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Flashcards in Test 2 Blueprint (3) Deck (56):
1

2 reasons the laboring woman must keep her bladder empty:

1) distended bladder may impede descent of baby
2) bladder trauma, leads to decreased bladder tone/uterine atony after birth

2

How often should a laboring woman void?

q1-2hr

3

Why are women given an IV bolus before an epidural?

Increases vascular space
Decreases fetal compromise
Keeps mom from becoming hypotensive

4

Mom needs to wear ____ ____ after epidural.

pulse oximeter

5

What is considered hypotensive for mom?

systolic below 100

6

If mom's HR drops, baby's HR ____.

drops

7

What interventions should be done if mom becomes hypotensive?

1) Prop mom on side
2) Increase fluids
3) Admin O2
4) Elevate legs 10-20 degrees
5) Call MD
6) Would need ephedrine (vasoconstrictor)

8

After an epidural, vitals should be taken:

every 5 min for first 20 min
then every 30 min

9

Relation of baby's spine to mom's spine:

Fetal lie

10

Transverse means baby's spine is at ____ ____ to mom's spine.

right angle

11

Longitudinal or vertical lie means baby's spine is ____ to mom's spine.

parallel

12

T/F: Presenting part is the part of the baby that comes out of the vagina first.

True

13

Relation of fetal parts to one another:

Attitude

14

Head flexed, arms folded, legs onto abdomen, back curved in shape of C. Examiner palpates POSTERIOR fontanel.

General flexion
AKA: fetal position

15

Presents wider part of skull to inlet. Examiner palpates the mentum (chin) or brow.

Extended
(dangerous position)

16

Why is EXTENDED ATTITUDE bad for baby?

Can break baby's neck

17

Presentation of baby in relation to front, back, or side of maternal pelvis:

Position

18

1st letter
2nd letter
3rd letter

1st letter: R or L of maternal pelvis
2nd letter: specific presenting part of fetus
3rd letter: location of the presenting part in relation to maternal pelvis

19

Labels for presenting part of fetus (2nd letter)

O=occiput
M=mentum (chin)
S=sacrum
A=acromion process (scapula)

20

Labels for presenting part in relation to maternal pelvis (3rd letter)

A=anterior (symphysis pubis)
P=posterior (sacrum)
T=transverse (to mom's side)

21

Which presentation is best for vaginal delivery?

Cephalic

22

Which fetal position is easiest for vaginal delivery?

LOA

23

Biparietal diameter:

measurement of head at widest part to evaluate if it will fit through birth canal

24

What positions are labeled as "breech"?

sacrum
foot
shoulder

25

These must be C-section:

Mentum (M is the middle letter)
Shoulder
Transverse (T is the last letter)

26

What constitutes fetal tachycardia?

FHR > than 160 bpm
Lasts more than 10 min

27

What causes fetal tachycardia?

Early fetal hypoxemia
Maternal fever
Maternal dehydration
Drug induced
Intraamniotic infection
Maternal hypothyroidism
Fetal anemia
Fetal heart failure
Fetal cardiac dysrhythmia

28

What drugs can cause fetal tachycardia?

atropine
ritodrine
cocaine
methamphetamine

29

What is fetal bradycardia?

FHR

30

What causes fetal bradycardia?

Late fetal hypoxemia
Hypoxia
Drug induced
Maternal hypotension/hypertension
Prolonged umbilical cord compression
Fetal congenital heart block
Maternal hypothermia
Prolonged maternal hypoglycemia
Last sign of hypoxia

31

What drugs can cause fetal bradycardia?

MgSO4
Propanolol
Anesthetics
Epidural
Stadol

32

What 2 things must happen before applying an IUPC or ISE?

ROM
Cervix dilated

33

TN nurses (can/cannot) place IUPC or ISE? What about MS nurses?

TN can
MS cannot

34

When assessing fetal heartrate, what is PMI?

location on maternal abdomen at which the FHR is heard the loudest

35

What part of the fetus is the HR usually heard best?

Over the the fetus' back

36

Where would you find FHT if baby is cephalic? (cephalic = below umilicus)

BELOW the mother's umbilicus
Either the RLQ or LLQ of mom's abdomen (over baby's back)

37

Where would you find FHT if baby is breech? (breech = above umbilicus)

ABOVE the mother's umbilicus

38

What shape pelvis is best for vaginal delivery?

gynecoid

39

In 4th stage of labor, what things are checked?

Vitals
Activity (can feel legs or wiggle toes)
LOC
Color of mom
Fundus
Lochia
Perineum

40

When assessing mom's color after delivery, what should be done if pallor is seen?

Ask MD to order Hct to see if too much blood was lost during delivery

41

In 4th stage of labor, what should be seen with the fundus?

- firm
- midline
- halfway between umbilicus and symphysis pubis

42

After delivery, lochia should be:

rubra, no large clots...small ok

43

After delivery, perineum should be assessed by _____.

REEDA
Redness
Edema
Ecchymosis
Drainage
Approximation (suture line straight or gaps/bulges?)

44

Intervention for boggy uterus/fundus?

Assess bladder - may be distended (void)
Breastfeed - releases oxytocin
Nipple stimulation - releases oxytocin
Uterine massage - promotes vasoconstriction
Admin oxytocin

45

Intervention for fundus deviated to right of umbilicus?

-Assess bladder - distended bladder may push uterus off center
-Void
-Reassess fundus

46

True labor results in ___ ___.

cervical change

47

7 signs of true labor:

1) Regular contraction
2) Start in back
3) Contractions increase in intensity and duration
4) Walking intensifies contractions
5) Mucus plug discharged
6) Cervix dilated
7) Sedation doesn't stop contractions

48

Multipara:

completed 2 or more pregnancies to 20 wks or more gestation

49

Nullipara:

not completed a pregnancy with a fetus or fetuses beyond 20 wks gestation

50

The enlargement of widening of the cervical opening and the cervical canal that occurs once labor has begun:

Dilation

51

The shortening and thinning of the cervix during the first stage of labor. Generally progresses significantly in first-time term pregnancy before more than slight dilation occurs. In subsequent pregnancies, this and dilation of the cervix tend to progress together.

Effacement

52

Dilation is expressed in:

0 to 10 cm

53

Effacement is expressed in:

0 to 100%

54

Relationship of the presenting fetal part to an imaginary line drawn between the ischial spines of the pelvis. It is a measure of the degree of descent of the presenting part of the fetus through the birth canal.

Station

55

Signs and symptoms of uterine infection:

- pain in lower abdomen
- fever
- foul-smelling vaginal discharge
- rapid HR
- swollen and tender uterus

56

What things can introduce or make uterus susceptible to bacteria?

- ruptured membranes (esp 18-24 hrs later)
- vaginal exams (sterile gloves should be used)
- mucus plug is expelled
- anemia
- prolonged labor