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ABSN Cohort 19 > OB Exam2 > Flashcards

OB Exam2 Flashcards

(64 cards)

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1
Q

2 Origins of Pain

A

Visceral - uterine/cervical radiation

Somatic -perineal tissue intense/sharp

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2
Q

Dick-read Preperation

A

deep to shallow, sustained pushing, breath holding

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3
Q

Lamaze Preparation

A

psychprophylactic PPM - mind control

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4
Q

Bradley Preparation

A

partner coached

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5
Q

Birthing from within, Hypnobirthing, professional association

A

Foster confidence!

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6
Q

Gate-Control Method

A

Only so much sense can go through nerve, other senses block pain

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7
Q

Local Perineal block is for…?

A

suturing lacerations

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8
Q

Pudendal block is for…? when?

A

supporting forcep/vacuum, 2nd - 3rd stage

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9
Q

Spinal block location and 3 ▲

A

L3 - L4

▲ HypoTN, breathing pattern, placental perfusion

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10
Q

Headache r/t block?

A

Use Blood patch to stop leak of fluid

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11
Q

Epidural block location

A

↓ L5

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12
Q

CSE - aka walking

A

Combo of opiod/analgesia

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13
Q

Naloxone

A

Counter to opiods if pt has respiratory depression

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14
Q

External/Internal FHR monitoring

A

Toco/Doppler - Intrauterine Pressure Cath and Fetal Spiral Electrode

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15
Q

FHR averages

A

Norm 110 - 160
Tach ↑ 160
Brad ↓ 110

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16
Q

FHR Variabilities (4)

A 
Absent = 0 ▲ r/t baseline
Minimal = ↑↓ 5
Moderate = ↑↓ 6 - 25
Marked = ↑ 25
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17
Q

Tracings (6)

A

Normal = Ø ▲ w/ contractions
Tach = ↑ 160 / 10 min
Brad = ↓ 110 / 10 min
Acceleration ↑ by 15 / 15 sec but ↓ 2 min (32: 10 / 10 sec)
Tachystole ↑ 5 UC / 10 min
Deceleration ↓ FHR with Nadir. ↓30s=cord ↑30s=head

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18
Q

Intensity Contractions FACE MODEL (4)

A

Mild = tip of nose
Moderate = chin
Firm = forehead
Resting - SOFT

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19
Q

Categories I, II, III

A 
I = no action req.
II = abnormal, evaluate
III = one of the Tracings, resusictative measures
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20
Q

Resuscitative Measures (4)

A

Turn laterally, change pos, fluids, O2

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21
Q

Labor begins and ends when…?

A

First contraction, begin attachment with infant

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22
Q

First Stage starts…? 3 stages.

A

Regular uterine contractions
Latent = 3cm
Active = 4 - 7cm
Transition = 8 - 10cm

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23
Q

Second Stage starts…? 3 stages.

A

Full dilation and complete effacement (100%, 10cm, x)
Latent = passive decent
Descent = active push
Transition = pushing most effective

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24
Q

Third Stage what drops…?

A

Placenta in 15 - 20 minutes

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25
Fourth Stage bis all about (2)...?
Recovery and transition
26
Nullip vs. Multip when birthing?
Nullip slower than multip (50/30min)
27
Ritgen Maneuver
Push up from bottom, grab head
28
Nuchal Cord
Cord is around neck
29
2 Types episiotomies and repair process
Mediolateral Medial dissolvable suture w/ local anesthetic
30
Birthing Care interventions (4)
``` Warm shower/compress for pain Cool cloth for face Urinate often - bladder Ice ships - bowel fx Ambulate ```
31
Reccurent Decelerations require...?
Fluid bolus (SLAM the bag, no pump)
32
PP: Post-Partum heal times (vaginal vs. C-section)
6 weeks vs. 8 weeks
33
PP: Linea Negra/Straie
fade w/ tie, sometimes permanent
34
PP: Uterus (3 possibilities)
Involution (1 -2cm q24hr, done in 2 weeks) Subinvoution (failure b/c fragments/infx) Inversion (it's OUT! Nurse put back in)
35
PP: Contractions AKA + what equalizes and how + hormone?
After Pains Hemostasis via blood vessel compression via contractions Oxytocin via pituitary coodinates
36
PP: Lochia (3 and time), Bleeding =?
``` Rubra = red 3 - 4 days Serosa = clearish 22 - 27 days Alba = whitish 10 days - 6 weeks Bleeding = period ```
37
PP: Cervix state and time to regain shape
Soft, regains overs 12 - 18 hrs
38
PP: Vagina/Perinum. Hormone and ▲
↓ Estrogen = thinness, dryness, painful sex | Decreases in size but NEVER the same again!
39
NO SEX FOR HOW LONG?!
5 - 6 weeks
40
PP: Introitus (Vaginal Opening), state, episiostomy heal time, hemorrhoid heal time, what to eat.
swollen/erythematous. Episio = 2 - 3 weeks Hemorrs = 6 weeks ↑ fiber, prenatal vits
41
PP: Pelvic Muscles heal time, possible problem?
6 months, do Kegels! | Pelvix relaxation = muscles relax and organs drop into vaginal space
42
PP: Placental Hormones
DROP in everything to reverse effects of pregnancy
43
PP: Abdomen
Relaxed 2 weeks | Return to non-prego in 6 weeks
44
PP: BOOB function
All in the stimulation | Should feed 10-12x a day q2hr
45
PP: Urinary
Diuresis/Diaphoreis 12hrs/2-3days
46
PP: GI
Very hungry, no BM for potentially 2 - 3 days
47
PP: Cardiovascular blood volume ▲ and possible issue
Blood volume ↓ / 2 weeks and normal by 6 months. THIS IS OK cause they're hypervolemic during pregnancy Cardiac output SAME for 48 hrs/elevated 12 weeks ↑ coagulability and immobility r/in thromboembolism.
48
PP: Neurologic ▲. Shaking? and time to normal.
Shaking is normal. | Discomforts (like carpal tunnel) should go away in 6 - 8 weeks unless prexisting
49
PP: Headaches?! Due to? Tx with?
cerebrospinal leak into extradural space | Otologist blood patch
50
PP: VS rounds and expectation.
``` Q15min x4 Q30min x2 Q1hr x 2 Q4-8hrs Should be stable unless HTN/Preclampic ```
51
Rubella Vaccine - sex lockout
3 months
52
Rogam given if...? time window to give? route?
Mom Rh+ Baby Rh-. Give within 72 hrs post-partum IM
53
PP: MusculoSkeletal heal time and shoe size?
6 - 8 weeks, ↑ shoe size 2
54
``` PP: Integumentary Chloasma Areolae/Linea Nega Vascular Abnormalities are b/c Spider Nevi, which hairs stay? ```
mask fades by end of pregnancy Hyperpigmentation that fades decline with declining estrogens FOREVER, fine hair leaves, coarse stays
55
Care of Family - Nursing Role
Faciliate transition
56
Family Care 4 Educations
Prevent infx Prevent excessive bleeding Maintenance of uterine tone Prevention of bladder distention
57
Emergency Treatment vs. Newborn Protection
Hospital MUST help laboring lady | By LAW must stay 2 days if VAG. Delivery, exceptions with multips
58
Estrogen FX on milk production
↓
59
Tub Bathing/hot tubbing?
NOPE!
60
Baby immunizations times (5)
2 mo, 4 mo, 6 mo, 1 year, 15 mo
61
Family Care Vaccinations and Routes (3)
Rubella SubQ lateral arm Varicella SubQ TDaP IM (10 years)
62
When to initiate breastfeeding
when baby is MOST ALERT 3- 4 hours post birth
63
BIG UTERUS + BREASTFEEDING = ???
PAIN!!!
64
4 Reasons for ▲ in PP discharge
Consumer demand Medical necessity Discharge criteria for lowrisk childbirth Cost-containment measures

ABSN Cohort 19 (28 decks)

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