pain
A
Anesthesia
5
Q
Abdominal incision in the uterus
A
Cesarean Delivery
6
Q
Normal Spontaneous Vaginal Delivery
A
Normal Delivery
7
Q
Obstetrical forceps
Stainless steel and they been sterilized
A
Forceps Delivery
8
Q
uses vacuum device to assist in extracting delivery
A
Vacuum Extraction Delivery
9
Q
Increase by rupturing the amniotic membrane and so there will be an escape of amniotic fluid
A
Amniotomy
10
Q
What do you do when cord prolapse happens or cord escapes vagina?
A
Immediately cover the exposed cord with sterile saline compress to presenting part
11
Q
Prior to Amniotomy
A
Dorsal recumbent position
12
Q
After amniotomy
A
Time as to when the amniotic membrane has been ruptured followed by assessing for fetal heart rate
13
Q
Active Genital Herpes/ Human Papillomavirus
AIDS/HIV
Cephalopelvic Disproportion
Cervical Cerclage
Disabling conditions
Failed induction
Obstructive benign or malignant tumor
Previous cesarean birth
Fear of birth
A
Risk for Operative Delivery: Maternal Factors
14
Q
Cesarean is advisable because this disease could be transmitted to the baby
A
Active Genital Herpes/Human Papillomavirus
15
Q
Pelvis is not conducive for normal delivery
A
Cephalopelvic Disproportion
16
Q
Stitching of the cervix due to cervical weakness
A
Cervical Cerclage
17
Q
It is when there is attaching of the placenta inside the uterus but is normally positioned near or lower or over cervical opening
A
Placenta Previa
18
Q
This would put the life of the baby at risk for possible compression of the cord and lack of oxygen
A
Umbilical Cord Prolapse
19
Q
Placenta Previa
Premature Separation of the Placenta
Umbilical Cord Prolapse
A
Risk for Operative Delivery: Placenta
20
Q
Macrosomic fetus in breach lie
Extreme low birth weight
A
Risk for Operative Delivery: Fetal
21
Q
Initiated before the time when it would have occurred spontaneous contractions
Mother has not started labor yet but fetal heart rate is not normal
Done because fetus is endager
A
Induction of Labor
22
Q
Assisting labor that has started
When contractions become weak, irregular, or ineffective
A
Augmentation of Labor
23
Q
Pre-eclampsia
Eclampsia
Severe Hypertension
Diabetes
Rh Sensitization
Prolonged ruptured of membranes
Intrauterine growth restrictions and post maturity
A
Indications of Induction of Labor
24
Q
Onset of high blood pressure and often a significant amount of protein in the urine
A
Pre-eclampsia
25
When there is incompatibility of Rh between the mother and baby
Rh Sensitization
26
Complete placenta previa
Abrupto Placentae
Transverse Fetal Lie
Prolapsed Umbilical Cord
Prior classic uterine incision that entered uterine cavity
Cephalopelvic Disproportion
Previous Myomectomy
Unknown cause of vaginal bleeding
Invasive Cervical Cancer
Active Genital Herpes
Abnormal FHR patterns
Contraindications of Induction of Labor
27
When there is an attachment of the placenta near or over cervical opening
Complete placenta previa
28
Placenta separates early from the uterus before childbirth
Abrupto Placentae
29
Ultrasound
Pelvimetry
Nonstress Test
Phophatidglycerol
Nitrazine paper or Fern test
CBC and Urinalysis
Vaginal Examination
Considerations of Induction of Labor
30
It is a glycophospholipid that is found in pulmonary surfactant in the membrane
Phosphatidglycerol
31
check if there is a premature rupture of membrane wherein upon testing the vaginal fluid, we detect that there will be a change of color
Nitrazine Paper Test
32
Oxytocin Injection
Amniotomy
Nipple Stimulation
Methods of Induction
33
A synthetic form of naturally occurring pituitary hormone that can be used to initiate labor contractions
Oxytocin
34
Other name for Oxytocin
Pitocin
35
30 is mixed with oxytocin in 1000mL of Ringer’s Lactate
Solution
36
Inadequate uterine contractions
Premature rupture of membranes
Post term pregnancy
Fetal Demise
Indications of Oxytocin
37
CPD, Cord Prolapse, Transverse Lie
Placenta Previa
Prior Classic Uterine Incision
Active Genital Herpes
Invasive Cancer of the Cervix
Contraindications of Oxytocin
38
40-90 mmHg
40-90s
2-3min Interval
1cm/hr
Criteria to maintain dose
39
Uterine Hyperstimulation
Non reassuring fetal heart rate pattern
Suspected uterine rupture
Inadequate uterine response at 20 mU/min
Reportable Conditions
40
Odorless
Clear/Straw
pH: 7-7.5
Characteristics of Amniotic Fluid
41
Increases the efficiency of contractions and therefore increase the speed of labor
Advantage of Amniotomy
42
Puts the fetus at risk for cord prolapse
Disadvantage of Amniotomy
43
Identify rupture of amniotic sac
Nitrazine Test
44
Green to Blue
presence of amniotic fluid
45
Yellow
No presence of amniotic fluid
46
Used to determine if the blood cells are maternal or fetal
Maternal: remains colorless
Fetal: turns purple pink
Klelhauer-Betke (Kleihauer-Betke)or Fetal Cell Blood Test
47
Helps release hormone oxytocin
Shortens labor
Avoids cesarean
Nipple Stimulation
48
Surgical incision of the perineum made to prevent tearing of the perineum
Episiotomy
49
Incision made with blunt-tipped scissors in the midline of the perineum
Midline Episiotomy
50
Less painful
Heals easily
Decreases blood loss
Less postpartum discomfort
Midline Episiotomy
51
Begun in the midline but directed away from the rectum
Creates less danger of a rectal mucosal tear
Mediolateral
52
Surgical repair of injury to the vulva by suturing
Episiorraphy
53
Monitor Vitals
Observe Aeseptic Technique
Support Perineum properly
During/Immediate Nursing Responsibilities for Episiotomy
54
Do perineal care
Apply ice pack or cold compress within three hours
Provide hot sitz bath
Render perilite exposure after 24hrs
After/Postpartum Nursing Responsibilities for Episiotomy
55
Primigravida
Macrosomic Fetus
Output Posterior Position
Forceps or Vacuum Extractor
Shoulder Dystocia
Factors that Predispose to Episiotomy
56
is the change in cervical consistency from firm to soft
Cervical Ripening
57
Prostaglandin E1: Misoprostol (Cytotec)
- encourage faster delivery of the baby since your cervix is ripe and soft to facilitate labor
Prostaglandin E2: Dinoprostone (Cervidil)
- used before induction to ripen
Chemical Agents
58
Laminaria tents
Hydroscopic dilators
Synthetic dilators
Stripping the membranes
Mechanical Methods of Cervical Ripening
59
Natural cervical dilators made from seaweeds
Laminaria tents
60
substances that absorb fluid rom surrounding tissues and then enlarge
Hydroscopic dilators
61
inserted into the endocervix without rupturing the membranes
Synthetic dilators containing magnesium sulfate (Lamicel)
62
separating the membrane from the lower uterine segment
Stripping the membranes
63
Prevent pressure from being exerted on the fetal head
Avoid subdural hemorrhage in the fetus as fetal head reaches perineum
Purpose of Forceps Delivery
64
Mother at Risk
Fetal Conditions
Cessation of progress in the 2nd stage of labor
Indications of Forceps Delivery
65
forceps are applied when the fetal skull has reached the perineum
scalp is visible between the contractions
sagittal sutures is not more than 45 degrees from the midline
Outlet Forceps
66
presenting part of the skull must be at a station of +2 or below (+3) but not on the pelvic floor
rotation of the fetal head less than 45 degrees
Low Forceps
67
Fetal head must be engaged but the presenting part is above station +2 (+1, 0, -1, -2)
Midforceps
68
Membranes must be ruptured
CPD is not present
Cervix must be fully dilated to avert lacerations and hemorrhage
Presenting must be engaged
Woman’s bladder must be empty
Conditions before Forceps Delivery
69
Barton
Kielland’s
Piper
Simpson’s
Tarnier’s
Types of Forceps Delivery
70
used to rotate fetal head to a more favorable position (ROP-ROA)
Barton
71
with short handles and marked cephalic curve
Kielland’s
72
used to deliver head in breech position
Piper
73
used most commonly as outlet forceps
Simpson’s
74
axis traction forceps
Tarnier’s
75
Laceration of Vaginal Canal
Cerebral Trauma of the Baby
Low IQ
Increased perinatal morbidity and mortality
Complications of Forceps Delivery
76
Birth method involving the attachment of a vacuum cup to the fetal head, using negative pressure to assist in the birth of fetal head
Vacuum Extraction Delivery
77
Little Anesthesia
Fever Lacerations of the Birth Canal occur
Advantages of Vacuum Delivery
78
causes marked caput that may be noticeable as long as 7days after birth
Tentorial tears from extreme pressure
Disadvantages of Vacuum
79
Prolonged Labor
Mother with Cardiopulmonary
Mother with high BP
Indications of Vacuum Extraction
80
Preterm (soft skull)
Fetus who undergone scalp blood sampling
Contraindications of Vacuum Extraction
81
pressure that is applied to the fetal head
Some under material complications:
Perennial
Vaginal cervical laceration of soft tissue trauma
Risk of Vacuum Extraction
82
Cephalohematoma
Scalp Laceration
Subdural Hematoma
Newborn Complications
83
turning of the fetus ap from one presentation to another; externally or internally
Version
84
externally moving by massaging the client’s abdomen
breech to cephalic
attempted in labor and birth setting after 37 weeks of gestation
Tocolytic agent such as Magnesium sulfate is given to relax the uterus
No contraindications to be happening to manipulate with administration of tocolytic agents
tocolytic agents given IM near buttocks
External Cephalic Version
85
Uterine anomalies
Previous cesarean
CPD
Placental Previa
Multifetal
Oligohydramnios (deficiency of amniotic fluid)
Rh incompatibility
unexplained 3rd trimester bleeding
Ruptured amniotic membrane
History of Premature labor
Contraindications of External Cephalic Version
86
Continuously monitor FHR esp Bradycadia
Check maternal VS
Ultrasound must be recorded continuously
Assess woman’s level of comfort
Nursing Responsibilities of External Cephalic Version
87
Fetus is turned by the physician who inserts a hand into the uterus and changes the presentation
May be used for multifetal
Internal Version
88
Lack of Anesthesia
Unskilled healthcare team member in internal podalic version
Retracted cervix or contracted thickened uterus
Contraindications for Internal Version
89
Support from a doula or couch doula
Hypnosis
Acupressure
Yoga
Nonpharmacologic Methods for Intrapartum Pain Management
90
emphasized the use of relaxation and proper breathing with contractions as well as family support
Dick-read method
91
combines relaxation, concentration, focusing, and complex well paced breathing patterns to reduce perception of pain through conditioned response of labor contractions
Lamaze Method
92
husband takes a active role in assisting the woman to relax during labor and use correct breathing techniques
Bradley Method
93
Given in labor because of analgesia effect
contraindicated in preterm labor
Narcotic Analgesics
94
Demerol (meperidine hydrochloride)
Morphine sulfate
Nalbuphine
Fentanyl
Naloxone
Narcotic Analgesics
95
has additional sedative and antispasmodic actions
crosses the placental barrier thereby causing fetal depression
Demerol (meperidine hydrochloride)
96
narcotic antagonist should be available
Naloxone (Narcan)
97
compliments the action of narcotics
Sedative-Hypnotics and Ataratics
98
Secobarbital sodium (seconal)
Promethazine (phenergan)
Sedative-Hypnotics and Ataratics
99
patient administer doses of IV narcotic analgesics
Patient Controlled Analgesia
100
Transmission of electrical impulses/current across the skin
two electrodes are positioned on each side of the abdominal surgical incision
effective in controlling pain
Transcutaneous Nerve Stimulation
101
injection of a local anesthesia to block specific nerve pathways interspace
Regional Anesthesia
102
injection of bupivacaine (Marcaine) into the subarachnoid space at the level of 3 rd and 4th lumbar interspace
block nerves and suspend sensation and motion to the black nerves and suspend sensation and motion to the lower extremities, perineum and lower abdomen
Spinal Anesthesia
103
Hypotension - validation
turn the woman to her left side to reduce a vena cava compression
Spinal Headache - advise lie flat and administer analgesic
Epidural - introduced in epidural space
blocks sympathetic nerve in order to increase contraction strength and blood flow to the uterus
Side Effect: Spinal Headache rarely happens (painless delivery)
Major Complications
104
used with heart problem, pulmonary disease
diabetic mother
Advantage of Regional Anesthesia
105
Induced hypotension
Nursing Responsibilities
106
Injection in the right or left pundendal nerves level with ischial spine
dorsal recumbent
provides relief in perineal
check FHR and maternal bo
2-10 mins for effect and lasts 60 mins
given if there will be a Physiography or the repair of surgical side of episiotomy
Local Anesthesia (Pudendal Block/Pudendal Nerve Block)
107
never preferred for childbirth due to hypoxia, possible inhalation of vomitus
General Anesthesia
108
Inhalant (nitroud axide, Halothanol)
Intravenous (Penthotal)
General Anesthesia
109
Ephedrine - used when blood pressure falls
Atropine Sulfate - dry and respiratory secretions to prevent aspiration
Thiopental Sodium- rapid induction of general anesthetic in an emergency
Succinylcholine - to achieve laryngeal relaxation for intubation in an emergency
Diazepam - controls convulsions
Isoproterenol - reduce bronchospasm
General Anesthesia: Drugs that should be readily available
110
done to preserve life of the mother and her fetus
Cesarean Delivery
111
Dystocia
Placenta Previa
Fetal Distress
Multiple births
Large tumors of the uterus
Genital herpes or infections
Uncontrolled diabetes or hypertension
Indications for Cesarean
112
IV Line
Catheter
Regional/General Anesthesia
Prior to Cesarean
113
3-5 day hospital stay
Breastfeed, nap when the baby sleeps, get out of bed
6-8 weeks full recovery
Scar lightens as it heals
After Cesarean
114
Scheduled & Emergency Cesarean
2 Types of Cesarean Section
115
CPD
Severe Hypertension during pregnancy
Active Genital Herpes
Previous C-section
Indications Maternal Factors
116
Transverse fetal lie
breech presentation
fetal distress
extreme low birth weight
macrosomic
multifetus
Indications Fetal Factors
117
Placenta previa
Abrupto Placentae
Indications Placental Factors
118
Incision made Vertically
Classical Incision
119
bigger space
larger version, less trauma
used in placenta previa
Advantage for Classical Incision
120
most common type
pfannestiel incision or bikini incision
Low Segment Incision
121
less uterine rupture
less blood loss
easier suture
less likely to cause gastrointestinal or postpartum complications
Advantages of Low Segment Incision
122
interval between the birth of the newborn and the return of the reproductive organs to their normal nonpregnant state
Postpartum Period
123
Contraction of Muscle a fibers
Catabolism - process of converting cells into simpler compounds
Regeneration of uterine epithelium
Involution of Uterus
124
T/F: Immediately after the delivery of the uterus is about the size of a grapefruit and weighs 1000g (2.2lbs)
TRUE
125
How many hours until the fundus rises about the level of the umbilicus?
within 12hours
126
What day does the fundus descends one fingerbreadth per day?
2nd Day
127
are composed of vaginal blood tissue and nucleus loss after birth lasting up to 6-8 weeks
Lochia
128
1-3 days
Blood with small particles of decidua and mucus
large clots, saturated pad, foul odor
Lochia Rubra
129
3-10 days
Serous exudate, leukocytes, erythrocytes, and cervical mucus
Excessive amount, foul smell, continued recurrent reddish color
Lochia Serosa
130
10-14 could last until 6 weeks (yellow or white)
leukocytes, decidua, epithelial cells, fat and cervical mucus
Persistent lochia serosa, return to lochia rubra, foul odor, continuing discharge
Lochia Alba
131
Immediately after childbirth the cervix is formless, flabby, and open wide
healing is rapud
firm and dilated the first week
Cervix
132
Round cervix
Nulliparous
133
Cervix shape remain slightly open and appears slitlike
Parous
134
Intermittent contractions and are source of discomfort
Afterpains
135
Afterpains
Ice packs on abdomen
Prone position with pillow under abdomen
136
Cause by episiotomy wound or laceration
Perineal Pain
137
Perineal Pain
provide ice packs on the 1st 24hrs
Perilite and Hot sitz after 24hrs
Perineal care - prevent infections
Analgesics as ordered
138
Mother experiences diaphoresis
Sweating or Excessive Perspiration
139
Sweating or Excessive Perspiration
Offer fresh dry gown
Encourage showers
Increase fluid intake
140
Nipple Soreness
Rotate breast feeding positions
Instruct mother to use finger to break suction before removing infant
Cold compress
Breast support
141
Urinary Incontinence
Kegel exercises
hot tea
running water in sink
pouring water over vulva
142
Mother is focused primarily on her own need for fluid, food, and sleep
1-3 day woman is passive
Major Task: Integrate her birth experience to reality
Taking In Phase
143
Mother becomes more independent
3-10 days
Optimum time to teach about baby care
Taking Hold Phase
144
Woman finally redefines her new role
Gives up fantasy image and accepts real one
Happens when her own needs are no longer predominate
Letting Go Phase
145
Major Role Attainment
Anticipatory Stage
Formal Stage
Informal Stage
Positive Stage
146
Concerned about regaining their normal figure and may have unrealistic expectations
Concerns on Body Image
147
Baby blues, maternity blues or mild depression
last no longer than 2 weeks
insomnia, fatigue, mood instability, anxiety
Postpartum Blues
148
34-35cm Head Circumference
32-33cm Chest Circumference
30-33cm Abdomen
7.5-13cm Midarm
47-52cm Length
2.5-4kg Weight
Measurements of a Newborn
149
Bluish black marks that resembles bruises on the sacrum, buttock, arms and shoulders
Mongolian Spots
150
Thick white substance that provides protective covering opportunities the fetal skin in the uterus
Vernix Caseosa
151
Fine hairs that covers the fetus during intrauterine life
Lanugo
152
White spots
1-2mm in size
caused by distention of sebaceous glands
Milia
153
sign of Dehydration
Sunken Fontanelle
154
Newborn is experiencing Intracranial Pressure/Hydrocephalus
Bulging Fontanelle
155
Placement of a newborn with its mother rather than nursery
Rooming In
156
father’s developing bond with the newborn
Engrossment
157
Position that allows eye to eye contact between the newborn and parent
En face
158
Factors that Affect Adaptation
Lingering discomfort or pain
Chronic fatigue
Knowledge of infant needs
Available support system
Expectations of newborn
Previous experience with infants
Maternal temperament
Infant characteristics
159
Preparation of Breasts (Mammogenesis)
Synthesis and Lactation (Lactogenesis)
Ejection of Milk (Galactokenesis)
Maintenance of Lactation (Galactopesis)
4 Phases in the Physiology of Lactation
160
Composition of Breast Milk
Colostrum
Transitional Milk
Mature Milk
161
Initial Goals once the baby is out
Airway
Warmth
162
Signs of Respiratory Distress
Retractions
Nasal flaring
Cyanosis
