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Nursing 2nd Spring Semester > Common disorders in Intrapartum- EXAM 1 > Flashcards

Common disorders in Intrapartum- EXAM 1 Flashcards

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1
Q

What are the problems of the powers

A

Ineffective contractions
Uterine disoverextension
Hypotonic labor dysfunction
Hypertonic labor dysfunction
Ineffective maternal pushing

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2
Q

What are problems with the passenger

A

Fetal size
Macrosomia: too large
Shoulder dystocia: shoulders too big
Abnormal fetal presentation or position
Multi-fetal pregnancy
Fetal anomalies

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3
Q

Precipitate labor

A

A rapid birth that occurs within 3 hours of onset of labor

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4
Q

Signs associated with intrapartum infection

A

Fetal tachycardia, Maternal fever, Foul or strong smelling amniotic fluid, Cloudy or yellow amniotic fluid

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5
Q

Preterm Labor

A

Begins after 20th week but before 37 weeks

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6
Q

How can you prevent preterm labor

A

Education, improving access to care, identifying rid factors, progesterone supplements, promoting adequate nutrition

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7
Q

How would you stop preterm births

A

Taking initial measures
Identifying and treating infections
Other causes for preterm contractions
Limiting activities
Hydration
Accelerating fetal lung maturity
Tocolytics: calcium channel blocker

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8
Q

Prolonged pregnancy

A

Lasts longer then 42 weeks
Can be due to insufficiency of placental function, meconium aspiration or dysfunctional labor due to continued fetal growth

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9
Q

Amnioinfusion

A
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10
Q

Induction

A

Use bishop scoring system
Used to look at dilation, effacement, fetal station, cervical consistency and position

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11
Q

Induction and Augmentation indications

A

Fetal compromises, Rh compatibility, Ruptured membranes, Postterm pregnancy, Hypertension in pregnancy, or fetal death
Mom may still have to go through labor and deliver baby

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12
Q

Induction nd Augmentation contraindications

A

Placenta previa
Vasa previa
Abnormal presentation
Umbilical cord prolapse
Previous uterine surgery
non reassuring fetal heart patterns

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13
Q

What are the techniques used for inductions

A

Cervical ripening: medication is used aka prostaglandins and catheter or laminaria is used to remove
Oxycotin used then given as a secondary infusion

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14
Q

What would cause complication to prostaglandins

A

If mother has asthma or heart disease or glaucoma

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15
Q

What would you observe for in inducation procedure

A

The fetal response to any meds given to mom
Fetal bradycardia, tachycardia, or late decelerations
The mothers response as well; any tachycardia

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16
Q

Cephalopelvic disproportion

A

Risk factor in intrapartum
Neonates head is too large to pass the pelvis

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17
Q

Retained placenta

A

Risk factor in intrapartum
A hemorrhage risk

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18
Q

Shoulder dystocia

A

Risk factor in intrapartum
Neonates shoulder becomes lodged in mothers pelvic cavity

19
Q

Perinatal loss

A

Death inside the uterus

20
Q

When is labor induced

A

To STIMULATE uterine contractions to help ACCOMPLISH BIRTH due to non ruptured membranes

21
Q

What must be done first before labor induction is attempted

A

Assessment must indicate that both the mom and baby are ready for labor based on fetal maturity and cervical readiness

22
Q

What are some indications that induced labor must be done

A

Gestational hypertension
Ruptured membranes without onset of labor
Infection in the uterus
Medical problems that worsen in pregnancy
Fetal problems:prolonged pregnancy, slowed growth
Placental insufficiency
Fetal death

23
Q

What are some contraindications that may occur when trying induced labor

A

Patient may refuse
Placenta previa or vasa previa
Fetus might be in transverse lie
Mom has bad too many c-sections
There may be active genital herpes
Umbilical cord prolapse
Sephalopelvic disproportion
Abnormal size or structure of the mothers pelvis

24
Q

What would you do to prepare the mom for labor augmentation

A

WHEN MEDS ARE ADMINISTERED
Explain procedure
Obtain baseline vital signs and fetal heart rate
Ensure they have an IV
Tell her to remain in bed for up to 2 hours
Induce oxy 6-12 hours after done
Assess for signs of uterine tachycardia

25
Q

Friedman curve

A

Used to graph the process of cervical dilation and fetal descent
Used as a guide to assess and manage the normal progress of labor

26
Q

What can prolonged labor cause

A

Maternal or newborn infection
Maternal exhaustion
Postpartum hemorrhage
Greater anxiety and fear

27
Q

When is a force assisted birth done

A

First time mom
Maternal age of 35 and over
Maternal height of less then 4’11
Weight gain of more than 33
Midline episiomity

28
Q

When is vacuume extraction done

A

When forcep assist does not work
Can cause fetal scape trauma

29
Q

What are the risks to forcep and vacuum extractions

A

Trauma to mom and fetal tissues
Lacerations or hematoma in moms vagina
Infant may have bruising, facial or scalp lacerations

30
Q

Episiotomy

A

Done if head can’t get out of vagina
Midline is done to allow bigger opening

31
Q

What do you stop oxycotin with

A

tachsystole

32
Q

First degree perineal laceration

A

Uncontrolled tearing caused on superficial vagina or on perineal skin

33
Q

Second degree perineal laceration

A

Uncontrolled tearing caused on vaginal mucosa and perineal skin

34
Q

Third degree perineal laceration

A

Uncontrolled tearing , same as second degree but also involves anal sphincter

35
Q

Fourth degree perineal laceration

A

Uncontrolled tearing that extends through the anal sphincter into the rectal musosa

36
Q

C-Section indications

A

Abnormal labor
Inability of fetus to pass
Mother has GH or DM
Previous surgery on the uterus
If mother is obese
Some mothers prefer them over vaginal delivery

37
Q

What incision is done in C-section

A

Low transverse incision

38
Q

What do you do to prepare for a c-section

A

Run labs to identify anemia or any blood clotting abnormalities
Identify blood typing and CBC and coagulation studies
Get baseline vitals and fetal heart rate
Have IV line in and foley catheter

39
Q

Vaginal birth after C-section

A

If C-section has been done in the past, mom needs to be monitored in case she is unable to do a vaginal labor and needs to get a c-section done again

40
Q

What would be the main concern in vaginal birth after having c-seciions

A

Uterine scar may rupture
May be placenta blood flow disrupt
Can lead to hemorrhage

41
Q

What are some intrapartum emergencies that may arise

A

Placental abnormalities
Umbilicalcord prolapse: cord may slip down and compress the fetus and pelvis

42
Q

What is umbilical cord prolapse and cause an increase for it

A

When the cord slips down and becomes compressed between the fetus and pelvis
Prompt delivery is performed
Ruptured membranes, fetus is too small or his in abnormal presentation or threes excess amniotic fluid volume may be risk factors

43
Q

How would you alleviate pressure on the prolapsed cord

A

Going in through the vagina, push the fetus upward and off the cord and elevate the moms hips

44
Q

What is anaphylactoid syndrome

A

AFE, embolisation of amniotic fluid
When the amniotic fluid is drawn into the mothers circulation and gets into her lungs

Nursing 2nd Spring Semester (42 decks)

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