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Nursing School > NUR 360 - Exam 2 > Flashcards

NUR 360 - Exam 2 Flashcards

(94 cards)

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1
Q

true labor

A

CERVICAL CHANGE
regular, frequent contractions
bloody show
fetus descends into true pelvis

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2
Q

false labor

A

NO CERVICAL CHANGE
painless, irregular contractions
NO bloody show

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3
Q

where are fetal heart sounds heard in cephalic position?

A

lower abdomen

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4
Q

where are fetal heart sounds heard in breech postition?

A

above umbilicus

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5
Q

pitocin action

A

stim uterine contractions for inductions and given postpartum to prevent/treat hemorrhage

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6
Q

pitocin considerations

A

continuous fetal monitoring
- tachy, uterine rupture, abruptio placenta

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7
Q

chronic hypertension

A

HTN before pregnancy for before 20 weeks
reading of 140/90 twice 4 hours apart and not stablizing

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8
Q

preeclampsia

A

HTN with proteinuria or signs of organ damage (severe features) after 20 wks

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9
Q

eclampsia

A

preeclampsia with seizures

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10
Q

HELLP syndrome

A

Hemolysis, Elevated Liver enzymes, Low Platelet count; a severe form of preeclampsia

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11
Q

management of Chronic Hypertension, Preeclampsia, Eclampsia, HELLP

A

Mag Sulfate, antihypertensives, early delivery

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12
Q

risk of multiple gestation

A

preterm labor, C/S, HTN disorders, placenta previa, PP hemorrhage

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13
Q

dystocia

A

difficult labor due to contractions, dilation, descent, and pelvic shape

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14
Q

pelvic dystocia

A

abnormal shape of pelvis

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15
Q

soft tissue dystocia

A

placenta previa, benign fibroid tumor, distended bladder

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16
Q

hypotonic labor dystocia

A

inefficient contractions - Pit or artificial ROM

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17
Q

hypertonic labor dystocia

A

delivering too fast - uterine rupture, laceration of birth canal, fetal distress - call MD

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18
Q

contraindictions for pitocin

A

too many contractions, fetal distress

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19
Q

pitocin complications and actions

A

hyperstimulation, HTN, N/V, arrythmias, fluid volume issues

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20
Q

preterm labor risk factors

A

metabolic diseases, infection, increased maternal age, smoking/drugs, violence, low maternal weight prepregnancy, previous PTL, uterine issues, recurrent cervical dilation, placental issues, multiple gestation, PROM

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21
Q

signs of onset preterm labor

A

contractions, “period-like” cramps, low back pain, discharge w foul odor, urinary freq.

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22
Q

interventions for preterm labor

A

terbutaline, tocolytics, corticosteroids for baby, bed rest, hydration

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23
Q

gate control theory + example

A

new pain distracts from exisiting pain ex. injecting saline to distract from labor pains

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24
Q

endogenous biochemical theory + example

A

once pain gets to a ceratin level brain releases morphine-like chemical that reduces pain ex. oxytocin in brain decreases labor stress

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25
fear/tension theory
pain will increase with fear and tension - nurses have the biggest impact on this theory
26
cognitive control theory
dissociation- focus on something nonpainful interference- focus on something not related at all
27
when to reassess pain
1 hour after PO med 20 min after IV med
28
systemic meds
opioids, analgensic potentiators, antiemetics
29
side effects of systemic meds
- resp. depression - slow labor - sedation - cross the placenta
30
contraindictions for systemic meds
- allergies - resp. issues - myasthenia gravis - addiction
31
opioids analgesics
stadol, nubain, demerol, fentanyl
32
analgesic potentiators
phenergan and vistaril
33
action of analgesic potentiators
antiemetics, relaxation, increase effectiveness of analgesics
34
opioids antagonist
narcan
35
when to give systemic meds
early in labor to avoid fetal resp depression
36
anesthesia
block sensation
37
analgesia
decrease pain
38
fetal kick counts
10 movements in 2 hours
39
FHR baseline
110-160
40
absent variability
0 - fetal distress - hypoxia/acidosis
41
minimal variability
< 5 - sleep pattern - anomalies - meds - neuro problem - gest. age less than 32 weeks
42
moderate variability
6-25 - normal
43
marked variability
> 25 - fetal over compensation -early hypoxia/distress
44
accelerations
increase of 15 bpm lasting 15 seconds - normal after 32wks - mature autonomic nervous system - good fetal O2 reserve
45
early decels
head compression - identify labor progress
46
late decels
utero-placental insufficiency - execute intervention
47
variable decels
cord compression - change position
48
prolonged decels
fetal hypoxia/injury - position, fluids, 10L o2 if ordered, tocolytics
49
sinusoidal
severe fetal anemia
50
category I
110-160 - accelerations moderate - NO late/variable decelerations
51
nonstress test
need 2+ accelerations in 20 minutes that increase by 15bpm and last for 15 seconds to be reactive
52
contraction stress test
3 contractions in 10 mins needed negative = normal - no late decels positive = problem - 50% of time late decels present
53
contraindictions for CST
- placenta previa - suspected placental abruption
54
VEAL CHOP MINE
V- variable - C - cord comp. - M - move patient E- early - H - head comp. - I - identify labor A- acceleration - O - okay! - N - nothing L- late - P - placental insufficiency - E- evacuate fetus
55
how to test for ROM
- nitrazine paper - ferning
56
assessment priotities after ROM
- FHR monitoring - check for infection - fluid color + quantity
57
when is AROM performed
during active labor
58
how is AROM performed
provider goes in with hook
59
oxytocics
drugs that stimulate labor; pitocin
60
tocolytics
drugs that inhibite contractions; Mg Sulfate, terbutaline, nifedipine
61
stage 1 labor
begins - dilation + effacement + contractions ends- 10 cm dilation
62
latent
early 0-3cm
63
active
4-7cm
64
transition
8-10cm
65
stage 2 labor
begins: onset of pushing ends: birth of baby
66
stage 3 labor
begins: birth of baby ends: delivery of placenta
67
stage 4 labor
begins: delivery of placenta ends: stable status
68
fundal assessments
q15 min PP
69
lochia assessments
q15 min PP
70
bladder assessments
empty prn and remove epidural to restore sensation
71
frank breech
butt down, face front, straight legs
72
full breech
facing moms back, legs bent
73
single footed breech
foot poking out of cervix - C/S
74
external cephalic version
procedure to turn the baby to a head-first position
75
ECV contraindictions
Active labor, cardiac disease,metabolic diseases, ROM, and uterine anomalies
76
nursing considerations for ECV
monitor fetus + mom, prep C/S if necessary
77
nursing assessments for magnesium sulfate
- change in LOC - DTR's - Ins and outs - vitals - lung and heart sounds HOURLY
78
nursing considerations for magensium sulfate
- NO methergine - frequent assessment - delay next pregnancy
79
signs of magnesium toxicity
- resp depression - absent reflexes - hypotension
80
placenta previa
low-lying, partial, and complete placement with painless bright red bleeding
81
nursing management for placenta previa
- no vaginal exams - bed rest w BR privledges if no bleeding - ultrasound surveillance - have blood ready - risk of hemorrhage and C/S
82
placental previa complications
fetal distress or death fetal hypoxia PTL
83
placenta previa risk factors
male fetuses, large placenta, minority women
84
placental abruption
premature seperation of all/part of placenta - sudden onset - dark red PAINFUL bleeding
85
placental abruption complications
hypovolemic shock or DIC hemorrhage fetal hypoxia
86
nursing management of placental abruption
- side lying position - monitor for shock - C/S prep - possible hysterectomy if uterus wont contract - poor fetal prognosis
87
types of placental abruption
1. marginal abruption external hemorrhage 2. central abruption concealed hemorrhage 3. complete abruption
88
descent
head enters inlet in occiput transverse
89
flexion
head flexes chin to chest
90
internal rotation
head rotates occiput transverse to occiput anterior
91
extension
head passes under pubic bone
92
restitution
birth of head - turns to realign w shoulders
93
external rotation
shoulders rotation to anteroposterior position
94
expulsion
birth of rest of body - anterior shoulder first

Nursing School (18 decks)

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