Exam 1 Review Flashcards
5/70%/ +1
dilation
effacement
station
dilation
how wide the cervix is
effacement
thinning of the cervix
station
how descended or “engaged” the fetus is
positioning during labor
- mom
open hips
and preferably up to help descend the fetus with gravity
positioning during labor
- fetus
fetal attitude head down, flexed, arms in
head first into the canal
primary vs secondary powers
primary: involuntary contractions
secondary: voluntary pushing
fergsons reflex
knowing when to push
do what before epidural
check platelets
postion
pee
fluid bolus
what is a common complaint of PP which could be caused by epidural
headache
VEAL CHOP
variable, early, accerlations, late
cord, head, ok, perfusion
how are we able to determine a deceleration
how it lines up with the contraction
accerlations
- over 32
15BPM 15 sec
accerlations
- under 32
10BPM for 10 sec
External fetal monitoring
ultrasound over fetal back (use leoplods)
toco over fundus for contractions (does not say how intense a contraction is)
internal fetal monitoring
spiral electrode into scalp for HR
IUPC into surrounding fluid/area for contractions
** need to be ruptured
true s false labor
true: CERVICAL DILATION, EFFACEMENT, AND FETAL ENAGGEMENT OR DESCENT
true: bloody show, increase of contractions, back pain
false: no show, contractions staying same, goes away with sleep, Braxton hicks, no appreciable cervix change
rupture of membrane what to check
time, odor, color, fetal HR for drop in HR which could be prolapse cord
when can we artificially rupture the sac
-3
what is the time peroid for delivery after rupture
18 hr
nurse support
emotional, pain, inform, educate, calming
maternal hypotension
bad because the placenta is not getting perfused which means the baby is not getting perfused
contraindication of epidural
afterpains
what is it and who is it more common in
contractions of uterus clamping down
increase pain in multips due to lack of uterine tone, over distended uterus (increase fluid, twins, large baby), breast feeding or on PIT since oxytocin stimulates contraction of uterus
lochia
rubra: red/dark red seen birth to 3/4 days
serosa: pink tinge, no clots seen 3/4-10 days
alba: white yellow seen 10-14 days but as long as 6 weeks
- foul odor or large clots (grape size) are bad
engorgment
- someone who does want to breast feed
breast feed 8-12 times/day, pump, hand express, warm compress, stimulation
engorgment
- someone who doesn’t want to breast feed
tight fitting bra, ice, no warm water on breast, no stimulation
puerperium
4th trimester
postpartum
return of body to prepregnant state
appointments for mom and baby
mom: 2-6 weeks
baby: 24-72 hours
platelet count for epidural
less than 100,000 no epidural
involution
uterus returning to prepregant state
subinvolution
inability of uterus to clamp down
- normally due to placental fragments left over
** reason for late (24+ hour) PP hemorrhage
blood loss for vag and C
vag: 500
C: 1000
Rh status
if not matching, certain medications can be given
can be one reason for hyperbili
PP depression vs blues
screen for depression before discharge
blues less than 10 days
depression greater than 10 days
most important physiologic change
imitation of breathing
heat loss types
convection: air
radiation: no touch
conduction: 2 objects touching
evaporation: water to vapor
APGAR
1, 5, 10 min and 5 until 20
does not determine how well baby will do in future
SGA
AGA
LGA
small: less than 10
A: 10-90
L: greater than 90
early feeding cue
lip smacking, sucking on hand, rooting, open and closing mouthm
mid feeding cue
increase physical activity, stretching, nuzzling
late cue
crying, fussing, frantic
* calm baby before feeding
LATCH
latch
audible swallowing
type of nipple
comfort
hold
fist appearance of full and hungry
hungry: closed
full: open
colostrum
liquid gold, secreted after birth for 2-3 days
small amounts since babies stomach is small
skin to skin
temp regulation and bonding
golden hour
FO, DV, DA
jaundice causes
increase RBC, breast non feeding, dehydration, mom and baby blood mismatch, delayed mec stool,
CCHD screening
spo2 on R hand and then monitor on lower extremities and maybe… L hand
weight calculation
birth weight - weight now = #
(#/birith weight) x 100 = %
maternal adaption
dependent
taking hold
letting go
why babies seen so early
weight and bili
4 basic types of pelvis and most common
gynecoid - most common
android
platypoid
antropoid
do you need to be ruptured for FSE and IUPC
yes
uterine activity
frequency
duration
relaxation
resting tones
holding breath during pushing is bad because
vaso
decrease CO
increase risk of perineal trauma
preeclampsia PP time frame
4 weeks
- inform ED you are PP
+4/5 birth is
imminent
pregnancy is what state
hypercoagualble
- increase fibrin and factor
pee how often
2 hour
open glottis pushing
pushing when needed and wants
open mouth making noise
Cat 1 HT
110-160 normal
variability moderate - normal
no late or absent decel
Cat 3 Ht
sinusoidal
late decel
Brady or tacky
no baseline
5 P
which one crosses
caput
tachystsole
> 5 in 10 min window averaged over 30 min
- tocolytics
gate control theory
narcan don’t give if baby is dependent
lowest blood sugar for baby
2 hours
peak jaundice
3-5 for term
5-7 for preterm
