Fetal Monitoring and Pain Relief - Unit 2 (Class) Flashcards
What effects fetal oxygenation?
Cord compression, BP, mom’s oxygenation, etc.
During contractions, everything presses down, so no blood flow to the baby. T/F?
True
What does the sympathetic system do for the heart? Parasympathetic?
Symp - increases HR, para decreases.
Parasympathetic - maintains variability, not present until what weeks?
28-32 weeks.
Chemoreceptors - respond to chemicals. T/F?
True
Numerous early decels- might mean…..?
baby is ready to come out!
Vibroacoustic - sound to get baby to ___.
MOve
Pressure on the back helps pain for mom, along with hot/cold therapy. T/F?
True
What is wagon wheel breathing?
Water wheel….you breathe in and out slowly.
Intrathecal opioid - doesn’t affect walking. T/F?
True
NO - used for what?
Nitrous oxide, used as a relaxer…used more in europe.
Meperidine - rarely used because….
half life of metabolite in newborn is really long.
Sublimaze (fentanyl) - Butorphanol (mixed, CAUTION with heroin users). T?F?
True
What is naloxone used for?
Narcan - reverses the bad effects.
Hydroxyzine - what is it? Used for?
Antihistamine that works as an antiemetic.
General anesthetic - when is it used?
For someone who needs emergency surgery/etc.
what is a risk for artificial rupture?
Cord prolapse.
The longer the water has been broken, the greater the risk of what?
Infection
Before AROM
Know stationing, trace fetal HR for 20-30 minutes, put pads underneath mom. etc.
Amniotic fluid - does it have a distinct odor?
Yes
A small abruption - might still be able to do a vaginal delivery. T/F?
True
Vasa previa - what is it
Fetal blood vessels are near the opening. Could harm baby if pushed through.
What are some risks of augmentation of labor?
Hypertonic uterine activity, uterine rupture, maternal water intoxication, greater risk for chorioamniotitis, greater risk for cesarean
To be induced, you should be around how many weeks?
39 weeks.
Cervotec - how is it implanted? What is it?
Cervical ripening agent - pill placed close to cervix. Make sure it’s not stuck to your glove!
Cervodil is on a string!
Oxytocin - isotonic solution. T/F?
True
What’s a serial induction?
When you get tons of pitocin…and then stop at night to rest.
If fetal HR is nonreassuring, what do we do with induction?
Stop!
Pitocin - makes contractions easier. T?F?
FALSE - hurts horribly
What are signs of possible water intoxication ?
Blurred vision, headache, wheezing, coughing, low BP, increased HR, etc.
What’s version?
When the baby is turned from the outside by a Dr.
When is version contraindicated?
Uterine malformations, previous CS with vertical incision, large baby, cephalic pelvic disproportion, multiple gestation, too much amniotic fluid, rupture, placental insufficiency, etc.
What are some risk for a baby with version?
entanglement in cord, placental abruption, mixing of maternal and fetal blood. MAKE SURE SHE HAS RHOGAN if Rh negative.
What’s a large baby weight?
over 8 lb, 14 oz.
Subgaleal hemorrhage - very serious for baby. T?F?
True
Episiotomy - why? Risks?
Fetal dystocia (shoulders could be stuck or head is stuck), vacuum extractor, occiput posterior position, preterm infant. Risk = infection, pain.
It’s not better to tear. T/F?
FALSE. It is!
Don’t put a lot of pressure on babies head, especially pre-term. T/F?
True
What are some indications for a cesarean?
Dystocia,cephalopelvic disproportion, HTN, maternal disease, active genital herpes, nonreassuring fetal HR, hemorraghic condition, etc.
What are some contraindications for cesarean?
fetal death, immature fetus, maternal coagulation defects.
Cesarean - risk for mom -?
Infection, hemorrhage, urinary issues, thromboembolism, paralytic ileus, atelectasis, anesthesia complications, etc.
Risks for infant (cesarean)?
Lung immaturity issues, transient tachypnea, pulmonary hypertension, traumatic injury, etc
Spinal - pretty typical for cesarean?
Yup
Lab tests before cesarean - what?
HgB, platelets, etc.
Skin prep before cesarean - what?
Cleanest to dirtiest area, 3 minutes!
Low transverse = what cut?
Low vertical = what?
Classic = what?
Low transverse = bikini cut
Low vertical = lower third but up and down.
Classic = emergent, top part - up and down.
2 staff members needed for mom when getting up after cesarean - t/f?
true - don’t want her to fall!
