Test 2 Blueprint (3) Flashcards

(56 cards)

1
Q

2 reasons the laboring woman must keep her bladder empty:

A

1) distended bladder may impede descent of baby

2) bladder trauma, leads to decreased bladder tone/uterine atony after birth

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2
Q

How often should a laboring woman void?

A

q1-2hr

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3
Q

Why are women given an IV bolus before an epidural?

A

Increases vascular space
Decreases fetal compromise
Keeps mom from becoming hypotensive

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4
Q

Mom needs to wear ____ ____ after epidural.

A

pulse oximeter

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5
Q

What is considered hypotensive for mom?

A

systolic below 100

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6
Q

If mom’s HR drops, baby’s HR ____.

A

drops

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7
Q

What interventions should be done if mom becomes hypotensive?

A

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)

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8
Q

After an epidural, vitals should be taken:

A

every 5 min for first 20 min

then every 30 min

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9
Q

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

A

Fetal lie

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10
Q

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

A

right angle

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11
Q

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

A

parallel

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12
Q

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

A

True

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13
Q

Relation of fetal parts to one another:

A

Attitude

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14
Q

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

A

General flexion

AKA: fetal position

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15
Q

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

A

Extended

dangerous position

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16
Q

Why is EXTENDED ATTITUDE bad for baby?

A

Can break baby’s neck

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17
Q

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

A

Position

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18
Q

1st letter
2nd letter
3rd letter

A

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

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19
Q

Labels for presenting part of fetus (2nd letter)

A

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

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20
Q

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

A

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

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21
Q

Which presentation is best for vaginal delivery?

A

Cephalic

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22
Q

Which fetal position is easiest for vaginal delivery?

A

LOA

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23
Q

Biparietal diameter:

A

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

24
Q

What positions are labeled as “breech”?

A

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