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Maternal Newborn > Birth > Flashcards

Birth Flashcards

1
Q

What are some other signs of impending labor? 今にも起こりそうな

A

Burst of energy (nesting)
Lighting(Baby drops into the pelvis 骨盤)
Weight loss
GI upset
Leg cramps
Water broke
Pelvic pressure

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2
Q

What are we looking for on the NST?

A

A normal baseline and 2 accelerations of 15 beats, lasting 15 seconds in a 20 min period.

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3
Q

a) baseline?
b) variability?
c) Accelerations?

A

The baby is currently well perfused because:
There is a normal baseline - 145
Moderate variability with 6 to 25 beats of variation
Accelerations are present; No decelerations

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4
Q

Latent phase

a) dilation cm?
b) duration?
c) frequency?

A

a) 0cm-3cm
b) 30-45secs
c) 5-30mins

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5
Q

Active phase?

a) dilation cm?
b) duration?
c) frequency?

A

a) 4-7cm
b) 40-70secs
c) 3-5 mins

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6
Q

Transition

a) dilation cm?
b) duration?
c) frequency?

A

a) 8-10cm (full)
b) 45-90secs
c) 2-3mins

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7
Q

Second stage is?

A

Full dilation to birth

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8
Q

Third stage is?

A

Birth to deliver placenta

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9
Q

Fourth stage is?

A

Deliver of placenta to hemostasis
2 hours post-delivery of the placenta

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10
Q

What does the acronym VEAL CHOP pertain to?

A

Assessment of changes in the Fetal Heart Rate

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11
Q

The complications to assess for in ALL women during labor are? 3

A

Bleeding
Infection
Decreased Fetal Perfusion

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12
Q

How can we measure the strength of her contractions?

A

Palpation

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13
Q

What is the only definite way to tell if a patient is in true labor?

A

Cervix is changing
頸部

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14
Q

Can we send mom who has false labor home?

A

No, we need to check the fetal heart rate and perform an NST.

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15
Q

Non-pharmacologic Pain Management
Cutaneous

example?

A

Massage
Heat or Cold packs
Rocking or Walking
Sacral counterpressure
(heal of hand to massage mom’s sacrum)
Acupressure

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16
Q

Non-pharmacologic Pain Management
Relaxation

example?

A

Non-touching aromatherapy
Music
Breathing
Imagery

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17
Q

a) Kelly’s baby is “-2” so that means
b) If Kelly’s baby was “+2” what would that mean?

A

a) Kelly’s baby is 2 cm above the ischial spines
b) The baby is 2 cm below the ischial spines

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18
Q

Tammy is afraid to get an epidural and wants to know if you can just give her something through her IV.

What can you tell her about systemic forms of pharmacologic pain relief?

A

IV Medications cross the placenta and may cause respiratory distress in the baby after delivery requiring Naloxone (Narcan). Therefore, we won’t administer any if you are close to delivery.

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19
Q

What form of pain relief is the epidural?
Is it systemic of regional?

A

Regional - which doesn’t enter the blood stream and doesn’t cross the placenta.

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20
Q

Which of the five process of labor may be affected at this stage? after epidural

A

Position - the patient will still need to move during labor so the nurse will have to help her change
position every couple of hours

Passenger - The epidural causes hypotension which can affect fetal perfusion

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21
Q

The provider decides to breaks Kelly’s water.
After the membranes are ruptured what is the first thing you do?

A

Assess the Fetal Heart rate

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22
Q

What is this?

A

Leopold’s Maneuvers
-determine the position of the fetus

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23
Q

Kelly is very anxious to see if she can start pushing and wants to know why you are not checking her cervix as frequently. (after water brake)

What can you tell her?

A

I want to limit your exams, so I don’t introduce an infection now that your water is broken.

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24
Q

Kelly states that she feels like she need to have a bowel movement.
Should you check her cervix now?

A

Yes!

25
Q

C/C/+2
This means that Kelly is in what stage of labor?

A

Second Stage

26
Q

a) Later stage of labor,
what pharmacological pain relief is
available? (for the lower vaginal and
perineal area)

b) Any risk?

A

a) The pudendal block
b) no risk from hypotension
it does not enter the blood stream and therefore does not affect the baby, like the IV medications

Unfortunately, it can’t be re-dosed like the epidural or IV medication

27
Q

What is this position called?

A

The occiput anterior position.
This is the best position for the fetal head to exit the pelvis.

28
Q

What is this position?

A

That is the occiput posterior position.
This is much harder to deliver. The second stage will likely take longer.

29
Q

The provider delivers the rest of the body, suctions the mouth and nose, then dries the baby and places the baby on Kelly’s abdomen.
What stage of labor is Kelly in now?

A

The third stage of labor

30
Q

The placenta slides out of the vagina.
What stage of labor is Kelly in now?

A

The fourth stage

31
Q

Now that the placenta has separated, Kelly is a risk for??

A

Hemorrhage

32
Q

What interventions should be implemented by fourth stage?

A

Oxytocics medication Pitocin(contract the uterus)
Assess fundus every 15 mins /(ensure that it is firm, and her lochia isn’t too heavy)

If her fundus is not firm, fundal massage is needed

33
Q

What are some benefits of skin-to-skin?

A

Bonding
Breastfeeding
Thermoregulation for baby
Glucose control for baby
Breastfeeding
(leads to increased uterine tone and decreases bleeding for Kelly)

34
Q

What are the 5 P?

A

Passenger
Passageway
Powers
Position of mother
Psychologic response

35
Q

What are the passenger factor?

A

Size of fetal head
Fetal presentation
Fetal position
Fetal lie
Fetal attitude

36
Q
A
37
Q
A
38
Q

Position
Why do they need to frequent changes in position?

A

Relieve fatigue
Increase comfort
Improve circulation

39
Q

Normal Psychologic Response
Latent Labor

A

Excited
Some apprehension
Pain controlled fairly well
able to follow directions

40
Q

Normal Psychologic Response
Active Labor

A

More serious
Attention is inward
Some difficulty following directions

41
Q

Normal Psychologic Response
Transition

A

Fearful
Irritable
doubt about ability to continue

42
Q
A
43
Q

Fetal adaptation, 3 changes occur in

A

Fetal heart rate
Fetal circulation
Fetal respiration

44
Q

What are the innervation when late and variable decelerations?

A

LIOON
Left lying
IV fluid
Oxygen
Stop oxytocin
Notify provider

45
Q

The nurse locates the fetal heart tones in the patient’s RUQ. The
nurse should suspect that the fetus is in which of the following
positions?

  • A – Cephalic
  • B – Transverse
  • C – Posterior
  • D – Breech
A

D

46
Q

A nurse is caring for a client who was just admitted at 39 weeks of
gestation and in active labor. Which of the following actions should
the nurse include in the patient’s plan on care?

  • A – Keep four side rails up while the client is in bed.
  • B – Monitor the fetal heart rate (FHR) every hour.
  • C – Check the cervix prior to analgesic administration.
  • D – Insert an indwelling urinary catheter.
A

C

47
Q

What is the Braxton Hicks Contraction?

A

Irregular in frequency, less intense and usually go away if you change positions

48
Q

What is the sing for preceding labor?

A

Weight loss
Lightening
Braxton Hicks contractions
Nesting

49
Q

What can we make for general comfort while moms have pain?

A

Patient is dry
Bladder empty
Room appropriate temp
Question answer

50
Q

Nursing care first stage?

A

Perform Leopold maneuvers
Perform a vaginal examination
Assessments related possible rupture of membrane
Suspected– FHR

51
Q

Nursing care in active phase?

A

Monitor FHR
Encourage frequent position change
Encourage voiding
Encourage relaxation
Provide pharmacological pain relief

52
Q

Nursing care during Transition phase?

A

Monitor FHR
Encourage voiding
Encourage breathing control
Encourage bearing down once cervix fully dilated

53
Q

What Is Crowning?

A

When you can see the top of your baby’s head through the opening of your vagina

54
Q

Transition phase and mom need to have bowel movement.
What nurse should do?

A

Prepare for an impending deliver 差し迫った
urge bowel movement indicate fetal descent 下降

55
Q

What is the sing for placenta separation?

A

Lengthening of the umblical cord
Appearance of dark blood from the vagina
Fundus firm upon palpation

56
Q

The patient has vaginal bleeding for 2weeks.

What should nurse do?

A

Defer vaginal exam 延期する

57
Q

Why do we encourage to mom to void every 2hours during labor?

A

A distended bladder reduces pelvic space needed for birth

58
Q

a) Effacement?
b) Dilation?

A

a) Thinning/stretching of the cervix 90-100%)
b) How wide opening cervix (0-10cm)

59
Q

a) Epidural cause what?
b) Intervention?

A

a) Maternal hypotension
b) Administer IV fluids
Position change

Maternal Newborn (20 decks)

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