Chapter 32 Obstetric and Gynecologic Emergencies Flashcards
What term describes the soft tissues that protect the entrance to the vagina?
Labia
What term describes the surface between the vagina and anus?
Perineum
What is the soft tissue that covers the pubic symphysis and is its the area where hair grows when a woman reaches puberty?
Mons pubis
What makes up the birth canal?
Vagina
What is the female reproductive organ?
Ovary
What is the muscular abdominal organ where the fetus develops?
Uterus (womb)
What makes up the neck of the uterus at the entrance to the birth canal?
Cervix
What is the phase of the female reproductive cycle in which an ovum is released from the ovary?
Ovulation
What term describes the baby from fertilization to 8 weeks of development?
embryo
What term describes the baby from 8 weeks of development to birth?
fetus
what is the organ of pregnancy where exchange of oxygen, nutrients, and wastes occurs between a mother and fetus?
Placenta
What term describes the fetal structure containing the blood vessels that carry blood to and from placenta?
umbilical
What term describes the “bag of waters” that surrounds the developing fetus?
amniotic sac
What term describes the dizziness and a drop in blood pressure caused when the mother is in a supine position?
supine hypotensive syndrome
Why does supine hypotensive syndrome occur?
The weight of the uterus, infant, placenta, and amniotic fluid compress the inferior vena cava
How are pregnant women in their third trimester transported?
On their left side
What stage of pregnancy starts with regular contractions and the thinning and gradual dilation of the cervix and ends when the cervix is fully dilated?
First stage
What stage of pregnancy is the time from when the baby enters the birth canal until he is born?
Seconds stage
What stage of pregnancy begins after the baby is born and lasts until the afterbirth is delivered?
Third stage
What makes up the afterbirth?
Placenta, membranes of the amniotic sac, part of the umbilical cord, some tissue from the lining of the uterus
What term describes prelabor contractions of the uterus?
Braxton-Hicks contractions
What term describes the sensation of the fetus moving form high in the abdomen to low in the birth canal?
Lightening
How is the duration of a contraction measured?
Time form beginning of a contraction to when the uterus relaxes
How do we measure the frequency of a contraction?
The time form start of one contraction to the beginning of the next (start to start)
When would contractions indicated that delivery is imminent?
When contractions last between 30 seconds and 1 minute and are 2-3 minutes apart
what is it called when the amniotic sac ruptures prior to delivery?
Water breaking or rupture of membranes
What is meconium staining?
Amniotic fluid that is greenish or bownish-yellow rather than clear as a result of fetal defecation. Possible sign of distress during labor
What is the bloody show?
watery, bloody discharge of the mucus plug
When does the second stage of labor begin?
after full dilation of the cervix
Why do women get the urge to push or move their bowels in the second stage of labor?
The baby is in the birth canal and is now exerting pressure on the rectum
What are some assessment elements that are specific to the woman in labor?
Name, age and expected due date Is it the first pregnancy? Has she seen a doctor to receive prenatal care, and if she knows if she has multiple gestations When did labor pains start? Has water broke? Bleeding or bloody show/ Does she feel the urge to push/move bowels? Examine for crowning Feel the uterine for contractions Take vital signs
What term describes when part of the baby is visible through the vaginal opening?
Crowning
What term describes when the baby appears headfirst during birth?
Cephalic Presentation
What are some things you should not let a woman in labor do?
Go to the bathroom or try to delay birth by holding legs togther
What should you do if crowning occurs while en route?
Pullover and prepare for delivery
What are some findings that may indicate the need for neonatal resuscitation?
No prior prenatal care
Premature delivery
Labor induced by trauma/medical conditions
Multiple births
History of problems with pregnancy (placenta previa/breech)
Labor induced by drugs/narcotics
Meconium staining with rupture of membranes
How do you prevent explosive delivery?
slight well distributed pressure over baby’s head
Do not pull on the baby
just don’t
What should you do if amniotic sac has not broken by the time the baby’s head is delivered?
Use your finger to puncture the membrane, pull it away from mouth, prepare to suction
What is the term neonate used for?
A newly born infant less than one month old
What does APGAR stand for?
Appearance Pulse Grimace Activity Respiratory effort
What should the neonates pulse be?
> 100
What appearance would give the neonate a score of 2?
Extremities blue, trunk pink
If local protocols call for it, when should the umbilical cord be cut?
no earlier than one minute after birth
After it has stopped pulsating
When would you never cut or clamp the umbilical cord of an infant?
if a baby is not breathing on its own
(unless you have to do so to remove from neck, or you have to do CPR)
Never cut a pulsating cord
Where should you clamp the umbilical cord?
at 7” and10”
What should you do with the newborn neonate that is breathing adequately, has a HR >100 but has central cyanosis?
administer blow by oxygen.
What should you do if a neonate is not breathing after warming and suctioning airway?
- Rub back
- Tap foot
- BVM
If the newly born neonate has inadequate respiration, how should you ventilate it?
40-60 breaths per minute, only enough to gain chest rise
What should you do if a neonates HR is less than 100?
Ventilate 40-60 breaths per minute
What should you do if the neonates HR is less than 60?
initiate chest compressions at rate of 120 per minute
What should you ration be when providing CPR when resuscitating a newly born neonate?
3:1
What are the steps of the inverted pyramid of neonatal resuscitation?
Drying, warming, positioning, suctioning, tactile stimulation Oxygen Bag-Mask ventilation Chest compressions Intubation Medications
How can you tell if the placenta is ready for delivery?
lengthening of the umbilical cord, indicates it has separated from the uterine wall
How do you control vaginal bleeding after delivery?
Blood loss is usually less than 500cc
Place sanitary napkin over mother’s vaginal opening
Have mother lower legs and keep them together
Massaging the uterus will cause it to contract
Encourage mother to breast feed
How do you care for a breech presentation?
Rapid transport
Never pull on baby’s legs
Provide high concentration of O2
Place mother in head-down position, with pelvis elevated
If body delivers, support it, inserted gloved index and middle finger into vagina to form V on either side of baby’s nose
Care for the baby, cord and mother, and placenta
How do you provide care when a limp presents?
Transport
Place mother in head down/pelvis elevated position
High concentration of O2
How do you provide care when the umbilical cord is prolapsed?
Position mother with head down and pelvis raised
Provide High concentration of O2
Check cord for pulses, wrap in sterile towel to keep warm
Insert fingers into vagina, gently push up on baby
Transport
Have partner get Vitals en-route
How do we define a premature infant?
weighs less than 5.5 lbs
born before 37th week
