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Maternity > CH 21 Labor and Birth at Risk > Flashcards

CH 21 Labor and Birth at Risk Flashcards

1
Q

risk factors for dystocia

A

maternal exhaustion, hydramnios, prior injury (pelvic fracture), occiput posterior position, VBAC, ineffective uterine contractions,

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2
Q

definition of dystocia

A

slow or difficult labor or delivery

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3
Q

hypertonic uterine dysfunction

A

uterus never fully relaxes b/w contractions
- mom gets really tired from these frequent, intense, and painful contractions with little progress
-mom usually stays at 2-3cm and doesn’t dilate as she should

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4
Q

hypotonic uterine dysfunction

A

occurs during active labor
- contractions become poor in quality and lack sufficient intensity to dilate and efface the cervix.

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5
Q

what is the biggest risk with hypotonic uterine dysfunction

A

postpartum hemorhage because mother;s uterus cannot contract effectively to compress blood vessels

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6
Q

protracted disorders

A

abnormal labor pattern
“failure to progress”

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7
Q

arrest disorders

A

no progress
contractions all of a sudden stop; baby stops decending; birth is progressing very slowly

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8
Q

maneuvers to help with shoulder dystocia

A

McRobert

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9
Q

precipitate labor

A

abrupt onset of higher-intensity contractions occurring in a shorter period instead of a more gradual increase in frequency, duration, and intensity

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10
Q

persistent occiput posterior position

A

baby’s occiput is facing mom’s posterior/spine

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11
Q

face and brow presentation

A
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12
Q

what is the favorable fetal presentation for childbirth

A

vertex presentation; complete flexion

  • huddled in completely
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13
Q

what is a breeched position

A

fetal buttocks or breech are presenting first rather than head

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14
Q

what would mom report if the baby is in posterior occiput position

A

intense back pain

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15
Q

nursing care for a mom with hypertonic contractions

A

maintain hydration, promote rest and relaxation in between contraction, place client in lateral position

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16
Q

what is “problems with the passageway”

A

contraction of one or more of the three planes of the maternal pelvis (become to narrow

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17
Q

what is the ideal female pelvis shape for vaginal birth

A

gynecoid

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18
Q

which part of the women’s pelvis is usually the one that is contracted/ misshapen that can affect birth

A

the midpelvis

19
Q

what weeks of gestation is considered preterm labor

A

20-37 weeks

20
Q

what is the contraction pattern for preterm labor

A

4 contraction every 20 minutes or 8 contractions in 1 hour

21
Q

diagnostic test for preterm labor

A

CBC to detect infection, urinalysis to detect bacteria and nitrates, amniotic fluid analysis to determine fetal lung maturity

PRESENCE OF BOTH: uterine contractions AND cervical change

22
Q

Tocolytic therapy

A

Primary goal is for pretermlabor and can prolong it for up to 48 hours to initiation corticosteroid therapy to stimulate fetal lung maturity

23
Q

post term or prolonged pregnancy
- ranges

A

extends beyond 42 weeks

24
Q

terbutaline

A

this is THE med for preterm labor, prolongs the labor for 2-7 days so that you can administer the betamethasone for baby’s lungs to mature

25
Q

fetal risk of postterm labor

A

macrosomia, shoulder dystocia, brachial plexus injuries, LOW APGAR, postmaturity syndrome, risk for jaundice

26
Q

what is CPD (cephalopelvic disproprtion)

A

baby’s head is too big or mom’spelvis is too small

27
Q

what do postertm babies have less of on their skin

A

less vernix, verrrrry wrinkly, dry and pealy skin

28
Q

what tests will we do on moms that are heading towards post term

A

nonstress test twice a week, daily fetal movement counts (same time everyday), biophysical profile every 3 days

29
Q

What are the 3 obstetric emergencies

A

umbilical cord prolapse, amniotic fluid embolism, and uterine rupture

30
Q

what is umbilical cord prolapse

A

-partial or total occlusion of the cord with rapid fetal deterioration
- you habe one minute to save

31
Q

if a nurse discovers there is a cord prolapse what can we do

A

try to find presenting part of baby and push up to releave pressure on the cord

or

tell mom to go on hands and knees position (stick her ass in the air doggy style)

32
Q

amniotic fluid embolism

A

sudden onset of hypotension, hypoxia due to breaking in barrier between maternal circulation and amniotic fluid

33
Q

s/s in mom if she has amniotic fluid embolism

A

difficulty breathing, hypotension, cyanosis, seizures, tachycardia, pulmonary edema, coagulation failure

34
Q

what will you do for a mom that is having an amniotic fluid embolism

A

administer oxygen/ intubate
administer blood products to correct coagulation failure
prepare for emergency c section

35
Q

what is labor augmentation

A

enhancing innefective contractions after labor has begun

36
Q

labor induction

A

stimulating contractions via medical or surgical means

37
Q

Bishop score

A

helps identify women who would be most likely to achieve a successful induction

want a score of 6+

38
Q

Misoprostol (Cytotec)

A
  • most effective for a vaginal delivery within 24 hrs
  • used to ripen the cervix
39
Q

uterine rupture is marked by what assessment finding

A

sudden fetal bradycardia

40
Q

risk factors for uterine rupture

A

VBAC, previous incision/scar on uterus, previous rupture,

41
Q

why is uterine rupture so life-threatening

A

mom delivers 500ml of blood to the term fetus every minute so maternal death is a real possibility without rapid intervention.

42
Q

amnioinfusion

A

procedure that involves injecting fluid (lactated ringers) into the amniotic cavity of the uterus
- done when the baby is showing slow/irregular heart rate due to low amniotic fluid

43
Q

what should you monitor during an amnioinfusion

A

that there is no fluid coming back out

Maternity (5 decks)

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