Assessing & Admitting Pregnant Woman Flashcards
the series of events by which uterine contractions and abdominal pressure expel a fetus and placenta from the uterus.
LABOR
Explain Bartolomew Rule
- 12 weeks - slightly above symphysis
- 20 weeks - level of the umbilicus
- 26 weeks - below xiphoid process
- 23 & 40 weeks - same level due lightening on the 40 weeks
Measure the heart rate through a wire called (electrode) contains a needle, inserted through the vagina and cervix, and placed under the baby’s scalp.
INTERNAL MONITORING
It is the time from the beginning of a contraction to the end of the same contraction
DURATION
Upper margin of the body of the uterus
FUNDUS
At what week is the fundus palpable for fundic height to be measured?
12 WEEKS
The size of the uterus usually reaches its peak at about ______
36 weeks gestation
Before measuring fundic height, the woman has to _____. Justify.
Empty her bladder if not done so in 30 minutes. Because a full bladder can change fundic height measurement and it may cause discomfort to the woman.
What position should the woman be when measuring fundic height?
SUPINE (placing a pillow underneath right side to avoid supine hypotension syndrome)
When a pregnant woman is lying flat on her back, the weight of her uterus and its contents compresses the large blood vessel (vena cava) leading from her lower body to the heart.
This condition is called ___
SUPINE HYPOTENSIVE SYNDROME
Give the 3 landmarks used when measuring fundic height
- Symphysis pubis
- Umbilicus
- Xiphoid process
- Fundic height below the umbilicus
- Fundic height above the umbilicus
- less than 20 weeks gestation
- more than 20 weeks gestation
Auscultation is a method of listening to the fetal heartbeat for about __________ by using a fetal stethoscope (Fetoscope or Pinard), or a hand-held Doppler ultrasound device.
60 SECONDS
In ____ presentation, fetal heart sounds are usually best heard through the ______
BREECH PRESENTATION; FETAL BAC
What are the 3 rules of estimating fundic height? Explain
- MCDONALD RULE - to estimate AOG thru fundal height
> AOG in Lunar Months: (FH)(2/7)
AOG in weeks: (FH)(8/7)
- BARTOLOMEW RULE - using 3 landmarks
> Symphysis pubis
> Umbilicus
> Xiphoid process - JOHNSON’S RULE - estimate weight of fetus in grams
> FH-(n)(k)
Is the measuring of the fetus’s heart rate during the labor by using a special instruments.
FETAL HEART RATE MONITORING
Types and method of FHR monitoring
- Intermittent auscultation
- Electronic fetal monitoring (EFM)
Intermittent auscultation should be done every how many minutes on
- First stage
- Second stage
First stage (active phase) = 15-30 mins
Second stage (pushing) = 5-15 mins
Refer to fluctuation caused by balancing acts of sympathetic (increase FHT) and parasympathetic branches ( decreases FHT ) of the automatic nervous system.
BASELINE VARIABILITY
is an electronic monitor used to continuously measures the fetus’s heart rate and using a pressure sensor to monitor the mother’s contractions at the same time.
EFM - ELECTRONIC FETAL MONITORING
Fetal heart sounds are transmitted best through the______portion of a fetus because that is the part that lies in closest contact with the uterine wall.
CONVEX
Normal FHR
120-160 bpm
In a face presentation, the back becomes concave so the sounds are best heard through the more _______
CONVEX THORAX
It is a visually apparent abrupt increase (onset to peak in less than 30 seconds) in the FHR.
ACCELERATIONS
Give instruments that can be used to auscultate FHR
- FETOSCOPE
- PINNARD
- DOPPLER
2 types of EFM
- External
- Internal
Beginning of a contraction to the beginning of the very next contraction
FREQUENCY
Differentiate early deceleration vs late deceleration
Early deceleration - occurs at the start of the contraction and ends when the contraction ends.
Late deceleration - occurs after the peak of a contraction and continuous beyond the end of the contraction
Rate of FHT decreases at the onset of uterine contraction but return to normal before the end of contraction
DECELERATIONS
Measured from the end of the contraction to the beginning of the next contraction
INTERVAL
Decelerations that are a decrease from the FHR baseline of 15bpm or more and lasts longer than 2-3 mins but less than 10 mins
PROLONGED DECELERATION
The tightening and shortening of the uterine muscles
UTERINE CONTRACTIONS
This describes the pain/ nature of the contraction
INTENSITY
Deceleration that occurs at unpredictable times in relation to contractions
VARIABLE DECELERATIONS
Healthcare practitioner and nurse will be checking fetal heart rate and uterine contraction.
LABOR WATCH
Thinning & shortening of the cervix
EFFACEMENT
Part of the fetal body that enters the true pelvis first and which is also the part that comes out first during delivery.
PRESENTING PART
Explain leopold’s maneuver
The relationship of the presenting part of the fetus to an imaginary line drawn at the level of the ischial spine of the mother
Also determines the advancement or descent of the presenting part through the pelvis
STATION
A blood-tinged mucus discharge that becomes heavier and more blood stained as labor progresses
SHOW
is a record of all the observation made on a woman in labor , the central feature of which is the graphic recording of the dilatation of the cervix as assessed by vaginal examination.
PARTOGRAPH
What is a partograph
Frequency of monitoring FHT
