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OB > Exam 4 > Flashcards

Exam 4 Flashcards

1
Q

Factors factors that affect the process of labor and birth - the 5 P’s

A

Passenger: Fetus and Placenta
Passageway: Birth canal
Powers: Contractions
Position (of mother)
Psychologic Response

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2
Q

Frank breach

A

Legs folded ankles to head

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3
Q

Single footling breach

A

One foot sticking out

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4
Q

Complete breach

A

Legs crossed, butt first

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5
Q

Shoulder presentation

A

Type of breach
Shoulder coming out first

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6
Q

Fetal lie

A

How spine of fetus and mother line up

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7
Q

Longitudinal fetal lie

A

Most common
Fetus aligned with mother

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8
Q

Transverse fetal lie

A

Fetus positioned across mother’s pelvis
Most common early in pregnancy

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9
Q

Oblique fetal lie

A

Baby turned sideways
Spine facing laterally

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10
Q

Vertex presentation

A

Chin tucked
Type of fetal attitude

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11
Q

Sinciput presentation

A

Chin neutral position
Type of fetal attitude

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12
Q

Brow presentation

A

Chin up
Type of fetal attitude

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13
Q

Types of fetal positions

A

ROA
ROT
ROP
LOP
LOT
LOA
Right/Left
Occipito
Anterior/Posterior/Transverse

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14
Q

Best fetal positions

A

ROA and LOA
Facedown

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15
Q

Fetal station

A

Measures the decent of the baby
In relation to ischial spine

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16
Q

x/x/x

A

dilation/effacement/station
ex. 8/100/0

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17
Q

Types of bony pelvis’

A

Gynecoid
Android
Anthropoid
Platypelloid

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18
Q

Gynecoid

A

Optimal pelvis type
Round, wide bone structure

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19
Q

Android

A

Wedge- or cone-like shape, with a wider top and narrower bottom

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20
Q

Anthropoid

A

Narrow, oval-shaped pelvis that’s deeper than it is wide

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21
Q

Platypelloid

A

Flat, wide, and shallow pelvis that’s the least common type. It’s more bean-shaped than heart-shaped

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22
Q

Lower uterine segment

A

Where contraction occur
Pushes baby down, putting pressure on cervix
Type of soft tissue

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23
Q

Introitus

A

Vaginal opening

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24
Q

Primary powers

A

Contractions

25
Q

Secondary powers

A

Bearing down

26
Q

What to measure during contractions

A

Frequency, duration, intensity

27
Q

Where to measure contraction

A

From beginning of one to the beginning of the next

28
Q

How much time is between the dark lines of the fetal monitoring strip

A

1 minute
Each box is 10 seconds

29
Q

Phases of contractions

A

Increment: Increasing
Acne: Peak
Decrement: Decreasing

30
Q

Signs preceding labor

A

Lightening - fetal head drops into pelvis
Bloody show
Losing mucus plug
Persistent low back pain
Braxton Hick’s contractions - no cervical change
Wt loss - 1-3lbs, fluid/electrolyte shifting
Nesting - surge to prepare for baby

31
Q

Phases in first stage of labor

A

Latent: 0-3cm
Active: 4-7cm
Transition: 8-10cm

32
Q

First stage of labor

A

Events preceding full dilation

33
Q

Second stage of labor

A

Time from fully dilated to baby coming out

34
Q

Third stage of labor

A

Pushing stage

35
Q

Fourth stage of labor

A

Delivery of placenta until mom is stable

36
Q

Things that initiate the onset of labor

A

Sex
Nipple stimulation - releases oxytocin

37
Q

7 Cardinal movements of mechanisms of labor

A

Engagement
Descent
Flexion
Internal rotation
Extension
External rotation (also called Restitution)
Expulsion

38
Q

Normal fetal HR

A

Monitor during labor
110-160

39
Q

What factors affect fetal HR

A

Reduction of blood flow d/t HTN (gestational or chronic), hemorrhage, hypotension, anemia

40
Q

Factors that alter fetal circulation

A

Compressed of umblilical cord
Fetal head compression
Reduction in blood flow to intervillous space of placenta

41
Q

Ways to monitor fetal HR

A

Intermittent auscultation - Usually Q30mins, with doppler, fetoscope, fetal monitor ultrasound
- Does not detect patterns
Electronic fetal monitoring (EFM)
- External or internal

42
Q

What must happen before internal EFM is used

A

Water broken
Dilated 1-2cm
Monitors uterine contractions
IUPC - Intrauterine pressure catheter
FSE - Fetal scalp electrode

43
Q

Sinusoidal pattern

A

Sawtooth FHR pattern
Not good

44
Q

When can you determine FHR is brachy or tachy

A

After 10 minutes

45
Q

Periodic changes in FHR

A

Occur in reaction to uterine contractions

46
Q

Episodic changes in FHR

A

Not related to uterine contractions

47
Q

Normal acel for 32+ wk

A

15x15 acels
For at least 15 seconds
1 box up and over

48
Q

Cause of early decels

A

Good thing, indicates progression of labor
Head compression d/t contractions
Peak of contraction should mirror decel (Periodic)
More than 30 seconds

49
Q

Cause of late decels

A

Poor oxygenation
Uterine tachysystole, hypertonus
Hypotension
Postterm date
Maternal diabetes
IUGR - small baby
Occurs right after contraction (Periodic)
More than 30 seconds

50
Q

Nursing interventions for late decels

A

Turn patient
Oxygen - nonrebreather at 10L
Fluid bolus
Turn off Pitocin
Administer Terbutaline - slow contractions

51
Q

Cause of variables/variablity

A

Cord compression
Abrupt onset
For less than 30 seconds

52
Q

Nursing intervention for variability

A

Turn pt
Fluids
Turn of Pitocin
Amnioinfusion: Fluid into uterus, more cushioning
Notify HCP

53
Q

Prolonged decel

A

Gradual or abrupt
At least 15 beats below baseline, more than 2 mins but less than 10 (after 10 min is considered baseline change)

54
Q

FHR category 1

A

HR WNL
Moderate variability
Absent late or variables
Early decels present or absent
Acels present or absent

55
Q

FHR category 2

A

Anything between 1 and 3
No acels after stimulation

56
Q

FHR category 3

A

Absent baseline variability
Recurrent late decels
Recurrent variable decels
Bradycardia
Sinusoidal pattern

57
Q

How often to document assessment of pt with epidural vs not

A

Q15mins
Q30mins

58
Q

When is fetal monitoring required

A

When receiving Pitocin

59
Q

Interuterine rescucitation

A

Top 3 interventions:
Turning pt, oxygen, and fluids

OB (6 decks)

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