Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

332 > Intra-Partum Complications > Flashcards

Intra-Partum Complications Flashcards

1
Q

What are the two phases of labour?

A

Latent and active.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How long can the latent phase of labour last? When do we know its over?

A

Two days. Over when regular contraction pattern is established and cervix is 3-4 cm dilated.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What occurs during the active phase of labour? What are the contractions like?

A

Cervix dilation of 3-10 cm. Contractions are strong, regular and effective. Every 2-3 min apart and at least 60 sec rest in between each. 3-4 contractions in 10 min.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What occurs in each stage of labour (1-4)?

A

1 - labouring and dilation. 2 - pushing, descent and delivery. 3 - placenta delivers. 4 - hemostasis established.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What does dystocia mean?

A

Difficult labour.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Dystocia causes an increased risk for what? (5)

A

Hemorrhage, infection, uterine rupture, fistula development, urinary/fecal incontinence.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are hypotonic contractions? What are two things that can cause hypotonic contractions? What can be administered to make hypotonic contractions more regular and effective? What should we get the mom to do every 2 hours? What can happen to the uterus with hypotonic contractions?

A

Number of contractions is infrequent/weak. Bowel/bladder distention, and admin of analgesia to early in labor. Oxytocin to regular contractions (can cause hypertonic contractions thought, need 1:1 care). Urinate every 2 hours. Exhausted uterus = increased risk for PPH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are hypertonic contractions? What can they lead to? What should we monitor? What might be necessary if we see a deceleration in FHR?

A

Stronger and more painful contractions than usual. Can lead to fetal anoxia from lack of relaxation between contractions. Monitor FHR and uterus contractions. C-section.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What do uncoordinated contractions indicate? What can they interfere with? What do we need to monitor? What can we administer to make contractions more effective?

A

Fetal head isn’t fitting well into pelvis. Can interfere with blood supply to placenta. FHR and uterus contractions. Oxytocin.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are major risk factors for problems with “the powers”? (5)

A

Dehydration, macrosomic infants, advanced maternal age, grand multipara (>6), multiple gestation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What does Cephalopelvic Disproportion (CPD) mean?

A

Fetal head is too large for birth canal.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the Pathologic Contraction Ring (Bandl’s ring)?What is a risk? What needs to be done if this happens?

A

Abnormal junction between two segments of the uterus. Uterine rupture. C/S.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What type of pelvis is the easiest to deliver a baby from?

A

Gynecoid pelvis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

In which situations does a prolapsed umbilical cord occur in? (4)

A

PROM, fetal presentation other than cephalic, placenta previa, LBW

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

If a prolapsed cord occurs, what should be done?

A

Manually move head off of cord to prevent compression and compromise to fetal blood supply.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Which delivery is done for a multiple gestation… why?

A

C-Section to reduce fetal anoxia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Which fetal positions are deliverable? Which ones aren’t?

A

Vertex or breech. Longitudinal (shoulder).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is an issue with breech delivered babies?

A

We don’t know if they’re head will fit in the birth canal (CPD)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Which fetal presentation is the most favourable?

A

Occiput anterior.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Which fetal presentations are deliverable but risky?

A

Occiput posterior, military, asynclitic, face.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Which fetal positions are not deliverable?

A

Brow, transverse (shoulder)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What issues result in an issue to the “passenger” in regards of delivery?

A

Macrosomia and shoulder dystocia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What do we do if mom experiences shoulder dystocia?

A

HELPER. Call for Help, Episiotomy, Legs into McRoberts, Pressure (hand on symphysis to push shoulder off of bony prominence), Enter, Rotate (snap clavicle)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

How often are we checking VS of the fetus during first stage of labour? Second stage of labour?

A

q 15. q 5.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

When would we want to use an electronic FHM?

A

High risk or non-reassuring FHR

26
Q

What is the baseline of the fetus HR? What is normal range of variability? When do we normally see acceleration of the FHR? For how long usually?

A

110-160 bpm. 15 - 25 bpm. During contraction for 15 sec.

27
Q

Why is variability in FHR important?

A

Tells us that fetus is healthy.

28
Q

What do early decelerations indicate? When are these normal to have?

A

Head compression. Labour with contractions.

29
Q

What do late decelerations indicate?

A

Fetal hypoxia

30
Q

What do variable decelerations indicate?

A

Cord compression.

31
Q

What do we do if we have a macrosomic infant?

A

HELPER

32
Q

How can we aid along delivery if there is an issue with the “passage” or birth canal?

A

Forceps or vacuum extraction.

33
Q

What are the indications for forceps delivery? What are some risks associated with this type of delivery?

A

Mom cannot push any more or fetus is showing late decels. Trauma to baby/mom, nerve damage, insult to skin.

34
Q

What are indications for vacuum extraction? What are risks associated with this? Who cannot be vacuum extracted?

A

Mom has no energy to push/fetal oxygen stores are depleted. Chignon formation (edema under scalp), can tear the dura mater, intracranial bleed. Can’t use on premature baby because the bones of skull are substantially softer.

35
Q

What is the maximum of hours a mom should push for?

A

2 hours

36
Q

What things affect the “psyche”?

A

Fear, adrenaline (prolong labor), environment, support.

37
Q

What developmental tasks may be interrupted by pregnancy in adolescents (4)?

A

Establish sense of self-worth, choose a vocation, emancipate from parents, adjust to new body image.

38
Q

What 7 prominent complications are associated with pregnancy in adolescents?

A

Gestational HTN, iron deficiency anemia, preterm labour, CPD, PPH, inability to adapt post-partally, lack of knowledge about infant care.

39
Q

What are unique considerations for a physical assessment of a pregnant woman 40 years and older (3)?

A

Look for variscosities, urine spec for glucose/specific gravity/protein (evaluate overall renal fx and T2DM/gestational DM), assess breasts for lumps.

40
Q

What chromosomal risk is associated with increased maternal age?

A

Down Syndrome

41
Q

How do we test for Down Syndrome? (5)

A

Nuchal translucency seen in DS… AFP, hCG, inhibin A, estriol will all be lower than normal in DS.

42
Q

What are 4 prominent complications of pregnancy and advanced maternal age?

A

Gestational HTN, PPH, failure to progress in labor, difficulty accepting the event.

43
Q

What harm can occur to fetus/mom from coke use (2)? What SS might be seen in newborn/mom (3)?

A

Premature separation of placenta (because of extreme vasoconstriction) resulting in preterm labor or fetal death. Tremulousness, irritability, muscle rigidity.

44
Q

What harm can occur to fetus/mom from amphetamine use? SS (3)?

A

Similar to coke. Jitteriness, poor feeding, IUGR.

45
Q

What harm can pot do to mom/fetus? Where is drug excreted?

A

Not well documented. Breast milk.

46
Q

What harm can phencyclidine do to mom/fetus? SS (3)?

A

Concentrates in fetal cells. Euphoria, irritation, hallucinations.

47
Q

What complications are there to mom from heroin (5)? For fetus (5)? Abstinence symptoms in babe?

A

Gestational HTN, hep B, phlebitis, subacute bacterial endocarditis, HIV. Opiate dependency, abstinence symptoms, IUGR, fetal distress, MAS. Poor feeding, diarrhea, high-pitched cry, poor sleep.

48
Q

What harm can alcohol to do fetus during pregnancy?

A

FASD, cognitive challenges.

49
Q

What harm can inhalants do to fetus during pregnancy?

A

Similar to alcohol. Cognitive challenges.

50
Q

What 6 risk factors predispose a woman to uterine rupture? SS? What is the management? What might need to be done to save fetus life

A

Prolonged labor, abn presentation, multiple gestation, unwise use of oxytocin, forcep trauma. No contractions, localized tenderness to one area of uterine segment, change in VS, lack of fetal heart sounds. IVF, IV oxytocin, lap. surgery to control bleed. C/S.

51
Q

What two events cause uterus inversion? SS? Management? How can we avoid an inversion (3)?

A

Child birth or delivery of placenta. Large amount of blood suddenly rushes out of vagina. IVF, O2 by mask, VS, nitro/general anesthesia (relax uterus), manually replace fundus. C/S for future pregnancy to avoid another inversion, don’t apply pressure to fundus when uterus is not contracted, don’t apply traction to UC.

52
Q

How does woman with amniotic fluid embolism usually present (5)? What is this condition associated with? Can we prevent this?

A

CP, inability to breathe, pale and cyanotic, unconscious. Induction of labor, multiple pregnancy, hydraminos. Can’t be prevented because it can’t be predicted.

53
Q

What is placenta succenturiata?

A

One or more accessory lobes attached to placenta.

54
Q

What is placenta circumvallata?

A

Fetal side of placenta covered with chorion.

55
Q

What is battledore placenta?

A

UC is marginally inserted into placenta instead of centrally.

56
Q

What is velamentous insertion of the cord?

A

Cord separates into small vessels instead of entering placenta directly. Spread across fold of amnion.

57
Q

What is vasa previa?

A

UC insertion across cervical os and delivers before fetus.

58
Q

What is placenta accreta?

A

Unusually deep attachment of placenta to uterine myometrium.

59
Q

What is a two-vessel cord (UC)?

A

Absence of one of two umbilical arteries.

60
Q

What is unusual cord length? What is short associated with (2)? Long?

A

Premature separation of placenta or abn fetal lie. Twist/knot/nuchal cord.

61
Q

What two types of things that show up on a FHR monitor worry nurses?

A

Loss of variability, late decelerations.

62
Q

What is the main cause of shoulder dystocia?

A

Macrosomia

332 (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions