Flashcards in Test 2 Blueprint (3) Deck (56):
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
How often should a laboring woman void?
Why are women given an IV bolus before an epidural?
Increases vascular space
Decreases fetal compromise
Keeps mom from becoming hypotensive
Mom needs to wear ____ ____ after epidural.
What is considered hypotensive for mom?
systolic below 100
If mom's HR drops, baby's HR ____.
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)
After an epidural, vitals should be taken:
every 5 min for first 20 min
then every 30 min
Relation of baby's spine to mom's spine:
Transverse means baby's spine is at ____ ____ to mom's spine.
Longitudinal or vertical lie means baby's spine is ____ to mom's spine.
T/F: Presenting part is the part of the baby that comes out of the vagina first.
Relation of fetal parts to one another:
Head flexed, arms folded, legs onto abdomen, back curved in shape of C. Examiner palpates POSTERIOR fontanel.
AKA: fetal position
Presents wider part of skull to inlet. Examiner palpates the mentum (chin) or brow.
Why is EXTENDED ATTITUDE bad for baby?
Can break baby's neck
Presentation of baby in relation to front, back, or side of maternal pelvis:
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
Labels for presenting part of fetus (2nd letter)
A=acromion process (scapula)
Labels for presenting part in relation to maternal pelvis (3rd letter)
A=anterior (symphysis pubis)
T=transverse (to mom's side)
Which presentation is best for vaginal delivery?
Which fetal position is easiest for vaginal delivery?
measurement of head at widest part to evaluate if it will fit through birth canal
What positions are labeled as "breech"?
These must be C-section:
Mentum (M is the middle letter)
Transverse (T is the last letter)
What constitutes fetal tachycardia?
FHR > than 160 bpm
Lasts more than 10 min
What causes fetal tachycardia?
Early fetal hypoxemia
Fetal heart failure
Fetal cardiac dysrhythmia
What drugs can cause fetal tachycardia?
What is fetal bradycardia?
What causes fetal bradycardia?
Late fetal hypoxemia
Prolonged umbilical cord compression
Fetal congenital heart block
Prolonged maternal hypoglycemia
Last sign of hypoxia
What drugs can cause fetal bradycardia?
What 2 things must happen before applying an IUPC or ISE?
TN nurses (can/cannot) place IUPC or ISE? What about MS nurses?
When assessing fetal heartrate, what is PMI?
location on maternal abdomen at which the FHR is heard the loudest
What part of the fetus is the HR usually heard best?
Over the the fetus' back
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)
Where would you find FHT if baby is breech? (breech = above umbilicus)
ABOVE the mother's umbilicus
What shape pelvis is best for vaginal delivery?
In 4th stage of labor, what things are checked?
Activity (can feel legs or wiggle toes)
Color of mom
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
In 4th stage of labor, what should be seen with the fundus?
- halfway between umbilicus and symphysis pubis
After delivery, lochia should be:
rubra, no large clots...small ok
After delivery, perineum should be assessed by _____.
Approximation (suture line straight or gaps/bulges?)
Intervention for boggy uterus/fundus?
Assess bladder - may be distended (void)
Breastfeed - releases oxytocin
Nipple stimulation - releases oxytocin
Uterine massage - promotes vasoconstriction
Intervention for fundus deviated to right of umbilicus?
-Assess bladder - distended bladder may push uterus off center
True labor results in ___ ___.
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
completed 2 or more pregnancies to 20 wks or more gestation
not completed a pregnancy with a fetus or fetuses beyond 20 wks gestation
The enlargement of widening of the cervical opening and the cervical canal that occurs once labor has begun:
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.
Dilation is expressed in:
0 to 10 cm
Effacement is expressed in:
0 to 100%
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.
Signs and symptoms of uterine infection:
- pain in lower abdomen
- foul-smelling vaginal discharge
- rapid HR
- swollen and tender uterus