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Nursing 2nd Spring Semester > Intrapartum- EXAM 1 > Flashcards

Intrapartum- EXAM 1 Flashcards

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1
Q

In what times is the mother instructed to call the doctor

A

Rupture membranes
regular, frequent uterine contractions
any vaginal bleeding
decreased fetal movement

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2
Q

4 P’s

A

Powers: Uterine contractions
Passage: bony pelvis, soft tissue of the cervix, pelvic floor, vagina and Introits
Passenger: fetus, membranes and placenta
Psyche:Womans emotional status

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3
Q

Lightening

A

Sign of labor
when fetus begins to settle into the pelvic inlet
Breathing better, leg cramps, increased pelvic pressure, urinary frequency, vaginal secretions, venous stasis and edema

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4
Q

Braxton Hicks contractions

A

Sign of labor
Irregular, intermittent contractions
“False” labor, can disturb mother without affecting cervical change if strong enough

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5
Q

What is ripening

A

A cervical change sign of labor
The softening of the cervix to stretch and dilate, allowing for the passage of the fetus

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6
Q

What is bloody show

A

Sign of labor
Pink-tinged secretion with mucous plug
Labor begins within 24-48 hours

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7
Q

What are the ruptures of membranes

A

PROM, SROM, AROM, PPROM

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8
Q

PROM

A

Premature rupture of membranes: 20,25,30 weeks
Occurs before onset of labor
Must be evaluated

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9
Q

SROM

A

Spontaneous rupture of membranes
Occurs at height of intense contractions

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10
Q

AROM

A

Artificial rupture of membranes
40-42 weeks and has had no rupture yet, so membranes are ruptures with amino hook

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11
Q

PPROM

A

Preterm premature rupture of membranes
Rupture before 37 weeks of gestation
Risk for infection

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12
Q

Signs of labor extras

A

Sudden burst of energy 24-48 hours before labor
weight loss, diarrhea, indigestion, nausea or vomiting

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13
Q

False labor

A

Irregular contractions
No change in effacement or dilation of cervix, no bloody show
Walking relieves these contractions

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14
Q

True labor

A

Contractions of regular pattern become stronger
Bloody show present and effacement and dilation

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15
Q

Inspection of the Amniotic fluid

A

color: normal clear fluid
green= meconium was passed
Should not smell
Trickle to a litter amount

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16
Q

6 Lamaze Institute basic

A

Labor should begin on its own
No routine interventions should be performed
Woman should have freedom to move
Have a birth support person
Be in non supine positions
Not be separated from infant

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17
Q

Birth passage & factors that may effect it

A

True bony pelvis consists of inlet, pelvic cavity and outlet
Size and type of maternal pelvis, ability to dilate and efface

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18
Q

Largest part of the fetus

A

Head

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19
Q

Fetal attitude

A

The way the fetus will flex, attitude must be compressible to be able to turn in any direction

20
Q

Fetal lie

A

Has to be in head to toe direction, longitude

21
Q

Complete breech

A

Sitting criss crossed, head to toe but in wrong direction, butt at vaginal opening, umbilical wrapped on legs
Will need to be C-sected

22
Q

Frank breech

A

Feet are touching his head, looks squished

23
Q

Single footling breech

A

leg is out vaginal opening

24
Q

What is engagement

A

When the largest diameter reaches or passes through the pelvis, aka the head

25
Q

Describe the station

A

When the presenting part is between the ischial spine of the pelvis
@ ischeal=0. Goes from -5 to +5
The lower down the head goes, it reaches positive numbers

26
Q

Occiput baby position

A

vertex presentation

27
Q

Mentum baby position

A

face presentation

28
Q

Sacrum baby position

A

breech presentation

29
Q

Acromion process baby position

A

shoulder presentation

30
Q

Theories to why labor occurs

A

Changes in estrogen
prostaglandin secretion
increased secretion of oxygen
Fetal role, wants to cone out
Stretching, pressure and irritation of the uterus

31
Q

First stage of labor

A

Onset of true labor
Has 3 stages: Latent,Active-4-6cm,Transition-6-10cm
May be anxious, feel out of control and tired
Strong contractions every 1.5-2 min for 60-90 seconds
Increased rectal pressure and amount of bloody show
Rupture of membranes

32
Q

Second stage of labor

A

Mom is fully dilated
Crowning, the fetus changes positions as it goes through the birth passage
Ends with delivery of baby

33
Q

Third stage of labor

A

Begins at delivery of newborn, ends with delivery of the placenta
20-30 min after birth, the placenta will separate from the uterine wall
Women will have to bear down to aid or gentle traction will be applied to help
Placenta will need to be inspected!

34
Q

Life span considerations for women over 35

A

Higher rate of miscarriage, stillbirth, preterm birth, low birth rate, perinatal morbidity and mortality

35
Q

Maternal assessment

A

Assess contractions:frequent, duration and intensity
Cervical assessment: check for dilation, 10cm is the most

36
Q

Baseline Fetal heart rate

A

Normal range of 110-160 BPM

37
Q

Fetal compromise conditions

A

High fetal heart rate
Meconium stained amniotic fluid
Cloudy, yellowish or foul odor to amniotic fluid
Excessive frequency or duration of contractions
Incomplete uterine relaxation
Maternal hypotension or hypertension
Maternal fever of 100.4 or higher

38
Q

Fetal bradychardia

A

Less then 110 BPM

39
Q

Fetal tachycardia

A

More then 160 BPM

40
Q

VEAL CHOP

A

Fetal heart rate
V:Variable C:Cord compression
E:Early. H:Head compression
A:Acceleration O:Okay!
L:Late P:Placental Insufficiency

41
Q

Breathing techniques and If hyperventilation

A

Slow, deep breathing
Shallow or modified paced breathing
Pant-blow
Hyperventilating: encourage slow breathing, shallow breaths

42
Q

How do you assess with nuchal cord after baby is born

A

suction mouth and then nose with the bulb syringe

43
Q

Assessing the fundus

A

Displaced=caused by full bladder or blood in uterus
Blood and clots can be expelled by grasping uterus and squeezing
DO NOT message uterus unless it is “boggy” or not firm

44
Q

APGAR

A

7-10=normal
4-6=moderetly depressed but can improve
0-3=needs resucution

45
Q

Analyzing umbilical cord after birth

A

Make sure it has:
2 umbilical veins, one artery one vein
Any deviation has to be analyzed
Fluid is checked to see acidosis

Nursing 2nd Spring Semester (42 decks)

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