Labor Flashcards
How do you date a pregnancy?
Take the FIRST day of the LMP and add 7 days to it then subtract 3 months
What is the first trimester weight gain? Second? Third?
First (12 weeks): 1lb/month or 3 pounds
Second (13-28): 1lb/week
Third (29-40): 1lb/week
What is the total ideal weight gain for a pregnancy?
28+/- 3 pounds
SO…. 25-31 pounds
If weight gain is +/- 3 pounds what should you do? If weight gain is +/- 4 pounds what should you do?
+/- 3 pounds: assess her
+/- 4 pounds: trouble, preform a BPP of fetus
When can the fundal height be palpated? When will the fundus be at the umbilicus?
Fundal height cant be palpated until 12 weeks (after first trimester and it’ll be midway between pubic symphysis and umbilicus)
At umbilicus at 20-22 weeks
In a trauma, when is mom a priority and when is baby?
Mom is in the 1st and 2nd
Baby is in the 3rd
What are positive signs of pregnancy?
Fetal skeleton on xray
Presence of fetus on ultrasound
Auscultation of fetal heart
Examiner palpates fetal movement
When is fetal heart beats heard? When is quickening felt?
Fetal heart: 8-12 weeks gestation (first: 8 weeks, most likely: 10 weeks, latest: 12 weeks)
Quickening: 16-20 weeks gestation (first: 16 weeks, most likely: 18 weeks, latest: 20 weeks)
What are maybe signs of pregnancy?
Positive blood/urine test
Chadwich (cervical/vaginal color change to cyanosis)
Goodell (softening of cervix)
Hegar (softening of uterus)
What order does Chadwick, goodells, and hegar occur?
Chadwick, goodells, and hegar
Alphabetical order
Move up form vulva, vagina, cervix, to uterus
When should prenatal visits be?
28 weeks once a month
28-36 every other week
36-42 weekly
What is considered a normal Hgb in first trimester? Second? Third?
First: 11
Second: 10.5
Third: 10
How do you treat morning sickness?
Dry carb before getting out of bed
When is urinary incontinence usually seen? Treat?
1st and 3rd trimester
Treat by voiding every 2 hours form the day she gets pregnant until 6 weeks PP
When does difficulty breathing occur? Treat?
2nd and 3rd trimesters
Tripod positioning
When does back pain occur? Treatment?
2nd and 3rd trimester
Pelvic tilt exercises to treat
What is the most VALID sign that true labor is occurring?
Onset of regular/progressive contractions
What is station?
relation between fetal presenting part and mom ischial spines (narrowest part of pelvis)
+3, +2, +1, 0, -1, -2, -3
0 is engaged (presenting part is at ischial spines)
What it the lie?
Relationship between spine of mom and spine of baby
Vertical lie is what you want
What is the presentation?
The part that is comes out first and how baby is sitting
ROA and LOA are most common
What 4 STAGES of labor?
- Onset of labor - cervical dilation/effacement
- Delivery of baby
- Delivery of placenta
- Recovery - 2 hours after placenta is delivered
What are the 3 phases of the first stage?
Phase 1: Latent. Contractions are 5-30 minute apart lasting 15-30 seconds with mild intensity. 0-4 cm dilated
Phase 2: Active. Contractions are 3-5 minute apart lasting 30-60 seconds with moderate intensity. 5-7 cm dilated
Phase 3: Transition. Contractions are 2-3 minutes apart lasting 60-90 seconds with strong intensity. 8-10 cm dilated
Uterine contractions should be no longer than ______ and no closer than _____. What is this a sing of? Would it make you stop the Pitocin?
Uterine contractions should be no longer than 90 seconds and no closer than 2 minutes
Sign of uterine tetany
Yes, stop pit
How do you palpate intensity of labor?
Palpate with one hand over fundus with pads of fingers
What do you do for painful back in labor?
OP position - oh pain
Place mom in knee-chest position then push with fist into sacrum to use counter pressure to relieve pain
What do you do for a prolapsed cord?
Push head off of cord and then position mom in knee-chest or trendleburg
Prep for c-section
What are the interventions for things like tetany, maternal hypotension, vena cava syndrome, uterine rupture, toxemia, eclampsia?
If Pitocin is running, stop if first THEN,
Left side
Increased IV
Oxygen
Notify HCP
In labor systemic pain medication is okay unless…
Unless baby is likely to be born when the medication peaks.
