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Flashcards in Test 2 Blueprint (2) Deck (51):
1

Beginning of one contraction to the beginning of the next contraction.

Frequency

2

Beginning to end of one contraction.

Duration

3

Frequency is measured in ____.
Duration is measured in ____.

minutes
seconds

4

How strong the contraction FEELS upon palpation.

Intensity

5

Intensity is classified as:

mild (nose)
moderate (chin)
strong (forehead)

6

The period in between contractions; palpation of uterus when no contraction is taking place.

Resting tone

7

Interventions for Late or Variable decels:
(The Big 5)

1) Reposition pt...prop on side
2) O2 per facemask
3) IV fluids or fluid bolus
4) Stop oxytocin
5) Call the doctor

8

What level of O2 is generally ordered?

8 to 10 L/min

9

Accelerations are indicative of ____ ____ ____ and ____ ____ which are considered signs of fetal well being.

well oxygenated fetus
fetal movement

10

What is an amniotomy?

AROM

11

Why is an amniotomy performed?

Induce or augment labor

12

The longer the membranes are ruptured, the greater the risk for ____.

infection

13

How often is temp measured after ROM?

q 1-2 hr

14

If membranes are ruptured more than 24, what intervention is performed?

prophylactic antibiotics as ordered

15

What would you assess immediately following ROM?

Amniotic fluid: color & odor
FHT: decels or change in variability

16

If variable decels are noted, check for ____ ____.

cord prolapse
This is an emergency!

17

Normal amniotic fluid...

Pale/straw colored
Flecks of vernix caseosa, lanugo, scalp hair
Characteristic odor

18

Abnormal amniotic fluid...
Greenish brown color

Meconium in fluid
(Risk for fetal meconium aspiration)

19

Abnormal amniotic fluid...
Yellow color

- Infection
- Breech presentation r/t pressure on fetal abdominal wall during decent
(May also be rupture of gonorrhea/chlamydia lesions)

20

Abnormal amniotic fluid...
Port wine color

Bleeding, possible abruption, premature separation of placenta

21

Abnormal amniotic fluid...
Thick, cloudy, foul odor

Intrauterine infection

22

What 5 things are assessed in the APGAR score?

Appearance (color)
Pulse (HR)
Grimace (Reflex irritability)
Activity (Muscle tone)
Respirations

23

When is APGAR score performed? What is considered normal?

1 and 5 min immediately after delivery
7-10 score normal

24

APGAR...
Appearance (Color)

0 blue, pale
1 acrocyanosis
2 completely pink

25

APGAR...
Pulse (HR)

0 absent
1 100

26

APGAR...
Grimace (Reflex irritability)

0 none
1 grimace
2 cry

27

APGAR...
Activity (Muscle tone)

0 flaccid
1 some flexion
2 well-flexed

28

APGAR...
Respirations

0 absent
1 slow, weak cry
2 good cry

29

Why is oxytocin important after delivery?

promotes uterine contractions
vasoconstriction

30

Why don't we want contractions any closer than 2 min apart?

Insufficient time to reoxygenate fetus between contractions

31

What happens if mother is hypotensive?

not enough pressure to adequately reperfuse placenta

32

When do you give Stadol (butorphanol tartrate)?

At the top of the contraction; due to vasoconstriction during contraction, the fetus will get less and the mom will get more

33

What is the goal of pain relief?

adequate pain relief without increasing maternal or fetal risk
OR affecting the progress of labor

34

Is it ok to give a preganant/laboring woman BENZODIAZEPINES?

No, this will effect the baby's ability to thermoregulate

35

What is the #1 stressor to a newborn?

cold

36

What are 2 examples of barbiturates?

Seconal (secobarbital) **this is no longer given
Nembutal (pentobarbital)

37

Can barbiturates be given during active labor? Why or why not?

NO
Causes CNS depression of newborn

38

Name 2 ataractics:

Reglan (metoclopramide)
Phenergan (promethazine)

39

What effect do ataractics have on the fetus?

CNS depression

40

Can ataractics be given with benzos?

No

41

Name 4 examples of opioids?

Dilaudid (hydromorphone)
Demerol (meperidine)
Sublimaze (fentanyl)
Sufenta (sufentanil)

42

What effect does Demerol (meperidine) have on the newborn?

Causes prolonged neurobehavioral changes that can last for 2-3 days

43

Sufenta (sufentanil) does not cross the ____ as readily so ____ fetal exposure.

placenta
less

44

What is an antidote for opioid overdose?

Narcan (naloxone hcl)

45

Can Narcan (naloxone hcl) reverse Stadol or Nubain?

No, these are opioid agonist-antagonists

46

List 2 opioid agonist-antagonists:

Stadol (butorphanol tartrate)
Nubain (nalbuphine hcl)

47

What is a positive characteristic of opioid agonist-antagonists like Stadol and Nubain?

Adequate analgesia w/o resp depression in mom or baby

48

What is a negative characteristic of opioid agonist-antagonists like Stadol or Nubain?

May precipitate withdrawal symptoms in narcotic dependent women and babies

49

What interventions can be performed in an infant with resp depression to get opioid out of system faster?

stimulation (rub vigorously with towel)
fluids

50

What is negative about a spinal block?

Increased incidence and degree of hypotension

51

Negative of general anesthesia?

fetal resp depression, hypotonia, lethargy