Final - 1 Reproduction Flashcards
VEAL CHOP
V: variable accelerations E: early decelerations A: accelerations L: late decelerations C: cord compression H: head compression O: okay P: placental-utero insufficiency
Is it bad or good to have early decelerations
Good!
Pressure on the baby’s head causes _____ response
vagal
Early Decelerations: - _____ intervention needed - get ready for _____ - the _____ and _____ line up
- no intervention needed - get ready for baby - the contraction & variable line up
Is it bad or good to have late decelerations
BAD!!!!!
What is happening with late decelerations
uteroplacental O2 deficiency
Late Decelerations: - roll mom onto her _____ - give _____, _____, etc - the contraction and variable d_____ line up
Late Decelerations: - roll mom onto her side - give O2, fluids, etc - the contraction and variable don’t line up
Variable Decelerations: - roll mom _____ to _____ (get baby off the _____) - start _____ (_____ baby off the cord)
Variable Decelerations: - roll mom side to side (get baby off the cord) - start amnioinfusion (float baby off the cord)
What is happening with prolonged decelerations
prolonged uteroplacental deoxygenations (placental abruption, prolapsed cord, etc)
Does a prolonged decelerations every come back up
No!
What do you do for prolonged decelerations
attempt interventions for variables and late decelerations, then cesarean-section
Early Decelerations
Late Decelerations
Variable Decelerations
Prolonged Decelerations
Factors Affecting Labor ( P’s)
- Passenger (fetus)
- passageway (the birth passage)
- powers (physiological forces of labor)
- position (relation between fetus & passageway
- psychological considerations
Normal Processes & Stages of Labor “Cardinal Movements)
Every Day Fine Infants Enter Eager & Excited:
- engagement
- descent
- felxion
- internal rotation
- extension
- external rotation
- expulstion
Nitrazine paper will turn _____ in presence of amniotic fluid
- yellow or green may mean _____
blue
- yellow or green may mean meconium
True/False Labor:
- regular interval for contractions
- increase in intensity & frequency
- unrelieved with rest
true
True or False Labor:
- irregular intervals for contractions
- no change in duration and frequency
- contractions relieved with rest
nulliparas:
contractions 5 min. apart x 1 r
Multiparas:
contractions 6-8 min. apart x 1 hr
Measured from beginning of 1 contractions to the end or completion of same contraction
length
measure either by palpation or internal monitor
strength
measure from beginning of one contraction to beginning of the next contraction
frequency
how many stages of labor
4
Which stage of labor:
- onset of contractions to complete cervical dilation
first stage
3 phases of first stage
- latent
- active
- transitional
nursing intervention for first stage
frequent monitoring of pt. and labor progression
Which stage of labor:
- complete cervical dilation to birth
- variable, pushing stage
second stage
Which stage of labor:
- birth to delivery of placenta
- placenta is guided out as expelled; watch for _____
third stage
- watch for hemorrhage
Which stage of labor:
- initial recovery
- monitor VS as scheduled & lacerations degrees
- will have slight _____ in BP, slight _____ in HR, uterus will be _____ & firm = normal
Fourth stage
- slight decreased BP
- slight increased HR
- normal uterus = midline & firm
1 cm cervical dilation =
cheerios
3 cm cervical dilation
slice of banana
4 cm cervical dilation
cracker
7 cm cervical dilation
soda can
10 cm cervical dilation
bagel
opioid agonists
fentanyl or morphine
opioid agonist-antagonist
nubain or stadol
Use analgesic in _____ stages of labor to prevent _____ _____ in newborn at delivery
use analgesic in early stages of labor to rpevent respiratory depression in newborn at delivery
analgesics shoudl only be given _____ hrs or more before delivery
analgesics shoudl only be given 4 hrs or more before delivery
analgeics can cause
1) _____ _____
2) _____ fetal HR
analgeics can cause
1) respiratory depression
2) decreased fetal HR
short acting, one injection directly into spinal fluid, can last up to 2 hours
Spinal block
longer acting, catheter inserted into epidural space to allow continuous anesthesia
Epidural
¨Uses local anesthetic (lidocaine or bupivacaine), opioid analgesic injection for immediate relief into spinal fluid, and insertion of epidural catheter into epidural space for continuous anesthesia, may be controlled by PCA
CSE – Combined Spinal / Epidural (most common)
Only for emergencies or if epidural contraindicated
general pain control
_____ monitors:
- transducer
- tocodynamometer
External monitors
_____ monitors:
- fetal scalp electrode
- intrauterine pressure catheter
interal monitors
Does external or internal fetal monitors measure strength of contractions
internal
Need at least ____ minutes of monitoring and _____ minutes of consistent baseline tracing to determine baseline
Need at least 10 minutes of monitoring and 2 minutes of consistent baseline tracing to determine baseline
_____ tracing is gold standard for determining if baby is well oxygenated. This is when FHR has normal baseline with moderate variability and 2 or more accelerations in a 20 minute period.
Reactive tracing is gold standard for determining if baby is well oxygenated. This is when FHR has normal baseline with moderate variability and 2 or more accelerations in a 20 minute period.
Minimum timeframe for FHR monitoring is _____ minutes if tracing is reactive. Longer if there are alterations in tracing
Minimum timeframe for FHR monitoring is 20 minutes if tracing is reactive. Longer if there are alterations in tracing
Precipitous Delivery:
Labor that progresses so rapidly (typically less than _____ hours from onset to delivery)
Important to stay calm.
Control the delivery of the head by supporting the _____.
Get help from the other staff and call the provider quickly.
Precipitous Delivery:
Labor that progresses so rapidly (typically less than 3 hours from onset to delivery)
Important to stay calm.
Control the delivery of the head by supporting the perineum.
Get help from the other staff and call the provider quickly.
abnormal size or shape of pelvis
cephalopelvic disproportion (CPD)
head delivers but not the shoulders; can be related to the size of the fetus but does occur in normal-sized fetus. Signs of impending shoulder dystocia include the slowing of progress or increasing formation of caput succedaneum; treatment is McRobert’s maneuver.
shoulder dystocia
Most difficult to deliver is _____ _____.
- The back of the baby’s head is against the mother’s back.)
occiput posterior
persistent lates or variables =
fetal distress
occurs }when cord comes before the presenting part; may be obvious or concealed.
prolapsed cord
