CBC T&S IV 18 G INTRADERMAL Lidocaine PRN for IV start LR 125 cc / hr 500cc Bolus prior to spinal anesthesia Antibiotic 1 - 2 G Cephalexin 80Kg = 2G Bicitra (Sodium citrate) Neutralize Stomach Acid & Nausea. Taste Sour So not to aspirate Acid contents

Test 2 C/S Flashcards by Jade Ring

1 Reason

Reasons for C/S

Labor arrest Dilation Stops
Nonreassuring fetal tracing Cat 2 or 3
Malpresentation Breech, Transverse, Occoput posistion
Multiple gestation
Maternal/fetal reasons
Preeclampsia
Maternal request

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C/S Increased Risk

Maternal/ Infant

Infection 5 - 20x
Hemorrhage
Urinary tract trauma
Paralytic ileus
Anesthesia (aspiration)

Infant

Transient Tachypnea
Laceration / Trauma

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It is recommended that mothers wait at home until True Labor begins then go to the hospital

T or F

This will prevent C sections
Walking helps the most

Regular, strong contractions that are occurring every 5 minutes or less, lasting for at least a minute each, for a period of at least an hour, or if her water breaks, regardless of contraction strength

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Before giving Pitocin what should the uterus state be…

Ripe

Thinned out

Give misoprostol to ripe the cervix

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What would be a good candidate for TOLAC/VBAC

When the last birth was theyes babies fault they couldn’t be born vaginal.

Breech baby / Issues with fetal heart tones

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Decrease C section rate most in which type

Nulliparous women with a term, Singleton baby in vertex posistion delivered without C Section

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Transient respiratory morbidity is higher in CS than VB why?

Fluid in lungs

Vag birth squeezes the fluid out of the lungs

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CS Urgency Time frame

Scheduled

Unscheduled Add-On

Urgent

STAT

Scheduled: Planned preassigned date

Unscheduled Add-On: Non emergency Wait until patient is 6Hrs NPO

Urgent: Decesion to incision time <30 min

STAT: Deceaion to incision <10 min

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Home CS prep the night before

NPO Past midnight

Reg meds (sip water)

Diabetic meds esp important (Insulin drip in OR)

NO SHAVING WITH REG RWZOR

SHOWER night before

Hibiclens (Chlorhexidine)

Remove all metal (rings ect)

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Prep OP CS Orders

CBC T&S

IV 18 G

INTRADERMAL Lidocaine PRN for IV start

LR 125 cc / hr

500cc Bolus prior to spinal anesthesia

Antibiotic 1 - 2 G Cephalexin
<80KG = 1G / >80Kg = 2G

Bicitra (Sodium citrate) Neutralize Stomach Acid & Nausea. Taste Sour

So not to aspirate Acid contents

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SCDs during C/S

Foley?

What does the ElectroCautery ground pad do? LOCATION?

Yes

Purpose: Prevents electrical burns by dispersing the current over a larger surface area as it exits the body.

Placement: thigh or buttock good skin contact, far from bony prominences, metal implants, and the surgical site

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Difference between a Spinal & Epidural

Spinal injects all meds at once

Epidural stays in and continue to infuse

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If woman is in labor for 24 hours which procedure is added to the C/S

This procedure wouldn’t be done if it was a scheduled CS

Betadine perineal area

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Chlorohexiden wipe on abdominal area will be tinted orange. Explan to mom why orange

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Lower Transverse Cesarean are the typical

Why would a classical be used?

Past vertical scar from surgery and surgeon wants to use the same entry

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CS layers (7)

Studying all Friday may provide us A’s

Skin
Adipose
Fascia - possible adhesions if R C/S
Muscle
Peritoneum
Uterus
Amniotic sac- May feel pressure / tugging when baby born. No pain

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_____ is used to protect the ballder from the scalple.

Bladder blade

This will happen right before uterine incision before baby is pull3d out

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Circulating RN responsibility

4 counts: Instruments, Sponges, Needles

Documention: Team members, Times, Delivery/baby information

Calculate QBL

Ensure sterile field

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Is oxytocin continued in the PACU?

Yes

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If PCA or Duramorph - morphine-like (Intrathecal route -Spine) monitor for…

Respiratory depression/ effectiveness of pain control

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What are priority assessment in the PACU 2 HRS postop

Fundal height/ Lochia

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______ involves holding a pillow, blanket, or specially designed splinting device firmly against the surgical site when coughing, sneezing, or moving.

Splinting

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Most effective birth control method

Implantation 0.05 failure rate

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Top 5 most effective birth control methods

Implantation 0.05
IUD 0.2 - 0.8
Sterilization 0.15 - 0.5
Injection 6
Pill 9

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Failure rate of condom

18%

Fetal Hypoxemia causes Brady / Tachycardia

Tachycardia

Accelerations have this time to reach their peak amount

<30 seconds Abrupt

Cephopelvic disproportion happens with which deceleration...

Early 😀

How often is mom having contractions Is called.... Is measured how? What units? CORRECT

UC frequency Range (From beginning of one contraction to beginning of next) Minutes EX 2 - 3 minutes

How long do the contractions last? Is called... How to measure? Which units?

Duration Range (From beginning to end) Seconds EX 50 - 100 Seconds

How long must contraction be to be considered a contraction

Atleast 40 seconds

Describe ideal uterus resting tone between contractions

Soft & non tender

BMI <18.5 18.5 - 24.9 25 - 29.9 >30 Total preggers weight gain? Weekly 2nd & 3rd trimester

<18.5 ( 28 - 40) 18.5 - 24.9 (25 - 35) 25 - 29.9 (15 - 25) >30 (11 - 20) <18.5 (1lb week) 18.5 - 24.9 (1lb week) 25 - 29.9 (0.5 lb week) >30 (0.5 lb week)

Fre

A rise of ____ % in hCG over 48 hours can be considered normal

35%

Pregnancy Presumptive symptoms Probable symptoms Positive

Presumptive symptoms Fatigue N/V Urinary frequency Amenorrhea Breast changes Probable symptoms Chadwick sign: Bluish vag, cervix, vulva Goodell sign: softening vag portion of cervix from Vascularization Hegar sign: Softening of cervical isthmus (Cervical portion between uterus & vag) POSITIVE Hcg TEST Positive: IUP Intrauterine pregnancy on US, Fetal heart tones / movements

Diastasis recti....

Separation of the rectus abdominal abs

Match these words to the appropriate trimester Identify with the mother role Prepares for birth Ambivalent

Ambivalent 1st Identify with the mother role 2nd Prepares for birth 3rd

Which week does a primitive heart beat start

3rd

All major organ systems formed Most vulnerable to Teratogens

3 - 8

Heart begins to pump Arms and legs bud Facial features beginning to form Weeks....

5 - 8

Extremities developed External Genital differentiated Weeks

9 - 12

Fetus begins to move Urine begins to form Weeks....

13 - 16

Meconium begins to collect in bowel Weeks

17 - 20

Skin wrinkled, red, vernix, lanugo Lungs begin to dev surfactant Weeks

21 - 24

Eyes partially opened Respiratory system still imature Weeks

25 - 28

Toe nails present Testies descended Weeks

29 - 32

Skin thicker, less wrinkled Subcutaneous fat accumulation Excelente chance for survival

33 - 36

Baby gains fat Nails extend beyond nail bed Weeks

37 - 40

AFI range indicative of fetal well being

8 - 20

Which fetal cord structure carries blood woth the most O²

Umbilical vein

Connects the pulmonary artery & descending aorta

Ductus Arteriosus

Which shunt closes first

Foramen Ovale (minutes)

Which shunt causes a Murmur to be heard. When does it close

Ductus Arteriosus Gradually 15 - 24 hrs

Routine & Non routine 1st prenatal visit 1st trimester screening Correct

1st prenatal visit Pregnancy test Blood/urine test Dating ultrasound 1st trimester screening Maternal blood serum: Checking for chromosomal abnormalities (Downs) Nuchal Translucency Test: This is an ultrasound that measures the clear space at the back of the fetal neck. Increased thickness in this nuchal translucency can be associated with a higher risk of chromosomal abnormalities, like Down syndrome, as well as congenital heart defects. Non - Routine Cell free DNA: Screening Test checks maternal blood for Chromosomal abnormalities Chorionic Villus Sampling: Diagnostic Small piece of the placenta is removed and cells analyzed to diagnose chromosomal abnormalities

VDRL , RPR Test for...

Syphilis

Taking OTC vitamins is the best practice for baby health T or F

F Only take prescribed vitamins

Reflexes disappear in this order give dates Rooting Moro Palmar / Plantar Babinski Sucking

Rooting 3 - 4 months Moro 5 - 6 months Palmar / Plantar 2 -3 & 8 -9 months Babinski 8- 9 months Sucking 12 months

Abnormal reasons why no reflexes Rooting Moro Palmar/Plantar Babinski Sucking

Rooting: Premature, neurological, drugs Moro: Absent CNS dysfunction Palmar/Plantar: Neurological defects Babinski: bilateral CNS / Unilateral Nerve damage Sucking: Premature, neurological, drugs

Age infant to sit with support? Age to sit by themselves?

6 - 8 8 - 12

Which age for object permence

8 - 12 months

____ is given to preggers mom in the 3rd trimester to prevent whooping cough

Dtap vaccine

Pregnancy related mortality ratio Which groups are most likely to die

Black Indians White Asians Latinos

____ % of PRMR can be prevented

60%

Which ethic considerations is most important

Nonmalifence

_______ is the principle that all people are of equal moral worth and deserve equal rights, opportunities, and resources.

Egalitarianism

Placental Placement and considerations Anterior Posterior Previa Low laying

Anterior: Feels less kicks and harder to measure heart rate Posterior: Desired, easier to feel movements and measure HR Previa: avoid strenuous task / Bedtime rest / C/S maybe needed if during 3rd Low laying: Low but not covering cervix. Will move up as uterus expands

Does the morning after pill affect a 1 month old fetus?

No, only stops implantation