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Obstetrics > Intrapartum Care > Flashcards

Intrapartum Care Flashcards

1
Q

Before placement of epidural

What CBC labs are specifically looked into?

A

Platelets

(low platelets; risk for hemorrhage)

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2
Q

before placement of epidural

Vital signs must be checked because it can cause what?

A

Epidurals can cause a hypotensive reaction.

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3
Q

before placement of epidural

What can decrease risk of hypotension?

A

IV access and bolus

Reduce risk of hypotension

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4
Q

after placement of epidural

what instrument must be in place?

(Not IV, since this is AFTER epidural placement)

A

Urinary Catheter

Patient is no longer able to get up and move around.

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5
Q

When should APGAR be assessed?

A

1 and 5 minute of birth

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6
Q

Describe the APGAR assessment

A
  • Appearance = Color
  • Pulse Rate = HR
  • Grimace = cries w/ stimulation
  • Activity = Flexion and resist extension
  • Respiratory effort = Strong cry observed
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7
Q

What APGAR score would require a further evaluation?

A

If < 7 on five minute assessment

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8
Q

What is the primary goal of external fetal heartrate monitoring?

What is it to prevent?

A

To continually assess fetal oxygenation

fetal acidemia and minimizing unncessary interventions

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9
Q

What are the contraindications for internal FHR monitoring?

A

Chorioamnionitis, active genital herpes, GBS+, HIV, placenta previa

Chorioamnionitis is infection of amniotic fluid and tissue

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10
Q

Which type type of FHR monitoring allows for objective measures of uterine contractions (mmHg)

A

Internal fetal heart monitoring

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11
Q

What does collecting umbilical cord help determine?
What does the blood from the vein and artery represent?

A
  • severity of hypoxia during labor
  • Vein assess oxygen supply and artery assess amount of oxygen used by fetus.
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12
Q

What is normal fetal heart rate?

A

110 to 160 bpm

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13
Q

what is fetal tachycardia baseline?

A

> 160 bpm for at least 10 min

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14
Q

what is fetal bradycardia baseline?

A

< 110 bpm for at least 10 min

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15
Q

How is normal FHR baseline assessed
Does it include accelerations and decelerations?

A

FHR is rounded to 5 bpm in 10-minute window of time, excludes accelerations and decelerations.

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16
Q

What is the following called?

Fluctuations from baseline FHR that are irregular in amplitude and frequency (excludes accelerations and decelerations)

A

Baseline variability

Fetal Heart Monitioring graph

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17
Q

Describe absent variability

A

Amplitutde range is undetectable

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18
Q

Describe minimal variability

A

amplitude range is ≤ 5 bpm

19
Q

Which type of variability is normal?

A

Moderate variability

20
Q

Describe moderate variability

A

amplitude from peak to trough is 6-25 bpm.

21
Q

Describe marked variability

A

amplitutde > 25 bpm

22
Q

What is an FH acceleration?

A

visually abrubt increase in FHR above baseline
≥ 15 bpm lasting for 15 sec but < 2 min

23
Q

Baseline variability represents an interaction of what?

A

sympathetic and parasympathetic fetal system

24
Q

a tear in the pernieum during labor is called what?

A

Laceration

25
Q

____ is a purposeful incision in the pernieum to provide more space for the presenting part at delivery

A

Episitomy

26
Q

What degree laceration is this?

tear in perineal skin and vaginal mucous membrane

A

1st deree laceration

27
Q

What degree laceration is this?

tear in perineal skin & muscle, and vaginal mucous membrane

A

2nd deree laceration

28
Q

What degree laceration is this?

tear in perineal skin, muscle, vaginal mucous membrane, and just before rectum.

A

3rd degree laceration

29
Q

What degree laceration is this?

tear in perineal skin, muscle, vaginal mucous membrane, and rectum.

A

4th degree laceration

30
Q

What is early deceleration?

A

When mother has a contraction babies HR drops at the SAME time.

(Mirrors Contractions)

31
Q

What is late deceleration?

A

After mothers contractions, babies HR drops.

(U-shaped Fetal HR)

32
Q

What is variable deceleration?

A

Variability in when the babies HR drops. The graph is non-uniform.

(Causes a V shaped fetal graph)

33
Q

Which fetal HR deceleartion is reassuring?

A

Early decelerations

34
Q

What causes early deceleration?

A

Contractions are causing head compression against the pelvis or soft tissue.

Just monitor it doesn’t drop below 110bpm

35
Q

What causes late deceleration?

A

Utero-placental insufficiency.
Fetus is not getting enough oxygen

(Non-Reassuring - Req intervention)

36
Q

What causes variable deceleration?

A

Cord compression (e.g., prolapse cord, nuchal cord, etc)

(Non-Reassuring - Req intervention)

37
Q

What is VEAL CHOP?

A

Variable = Cord compression
Early = Head compression
Acceleration = Okay
Late = Placental insuffieciency

38
Q

What is a FH category III?

A

Absent variability w/ either:
1. recurrent late or variable declerations
2. bradycardia.

or Sinusoidal pattern.

39
Q

What is a FHR category III?

A

Absent variability w/ either:
1. recurrent late or variable declerations
2. bradycardia.

or Sinusoidal pattern.

Abnormal

40
Q

What is a FHR category I
What type of variability?
Any decelerations?

A

Normal HR w/ moderate variability.
* Early decelerations present or absent
* ABSENT late or variable decelerations

41
Q

What is a FHR category II

A

All FHR tracing that isn’t category I or II.
(*e.g., tachycardia, bradycardia w/o absent variability, minimal variability, etc. *)

Inderterminate

42
Q

What is the primary goal of external fetal heartrate monitoring?

What is it to prevent?

A

To continually assess fetal oxygenation

fetal acidemia and minimizing unncessary interventions

43
Q

Describe moderate variability

A

amplitude from peak to trough is 6-25 bpm.

44
Q

Uterine activity is assessed for what three things?

A
  1. Frequency
  2. Intensity
  3. Duration

Obstetrics (9 decks)

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