Brainscape's Knowledge GenomeTM

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


See full index

Ngozi's Family Health > L&D II > Flashcards

L&D II Flashcards

Exam 2

1
Q

What is category I?

A

Normal fetal heart rate patterns

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

What is variability

A

Variability is defined as fluctuations in the BL rate

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

What does marked variability look like?

A

> 25 bpm

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

What does moderate variability look like?

A

6-25 bpm

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

What does minimal variability look like?

A

<6 bpm

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

What do absent variability look like?

A

straight line

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

What is a tachycardic FHR?

A

> 160

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

What is a bradycardic FHR?

A

<110

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

What is a normal FHT?

A

110-160

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

What are the purposes of fetal surveillance?

A

To assess how the fetus is tolerating labor and to monitor oxygenation status.

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

What are the two approaches to intrapartum fetal monitoring?

A

Intermittent auscultation with palpation of uterine activity (low tech) and electronic fetal monitoring (high tech).

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

How would a nurse do intermittent auscultation and palpation?

A

Doppler for 15-60 seconds or longer between ctx
Simultaneously palpate maternal pulse
Listen after ctx 15-30 seconds for increases or decreases
Palpate ctx

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

What are the limitation of intermittent auscultation and palpation?

A
  • 1-1 nursing care
  • Not always ideal
  • Can’t assess patterns of FHR variability, periodic or non-periodic changes
  • No permanent, documented visual record of FHR or UA
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the advantages of intermittent auscultation and palpation?

A
  • Mobility
  • Position changes and ambulation
  • Least invasive
  • Natural atmosphere
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Who is 1 to 1 nursing care appropriate for when doing intermittent auscultation?

A

Low-risk mothers without complications.

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

Why should contractions be felt in the forehead?

A

To indicate strong and effective contractions.

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

What are the limitations to external electronic fetal monitoring?

A
  • Reduced mobility is the major limitation.
  • Frequent repositioning of transducers
  • May double-count a slow FHR or half-count a fast FHR
  • Maternal HR may be recorded rather than FHR
  • Obese and preterm clients may be difficult to monitor
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the advantages of external electronic fetal monitoring?

A
  • Noninvasive
  • Does not require rupture or membranes
  • Supplies more data about the fetus and ctx
  • Continuous recording and permanent record
  • Gradual trends in FHR and uterine activity are apparent.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is external electronic fetal monitoring?

A

Monitoring the baby’s heart rate and uterine contractions during labor

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

Why is external electronic fetal monitoring important?

A

To assess the well-being of the baby during labor

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

What is a con of external fetal monitoring

A

Less accurate than internal devices but are noninvasive and suitable for most women in labor

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

What is external fetal monitoring?

A

Noninvasive monitoring of the baby’s heart rate and uterine activity

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

What is remote surveillance in external fetal monitoring?

A

Surveillance of the baby’s heart rate and uterine activity from a distance

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

What is an ultrasound transducer used for in external fetal monitoring?

A

To monitor the baby’s heart rate

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

What is a toco transducer used for in external fetal monitoring?

A

A pressure-sensitive area detects changes and abdominal contour to measure uterine activity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Where does a toco transducer go on the mother’s abdomen?

A

On the fundus of the uterus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is a transducer?

A

A device that converts one form of energy into another

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What are the limitations of internal fetal monitoring?

A
  • Requires rupture of membranes
  • Cervix must be dilated
  • Improper insertion can cause trauma (vaginal lacerations, uterine perforation, placental abruption)
  • Presenting part must be identifiable
  • Increased risk of infection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What are the advantages in internal fetal monitoring?

A
  • Accurate FHR
  • Maternal position changes does not effect quality of tracing
  • Possibility of displaying ECG
  • Only true measurement of ctx
  • Allows for amnioinfusion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

When should the cervix be dilated and ruptured?

A

In obese patients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

When is internal fetal monitoring helpful?

A

In obese patients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What is the main advantage of using internal devices for fetal monitoring?

A

Accuracy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What are the requirements for using internal devices for fetal monitoring?

A

Ruptured membranes and about 2 cm of cervical dilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What is the slightly increased risk associated with internal fetal monitoring?

A

Infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What does an FSE detect?

A

Electrical signals from the fetal heart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What is the baseline fetal heart rate?

A

Determined in a 10-minute period

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What is variability?

A

Measure of how spread out or dispersed a set of data values are

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

How is variability measured?

A

Using statistics such as range, variance, and standard deviation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What a s/s of a compromised fetus?

A

severe fetal anemia, twin-twin transfusion, intracranial hemorrhage, infection, hypoxia, gastroschisis, cardiac anomalies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What is a sinusoidal pattern?

A

Sinusoidal pattern is a regular pattern with 3-5 cycles per minute over at least 20 minutes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Does a sinusoidal pattern have any accelerations or fetal movement?

A

No, a sinusoidal pattern does not have accelerations or fetal movement with or without stimulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

When does a sinusoidal pattern require immediate attention?

A

A sinusoidal pattern requires immediate attention when there is a compromised fetus.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What can cause a sinusoidal appearing pattern?

A

Opioid administration can cause a sinusoidal appearing pattern.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What are the two type of fetal heart rate pattern?

A

Periodic and Episodic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

What type of fetal heart rate pattern is associated with uterine contractions

A

periodic fetal heart rate patterns

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What type of fetal heart rate pattern is associated without uterine contractions

A

Episodic fetal heart rate patterns

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

What are accelerations?

A

Temporary increase in FHR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

At what gestational age do accelerations occur at the rate of 15 x 15?

A

> 32 weeks gestation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

At what gestational age do accelerations occur at the rate of 10 x 10?

A

< 32 weeks gestation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

What are accelerations associated with?

A

Fetal movement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

When else may accelerations occur?

A

During a vaginal examination, during uterine contractions, mild cord compression, breech presentation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

What is considered a prolonged acceleration?

A

> 2 minutes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

When does a prolonged acceleration become a baseline change?

A

> 10 minutes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

What are early decelerations?

A

Fetal head compression; Deceleration onset, nadir, and recovery coincide with, or mirror, the beginning, peak, and ending of a contraction.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

What is the onset to nadir for early decelerations?

A

30 seconds or more and are periodic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Are early decelerations indicative of fetal compromise?

A

No

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Do position changes usually have an effect on early decelerations?

A

No

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

What is the onest of nadir for late deceleration?

A

Onset to nadir is 30 seconds or more

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

What are late decelerations?

A

Impaired oxygen exchange; In most cases, the onset, nadir, and recovery of the deceleration occur after the beginning, peak, and end of a uterine contraction.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

When do late decelerations begin and end?

A

Begin after peak of contraction, return to baseline after contraction ends

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

What is a concerning pattern for late decelerations?

A

Recurrence of 50% or more contractions in 20 minutes

62
Q

What nursing intervention is required for late decelerations?

A

Improve placental blood flow and fetal oxygen supply

63
Q

What falls below the baseline rate in variable deceleration?

A

Shape, duration, and degree of fall below baseline rate are variable.

64
Q

What are variable decelerations?

A

Reduced flow through umbilical cord

65
Q

How long does it take for the onset to nadir of variable decelerations?

A

< 30 seconds

66
Q

What is the minimum frequency of variable decelerations?

A

At least 15x15

67
Q

What may cause variable decelerations?

A

Cord compression

68
Q

Do variable decelerations require nursing intervention?

A

Yes

69
Q

What is prolonged deceleration?

A

Periodic or episodic deceleration lasting 2-10 minutes.

70
Q

When does prolonged deceleration occur?

A

2-10 minutes from onset to return to baseline.

71
Q

Is nursing intervention necessary for prolonged deceleration?

A

Yes.

72
Q

What does category III consist of?

A
  • Tracings include absent variability AND any of the following:
    • Recurrent late decels
    • Recurrent variable decels
    • Bradycardia
    • Sinusoidal pattern
  • IS indicative of an abnormal fetal acid-base status and poor fetal well-being.
  • Requires prompt intervention
73
Q

What is category III?

A

abnormal fetal heart rate patterns

74
Q

What are the components of category II

A
  • Includes ANY tracing that isn’t Category I or III
  • Is not enough evidence to be category I or III
  • Not predictive of abnormal fetal acid-base status
  • Requires nursing intervention, close monitoring and re-evaluation
75
Q

What is category II?

A

Indeterminate and you want to see if the fetal heart rate patterns falls closer to I or III

76
Q

What consists of category I

A

Includes ALL of the following
- FHR Baseline 110-160 bpm
- Moderate variability
- Accels present OR absent
- Early decels present OR absent
- Late and variable decels absent
- Indicative of normal fetal acid-base
- No necessary interventions r/t tracing

77
Q

What is intensity of contraction?

A

how they fell mild moderate or strong

78
Q

What is duration?

A

period from the beginning of a uterine contraction to the end of the same contraction

79
Q

What is frequency?

A

time elapsed between the beginning of one contraction and the beginning of the next

80
Q

What are the four components of the assessment of uterine activity?

A

Frequency, Duration, Intensity, Resting tone

81
Q

What should you know in terms of decls

A

It’s okay to be EARLY for dinner, but don’t be LATE!!

82
Q

What does MINE stand for

A

Move patient
Identify labor progress
No action needed
Execute immediately

83
Q

What does CHOP stand for?

A

Cord compression
Head compression
Okay
Placental insufficiency

84
Q

What does VEAL stand for?

A

Variable
Early
Acceleration
Late

85
Q

What are some common corrective measures for Cat. II or III readings?

A
  • Maternal repositioning
  • Oxytocin off
  • Withhold misoprostol
  • Oxygen
  • IV fluid bolus
  • SVE
  • Amnioinfusion
  • Notify physician
  • Modify pushing efforts
  • Administer terbutaline
  • Prepare for C/S
86
Q

How is a sample of cord blood obtained?

A

From umbilical artery (unoxygenated) and umbilical vein (oxygenated)

87
Q

What is the time frame to send the samples to the lab after collection?

A

Within 60 minutes

88
Q

What parameters are analyzed in cord blood to determine the presence of fetal acidosis?

A

pH, partial pressure of carbon dioxide, bicarbonate, and base deficits or excess

89
Q

How is fetal acidosis distinguished if detected?

A

Respiratory, metabolic, or mixed

90
Q

What should nurses do to increase fetal oxygenation?

A

Take corrective action to increase fetal oxygenation and promote adequate fetal oxygenation

91
Q

Who should nurses report changes in patterns to?

A

Report changes in patterns to the physician or nurse midwife

92
Q

What should nurses do to support the woman and her partner?

A

Support the woman and her partner and provide education

93
Q

What should nurses do after assessment and care?

A

Document assessment and care

94
Q

What factors should be considered when making the decision to go to a birth facility?

A

Distance, transportation, child care needs

95
Q

What information is important to know about previous labors?

A

Number, duration

96
Q

What are the signs that indicate it’s time to go to the hospital/birth center?

A

Contractions that are regular, 5 mins apart, last 1 min for 1 hour, ruptured membranes A gush or trickle of fluid from the vagina, with or without contractions, bright red bleeding, decreased fetal mvmt

97
Q

What are the nursing responsibilities during admission to a birth facility?

A

Establish therapeutic relationship, assessment

98
Q

What does the assessment during admission include?

A

Medical, surgical, psychosocial, and obstetric history; head-to-toe physical examination/assessment; labor plan; maternal-fetal status

99
Q

What is considered a normal fetal heart rate (FHR)?

A

FHR 110 to 160 bpm

100
Q

What should be assessed in the fetal heart rate?

A

Regular rhythm: Presence of acceleration; absence of deceleration

101
Q

What vital signs should the nurse identify signs of?

A

Hypertension and infection

102
Q

What are some signs of impending birth?

A

Grunting sounds, bearing down, urgency to push, screaming, rocking

103
Q

What is Aminisure?

A

A test to determine the pH level

104
Q

What is Srom?

A

A term related to the rupture of the membranes

105
Q

What is Arom?

A

A term related to artificial rupture of the membranes

106
Q

What indicates labor?

A

Actual changes occurring in the cervix

107
Q

What nursing responsibilities are involved during admission to a birth facility?

A

Focused assessment, Basic information, Physical exam, reflexes, Labor status, Contraction pattern, SVE unless preterm (<37 weeks) or bleeding, Establish if rupture of membranes, Amniosure, nitrizine ph test, AROM vs SROM, Clear with vernix particles, Determine true or false labor

108
Q

What should the nursing staff determine during admission regarding the patient’s labor status?

A

Whether the patient is in true or false labor

109
Q

What are some methods used by the nursing staff to determine if there has been a rupture of membranes?

A

Amniosure, nitrizine ph test

110
Q

Which patients should not have a sterile vaginal examination (SVE) performed during admission?

A

Preterm patients (<37 weeks) or those experiencing bleeding

111
Q

What color is amniotic fluid when presenting with meconium?

A

Brown

112
Q

What color does amniotic fluid turn in the presence of chorioamnionitis infection?

A

Yellow or cloudy

113
Q

What are nursing responsibilities during admission to a birth facility?

A

Notify provider, give report, obtain orders, admit or discharge

114
Q

What assessments should be done during admission to a birth facility?

A

UA, UDS

115
Q

What should be done to reassess labor status?

A

Observe for 1-2 hours

116
Q

What is an important aspect of managing false or early labor?

A

Identification of patient problems

117
Q

What is the ultimate goal for a patient experiencing false or early labor?

A

Discharge

118
Q

What are some important aspects of true labor?

A

Admit to unit, Consent forms, Pain management

119
Q

What are some common interventions during labor?

A

Epidurals, C-section, Induction

120
Q

What laboratory tests are typically performed during labor?

A

CBC, UA, UDS, Type & Screen

121
Q

What is the recommended size for IV access during labor?

A

18g

122
Q

What kind of maternal assessment do you perform for true labor?

A
  • Labor progress
  • Contractions
  • Intake and output
  • Response to labor/signs of coping
123
Q

During ongoing assessment what kind of fetal assessment do you perform?

A
  • FHR
  • Fetal membranes and amniotic fluid
124
Q

What are conditions associated with fetal compromise?

A
  • FHR outside normal limits (110-160 bpm) and loss of variability
  • Meconium-stained amniotic fluid
  • Cloudy, yellowish, foul-smelling amniotic fluid
  • Excessive frequency or duration of contractions
  • Incomplete uterine relaxation
  • Maternal hypotension or hypertension
  • Maternal fever
125
Q

What are some strategies for promoting labor progress?

A

Positioning and movement, teaching, comfort measures

126
Q

Is pain relief during labor realistic?

A

No

127
Q

What is the goal during the second stage of labor?

A

Pushing efforts 3 times every contraction to fully dilate and have the baby low

128
Q

What is laboring down?

A

Allowing the woman to rest and let the baby descend during the second stage of labor

129
Q

What are some positions that can be used during labor?

A

Various positions to aid in comfort and progress

130
Q

Why are varied positions important for labor?

A

Promote comfort and optimal fetal positioning

131
Q

What is induction of labor?

A

Artificial methods to stimulate uterine contractions

132
Q

what is induction associated with?

A

high cesarean rate

133
Q

When are elective induction allowed?

A

After 39 weeks

134
Q

What are the indications for induction and augmentation of labor?

A

SROM, Post term pregnancy, Chorioamnionitis, Hypertension, Abruptio placentae, Maternal medical conditions, GDM, Fetal demise

135
Q

What are the contraindications for induction and augmentation of labor?

A

Placenta previa, Vasa previa, Umbilical cord prolapse, Abnormal fetal presentation, Active genital herpes, Previous uterine surgery, Breech presentation, Overdistended uterus, Severe maternal conditions

136
Q

Who is done by amniotomy fluid?

A

physical or nurse midwife and they do it by snagging the amnio hook snags membrane

137
Q

What is the risk of amniotomy?

A
  • prolapse umbilical cord
  • infection
  • abruption placenta
138
Q

What is amniotomy?

A

Artificial rupture of membrane

139
Q

What are some nursing considerations for amniotomy?

A

Baseline information, fetal heart rate 20 to 30 min before procedure

140
Q

What should be done to assist with the amniotomy procedure?

A

Place absorbent pads, provide necessary equipment

141
Q

What should be done after the amniotomy procedure?

A

Provide post-procedure care and identify complications

142
Q

What is the purpose of induction and augmentation of labor?

A

To start or speed up the labor process

143
Q

What is the Bishop score used for?

A

Assessing cervical readiness for induction

144
Q

What is a pharmacologic method for induction?

A

Misoprostol (Cytotec)

145
Q

What is a mechanical method for induction?

A
  • Transcervical balloon catheter
  • membrane stripping
  • separate sack from uterus
  • hydroscopic inserts
146
Q

What is the most common technique for inducing and augmenting labor?

A

Oxytocin administration

147
Q

What is the recommended starting rate for oxytocin administration?

A

0.5-2 milliunits/min

148
Q

How often should the dose of oxytocin be increased?

A

Every 15-40 minutes

149
Q

What should be monitored frequently during oxytocin administration?

A

Uterine activity, FHR, and fetal heart patterns

150
Q

What are some responsibilities during birth?

A

Preparing delivery table, perineal cleansing, supporting woman during pushing, initial care of newborn, administering medications

151
Q

What is the purpose of administering medications during birth?

A

To contract the uterus and control blood loss

Ngozi's Family Health (7 decks)

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