Dressler Module 4 Complications of Labor Flashcards

1
Q

Prenatal and Antepartum is referring to _____ birth

A

prior to

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2
Q

Nutritional Status of newborn is greatly affected with ________ patients

A

overweight

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3
Q

What are some Socio-Demographic factors that may affect birth

A
Low income 
No prenatal care 
Age (Under 16, Over 40)
Parity 
Support System
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4
Q

This fetal status test visualizes fetal & maternal structures

A

Ultrasound

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5
Q

This fetal status test can be done transvaginally

A

Ultrasound

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6
Q

This fetal status test is to check for abnormalities usually prior to 20 weeks

A

Amniocentesis

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7
Q

This test can check for genetic diseases, quadruple screening, and fetal lung maturity

A

Amniocentesis

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8
Q

This Fetal Status Test can be done externally referred to as Reactive vs Nonreactive

A

Non-stress test

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9
Q

A maternal HGB test can be used to check for _______ levels and ______ levels

A

Blood and Oxygen

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10
Q

An indirect coombs test can be used to check for (2)

A

Rh factor and Billy rubin

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11
Q

The triple screen tests consists of what three levels and when is it usually done

A

Usually done at 16 weeks
AFP
HCG
Estriol

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12
Q

AFP stands for

A

Alpha Fetal Protein

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13
Q

HCG stands for

A

Human Choreographic (too much is a problem)

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14
Q

Elevated estriol could lead to

A

Down Syndrome

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15
Q

Glucose Screening can be used to check for

A

diabetic ketoacidosis

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16
Q

Vaginal Culture can be used to check for

A

localized infection

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17
Q

Newborn Vital sign norms

A

B/P 60/40
Pulse 110-160
Resp 35-45

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18
Q

Excessive & difficult to alleviate N&V, in young obese non-smoker is called

A

Hyperemesis Gravidarum

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19
Q

A lot of vomiting during pregnancy is called

A

Hyperemesis Gravidarum

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20
Q

Signs and Symptoms of Hyperemesis Gravidarum include

A
Weight loss
Dehydration 
Ketonuria
Acetonuria 
Electrolyte imbalances
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21
Q

What is the main difference between morning sickness and Hyperemesis

A

Dehydration

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22
Q

PPN stands for

A

Partial Parenteral Nutrition

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23
Q

TPN stands for

A

Total Parenteral Nutrition

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24
Q

What are some treatments for hyperemesis

A

Rest
IV fluids
Antiemetics
Small Meals

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25
Q

Painless, premature dilation of cervix and being at risk for a spontaneous abortion is having an

A

Incompetent Cervix

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26
Q

The main job of the cervix is

A

stays closed to help maintain pregnancy

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27
Q

What is a Cervical Cerclage and when is it needed and when is it usually done

A

When the cervix is dilated more than 3cm, between 14-26 weeks and it is the SUTURING OF THE CERVIX (ARTIFICIAL PLUG TO KEEP CERVIX FROM DILATING

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28
Q

Spontaneous Abortions, Ectopic Pregnancy, Hydatidiform Mole are bleeding disorders during

A

Early Pregnancy

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29
Q

Placenta Previa and Placenta Abruptio are bleeding disorders during

A

late pregnancy

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30
Q

A spontaneous abortion is loss of pregnancy before

A

20 weeks

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31
Q

Abortion is the medical term for

A

miscarriage

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32
Q

Vaginal bleeding, closed cervix, mild cramps where the fetus is in danger is called a _______ spontaneous abortion

A

threatened

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33
Q

Cervical dilation, ruptured membranes, vaginal bleeding, not being able to maintain pregnancy are S&S of a _________ spontaneous abortion

A

inevitable

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34
Q

products of conception expelled, uterine contractions, bleeding are S&S of a ___________ spontaneous abortion

A

Complete

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35
Q

POC stands for

A

Products of conception

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36
Q

Profuse bleeding, and retained tissue parts are S&S of _______ spontaneous abortion

A

Incomplete

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37
Q

Fetus dies but retained, amenorrhea, foul smelling discharge or bleeding (fetus will die in utero, not expelled, becomes necrotic) is an example of a __________ spontaneous abortion

A

Missed

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38
Q

Infection of uterus, not all tissue is expelled is S&S of ________ spontaneous abortion

A

Septic

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39
Q

3 or more consecutive losses becomes to get called a ______ spontaneous abortion and the most frustrating thing is that …

A

Habitual

We don’t really know what’s going on

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40
Q

What is the treatment for spontaneous abortion

A

IV Oxytocin
Dilation and Curettage
Vacuum evacuation

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41
Q

What is the best treatment for Threatened spontaneous abortion

A

Bedrest

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42
Q

What does Oxytocin do

A

causes contractions so we can expel stuff

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43
Q

D+C is when you

A

scoop everything out after Dilation

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44
Q

Vacuum evacuation is ….

A

attached to cervix to remove products, LESS INVASIVE THAN D+C

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45
Q

Provide nursing care for Rhogam is RH

A

Negative

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46
Q

Not occupying uterine cavity, increases with STD’s, Endometriosis is the etiology for

A

Ectopic Pregnancies

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47
Q

Abdomen Tenderness, Spotting, Bleeding, decreased H&H, Increased WBC, shoulder pain are S&S of

A

Ectopic Pregnancies

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48
Q

Referred pain is the same is ________ pain

A

Radiated

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49
Q

Main treatment for Ectopic Pregnancy (3)

A

Trans vaginal ultrasound
Methotrexate
Salpingectomy

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50
Q

decreasing production of cells, kills of rapidly growing cells, so no rupturing occurs is called

A

Methotrexate

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51
Q

If rupturing occurs with a Ectopic Pregnancy mom can go into

A

Shock

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52
Q

Removal of fallopian tubes is called

A

Salpingectomy

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53
Q

Nursing care of Ectopic pregnancy would include

A
Pre and post op care
Monitor at risk for shock
Grief counseling 
Pregnancy counseling 
Monitor HCG levels
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54
Q

After an ectopic pregnancy resident should wait at least _____ before next pregnancy

A

1 year

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55
Q

Abnormal trophoblastic tissue - avascular vesicles. Instead of layers forming, cells keep multiplying. WILL NOT DEVELOP INTO EMBRYO/FETUS is called a

A

Hydatidiform Mole

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56
Q

Abnormal Uterine growth, PIH, increased HCG levels, excessive N/V, and vaginal bleeding are S&S of

A

Hydatidiform Mole

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57
Q

Treatment for a Hydatidiform Mole would include (3)

A

Transvaginal Ultrasound
D&C
Rhogam (If Negative)

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58
Q

Hydatidiform Mole puts mom at high risk for

A

Chorionic Carcinoma

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59
Q

What is Chorionic Carcinoma

A

Choriocarcinoma is a quick-growing form of cancer that occurs in a woman’s uterus (womb). The abnormal cells start in the tissue that would normally become the placenta, the organ that develops during pregnancy to feed the fetus. Choriocarcinoma is a type of gestational trophoblastic disease.

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60
Q

Abnormal placement of the placenta, placenta being misplaced in the uterus is called

A

Placenta Previa

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61
Q

Marginal Placenta Previa means fetus is placed near _____ and there is a ______ chance of c-section

A

Sidewall

High

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62
Q

Partial Placenta Previa means placenta is located

A

comes close to cervix

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63
Q

Total placenta previa means

A

Placenta is completely upside down

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64
Q

With partial placenta previa, or total placenta previa c section is

A

guaranteed

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65
Q

Placenta Previa can be diagnosed by looking at

A

a sonogram

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66
Q

Painless bleeding in 3rd trimester could be a sign of

A

Placenta Previa

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67
Q

The goal for a resident with placenta previa is to get lots of ______ and reach ____ weeks

A

Bedrest

34

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68
Q

What are some Nursing care tactics with Placenta Previa

A

Monitor FHR
Assess for hemorrhage
Assess FUNDUS

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69
Q

PIH stands for

A

Pregnancy induced hypertension

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70
Q

PIH, H/o abruption, smoking, cocaine, PROM are means for diagnosing a

A

Abruptio Placentae

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71
Q

PROM stands for

A

Premature rupture of membrane

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72
Q

Painful bleeding, sudden bleeding, severe pain, fetal distress, hard uterus, maternal shock are S&S of

A

Abruptio Placentae

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73
Q

Best treatment for partial abruption is

A

Bedrest

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74
Q

When a resident is diagnosed with Abruptio Placentae we have about ______ to take baby out

A

30-45

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75
Q

Fetus not getting any circulation is called

A

Fetal distress

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76
Q

In complete abruption mom has a

A

concealed hemorrhage

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77
Q

With abruptio Placentae mom is at risk for

A

shock or death, Fetal brain damage, Fetal demise (Death)

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78
Q

Dysfunctional labor can also be called

A

Dystocia

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79
Q

Friedman curve is used to

A

graph dilation and descent

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80
Q

With Dystocia mom and fetus has a potential for

A

Infection
Postpartum hemorrhage
Exhaustion to mother

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81
Q

Dystocia can be related to

A

Power Contractions
Position or Presentation of fetus
Size of Fetus

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82
Q

Amniotomy is the

A

breaking of water

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83
Q

IV pitocin is given to

A

speed up contractions

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84
Q

Hypotonic Contractions are

A

unprogressive contractions

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85
Q

Treatment for hypotonic contractions are

A

Amniotomy
IV pitocin
C-section

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86
Q

Hypertonic contractions are

A

Strong uncoordinated contractions

87
Q

We can diagnose Hypertonic Contractions during ______ phase

A

Latent

88
Q

Hypertonic contractions can be treated with

A

Sedative or medication to relax uterus

89
Q

Forceps mean to

A

Pull baby forward

90
Q

Abnormal position is treated with

A

Forceps

Trying to rotate to normal position

91
Q

Cephalopelvic Disproportion is a term for saying

A

Head too large or pelvis too small

Possible C-section

92
Q

Large baby, frequently due to diabetic mother is called

A

Macrosomia

93
Q

Linea Terminalis means

A

100% c-section

94
Q

Precipitous Labor is labor with _____ usually completed within ___

A

Strong frequent contractions usually completed within 3 hours

95
Q

During precipitous labor is more common in ______ and best thing to do is

A

Multips

DO NOT LEAVE MOTHER ALONE

96
Q

Accelerates or helps labor after it has started is called

A

Augmentation

97
Q

Cervical Gel is also called

A

Prostaglandins

98
Q

Dried seaweed is used to ________ and is called ______

A

pulls fluid out of cervix

Laminaria

99
Q

Nipple stimulation is increasing

A

secretion of oxytocin from posterior pituitary

100
Q

Walking helps

A

induce labor

101
Q

Oxytocin does….. and is usually given in

A

Stimulates uterine contractions

10units/1000cc Ringers

102
Q

contractions closer than every 2min, longer than 90sec, rest less than 60, possible fetal distress, rupture of uterus are S&S of

A

Overstimulation of Oxytocin

103
Q

What are some conditions where we don’t want to induce labor

A

Placental abnormalities, abnormal presentation, prolapsed cord, obstructed cord, fetal distress, prior C-section with classic or low vertical incision.

104
Q

Bikini line incision means

A

less healing time

105
Q

Sometimes inducing labor can be

A

dangerous

106
Q

Artificial rupture of membranes to stimulate or augment labor

A

Amniotomy

107
Q

What are some potential complications of an Amniotomy (3)

A

Umbilical Cord Prolapse
Infection
Abruption

108
Q

A post term pregnancy is one that lasts longer than

A

42 weeks

109
Q

Post term pregnancy etiology examples are

A

Decrease placental perfusion risk of decrease O2 to the fetus
May pass meconium
Decrease in amniotic fluid
Fetus keeps gaining weight

110
Q

PIH after 20 weeks, no proteinuria, Hypertension, INCREASE IN 30mm Systolic, INCREASE in 15mm Diastolic are signs of

A

Toxemia

111
Q

Treatment for Toxemia includes

A

low salt diet, rest monitor closely make personal

112
Q

Contractions causes B/P to go

A

Sky high

113
Q

Any hypertension before 20 weeks is called _________ and is not due to ________

A

Essential hypertension

Pregnancy

114
Q

If PIH isn’t treated ______ can occur

A

Pre eclampsia

115
Q

Hypertension after 20 weeks is called _______ and it can be _______ or _______

A

20 weeks

Mild or severe

116
Q

Edema of hands and face, H/A, Blurry vision, and DAMAGE TO EPITHELIUM LINING of blood vessels due to low blood supply are S&S of

A

Pre eclampsia

117
Q

Pre Eclampsia can lead to the __________

A

HELLP Syndrome / Eclampsia

118
Q

Hemolysis Elevated Liver Enzyme Low Platelets can also be considered the

A

HELLP Syndrome

119
Q

Pre eclampsia can lead to damage to the _______ causing a decrease of ______ supply

A

Placenta

Oxygen

120
Q

Treatment for Mild Pre Eclampsia includes

A

Limit activity
Possible CBR (complete bed rest) lying on back or left side
Antihypertensive meds

121
Q

Treatment for Severe Pre Eclampsia includes

A
Hospitalization 
Antihypertensives 
MagSO4/Calcium Gluconate 
Lasix 
Amniocentesis
122
Q

MagSO4 / Calcium Gluconate helps

A

decrease smooth muscle action in the myometrium

123
Q

Once a pre eclamptic mom has had a seizure she is considered

A

eclamptic

124
Q

S&S of Preeclampsia w/ a seizure, P/F abruption, Fetal compromise, Fetal death, Maternal Death are etiology examples for

A

Eclampsia

125
Q

Seizures, proteinuria, DECREASED URINARY OUTPUT, INCREASED BUN & CREATININE, DECREASED PLATELETS, pulmonary edema, visual problems are S&S or

A

Eclampsia

126
Q

Explain how Eclampsia can affect visual senses

A

pressure on optic nerve can cause eyesight blockage

127
Q

With an eclamptic mom we might put mom on Dialysis to

A

Give Kidneys a rest

128
Q

Treatment for Eclampsia includes

A
Antihypertensives 
MagSO4
Calcium Gluconate 
Lasix
Amniocentesis
129
Q

When U/O is less than 30ml/hour mom is going into

A

Renal Failure

130
Q

A sign of loss in deep tendon reflex, (coming from too much MagSO4 is ______ and we should administer ______

A

Hands turn out

Calcium Gluconate

131
Q

Nursing care for mom with Pre eclampsia / Eclampsia include

A
Quiet room
Dim lights
SIDE LYING POSITION
Seizure precautions
Padded side rails
Keep suction machine at bedside
 INCREASE PROTEIN
132
Q

Mom is still at risk _______ after labor for Pre eclamptic Seizure

A

48 hours

133
Q

ABO blood incompatibility happens when mom is ____ and Fetus is ____ . This can cause ________ or _______

A

Mom is O
Fetus is A or B
Jaundice or Hepatosplenomegaly

134
Q

Rh incompatibility happens when Mom is ____ and Fetus is ____ this can cause ______

A

Mom is RH-
Fetus is RH+
Leakage of antibodies

135
Q

Treatment for blood incompatibility includes

A

Rhogam (immunoglobulin) 72 hours after delivery

136
Q

In sickle cell moms we might want to administer extra

A

Oxygen

137
Q

In mothers with a prolapsed cord what are the priorities

A

Need to decrease compression

138
Q

In mothers with prolapsed cord what position should we put them in

A

Trendelenburg / Side lying

139
Q

What are some of the things that happen with a Uterine Rupture (3)

A

Strong contractions with little descent
Fetal distress
Maternal shock

140
Q

With a Uterine rupture a ______ is most likely to happen

A

Emergency C-section or a Hysterectomy

141
Q

What are some nursing implications for a mom with Uterine Inversion

A

Fundal Massage
Cord pulled
Surgery to revert uterus
Hysterectomy

142
Q

Define hysterectomy

A

hysterectomy is an operation to remove a woman’s uterus

143
Q

What are the signs and symptoms for Uterine Atony

A

Boggy Fundus

Increase lochia with clots

144
Q

No muscle tone with possible loss of contractions is called

A

Uterine Atony

145
Q

Treatment for a Uterine Atony includes

A

Fundal massage

Meds to increase contractions

146
Q

Two main meds that increase contractions are

A

Oxytocin

Methergine

147
Q

Possible complications of C-sections (5)

A
Infection
Hemorrhage
Paralytic Ileus 
Thrombophlebitis 
Dehiscence
148
Q

What are priorities for mom post op c-section (5)

A
Empty bladder
Monitor VS 
Monitor incision 
Asses homans sign 
Bowel Sounds
149
Q

Mom may develop _______ post op c-section that are very painful where she would not like to move

A

Gas pockets

150
Q

Near incision post op c-section it is important to make sure ….

A

there isnt any drainage

151
Q

Locchia should be ….. post op c section

A

same amount as vaginal delivery

152
Q

VBAC stands for

A

Vaginal Birth After C-section

153
Q

Major complication for Premature Rupture of membranes

A

Umbilical cord coming out

154
Q

Premature Rupture of Membranes happens

A

before 38 weeks

155
Q

What is Chorioamnionitis and what might it cause

A

Inflammation of Chorion Amniotic Sac, may cause premature rupture of membranes

156
Q

What can we use to check pH of Vagina

A

Nitrazine Paper

157
Q

Hypertension can

A

induce labor

158
Q

Temp of 100.5 or more in pregnant mom may call for

A

C-section, induced labor

159
Q

When baby is at risk for being born immaturely we try our best to

A

get labor to at least 32 weeks, then 34, then 36 hopefully

160
Q

At 36 weeks baby begins to make its own

A

Surfactin

161
Q

Premature labor can be caused by (5)

A
Young mother under 17
Incompetent cervix 
Decreased blood supply to uterus 
Abdominal trauma
Polyhydramnios
162
Q

Tocolytics are given to

A

Relax uterus and stop contractions

163
Q

Betamethasone is given to

A

hasten fetal maturity and increase surfactant production in fetus

164
Q

Nursing care for Pre term Labor

A

Give Tocolytics
Give Betamethasone
bed rest
IV hydration

165
Q

Retinal Atrophy of Prematurity is

A

eyes, oxygen effects optic nerve

166
Q

Blood loss greater than 500cc for NSVD or 1000cc for c/sec is defined as

A

Hemorrhage

167
Q

Mom is at risk for _______ after labor for Hemorrhage

A

48 hours

168
Q

NSVD stands for

A

Normal Delivery

169
Q

Treatment for Hemorrhage is

A

Blood transfusion

170
Q

Before a blood transfusion we must

A

stop the bleeding with a vigorous massage

171
Q

Fluid or fetal cells enters mothers venous system is defined as

A

Amniotic Fluid Embolism

172
Q

Massive clotting, then massive fibrinogen breaks down causes bleeding from all orifices is called

A

DIC - Disseminated Intravascular Coagulation

173
Q

Possible DIC is

A

bleeding from IV site

174
Q

Tears to perineum, cervix or both during delivery is called

A

Perineal Lacerations

175
Q

1st and 2nd degree Lacerations are

A

tear of perineum not extending to rectal sphincter

176
Q

3rd degree Lacerations are

A

involves anal sphincter

177
Q

3rd degree Lacerations are bad because

A

difficult to repair, can have permanent damage

178
Q

4th degree lacerations are

A

lacerations in the recto vaginal wall

179
Q

Nursing care for lacerations include

A

Sitz bath
meds
ice pack

180
Q

ball of blood, accumulation of blood under the skin is defined as

A

Hematomoa

181
Q

Nursing care of Hematoma include

A

Ice pack to area

pain management

182
Q

1 egg that separates into 2 fetus

A

Monozygotic

183
Q

2 sperm fertilize 2 eggs

A

Dizygotic

184
Q

Vomiting during pregnancy that results in electrolyte imbalance

A

Hyperemesis

185
Q

Premature dilation of cervix early in pregnancy

A

Incompetent Cervix

186
Q

Procedure done to keep cervix closed

A

Cerclage

187
Q

Loss of pregnancy prior to 20 weeks gestations; Can be threatened; inevitable; incomplete; missed; or septic

A

Spontaneous Abortion

188
Q

defines a woman who has had 3 or more consecutive spontaneous abortions

A

Habitual Spontaneous Abortions

189
Q

medication given to RH NEGATIVE mothers at 28 weeks of pregnancy and 72 hours after delivery to prevent production of antibodies

A

Rhogam

190
Q

pregnancy that takes place outside the uterus (tubal pregnancy

A

Ectopic pregnancy

191
Q

failure of embryo to develop after fertilization; abnormality of the trophoblast

A

Hydatidiform mole

192
Q

condition in which the placenta is implanted close the the cervical is which impacts delivery, can be marginal, partial, or complete

A

Placenta Previa

193
Q

sudden separation of the placenta from the uterine wall characterize by severe abdominal pain and bleeding

A

Placental abruption

194
Q

Pregnancy induced Hypertension or toxemia is known as

A

PIH

195
Q

PIH with proteinuria

A

Pre-eclampsia

196
Q

PIH, with proteinuria and seizures

A

Eclampsia

197
Q

medication given IV to prevent seizures of eclampsia

A

Magnesium sulfate

198
Q

Antidote for Magnesium Sulfate

A

Calcium gluconate

199
Q

Difficult labor is defined as

A

Dystocia

200
Q

contractions that are too weak to effectively progress labor

A

Hypotonic contrations

201
Q

contractions that are too intense and may put mom and fetus at risk

A

Hypertonic contractions

202
Q

baby born bigger than average size is known as

A

Macrosomia

203
Q

the repositioning of a breech or transverse fetus

A

Version

204
Q

labor that is completed in less than 3 hours

A

Precipitate labor

205
Q

an intervention to help labor progress

A

Augmentation

206
Q

an intervention to help labor process start

A

Induction

207
Q

Drug applied topically to cervix to help increase dilation of cervix

A

Prostaglandin

208
Q

product applied to cervix that absorbs fluid and hastens labor process

A

Laminaria

209
Q

Pitocin; medication given IV to induce or augment uterine contractions

A

Oxytocin

210
Q

artificial rupture of the membranes

A

Amniotomy

211
Q

the rupture of the uterus due to abnormal strong and frequent contractions requires surgical repair

A

Uterine rupture

212
Q

the descent of the umbilical cord before the fetus causing pressure and impaired circulation

A

Prolapsed cord

213
Q

the fundus inverts down into uterus after delivery is called

A

Uterine inversion