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Maternal Child And Health Nursing > Chapter 23 > Flashcards

Chapter 23 Flashcards

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1
Q

Defined as the abnormal or difficult labor

A

Dystocia

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2
Q

Dystocia or difficult of labor can arise from four components:

A

*power (uterine contractions)
*passenger (fetus)
*passageway (birth canal)
*psyche (perception of the pregnancy)

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3
Q

Time-honored term to denote sluggishness of contractions

A

Inertia

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4
Q

Common causes of dysfuntional labor:

A

*Primigravida status
*CPD
*failure of the uterine muscle to contract properly
*nonripe cervix
*patient exhausted from labor
*rectum or urinary bladder is full that impedes fetal descent

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5
Q

Are the basic force that moves the fetus through the birth canal

A

Uterine contractions

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6
Q

Contractions not more than two or three occuring within a 10-minute period

A

Hypotonic uterine contractions

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7
Q

What is the resting tone and strength in hypotonic uterine contractions

A

*Resting tone remains less than 10 mmHg
*Strength of contraction does not rise above 25 mmHg

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8
Q

Occur during active phase of labor and tend to occur after administration of analgesia

A

Hypotonic Uterine Contractions

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9
Q

Are marked by an increase in resting tone to more than 15 mmHg

A

Hypertonic Contractions

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10
Q

Occurs frequently and are most commonly seen in the latent phase of labor

A

Hypertonic Uterine Contractions

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11
Q

Lack of relaxation between conteactions that prevent optimal uterine artery filling leading to

A

Anoxia

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12
Q

During this contraction, lack of relaxation between contractions that prevent optimal uterine artery filling leading to anoxia

A

Hypertonic Uterine Contractions

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13
Q

Administer ______ to soften cervix for cervical thinning

A

Hyoscine

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14
Q

More than one pacemaker may be initiating contractions, or receptor points in the myometrium may be acting independently of the pacemaker.

A

Uncoordinated Contraction

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15
Q

Can occur so closely together that they can interfer with the blood supply to the placenta.

A

Uncoordinated contractions

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16
Q

_______ administration is helpful in uncoordinated labor to stimulate better pattern of conteactions

A

Oxytocin

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17
Q

Dysfunction occurs with the first stage of labor involves a

A

*prolonged latent phase
*protracted active phase
*prolonged deceleration phase *secondary arrest of diltation

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18
Q

In prolonged latent phase, how long does latent phase lasts

A

*longer than 20 hours in nullipara
*14 hours in multipara

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19
Q

With a prolonged latent phase, the uterus tends to be in

A

Hypertonic State

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20
Q

What is the management of a prolonged latent phase?

A

*helping uterus to rest
*provide adequate fluid for hydration
*administer pain relief drugs like morphine sulfate or epidural

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21
Q

Is simple measures of management does not work for prolonged latent phase

A

Cesarean birth or amniotomy or oxytocin infusion to assist labor may be necessary

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22
Q

This phase if prolonged if cervical dilatation does not occur at a rate of at least 1.2 cm per hour for nullipara or 1.5 cm for multipara

A

Protracted Active Phase

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23
Q

If the active phase lasts longer than 12 hours in a primigravida or 6 hours in a multigravida

A

Protracted Active Phase

24
Q

Extends beyond 3 hours in a nullipara or 1 hour in a multipara

A

Prolonged Deceleration Phase

25
Q

Occured if there is no progress in cervical dilatation for longer than 2 hours (for nullipara) and 1 hour for multipara

A

Secondary Arrest of Dilatation

26
Q

A prolonged decelertion phase most often results from

A

Abnormal fetal head position

27
Q

Occurs if the rate of descent is less than 1 cm per hour for nullipara or 2 cm per hour in multipara

A

Prolonged Descent

28
Q

Results when no descent has occured for 2 hours in nullipara or 1 hour in multipara

A

Arrest of Descent

29
Q

When expected descent of the fetus does not begin or movement beyond 0 station does not occur.

A

Arrest of descent

30
Q

Most likely cause for arrest of descent during the second stage is

A

CPD or Cephalopelvic Disproportion

31
Q

Cervical dilatation that occurs at a rate of 5 cm or more per hour in a primipara or 10 cm or more for multipara per hour.

A

Precipitate Labor

32
Q

Occurs when uterine contractions are so strong a parent gives birth with only a few, rapidly occuring contractions

A

Precipitate birth

33
Q

Often defined as a labor that is completed in fewer than 3 hours.

A

Precipitate Birth

34
Q

Contractions can be so forceful they lead to

A

Premature separation of the placenta or lacerations of the perineum

35
Q

Labor is started artificially

A

Induction of Labor

36
Q

Refers to assisting labor that has started spontaneously but is not effective.

A

Augmentation of Labor

37
Q

Induction of labor is not used unless the fetus is

A

At term (39 weeks)

38
Q

Even if the fetus is less than 39 weeks, induction can still be done if

A

Fetus was proven to have adequate lung surfactant by amniocentesis

39
Q

Before induction of labor is done, the following conditions should be present:

A

*fetus is in longitudinal lie
*cervix is ripe
*presenting part is engaged
*no suspected CPD
*fetus is estimated to be mature (over 39 weeks)

40
Q

Change in the cervical consistency from firm to soft.

A

Cervical Ripening

41
Q

Simplest method for ripening the cervix

A

Stripping (or sweeping) the membranes

42
Q

Most common method to promote cervical ripening

A

Insertion of prostaglandin like dinoprostone into the posterior fornix of the vagina

43
Q

A synthetic form of naturally occuring pituitary hormone

A

Oxytocin

44
Q

In case of hyperstimulation, a primary care provider may prescribe ______ to relax the uterus

A

Terbutaline

45
Q

If hyperstimulation occurs, these interventions are done

A

*Turn patient to their left side to improve blood flow to the uterus
*administer IV fluid bolus to dilute level of oxytocin in bloostream
*administer oxygen by mask at 8 to 10 L

46
Q

Fetus needs ___________ between contractions to receive adequate oxygenation from blood vessels in the placenta.

A

60 to 90 seconds

47
Q

Uterine rupture occurs most often in patients who have _________

A

Previous cesarean scar

48
Q

If uterus should rupture, patient experiencea

A

“Tearing sensation”

49
Q

If uterus should rupture, what will be visible on the patient’s abdomen

A

Retracted Uterus and the extrauterine fetus

50
Q

With an incomplete rupture, a patient may experience

A

Only a localized tenderness and a persistent aching pain over the lower uterine segment

51
Q

Refers to the uterus turning inside out with either birth of the fetus or delivery of the placenta

A

Uterine Inversion

52
Q

In uterine inversion, a patient will likely be given

A

General anesthesia or possibly nitroglycerin or a tocolytic drug by IV to relax the uterus

53
Q

These may speed the descent

A

Semi-fowler position, squatting, kneeling, or more effective pushing.

54
Q

A loop of the umbilical cord slips down in front of the presenting fetal part

A

Umbilical Cord Prolapse

55
Q

Umbilical cord prolapse tends to occur most often with:

A

*premature rupture of membranes
*fetal presentation other than cephalic
*placenta previa
*small fetus
*CPD preventing firm engagement

56
Q

Management for cord prolapse

A

*elevating the fetal head off the cord
*placing the patient in a knee-chest or Trendelenburg position

Maternal Child And Health Nursing (46 decks)

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