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OB > High Risk Labor/Birth > Flashcards

High Risk Labor/Birth Flashcards

1
Q

dystocia

A

dysfunctional/difficult labor and common reason for C-section

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2
Q

most concerning side effect of dystocia is

A

tachysystole

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3
Q

associated factors of dystocia

A

weak contractions, fetal presentation/position/development, not good pelvis

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4
Q

uterine dystocia

A

weak or uncoordinated contractions

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5
Q

hypotonic uterine dystocia

A

low tone, no dilation, long labor, no fetal perfusion, exhaustion/infection, fetal asphyxia,

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6
Q

risk factor of hypotonic dystocia

A

multiparous women

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7
Q

management of hypotonic dystocia

A

oxytocin, amniotomy, c section

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8
Q

hypertonic dystocia

A

uncoordinated frequent contractions, painful, exhaustion

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9
Q

risk factor of hypertonic dystocia

A

nulliparous women

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10
Q

manage hypertonic dystocia

A

hydration, pain meds, monitor

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11
Q

nursing interventions for hypo dystocia

A

assess fetal/maternal status, admin oxytocin, minimize vag exams

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12
Q

nursing interventions for hyper dystocia

A

pain meds(morphine), epidural, relax, hydrate

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13
Q

long second stg of labor disorder is from

A

delayed pushing, epidural, BMI over 35, macrosomia, occiput posterior, high fetal station

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14
Q

risks of long second stg labor

A

mortality, fetal asphyxia, perineal trauma, no natural birth

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15
Q

manage long second stg labor

A

monitor, pitocin, vacuum/forceps, consider c-section

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16
Q

nursing actions of long second stg labor

A

coach pushing, open glottis pushing, pain relief, change positions, support

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17
Q

precipitous labor

A

less than 3 hr delivery w increased pain/anxiety

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18
Q

precipitous labor risk factors

A

grand multiparas, hx of precipitous

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19
Q

risks of precipitous labor

A

PPH, fetal hypoxia/CNS depression if mother given narcotics

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20
Q

nursing actions of precipitous labor

A

monitor FHR every 15 mins, assess cervix change, anticipate complications

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21
Q

fetal dystocia

A

fetus delaying delivery

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22
Q

causes of fetal dystocia

A

macrosomia, malpresentation, multifetal preg, fetal anomaly

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23
Q

risks of fetal dystocia

A

asphyxia, injuries, maternal lacerations, cephalopelvic disporportion

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24
Q

labor induction (medically only)

A

oxytocin, cervical ripening, strip membranes, amniotomy

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25
Q

induction of labor

A

start of contractions before spontaneous onset to cause birth

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26
Q

cervical ripening

A

softening cervix with cervidil/cytotec

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27
Q

mechanical methods of induction

A

balloon cath, dilators, amniotic membrane stripping

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28
Q

amniotomy

A

AROM w pitocin but presenting part must be at least -2 or below

29
Q

oxytocin induction

A

when cervix is a bishop score of 8 or more

30
Q

risks of oxytocin induction

A

tachysystole, category 2/3 FHR, failed induction, water intoxication

31
Q

augmentation

A

stimulation of contraction when labor fails to progress

32
Q

nursing actions of inducing labor

A

informed consent, auscultation, fetal monitoring, FHR, assess strength, duration and frequency, monitor dilation/descent, amniotic fluid

33
Q

external cephalic version

A

change fetal position vertex and often give terbutaline to relax uterus

34
Q

contraindications of external cephalic version

A

placental abnl

35
Q

risks of external cephalic version

A

severe variable decels

36
Q

vacuum assisted delivery

A

easier to apply, less anesthesia, less tissue irritation, fewer injuries

37
Q

effects of vacuum assisted

A

cephalic hematoma

38
Q

forceps

A

vag lacerations, tissue/perineal damage, hemorrhage, hematomas, bladder trauma

39
Q

effects of forceps

A

facial bruise, corneal abrasions, skull fracture, hemorrhage

40
Q

trial of labor after c-section/vaginal birth after c-section

A

fewer risks for mother, fetal hypoxia, neuro issues, acidosis, seizures, cerebral palsy, death

41
Q

post term preg risk to mom

A

dysfunctional labor, infection, PPH, poor blood flow to placenta

42
Q

post term preg risk to fetus

A

Stillbirth, macrosomia, post maturity syndrome, oligo, meconium aspiration

43
Q

meconium stained fluid

A

GI maturation/neural stimulation as a result from hypoxic stress that can easily be aspirated

44
Q

meconium stained fluid maternal risk

A

difficult labor, perineal injuries, infection, PPH, anxiety

45
Q

meconium stained fluid fetal risk

A

stillbirth, macrosomia, dysmaturity, oligo, aspiration/resp distress, placenta insufficiency

46
Q

multiple gestation risks

A

PPH, preeclampsia, PTB, labor dystocia

47
Q

manage multiple gestation

A

IV, positions, blood prn

48
Q

intrauterine fetal demise

A

fetal death after 20 wks

49
Q

risk factors of fetal demise

A

age, african, 1st time mom, obese, diabetes, hypertension, ART, smoking/alc, multi gestation, male fetus

50
Q

intraamniotic infection (chorioamniotitis)

A

infection of fluid, lining, membrane, placenta

51
Q

S/S of chorioamniotitis

A

fever, tachycardia, high WBC over 1500, discharge

52
Q

nursing actions of chorioamniotitis

A

cultures, antibiotics, blood transfusion if loss of 500cc or more

53
Q

pregestational complications

A

shoulder dystocia, macrosomia, high hemorrhage risk, delayed wound healing, DVT, infection

54
Q

shoulder dystocia

A

shoulder coming out first

55
Q

maternal risks of shoulder dystocia

A

perineal lacerations, bladder injury, hemorrhage, trauma

56
Q

management of shoulder dystocia

A

dont want more than 5 mins btw head and body delivery

57
Q

fetal risks of shoulder dystocia

A

asphyxia, neuro injury, intracranial pressure, death

58
Q

umbilical cord prolapse

A

cord coming out first so nurse must stick fingers in to relieve pressure and give C-section

59
Q

vasa previa

A

blood vessels run in front of cervix blocking exit and can pop causing blood loss

60
Q

risk factors of vasa previa

A

low laying placenta, multiple gestation, IVF

61
Q

manage vasa previa

A

odd FHR and bleeding indicate this

62
Q

uterine rupture

A

separation of uterine muscle common from previous C-section

63
Q

risks of uterine rupture

A

fetal shock/compromise, maternal shock/hemorrhage

64
Q

amniotic fluid embolism/anaphylactic syndrome

A

amniotic fluid enters maternal circulation causing proinflammatory response, acute pulmonary hypertension and cardiovascular failure/arrest, DIC

65
Q

risk factors of AFE

A

older, multi gestation, labor induction, vacuum/forceps, pre/eclampsia

66
Q

DIC

A

Body breaking down blood clots faster than they can form them and deplete bodies clotting factors leading to hemorrhage and maternal death

67
Q

DIC cause

A

placental abruption, amniotic fluid/anaphylactic syndrome, HELLP syndrome, precreta

68
Q

DIC S/S

A

Low UO, cyanosis, LOC, chest pain

OB (9 decks)

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