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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
induction of labor
start of contractions before spontaneous onset to cause birth
26
cervical ripening
softening cervix with cervidil/cytotec
27
mechanical methods of induction
balloon cath, dilators, amniotic membrane stripping
28
amniotomy
AROM w pitocin but presenting part must be at least -2 or below
29
oxytocin induction
when cervix is a bishop score of 8 or more
30
risks of oxytocin induction
tachysystole, category 2/3 FHR, failed induction, water intoxication
31
augmentation
stimulation of contraction when labor fails to progress
32
nursing actions of inducing labor
informed consent, auscultation, fetal monitoring, FHR, assess strength, duration and frequency, monitor dilation/descent, amniotic fluid
33
external cephalic version
change fetal position vertex and often give terbutaline to relax uterus
34
contraindications of external cephalic version
placental abnl
35
risks of external cephalic version
severe variable decels
36
vacuum assisted delivery
easier to apply, less anesthesia, less tissue irritation, fewer injuries
37
effects of vacuum assisted
cephalic hematoma
38
forceps
vag lacerations, tissue/perineal damage, hemorrhage, hematomas, bladder trauma
39
effects of forceps
facial bruise, corneal abrasions, skull fracture, hemorrhage
40
trial of labor after c-section/vaginal birth after c-section
fewer risks for mother, fetal hypoxia, neuro issues, acidosis, seizures, cerebral palsy, death
41
post term preg risk to mom
dysfunctional labor, infection, PPH, poor blood flow to placenta
42
post term preg risk to fetus
Stillbirth, macrosomia, post maturity syndrome, oligo, meconium aspiration
43
meconium stained fluid
GI maturation/neural stimulation as a result from hypoxic stress that can easily be aspirated
44
meconium stained fluid maternal risk
difficult labor, perineal injuries, infection, PPH, anxiety
45
meconium stained fluid fetal risk
stillbirth, macrosomia, dysmaturity, oligo, aspiration/resp distress, placenta insufficiency
46
multiple gestation risks
PPH, preeclampsia, PTB, labor dystocia
47
manage multiple gestation
IV, positions, blood prn
48
intrauterine fetal demise
fetal death after 20 wks
49
risk factors of fetal demise
age, african, 1st time mom, obese, diabetes, hypertension, ART, smoking/alc, multi gestation, male fetus
50
intraamniotic infection (chorioamniotitis)
infection of fluid, lining, membrane, placenta
51
S/S of chorioamniotitis
fever, tachycardia, high WBC over 1500, discharge
52
nursing actions of chorioamniotitis
cultures, antibiotics, blood transfusion if loss of 500cc or more
53
pregestational complications
shoulder dystocia, macrosomia, high hemorrhage risk, delayed wound healing, DVT, infection
54
shoulder dystocia
shoulder coming out first
55
maternal risks of shoulder dystocia
perineal lacerations, bladder injury, hemorrhage, trauma
56
management of shoulder dystocia
dont want more than 5 mins btw head and body delivery
57
fetal risks of shoulder dystocia
asphyxia, neuro injury, intracranial pressure, death
58
umbilical cord prolapse
cord coming out first so nurse must stick fingers in to relieve pressure and give C-section
59
vasa previa
blood vessels run in front of cervix blocking exit and can pop causing blood loss
60
risk factors of vasa previa
low laying placenta, multiple gestation, IVF
61
manage vasa previa
odd FHR and bleeding indicate this
62
uterine rupture
separation of uterine muscle common from previous C-section
63
risks of uterine rupture
fetal shock/compromise, maternal shock/hemorrhage
64
amniotic fluid embolism/anaphylactic syndrome
amniotic fluid enters maternal circulation causing proinflammatory response, acute pulmonary hypertension and cardiovascular failure/arrest, DIC
65
risk factors of AFE
older, multi gestation, labor induction, vacuum/forceps, pre/eclampsia
66
DIC
Body breaking down blood clots faster than they can form them and deplete bodies clotting factors leading to hemorrhage and maternal death
67
DIC cause
placental abruption, amniotic fluid/anaphylactic syndrome, HELLP syndrome, precreta
68
DIC S/S
Low UO, cyanosis, LOC, chest pain

OB (9 decks)

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