exam 2 Flashcards
1
Q
power, passenger, passage, position, and psychological state are the five __ of labor
A
p’s
2
Q
fear/anxiety have to do with what P?
A
Psychological state
3
Q
abuse history and mom in room have to do with what p?
A
Psychological state
4
Q
labor stays productive if you ___ moving and have to do with position
A
keep
5
Q
use ___ for productive labor
A
gravity
6
Q
position is referring to mom not ____
A
baby
7
Q
in labor, you want it to begin ____
A
natural
8
Q
in labor, you want walk, move and __ positions
A
change
9
Q
with labor, have __ support and dont intervene til you need to
A
consistent
10
Q
with labor, get __ and follow urge to push and keep the baby with you after birth
A
upright
11
Q
the pushing efforts/contractions are which P?
A
powers
12
Q
good contractions are 2-4 min __ and last 50-60 seconds each
A
apart
13
Q
contractions are required to get the __ open
A
cervix
14
Q
the toco ___ monitor strength
A
doesnt
15
Q
you only put in a internal mon if the __ are ruptured
A
membranes
16
Q
passage is ass with the ___ structure(bony and soft)
A
pelvic
17
Q
gynecoid pelvis is the ideal pelvic ___
A
structure
18
Q
the ___ pelvic structure is wide, open and round
A
gynecoid
19
Q
as you get closer to labor, the ___ joints relax and open up to make birth easier
A
pelvic
20
Q
the baby position refers to what P? it is good for baby to be flexed
A
passener
21
Q
breech and post occult is __ positions and associated with passenger
A
bad
22
Q
macrosomic makes it hard to do vaginal birth or csection. but you still __
A
can
23
Q
first stage of labor is 0 to __ cm
A
ten
24
Q
second stage of labor is from 10 cm to ___ of baby
A
birth
25
third stage of labor is from baby birth to __ birth
placenta
26
latent/early stage is from 0-3 cm. t or f?
true
27
active stage is from 4-7 cm . torf?
true
28
transition stage is from 8-10 cm. torf?
tru
29
the third stage of labor lasts 30 __
min
30
you get the fergusion reflex is in ___ stage and 10cm=complete/fully effaced
second
31
with a multipara, the second stage lasts one to 30 ___
min
32
with a nullipara, the second stage lasts __ hours
2
33
the cardinal movements are: engagement, descent, flexion, internal rotation, extension, ___, and expulsion
restitition
34
presenting part is at zero station
engagement
35
head continues to descend lower and lower
descent
36
chin to chest
flexion
37
this makes it so that the smallest part thru the canal
flexion
38
___ is key to a good delivery
flexion
39
when the head curve of carus the head to moms back
internal rotation
40
head is crowing in what cardinal movement?
extension
41
restitution can also be called ___ rotation
external
42
music and counter pressure on back if back pain is ____ relief measures
nonpharm
43
relaxation and imagery are ___ relief measures
nonpharm
44
light massage and heat or cold pack are ___ relief measures
nonpharm
45
aromatherapy and biofeedback and breathe and water are nonpharm ___measures
relief
46
___ analgesia(IM/IV)cross the blood brain barrier and can effect the fetus
systemic
47
opioid agonist/antagonists and nubain are systemic ____ and you need an order for them
analgesia
48
stadol is a systemic analgesia. torf?
true
49
the narcotics and opioids __ the system faster but make sure to have narcan on hand bc they can cause resp despression
leave
50
do __ give demeral or morphine if the baby is still inside.
not
51
anesthesia does __ cross the blood brain barrier and effects the fetus less
not
52
epidurals(the nurse will support shoulder and M FHR and M VS; this is better it lasts the whole time)and intrathecal are ___
anesthesia
53
spinal and local blocks like prudental are ____
anesthesia
54
general anesthesia(for Emergency) and nitric oxide are ____
anesthesia
55
when not prego, there is no placenta and there are __ arteries to bring blood to the uterus in the decidua
spinal
56
when preeclampic, this is ___ function of placenta and endometrium has the spiral arteries that bring blood to uterus
abnormal
57
when preeclampic, the ___ doesnt form correctly and the blood doesnt get to the placenta easy
placenta
58
when preeclampic, there is pressure bc the __ artieries are skinny
spiral
59
in a norm pregnancy, the placenta develops then the __ develop so blood can get to the intervillous space and O2 and nutrients can transfer easy
arteries
60
when preeclamptic, there is less __ blood flow to placneta that causes hypoperfusion which causes hypoxemia which causes ischemia
maternal
61
due to less maternal blood flow in preeclampsia, poison is leaked into the lining of the endothelium and it results in end organ damage and __
HTN
62
when preeclamptic, there is increased peripheral vascular resistence which leads to ___
HTN
63
when preeclamptic, u have face and hand swelling. torf?
tru
64
when preeclamptic, you have weight gain of GT5lbs a ___
week
65
when preeclamptic, there are ___changes and headaches
vision
66
when preeclamptic, there is sudden nausea and RUQ ___
pain
67
when preeclamptic, there is a ___ breath
gasping
68
preeclampsia can cause seizure and stroke. torf?
true
69
preeclampsia can cause organ damage and __term birth
pre
70
preeclampsia can cause death. torf?
tru
71
preeclampsia can ___ the brain(vision and headache) and liver(upper epigastric pain)
effect
72
preeclampsia has labs like __ labs drawn
liver
73
early preg bleeding is before __ weeks
20
74
miscarriage and tubal __ are examples of early preg bleeding
preg
75
incompetent cervix and molar preg are examples of ___ preg bleeding
early
76
in a __ the bleeding and cramping stops, or doesnt stop, or the baby can die without symptoms
missacarriage
77
a spontanous abortion is also called a ___
misscarriage
78
a ___ preg is anything outside the uterus
eptopic
79
__% of tubal pregs are in the fallopian tubes
90
80
with a ectopic preg, you see ___bleeding/cramping/pain and give meds and surgery to cure
vaginal
81
a incompetent cervix is shorter than __ cm and opens easily
3
82
if you have a incompetent cervix, the ___ will do a cerclage(stich it shut)
doctor
83
with a hydatidiform mole, there is __ baby
no
84
there is cancer like tissue and abnormal placenta tissue formed in a ___ mole
hydatdiform
85
with a molar preg, treat with chemo for a __ after cells removed
year
86
placenta previa and abruption are examples of bleeding __ in preg(GT20 weeks)
later
87
__ previa look like bleeding and the placenta is lower near cervix opening
placenta
88
__ previa is where the placenta doesnt adhere to the cervix as high as normal
placenta
89
____ previa is where the placenta can cover the cervical opening completely
placenta
90
___ previa is needing a c-section and giving no vaginal exam
placenta
91
you can see __ previa on a U/S
placenta
92
____ abruption is when the placenta is not on the uterus lining/moms blood
placental
93
_____ abruption is when the baby is getting no O2
placental
94
____ abruption is caused by trauma, MVA or high BP
placental
95
____ abruption is caused by drugs
placental
96
a mom's high blood pressure is placing pressure on the baby's ___
BVs
97
2cm/70%/-2 vertex is what phase of labor?
stage 1 latent
98
5cm/90%/-2vertex is what stage of labor?
stage 1 active labor
99
in the active phase of labor, there are ____ intensity of contractions and rapid progress
increasing
100
the ___ phase of labor is from onset of contractions to active phase
latent
101
when a prego feels ___ of fluid, assess FHT and TACO
gush
102
TimeAmtColorOdor
TACO
103
5cm/100%/0 station is what stage of labor?
first stage active
104
SUPPORT HER and COOL WASH CLOTH is
what you respond with when the women doesnt dilate quicker
105
SHE HAS MADE PROGRESS and KEEP GOING YOU CAN DO IT is
what you respond with when the women doesnt dilate quicker
106
SUPPORT THE FAMILY MEMBERS and GIVE THEM TASKS TO DO is
what you respond with when the women doesnt dilate quicker
107
ASSESS PAIN and DO POSITION CHANGES is
what you respond with when the women doesnt dilate quicker
108
SHOWER AND WATER and ENCOURAGE is
what you respond with when the women doesnt dilate quicker
109
when a women is tired and wants pain meds, you should say
encourage the nonpharm meds and you can change pain plans at any time
110
systemic analgesics can be given for pain but they can __ the placenta and cause resp depression. they last 2-3 hours and the second dose is not as effective
cross
111
transition phase is when you lose control and cant cope anymore, you may see ___ show and suddenly vomit
bloody
112
for the transition phase you can give ___SUPPORT EVEN WHEN PUSHED AWAY and CONTINUE MONITORING
increasing
113
for the transition phase you can _____POSITIONS, ASSESS PAIN, and REMIND HER THAT SHE IS DOING GOOD
change
114
8cm/100/0station is the __ phase
transition
115
when a women wants an epidural, you can respond with, ___
ITS OKAY TO CHANGE YOUR MIND and GUIDE TO NONPHARM TECHNIQUES WITH CLOSE DELIVERY AND GOOD PROGRESS
116
MOM BP DROPS AND FHR DROPS DUE TO NO FETAL PERFUSION are the risks, and side of effects of a ___
epidural
117
get a PO and ANESTHEHOLOGIST, GOOD IV ACCESS (18G), assess NO COAG OR CLOTTING PROBS, 1-2 L OF BOLUS BEFORE EPIDURAL are the roles of a ____
nurse
118
10cm/100%/+2 is what stage of labor?
second pushing
119
the women pushes bf needle guy comes, whats the nurses role?
PROVIDER TO ROOM and INSTRUMENTS SET UP
120
the women pushes bf needle guy comes, whats the nurses role?
GET MORE STAFF and COACH MOM ON HOW TO PUSH WELL(IN CONTRACTION)
121
the women pushes bf needle guy comes, whats the nurses role?
TELL SUPPORT PERSON TO SUPPORT LEGS AND GET HER WATER
122
the women pushes bf needle guy comes, whats the nurses role?
GIVE “SBAR” TO IMPT PEOPLE
123
baby born, skin to skin and no placenta yet. what labor stage?
third
124
MAKE SURE NEWBORN IS OKAY and APGAR SCORE are the ___ role in 3rd stage
nurses
125
DON’T MASSAGE FUNDUS TIL AFTER PLACENTA IS DELIVERED and GIVE MOM PACTOCIN TO PREVENT POSTPARDUM BLEEDING are the __ role in third labor stage
nurses
126
HELP ASSESS LOCHIA, DOCUMENT BIRTH, and ENCOURAGE BONDING are the __ role in third stage
nurses
127
a prego women comes in with HTN, what else do you ask her?
headaches? vision changes?
128
a prego women comes in with HTN, what else do you ask her?
epigastric pain?
129
a prego women comes in with HTN, what else do you ask her?
face and hand edema
130
a prego women comes in with HTN, what else do you assess?
weight gain 5lbs+in week, protein urine and take BP
131
35+, prima gravita and new partner are __ for preeclampsia
RF
132
GHTN and preeclampsia have HTN. torf?
true
133
preeclampsia has protein urine while ___ doesnt.
GHTN
134
prego women with preeclampsia at 35 wks is induced for labor, why cant she wait two wks?
START DUE TO MEDICAL COMPLICATION. BABIES AINT GETTING O2, NOT ENOUGH MOM BLOOD GETTING TO PLACENTA. MOM AND BABY AT RISK WITH PREECLAMPSIA. HAVE A NICU NURSE COME EXPLAIN AND REASSURE HER
135
for severe preeclampsia what med do you give?
Mg sulfate
136
CNS depressant and antiseizure med is __ sulfate
Mg
137
__ is the only solution for preeclampsia
delivery
138
__ is a high alert drug(need a second nurse to check)
mg sulfate
139
the ___ dose of mg sulfate is 4G in 30min then 2G an hour as maintenence
loading
140
when ___ Mg sulfate, do comfort measures
giving
141
wash cloth and ice packs due to N/V/fever/diarrhea are comfort __
measures
142
with Mg sulfate ___ RR and DTR
assess
143
with Mg sulfate ___ BP/VS and urine output
assess
144
with Mg sulfate ___ the environment low stimulus to prevent seizures
keep
145
a preeclamptic labor is full of __ and a c-section
complications
146
___ BG levels in mom gives extra glucose to baby that makes the baby gain weight
high
147
with extra glucose to baby the fetus makes more insulin then the extra glucose is stored as fat and the fetus is ___
large
148
moms glucose crosses the placenta but the insulin does ___, this leads to macrosomic fetus
not
149
the 1 hour GTT is bad if over 140, all ___ get this screening
women
150
the GTT is at weeks __ to 28 weeks
24
151
the healthy range for glucose is 130-___
140
152
if high in 1 hr GTT, do a 3 hr OGTT and if __ or more are abnormal, diagnose GDM
two
153
___ with GDM are macrosomia, shoulder dystocia and newborn hypoglycemia
complications
154
with GDM, ___ abt diet and BG tests and say that RF is obesity
teach
155
with GDM, ___ abt how to stick finger 4xs a day and document
teach
156
with GDM, ___ abt the mainstay treatment and meds if nothing works
teach
157
diet, exercise plus BG watching are the mainstay __& can lead to fetal death/congenital abnormalities/miscarriage
treatment
158
uterine contractions are what P?
powers
159
a contraction is from the beginning of one to the ___ of the next
beginning
160
when water ___, chart time of rupture, amt, color, and odor
breaks
161
3/80/-1 is what labot stage?
first
162
the chin rests on chest as it moves down
flexion
163
chin __ is a challenging presentation for birth
up
164
waiting on placenta delivery is what labor stage?
third
165
the fetus is in OP position, what p is this?
passenger
166
baby's full body is born this is
expulsion
167
with a __you can have hypotension
epidural
168
with hypotension due to epidural give IV fedran or O2 or turn to __ side
left
169
with a __ cervix, you are ready for labor
ant
170
a bishop score of above 8, induction of __ is successful
labor
171
bishop score of LT 8, you need to get the __ ready for labor
cervix
172
the bishop score answers the question of if the cervix is __(ready for labor)
ripe
173
dilation of 0is is 0 on ____...1-2 cm is 1...3-4 is 2 and >5 is 3
bishop
174
effacement of 0-30 is 0...40-50 is 1...60-70 is 2...>80 is 3 on what scale
bishop
175
station of -3 is 0...-2 is 1...-1,0 is 2...+1,+2 is 3 on what scale?
bishop
176
cervical consistency firm is 0...medium is 1...soft is 2 on what scale
bishop
177
cervix position is post is 0...midposition is 1...ant is 2 on what scale
bishop
178
bishop score of 5 is 1__/50%/-1/medium/post
cm
179
__ score of <8 is not ripe, use prostaglandins and CID
bishop
180
cervix not ripe use cytotec(chemical) or foley cath to add pressure to the cervix(soften it)(___)
mechanical
181
__ score of >8, the cervix is ripe, you give pitocin or oxytocin
bishop
182
make labor stronger and more effective, you can break water bag is ___ augmentation
labor
183
preterm labor is is uterine contractions and cervical change that happens between 20 and __ wks
37
184
contractions Q 3 min and 50-60 sec you give __ meds(stop contractions; terbutaline SC; nifedipine; Mg sulfate)
tocolytic
185
at risk preterm women have __ cervix(<30 mm)
short
186
at risk ___women is triplets at 20 weeks G1P0
preterm
187
a preg women feels crampy and pressure down there. you tell her: ___
Empty your bladder now, drink 2-3 glasses of water and rest for an hour. Call me if the cramping is still happening after all that
188
at 32 wks gestation, give betamethasone to help fetal lung __
mature
189
with ___, baby needs to be crowing and in second stage
vacuums
190
with __, head is sucked out when a contraction happens
vacuums
191
with __, grasp baby head with tongs/forceps and pull baby out
forceps
192
_____ of V and F are prolonged 2nd stage when pushing for more than 2 hours
indications
193
____ of V and F are fetal distress(lowFHR) and maternal fatigue
indications
194
___ of V and F trauma to moms perineum and newborn trauma
risks
195
when you contract, bear down and the doctor will pull the __ out
baby
196
c-section ___ are macrosomia and maternal complications(heart probs/genes)
indications
197
csection ___ are fetal malpresentation(can compress cord if you deliver body first)
indications
198
csection ___ are fetal distress and GI anomilly
indications
199
csection ___ are failure to progress in labor and repeat csection
indications
200
csection ___ are bleeding and infection
risks
201
csection ____ are risk for uterine rupture in future pregnancies
risk
202
the __ risk with TOLAC/VBAC is uterine rupture
main
203
a ___ rupture can occur spontaneously, not always the result of csection scar
uterine
204
___ dystocia is due to a small passageway/pelvis
shoulder
205
___ dystocia is due to large passenger/fetus or GDM
shoulder
206
__ dystocia is where the shoulder is lodged in the pubic bone
shoulder
207
a __ scar heals better than a vertical one
horizontal
208
__ scar is against the uterus horizontal muscles and more likely to rupture
vertical scar
209
you can have a vertical scar on the inside but a hori scar on the __
outside
210
trial of labor after csection is long for
TOLAC
211
vaginal birth after cseciton is long for
VBAC
212
LST stands for
low segment transverse
213
vertical or classical incision is not safe for vaginal birth.torf?
true
214
with ___ dystocia, try mcroberts position first then suprapubic pressure(this will dislodge the shoulder)
shoulder
215
if mcroberts and suprapubic dont work, try __ and knees
hands
216
if in shoulder dystocia, you ___ do a csection
cant
217
with a __ cord, the cord is out of the body bf baby is and no O2 is getting to baby
prolapsed
218
with a __ cord, hands and knees or trendelenburg + vaginal exam to push the baby head off the cord
prolapsed
219
with a __ cord, you end up in an emergency c section
prolapsed
220
__ with meconium fluid are meconium aspiration syndrome
risks
221
meconium aspiration syndrome is when you ____ it into lungs and makes it hard to breathe
breathe
222
with meconium __, the baby is past due date or under stress or has BM in amniotic fluid
fluid
223
with meconium fluid, the __ are to have extra hands on deck and suction out mouth and mon baby
interventions
224
__ role is to assess for s/s of complications early on
nurse
225
__ role is provide comfort
nurse
226
__ role is restore function and promote health
nurse
227
__ role is do family edu
nurse
228
BUBBLE-LE stands for
breasts, uterus, bowel, bladder, lochia, episiotomy/lacerations, legs(thrombosis) and emotions
229
for perineal ____ know REEDA
injury
230
redness, edema, ecchymois, discharge and approximation of edges stands for
REEDA
231
injury to vaginal mucosa
first degree perineal injury
232
injury of vagina mucosa and perineal muscles but not anal sphincter
second degree
233
injury to perineum with anus
3rd degree perineal injury
234
LT 50% of external sphincter torn
3a
235
GT 50% of external sphincter torn
3b
236
internal sphincter is torn
3c
237
injury to external and internal sphincter and anus/rectum
fourth degree perineal injury
238
breast focus on nipple everted and _____ for lactation
readiness
239
trauma or bleeding and trouble latching are ___concerns
breast
240
fundal massage right after ___ delivery
placenta
241
one hand under uterus one hand massaging with __ massage
fundal
242
uterus clamps and prevents ____
bleeding
243
when assessing the ___, look at in the middle of massage and feel for firm or boggy
uterus
244
when assessing the ___, how many cm above or below the umbilicus is it, are there clots or is it midline?
uterus
245
when assessing the ___, look at how much bleeding and to look at the perineum go on left and on on leg
uterus
246
it is normal not to poop 2 __ post partum
days
247
you should have trouble to pee __ after birth
right
248
the bleeding that happens is the ____ and its a mix of placenta and blood
lochia
249
___ rubrica is red and for the first 7 days
lochia
250
___ cirosa is round with little red and up to 2 wks
lochia
251
___ alba is yellow/white discharge and up to 4 wks
lochia
252
the flow of lochia is __ to C to A
R
253
episiotomy is when a doctor makes a cut and the __ are fetal distress and pushing with no stretching
indications
254
lacerations are a ___ tear
natural
255
with the __ you look for thrombosis bc they are more likely to clot
legs
256
when assessing the legs, look for red, swelling, pallor. torf?
true
257
post partum blues are normal for 2 weeks, ___ then depression can set in
after
258
for hemorrhoids, give witch ___bc they are common
hazel
259
birth of infant to repro organs returning to normal size/state is the ___ period
postpartum
260
involution is the uterus __ to prepreg state/shape/location
returning
261
involution is due to the __ contractions and atrophy of uterine muscle
uterus
262
involution is due __ size in uterus cells
decreased
263
subinvolution is when involution is __ healed(there is a fear of bleeding with this)
half
264
post partum hemostasis is __ by the uterus contracting
achieved
265
uterus contracting means you decrease the hemorrhage and compresses the ___ to control blood loss
BV
266
if uterus is boggy/feel wet, __ __ is an issue
bleeding out
267
the placental site heals by exfoliation with new __ tissue. there is no scar
endometrial
268
in the lochia you see __ tissue from the placenta site healing
necrotic
269
the umbilicus is displaced to the right and 2cm above umbilicus. why is this not expected?
it should be firm, midline and at bellybutton
270
with a __ the postpartum hemmorrhage level is 1000mL+
csection
271
with a ___ birth the postpartum hemorrhage is 500ML+
vaginal
272
to help the uterus contract ___patocin IV(no limit post partum) and breastfeed
increase
273
breastfeeding will increase __ naturally
oxytocin
274
bleeding and lochia ___with breastfeeding
increase
275
scant is LT __cm
2.5
276
light is LT __cm
10
277
moderate is 10cm or __
more
278
heavy is one __ saturated within 2 hours
pad
279
blood __ after birth is assessed by the extent of perineal pad saturation
loss
280
parental ___ is how you love and attach to baby
adaptation
281
reva rubins model is about ____ adataptation
parental
282
taking in...hold....letting go is the reva rubin ___
model
283
the dependent phase is the first __hours after delivery and taking in
24
284
focus on self and meeting basic needs in in the ___ in phase
taking
285
need nurse to help you with everything is the taking __ phase
in
286
excited and talkative is the __ in phase
taking
287
want to review/relive birth is what phase of parental adaptation?
taking in
288
taking hold is ind and dependent and last __ days to several weeks
10
289
focus on new role and desire to change is __ hold phase
taking
290
optimal time for teaching and learning is taking __ phase
hold
291
impt for first time parents are in the ___ hold phase
taking
292
letting go is interdependent and fully incorporating the mother ___
role
293
focus on moving forward with fam unit is what phase
letting go
294
reassertion of relationship with partner is what phase
letting go
295
committment, attachment, prep is the first __ in mercer model
stage
296
aquaintence, learning, physical restoration(2-6 wks) is the second __ in mercer model
stage
297
moving toward normal is the third stage in ___model
mercer
298
achievement of maternal ID(abt 4 mnths)is the fourth __ in mercer model
stage
299
with a CSECTION/post partum complication, its ____ SURGERY & SEDENTARY POST PARTUM(BLOOD CLOT AND INFECTION COMPLICATION)
abdominal
300
PROLONGED ROM is
| a ___ partum complication you NEED TO DOCUMENT TIME, at 24 HRS...INFECTION
post
301
PROLONGED LABOR is a post ___ complication the UTERUS IS TIRED AND CONTRACTED TOO LONG AND NOT AS EFFICIENT IN LABOR(RISK FOR HEMMORHAGE)
partum
302
CATH can be
| ___partum complicationBACTERIA INTO BLADDER
post
303
HEMORRHAGE is a post partum ___ . ANEMIA AND WEAK BODY
complication
304
a post partum complication is a HEMATOMA is a BLOOD ___ IN TISSUE(PERINEAL AREA)(HARD TO ASSESS)
clot
305
with PPH, screen all women for hemorrhage risk and get blood knowledge___ birth
bf
306
with PPH, have active management in 3rd labor __
stage
307
do fundal massage as long as you are bleeding and VS in __ stage of labor
third
308
give patocin and maintain O2 in __ stage of labor
third
309
ID the __ of hemorrhage to correct it
cause
310
there are 4 causes of PPH: tone, trauma, tissue and ______
thrombin
311
post __ hemorrhage is a 10% change in Hct between labor and postpartum
partum
312
post __ hemorrhage is the leading cause of morbitiy and mortality
partum
313
post __ hemorrhage is unrecognized til profound symptoms occur
partum
314
tone refers to uterine atony and is 70% of the cause of ___
PPH
315
uterine atony has marked hypotonia of uterus and ass with __ parity
high
316
uterine atony has marked hypotonia of uterus and ass with hydramnios and ____ fetus
macrsomic
317
uterine atony has marked hypotonia of uterus and ass with __ gestation and treated with fundal massage
multifetal
318
uterine atony is treated with ___feeding and patocin(med)
breast
319
uterine atony is treated with __ bladder and methergin(med)
empty
320
hydramnios is __ baby or fluid in uterus and overextended uterus
big
321
trauma can cause ___
PPH
322
a laceration to genital tract is ___
trauma
323
episiotomy is a cut and lacerations are ___, both are trauma
tears
324
___ on perineum are easy to ID and stitch up
lacerations
325
___ on vagina are hard to find
lacertations
326
hematoma is a trauma. torf?
true
327
retained placenta is ass with tissue(10%) and causes ___
PPH
328
trauma causes 20% of ___
PPH
329
thrombin causes 1% of __
PPH
330
tone causes 70% of ___
PPH
331
nonadherent retained placenta and adherent retained placenta is ass with what T?
tissue
332
___ accreta is most superficial and nonconcerning
placenta
333
___ increta is partially grown on uterus slide
placenta
334
____ percreta is the placenta growing all the way onto the side of abdominal cavity
placenta
335
____ percreta is a large hemorrhage risk and needs surgery
placenta
336
retained products in placenta are left in the uterus and make the __ not able to clamp down
uterus
337
retained products in placenta need to be manually removed under anesthesia and needs to be removed so the uterus can clamp ___
down
338
thrombin is rare and has to do with clotting/___ probs
coag
339
thrombin has to do with DIC, ITP and vWD. torf?
true
340
once you start to bleed the coag system stops __
working
341
once you start to lose blood, its ____ to clot and coag
harder
342
endometritis in __ is most common PP infections.
uterus
343
wound infections and UTI are PP ____
infections
344
mastitis is a lactation infection. a ie of PP ____
infection
345
a plugged milk duct will need to be massaged and is ass with ____
mastitis
346
prolonged labor/ROM is at risk for PP infection. torf?
true
347
treat infection with antibiotics IV or orally. torf?
true
348
csection and episiotomy/laceration repair make you at __ for infection
risk
349
call abt a fever, chill, or flu bc of __ for infection
risk
350
you can still breastfeed while on antibiotics. torf?
true
351
UTI is due to probs voiding and can lead to pyelonephritis. s/s can be pain and ____
frequency
352
venous stasis and hypercoag puts you at risk for increased ___ clots
blood
353
primary cause of blood clots post partum is venous stasis(____ dont come and go from legs as easily)
blood
354
primary cause of postpartum blood clots are hypercoag(___ but more at risk for blood clots)
protective
355
SVT is the ___ common thrombophlebitis and you see pain/tender calves
most
356
with SVT treat it by: __ calf, give tylenol, move and give compression socks
elevate
357
DVT requires anticoag therapy and bed __
rest
358
DVT requires analgesia and you want to ___a PE
prevent
359
PE can result from a ___ DVT. it can be seen on U/S at the bedside
dislodged
360
dislodged DVT is a emergency but __
rare
361
SSRIs are safe for the PPD mom, but do cross placenta and __ in breastmilk
excreted
362
for SSRIs use the ___ effective dose
lowest
363
after 2 wks post partum to a year is PPD risk and can be __
diagnosed
364
if struggled with depression bf pregnancy, more at __ for PPD
risk
365
baby blues is common and ass with mood ___
swings
366
baby blues is common and ass with anxiety and depression. torf?
true
367
baby blues is common and ass with __ thoughts toward infant
neg
368
psychosis is bc of untreated PPD or day of birth and is a medical __
emergency
369
with psychosis you see baby blues, PPD and __ voices
hear
370
with psychosis you see hallucinations and ___ thoughts
disturbing
371
its __ for vaginal wounds to take a few weeks to heal but look for infection signs
normal
372
with lochia, R extremely __ clots, bleed if multiple pads are saturated an hour and smell foul
large
373
apply cold packs to anus to ease swelling and pain. take a ___ bath to combat hemorrhoids and vaginal tears
sitz
374
for cracked nipples, use lanolin to soothe the ____
nipples
375
apply cold and cabbage leaves on sore ___
breasts
376
massage breasts or pump milk if need be on __ breasts
sore
377
diastasis recti prevents you exercising until 6 __PP
weeks
378
the ___ needs to go back to preprego size after L&D this will cause contractions that are painful
uterus
379
do kegals post birth due to weaker pelvic ___ bc of prego and birth
muscles
380
tell the mom when they can have sex again and tell about support groups and to __ the provider if need be
call
381
newborn homeostasis transitions include: thermal ___, glucose metabolism and Resp/cardio function
regulation
382
the __ of cold stress are: increased O2 consumption leading to met acidosis/hypoglycemia/resp distress
effects
383
you need __ to do chemical thermoregulation
glucose
384
the ___ releases NE and triggers the glucose production within the mitochondria of the brown fat which releases heat in ATP form. this is thermal regulation
hypothalamus
385
it takes __hours to est thermal balance
12
386
there is risk RT ___ fat and BV close to the surface with TR
SC
387
there is risk RT __ body SA with TR
larger
388
babies cant shiver and the heat ___ is due to metabolism of brown fat with TR
production
389
heat can be produced by muscles moving and flexion of __
extremities
390
heat is produced by restlessness and crying with TR. torf?
true
391
transfer of body heat to surrounding air ( cold del. Room)…AC….fan…O2
convection
392
Heat loss as water evaporates from the skin –wet baby lose heat faster than dry baby, dry baby ASAP
evaporation
393
loss of heat through the air to a cooler surface ( not in direct contact with the neonate)
radiation
394
transfer of heat to surface the newborn is lying on….cold scale, put baby on mom for warmth
conduction
395
glucose metabolism is when a ___ needs to learn to balance GM on its own
baby
396
cold stress can: __ O2 consumption and lead to met acidosis
increased
397
cold stress can: ____ glucose utilizes leads to hypoglycemia
increase
398
cold stress can: have surfactant production decrease and resp __ occurs
distress
399
the fetus resp sys is fluid __
filled
400
the fetus resp sys has high pressure that leads to blood shunting from the __ thru duct arteriosus to the rest of the body
lungs
401
newborn resp sys is airfilled and__pressure
low
402
newborn resp sys allows blood flow thru lungs and there is ____ O2 content of blood that leads to closing of duct arteriosus
increased
403
newborn gas __ in the lungs, while fetus is in placenta
exchange
404
Right atrium pressure is greater than left atrium, allowing blood flow through foramen ovale is __ circulation
fetal
405
restitution is when the head goes to the side and you deliver the __ shoulder first
ant
406
turns and adjustments of fetus needed for birth
cardinal movements
407
2cm/70/-2 is what stage and phase
S1 latent phase
408
5cm/90/-2 is S1 __phase
active
409
latent is the onset of contractions until active. torf?
true
410
effaced is how much the __ is thinned out
cervix
411
when there is a fluid gush, check FTH and TACO, assess VS and do comfort measures. torf?
tru
412
AROM is to further labor. torf?
true
413
the transition phase in Stage __ of labor is from 8-10 cm
one
414
in what phase is irritable, sweat and body show
transition
415
in what phase is no coping, vomit and diarrhea
transition
416
you need to increase support and monitor in the __ phase
transition
417
you need to assess pain and change position in what phase
transition
418
with an epidural the maternal BP drops and the FHR drops so there is no ___
perfusion
419
a __ will get a PO, needle guy and get 18g/IV access for an epidural
nurse
420
a __ will see if there are clotting or coag probs and do the 1-2 L bolus of IV fluid bf an epidural
nurse
421
10cm/100/+2 is what stage
second
422
a __ will set up room, coach in pushing and M HR in the second stage
nurse
423
a __ will tell support person to support legs and get water in second stage
nurse
424
waiting for the placenta what stage
third
425
a __ will check the newborn and APGAR score in third stage
nurse
426
a __ will massage fundus after placenta delivery and give OXY to prevent PPH
nurse
427
a __ will assess lochia, docu birth and encourage bonding in third stage
nurse
428
RF for preeclampsia are 35+, prima gravita, and new partner. torf?
true
429
bad __ with preeclampsia is 160/95.
BP
430
the ___ solution to preclampsia is delivery so you do a AROM
only
431
give MG __ for preeclamspia
sulfate
