Exam 2 Flashcards
what is an expected fetal heart rate?
110 - 160
what is the cause of variable decelerations?
cord compression
what is the cause for early decelerations?
head compression
what is indicated by accelerations in fetal HR?
normal/fetal wellbeing
(uterine contractions, fetal movement, vaginal exam)
what causes late decelerations?
placental insufficiency
what does VEAL stand for?
Variable decelerations
Early deceleration
Acceleration
Late deceleration
what does CHOP stand for?
Cord compression
Head compression
Okay!
Placental Insufficiency
what does MINE stand for?
Maternal repositioning
Identify labor progress
No interventions
Execute interventions
what is the goal FHR variability?
moderate variability
what defines absent variability?
inability to detect amplitude
what type of variability is seen with an amplitude range of < or = 5bpm?
minimal variability
what is the range for moderate variability?
6-25 bpm variations
what does sinusoidal variability indicate?
fetal morbidity
how can cord compression be relieved?
maternal repositioning (on side with pillow under hips)
- amnioinfusion for oligohydramnios
what mantra can be used to intervene for absent variability?
turn, float, bloat
(reposition, fluids, oxygen)
what may cause fetal tachycardia?
- maternal fever
- fetal hypoxia
- intrauterine infection
- drugs (cocaine)
what may cause fetal bradycardia?
- profound hypoxia
- anesthesia
- beta blockers
- relaxant medications
what is a very common epidural complication?
maternal hypotension
how can hypotension caused by epidural be prevented?
fluid bolus administration prior to epidural insertion
- don’t lay mom on back, compresses arteries
what is the first stage of labor?
onset of regular contractions - complete dilation (10 cm)
what are the 3 steps in the first stage of labor?
- latent
- active
- transition
what occurs during the latent phase of the first stage of labor?
0 - 3cm
- low pain, should occur at home
what occurs during the active phase of the first stage of labor?
4 - 7 cm
- irritability due to contractions, anxious, ideal for epidural insertion
what occurs during the transition phase of the first stage of labor?
8 - 10 cm
- 30 min- 2hr , mom in lots of pain, yelling, screaming
what is the second stage of labor?
expulsion
baby is delivered
what is the 3rd stage of labor?
placental stage
birth - placental delivery
what is the 4th stage of labor?
maternal homeostatic stabilization
- placental delivery - 4 hr after delivery
what nursing actions should be implemented during the 4th stage of labor?
- Q15 fundal checks
- monitor for hemorrhage
- encourage bonding w/baby
what is the OP position?
occiput posterior
- sunny side up
what positioning is beneficial to the mother during back labor caused by OP position?
hands and knees
what is the bishop score?
test to determine cervical readiness for induction
what bishop score is ideal for delivery?
at least 8
What are the contraindications for VBAC?
-large for gestational age newborn, malpresentation, cephalopelvic disproportion, previous classical vertical uterine incision, previous rupture
What are the indications for VBAC?
Clinically adequate pelvis, providers immediately available, previous c section that was performed for: dysfunctional labor, breech, abnormal FHR but aren’t recurring, 1-2 previous low transverse births
What are the indications for VBAC?
Clinically adequate pelvis, providers immediately available, previous c section that was performed for: dysfunctional labor, breech, abnormal FHR but aren’t recurring, 1-2 previous low transverse births
