Intrapartum/Labor Flashcards
Epidural
What is Epidural Anesthesia
- injected into epidural space
- boloused into C-section
- increased vs decreased
Epidural
What are side effects of epidural
Hypotension
* decrease uteroplacental perfusion (watch monitor strip)
Epidural
What position should patient be placed for epidural
angry cat position
or sitting upstriaght/lying on side in fetal position
Epidural
What are saftey concern for epidural
- monitor signs of hypotension
- fluid bolus given in large amount before epidural
Epidural
What are routine intervetions of Epidural
- vital signs: bp, hr, rr
- assessing efficacy: pain levels
- bladder management: urinary catheter rotuine monitoring of urge of urination and retention
Pharmacological Pain Methods
What pain methods are used during labor
- prostaglandind
- oxytocin
- cervical ripening
- Balloon cathetor
Pharmacological Pain Methods
Narcotic Pain charcteristics
- aid relaxation
- provide releif from pain
- wear off quickly
- increase morther’s fals
Pharmacological Pain Methods
Nitrous Oxide charcteristics
- laughing gas
- increase relaxation
Induction
Indications of Ripening and Induction
- hypertension
- GDM
- preeclampsia
- PRO
Induction
Contrindication of Ripening and Induction
- refusal
- placenta previa
- malpresentation
- prolapsed cord
- prevoius c-section
- hx of uterine rupture
Induction
What is the cervical ripening agent
- Dinoprostone: vervidil
- Misoprostol: cytotec
Induction
What are the ripening methods
- prostaglandins
- balloon catheters
Induction
Rippening Method: Prostaglandin
applied to cervix to soften and thin it
Induction
Rippening Method: Ballon Cathetor
- physical dialte cervix
Induction
what is the use of Oxytocin
- inducing labor
- low dose and gradullary increase
Induction
What are the risks of oxytocin
tachysystole
uterine rupture
fetal hypoxia
Induction
How to monitor Oxytocin
- continous fetal heart monitor
- continuous uterine contractions
Fetal HR - contractions = decreased blood flow
Operative Vaginl Delivery
What indicated need for operational delivery
- mother to fatique
- prolapsed cord
- worsened maternal conditions
Operative Vaginal Delivery
What is a Vaccum
- application of suction on fetal head
- mom still has to push
- risks of cephalhematoms, fetal brain injury, fetal death
Operative Vaginal Delivery
What are the nursing responsibilities of Vaccum assisted Vaginal Delivery
- striagh cathetor
- monitor fetal heart rate
- note application, length of pulls, pop off
- make sure mityvac stays in green zone
Operative Vaginal Delivery
What is forcep assistance
- baby is crowning
- low -/+ 2 station
- risks: fetal head, brain injury, 4th laceration, perineal hematoma, bladder injury
Operative Vaginal Delivery
What is Episiotomy
incision into perineum to provide more space for delivery
Operative Vaginal Delivery
What are indicatins of episiotomy
- prevent laceration
- reduce length of second stage
- allow instrumental delivery (forcep/vacuum)
Operative Vaginal Delivery
What are the types of episiotomy
- Midline
* advantage: heal faste/less comfort
* disadvantage: extend into rectal mucosa - Mediolateral
* advantage: no rectal involvment, more room
* disadvantage: heal slow, more pain, more blood loss
Operative Vaginal Delivery
What are indication of Cesarean Section
- fetal distress
- faulure to progress in labor
- maternal health issue
- multiple gestation
- abnormal fetal position
Operative Vaginal Delivery
What are risks of Ceasarean Section
- hemorrhage
- infection
- injury to bladder
- scarring
- increased risk of placenta previa
Operative Vaginal Delivery
What occurs in the recovery of the Cesarean Section
- longer
- more pain
- longer stay
- deep vein thrombosis
