Exam 2 part 3 Flashcards
PP hemorrhage that happens in the 24 hours after delivery
Highest risk
early PP hemorrhage
PP hemorrhage that happens between 24 hours and 6 weeks after delivery
late PP hemorrhage
when is most blood lost
during delivery or immediately after
assessment for late or delayed hemorrhage related to
Fundal height not where expected
Failure of lochia progression
treatment of subinvolution
remove placental frags
Methergine
Dose for methergine
0.2 mg IM
PO Q3-4 X24-48 hrs
acts on uterine smooth muscle to increase tone
methergine
placenta adheres to myometrium
placenta accreta
placenta invades the myometrium
placenta increta
placenta penetrates the myometrium
placenta percreta
accounts for the most of retained fragments
accerta
collection of blood, may be caused by injury to a vessel or inadequate hemostasis w/ laceration
PP hematomas
treatment for small hematomas
ice and pressure after 24 hours heat
treatment for large hematomas
incision and drainage (vessel ligated)
first pharacological treatment for hemorrhage
oxytocin
do not give methergine to people with
heart problems
do not give hemabate to people with
asthma
assessment of uterine rupture
severe abdominal pain
Hard to palpation
Bleeding may be hidden
mastitis is most commonly caused by
staph aureus
Temp 100.4 or higher on any two days during PP day 2-10, then suspect
puerperal pyrexia
Genital tract infection in early onest (24-36) is
GBS
genital tract infection in late onset is
Chlamydia
treatment for genital tract infection
penicillins Amoxicillian clavulanate (beta-lactam inhibitors)
pelvic cellulitis or infection of parametrial structures
parametritis
causes of PP UTI
urine stasis
Bladder trauma during birth
Catherterization
Treatment for PP UTI
Bactrim
Nitrofurantoin
Keflex
when is thromboembolic disease most common
PP 10-20 days
what effect can the psyche have on labor
can cause stress hormones to be formed and impead labor
antacid and dose used during for preparation for c-section
Bicitra 30 ml PO
Reglan IV
treatment for spinal headache
blood patch
the skin and the subcutaneous are incised using lower transverse, slightly curvilinear incision
Pfannensteil (skin)
Cut where lower segemnt transverse
Area less likely to transverse
Least morbid and most common
1% risk of rupture with VBAC
Kerr (uterine)
vertical incision in lower uterine segment
Can VBAC
selheim (uterine)
Vertical cut through fundus
Cannot VBAC 6% risk for rupture
Skin scar does NOT = uterine incision type
classical (uterine)
placental aging triggers
contractions
fetal membranes synthesize prostaglandins cause
contractions
what would you suspect with green discharge
meconium
what would you suspect with bright red discharge
placenta previa
Abruption
occurs when the biparietal diameter is at or below the inlet of true pelvis
engagement
is the widest upper portion of the body pelvis
false pelvis
is the entrance to the true pelvis
inlet (linea terminalis)
is that portion of the pelvis below the linea terminals or the inlet
true pelvis
the relationship of the presenting part of the fetus to an imaginary line drawn between the ischial spines of the maternal pelvis
station
what to do with ROM/ BOM
immediately assess FHT
what to do with a cord prolapse
Trendelenburg position and lift presenting part off cord
Factors affecting labor (5ps)
Power Passage passenger Psyche Postion
Beginning of one contraction to the beginning of the next
Frequency
beginning of a contraction to the end of the contraction
duration
increment build up of contraction
cresendo
the peak of the contraction
apex/ acme
decrement of contraction
decrescendo
thinning and shortening of the cervix that occurs during labor
effacement
widening of the cervical external OS from less than 1cm to full dilation (about 10cm) to allow birth of a full term
Dilatation/ dilation
why does dilation occur
contraction
The fluid filled membranes press agains the cervix
types of pelviss
gynecoid
android
anthropoid
platypelloid
pelvis that has ideal wide sacrum, flat iliac bone, >basin
Gynecoid
pelvis that is ape like
Long a-p
anthropoid
if tissue doesnt respond how it is suppose to during a contraction
tissue dystocia
low lying placenta may cause the baby to assume a
transverse lie
placenta previa can be associated with
breech presentation
the relationship of the fetal long axis to the long axis of the mother
fetal lie
head first
vertical/longitudinal (normal)
breech
vertical/longitudinal (variation)
transverse
oblique lie
perpendicular (abnormal)
the leading or most dependent portion of the fetus
fetal presentation
vertex, brow, face presentation
cephalic
feet up presentation
frank breech
both feet and sacrum presentation
complete breech
just a foot/ feet presentation
footling breech
manipulating the fetus in order to turn it to head first
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