Intrapartum Flashcards
1
Q
How many cm is active labor
A
3-6 cm
4 cm
2
Q
it is the care given during the delivery
A
Intrapartum Care
3
Q
Why should the mother avoid lying flat
A
decrease fetal heart rate abnormalities
less pain
4
Q
best birthing position
A
upright
5
Q
surgical cut of vagina
A
Epistiotomy
6
Q
two kinds of epistiotomy
A
Media Lateral
Median/Midline
7
Q
Safest way of Episiotomy
A
Media Lateral
8
Q
is routine episiotomy recommended or not
A
not recommended
9
Q
4 stages of labor
A
1st - Cervix Dilatation
2nd > Delivery of the baby
3rd> expulsion of the placenta
4th> recovery stage
10
Q
stage of labor where it is shortest and most critical
A
3rd stage
11
Q
what position of mother during DR
A
Lithotomy Position (68%)
4% is upright
12
Q
surgical procedure wher ethe vaginal outlet is incised just prior t delivery to extend the passageway of the newborn
A
Episiotomy
13
Q
is episiotomy required
A
not required for primipara
14
Q
indications that episiotomy should be done
A
fetal distress
risk of tearing
15
Q
why is episiotomy done to primipara
A
aid in deivery/ prevent rupture of tissue
16
Q
what is used for the 3rd stage of labor
A
Prophylactic Oxytocin
17
Q
Drug used to stimulate uterine contraction
A
Oxytocin
18
Q
how many minutes-hour for primipara is the 3rd stage of labor
A
30-1hour
19
Q
how many minutes-hour for primipara is the 3rd stage of labor
A
30-1hour
20
Q
what is done before administering oxytocin
A
- Palpate to check for twins
- Check bp
- check if placenta is complete
21
Q
what is placed at fundus during the manual extraction procedure
A
ice
22
Q
it is a procedure done of placenta is not expulsed after an hour of the 3rd stage labor
A
Manual Extraction
23
Q
How many minutes in delayed cord clamping
A
1-3 mins
24
Q
Rationale for Delayed Cord Clamping
A
- allow remaining blood from placenta to bab- -bring nutrients(iron) & blood to baby
have greater iron storage 3-6 months after burth
25
___ it js a traction applied to the umbilical cord once the woman’s uterus has contracted after the birth of her baby, and her placenta is felt to have seperated from the uterine wall
Controlled Cord Traction
26
___ traction of the placenta pressure applied to her uterus beneath her pubic bone until placenta felivers
Counter traction
27
why cct with ct is done
precent PPH
28
rationale for uterine massage after placental delivery
stimulate uterine contraction (help the blood clot na maka prevent sa contractuon)
- prevent sa mga heavy blredin- dili puyde mo relax and uterus kay mo bleed heavily
29
Clots that may have accumulated in the uterine cavity interfere with the ability of the uterus to contract effectively.
true or false
true
30
stage of labot
the time between the birth of the baby and the delivery of the placenta
3rd stage
31
what is the purpose of active management of the 3rd stage of labor
prevent PPH
avoid tranfusion of blood products
32
3 components of AMSTL
1. Administer uterotonic (1 minute after delivery(
2. CCT with ct
3. Uterine Massage
33
what is the primary drug of choice with adminstering uterotonic
Oxytocin
34
how much does a mother need for oxytocin
1 ampule - 10 IU@ deltoid
35
3 Practices not recommended during delivery
1. Coaching to push
2. Perineal massage during 2nd stage
3. Fundal Pressure during 2nd arage
36
this procedure can cause Shoulder Dystocia kf the baby
Fundal Pressure
37
it is the cleansing of the perineum in a Systematic manner
Perineal Care
38
the region of the body between the anus and the pubis (urethral opening).
Perineum
39
Perineum or in other words
Diamond Shape
40
3 reasons WHY we should do perineal care
remove perineal secretions/odors
Prevent infection (bcs of further complications)
so that clean sya before of after birth or surgery
41
first step of perineal care
Check to see specific physician’s orders to be followed. (to ensure accuracy)
42
what position should the client be in when doing the perineal care
Dorsal Recumbent Position
43
what temp should the water be in perineal care
Warm Sterile Water over vulva
44
what techniue used during perineal care
9 cotton ball technique
45
what technique is used during the perineal care
9 cotton ball technique
46
what technique to used during perineal carr
9 cotton ball technique
47
during perineal flushing, what position should the client be in?
Lithotomy/upright position
48
during perineal flushing, what position should the client be in?
Lithotomy/upright position
49
in picking the cotton ball what forcep is used
pick up forcep then transfer to handling forcep
50
unsa ang space betweent eh pitcher kg sa vagina kung mo pour na
1 foot away
51
Specific manner in covering the woman for delivery applying the sterile
technique.
draping
52
WHY IS THE PURPOSE OF DRAPING GIVE ME 2
provide sterility during dr
prevent pospartum neonatal infection
53
position for the client when draping
lithotomy
54
in draping, should we use stirrups
yes & adjust it according to size of client
55
why should we iInstruct and assist client to place her buttocks at the edge of the delivery
table and hands on her sides. during draping
to facilitate insertion
56
why should we seperate the legs and flex the thighs. Elevate the legs and support them
with stirrups. during draping
to relax the abdominal muscles
57
When draping the client with clean hands,
The same steps are followed except the
ungloved hands should remain holding the
inside part.
true or false
true
58
when removing the drape, why should we perform perineal washing
to remove blood etc during delivery or surgery
59
sterile or clean filled coverings of hands with separate sheath of each finger & thumb.
gloves
60
are worn when there is contact with sterile instruments or patients sterile part.
sterile gloves
61
re worn to protect the health care providers from urine, stool, blood, saliva & drainage from wound & lesions, & protect patients from health personnel who may have cuts.
clean gloves
62
– are worn to protect the health care providers from urine, stool, blood, saliva & drainage from wound & lesions, & protect patients from health personnel who may have cuts.
clean gloves
63
Gloves must be changed between procedures on the same patient.
true or false
true
64
Examination gloves **must not be worn outside the patient’s room** except for certain procedures.
true or false
true
65
Special considerations of gloving
1. Size
2. Sterile or clean
3. replace gloves that are torn etc
4. latex may cause allergy
5.before performing or assisting, you must know the procedure to be performed first
66
Grasp the folded edges of the __ package using __ finger & __ of each hand.
inner, index and thumb
67
cuff of gloves is ___ wide
2-3 inches wide
68
Open the inner package by touching only the ___ of the package.
bottom
69
worn by ones delivering the chilf
sterile gloves
70
worn by ones assisting the delivery
clean gloves
71
refers to the dilation (opening) of the cervix and the surgical removal of the contents of the uterus
Dilatation & curettage
72
what us the purpose of dilatation and curettage
- resolve any bleeding
- remove any tussue
also for giagnkstic examination
73
7 Dilatation and curettage Set
Heavy Weight retractor
Sim’s Retractor
Tenaculum
Hysterometer/uterine sound
Curette
Uterine Forceps
Ovum Forceps
74
additional instruments for primigravjda
additional glove
ovum force
needle holder
5cc syringr with needle
additional scissor
additional gauzr
tissue forceps
needle with suture
75
clamp the upper anterior tip of the cervix
Tenaculum
76
it dilates the posterior wall
heavy weight retractor
77
dilate the anterior wall
sim’s retractor
78
measure the depth of the uterus, contour shape and position
hysterometer/uterine sound
79
scrape the uterine content
Curette
80
dilate the cervical opening
help push gauze inside the uterus
uterine forceps
81
remove the uterine contents
ovum forceps
82
prior to the woman’s transfer in DR why should we communicate to client if she want to eat or drink
maintain hydration anf nutritional status of client
83
what should do prior to transfer to dr
if she want to eat or drink
ask if she want to have support
- if she is comfortable position
84
what should ve the humifity of the room in FT
25-28 degree celcius
eliminate airdraft
85
why dhould we position client in semi upright position in DR table
to facilitate the descent of fetus during bearing diwn with contraction
86
why should we place clean dry linen on the mother’s abdomen
to absorm fluids/discharges from the body/ keep the baby dry
87
during the delivery, what is the rationale why we should apply perineal support and gently control the deivery of the head
prevent laceration of cervical vaginal walls perineum
88
why palpate the lower abdomen (during delivery) tas na gwa ang bb
para ma determine if may tein para prepre pod sa pag administer sa oxytocin
89
steps of AMSTL
- administration of oxytocin
- Controlled cord traction and counter traction
- uterine massage
90
when do we apply the CCT and CT
we shoudl wait for a strong uterine contaction then apply CCT and CT on uterus until placenta is delivered
91
how do you decontaminate (during delivery
soak instruments/ decontaminate before washing
THEN soak the second pair of gloved in ANTISEPTIC solution for 10 minutes
92
why should we insteuct mother skin to skin and haby head turn to one side
maintain breathing/ keep bb warm
93
when do we insteuct mothers for heeding cues
after 15-90 minutes
94
why delay bathing of bb
keep baby warm and prevent loss of heat
95
AFTER 15-90 MINUYES sa delivery na
first and second hour what should you do
1st hour > check vitals and massage uterus
2nd hour> check mother/baby every 30 mins to 1 hr
96
Final assessment (3)
1. check sa bleeding
2. check sa mga instruments if complete
3. kwa virals and lantaw sa condition sa mom
97
is applying ice pack on pubic area part of the immediate post partum care?
yes
