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Maternity > Exam Two > Flashcards

Exam Two Flashcards

1
Q

What are some examples of health promotion that should be provided to patient about childbirth and perinatal education?

A 
Diet
Exercise
Rest
Avoid unsafe practices
Fetal growth and development
Signs and symptoms of labor
options for birth
family planning
infant nutrition
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2
Q

a psychoprophylactic (“mind prevention”) method of preparing for labor and birth that promotes the use of specific breathing and relaxation techniques…

A

Lamaze Method

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3
Q

various exercises and slow, controlled abdominal breathing to accomplish relaxation

A

Bradley (Partner-coached) method

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4
Q

focus on fear reduction via knowledge and abdominal breathing techniques

A

Dick-Read

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5
Q

List pros and cons of breast feeding

A

Pros:
bonding between mother and child
free
extra calories are used
oxytocin is released
sucking helps to develop muscles in the infant’s jaw
food allergies are less likely to develop

Cons:
breast discomfort
sore nipples
mastitis
engorgement
breast abscess
milk stasis
flat or inverted nipples
vaginal dyness
decreased libido
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6
Q

Pros and cons for bottle feeding

A

Pros:
Anyone can feed baby

Cons:
Not free, can become costly

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7
Q

During the last trimester of pregnancy, estrogen levels ____ and progesterone levels ____.

A

During the last trimester of pregnancy, estrogen levels increase and progesterone levels decrease.

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8
Q

Signs and Symptoms of true labor

A

Pain in back radiates to front
regular rhythmic contractions that increase with ambulation
Progressive cervical dilation

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9
Q

SIGNS AND SYMPTOMS OF FALSE LABOR

A

Irregular contractions
No progression/dilation
tightening but not painful
change in position or activity usually slows contractions down

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10
Q

Signs before labor

A 
cervical changes
lightening
increased energy level
nesting
Blood show
Braxton hicks contractions
Spontaneous ROM
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11
Q

The _______ is the route through which the fetus must travel to be born vaginally.

A

The birth passageway is the route through which the fetus must travel to be born vaginally.

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12
Q 
Which type of pelvis is not favorable and male shaped for child birth
Gynecoid
Android
Anthropoid
Platypelloid
A

Android

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13
Q

As contractions increase, what happens to cervix?

A

cervix grows and thins but then disappears

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14
Q

If a doctor says, “patient is 7/80/+1” what does this mean? Using this statement is patient close to giving birth or has she just begun the labor process?

A

Patient is 7cm dilated, 80% effaced and has a station of +1. Patient is closer to giving birth

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15
Q

What feature in a baby’s head or skull helps identify the position of the fetal head during vaginal examination?

A

Sutures

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16
Q

What refers to the posturing (flexion or extension) of the joints and the relationship of fetal parts to one another

A

Fetal attitude

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17
Q

What refers to the relationship of the long axis (spine) of the fetus to the long axis (spine) of the mother. There are three possible lies: longitudinal (the most common), transverse, and oblique.

A

Fetal lie

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18
Q

What refers to the body part of the fetus that enters the pelvic inlet first

A

Fetal presentation

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19
Q

How do you identify fetal lie? if the baby is transverse, what type of delivery will the mother have?

A

Leopold’s manuever

C-section

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20
Q

What type of position is the baby if they ROA?

A

Right occiput anterior

21
Q

What type of position is the baby if they are lOT

A

Left occiput transverse

22
Q

What type of position is the baby if they are ROP

A

Right occiput posterior

23
Q

The fetus goes through many positional changes as it travels through the passageway. These positional changes are known as

A

The fetus goes through many positional changes as it travels through the passageway. These positional changes are known as the cardinal movements of labor

24
Q

What are maternal physiologic responses to labor

A 
Heart rate increases by 10-20 bpm
Cardiac output increases
Blood pressure increases
WBC increases
RR increase
gastric motility and food absorption decrease
Slight temperature elevation
decreased glucose levels
25
Q

Fetal physiologic responses to labor

A

Periodic FHR accelerations and slight decelerations
decrease in circulation and perfusion
Increase in arterial carbon dioxide pressure (PCO2)
Decrease in fetal breathing movements throughout labor
Decrease in fetal oxygen pressure with a decrease in the partial pressure of oxygen (PO2)

26
Q 
Which stage of labor?
Onset of contractions to full dilation
2 phases: latent and active
latent--> 0-6cm  and 6-8 hours
active --> 6-10 cms and 3-6 hours
Longest of all stages
quicker for multipara than primipara patients
Breathing techniques are encouraged
A

1st stage

27
Q

What stage of labor?
1-2 hr for multipara, 2-3 hr for primipara
Complete dilation until birth of fetus
maternal pushing
Contractions are every 2-3 minutes and last 60-90 seconds

A

2nd stage

28
Q

What stage of labor?
lasts 5-30 minutes
Birth until placental separation
placental separation and placental explusion

A

3rd stage

29
Q

What stage of labor?
First 1-4 hours following develiery
Post partum
risk fo post-partum hemorrhage

A

4th labor

30
Q

What are active managements a nurse might do for post partum eating?

A

active management includes administration of a uterotonic agent after the birth, expulsion of the placenta with controlled traction of the cord, and uterine fundal message after placental expulsion

31
Q

The following signs of separation indicate that the placenta is ready to deliver:

A

The uterus rises upward.
The umbilical cord lengthens.
A sudden trickle of blood is released from the vaginal opening.
The uterus changes its shape to globular.

32
Q

The focus during the 4th stage is to monitor the mother closely to prevent…

A

The focus during this stage is to monitor the mother closely to prevent hemorrhage, bladder distention, and venous thrombosis.

33
Q

What is the priority in triage?

A

Assessment is first priority

Place patient on monitor

34
Q

List nonpharmacologic measures that help with labor and pain management

A 
Continuous labor support
Hydrotherapy
Ambulation and position changes
Acupuncture nd acupressure
Attention focusing and imagery
Therapeutic touch and massage; effleurage
Breathing techniques
35
Q

T/F Changing position frequently (every 30 minutes or so)—sitting, walking, kneeling, standing, lying down, getting on hands and knees, and using a birthing ball—helps relieve pain

A

True

36
Q

_______ is a light, stroking, superficial touch of the abdomen, in rhythm with breathing during contractions. It is used as a relaxation and distraction technique from discomfort. External fetal monitor belts may interfere with the ability to accomplish this.

A

Effleurage is a light, stroking, superficial touch of the abdomen, in rhythm with breathing during contractions. It is used as a relaxation and distraction technique from discomfort. External fetal monitor belts may interfere with the ability to accomplish this.

37
Q

_______ involves the use of one or more drugs administered orally, intramuscularly, or intravenously; they become distributed throughout the body via the circulatory system.

A

Systemic analgesia involves the use of one or more drugs administered orally, intramuscularly, or intravenously; they become distributed throughout the body via the circulatory system.

38
Q

Why would a patient being given opioids also be given an antiemetic?

A

For nausea and vomiting

39
Q

What route is systemic analgesic typically administered through?

A

Existing IV line, can be oral or IM also but PO is not preferred

40
Q

_______ provides pain relief without loss of consciousness. It involves the use of local anesthetic agents with or without added opioids to bring about pain relief or numbness through the drug’s effects on the spinal cord and nerve roots.

A

Regional analgesia provides pain relief without loss of consciousness. It involves the use of local anesthetic agents with or without added opioids to bring about pain relief or numbness through the drug’s effects on the spinal cord and nerve roots.

41
Q

An epidural is contraindicated for women with a previous history of…

A

spinal surgery or spinal abnormalities, coagulation defects, cardiac disease, obesity, infections, and hypovolemia. It is also contraindicated for the woman who is receiving anticoagulation therapy.

42
Q

Complications of epidural include

A

nausea and vomiting, hypotension, fever, pruritus, intravascular injection, maternal fever, allergic reaction, and respiratory depression.

43
Q

T/F General anesthesia is common and used similar to an epidural

A

FALSE, general is used only on emergencies

44
Q

What is important to indentify during a phone assessment of a patient who believes she is in labor

A

Identify S/S of true and false labor

45
Q

What are some things to ask during a phone assessment?

A 
EDD
Fetal movement; frequency
other signs of labor
GP
time frame of previous labors
characteristics of contractions
bloody show and ROM status
Presence of supportive adult in household or alone
46
Q

List nursing care and interventions that are done during the 1st stage of labor

A

Identifying the estimated date of birth from the client and the prenatal chart
Validating the client’s prenatal history to determine fetal risk status
Determining fundal height to validate dates and fetal growth
Performing Leopold maneuvers to determine fetal position, lie, and presentation
Checking FHR
Performing a vaginal examination as appropriate to evaluate effacement and dilation progress
Instructing the client and her partner about monitoring techniques and equipment
Assessing fetal response and FHR to contractions and recovery time
Interpreting fetal monitoring strips
Checking FHR baseline for accelerations, variability, and decelerations
Repositioning the client to obtain an optimal FHR pattern
Recognizing FHR problems and initiating corrective measures
Checking amniotic fluid for meconium staining, odor, and amount
Comforting the client throughout the testing period and labor
Documenting times of notification for team members if problems arise
Knowing appropriate interventions when abnormal FHR patterns present
Supporting the client’s decisions regarding intervention or avoidance of intervention
Assessing the client’s support system and coping status frequently

47
Q

What are some things that are assessed throughot 1st stage of labor

A 
VS
Vaginal exam
uterine contractions
pain level
coping ability
FHR
amniotic fluid
48
Q

An ______ is an incision made in the perineum to enlarge the vaginal outlet and theoretically to shorten the second stage of labor.

A

Episiotomy

Maternity (2 decks)

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