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RNC OB > Labor > Flashcards

Labor Flashcards

1
Q

What is considered hypotonic labor?

A

This is inadequate, less intense contraction that doesn’t dilate or efface.
this can be caused by a tired, overdistended uterus (think poly and multiples)

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2
Q

What is the definition of active labor?

A

6 cm dilation and painful, regular contractions with cervical change

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3
Q

How long can a Primigravida push for?

A

up to 4 hours with an epidural
up to 3 hours without an epidural

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4
Q

How long can a Multiparous woman push for?

A

up to 3 hours with an epidural
up to 2 hours without an epidural

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5
Q

What is the most effective way to push?

A

With open glottis pushing
push 5-8 seconds

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6
Q

How can Peroneal Nerve Damage be done? What is the sign of this?

A

This can be caused by pushing in stirrups, putting pressure on the Peroneal Nerve.
This is shown by the foot drop after delivery

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7
Q

What are 3 ways that Immediate active pushing can be beneficial?

A
  1. Shorter 2nd stage
  2. Decreased risk of postpartum hemorrhage
  3. Lower Chorioamnionitis rates
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8
Q

At what point is the placenta considered retained?

A

30 minutes

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9
Q

What are three signs of the placenta being ready to be delivered?

A
  1. Lengthening of the cord
  2. Rise of the uterus in the abdomen
  3. increase in vaginal bleeding
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10
Q

True or False: The nurse is allowed to give fundal pressure to assist in a delivery.

A

False: this is not allowed per the Nurse Practice Act

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11
Q

How many degrees of lacerations are there?

A

4
1. 1st Degree: perineal skin and vaginal mucous membranes torn
2. 2nd Degree: this includes fascia and muscle of the perineum
3. 3rd Degree: this extends into the rectal sphincter
4. 4th Degree: this includes inner lumen of rectum is exposed

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12
Q

When is the earliest you can start oxytocin after the last dose of Cytotec?

A

4 hours

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13
Q

What are the major risks of prostaglandins?

A

Uterine Rupture

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14
Q

In which circumstance are Prostaglandins contraindicated?

A

Previous uterine surgeryWh

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15
Q

Where is the placement of Prostaglandins?

A

In the posterior fornix of the cervix (behind it)
For Cervidil it must be placed transvaginal

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16
Q

Over which number is the cervix considered favorable to start Pitocin?

A

> 6

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17
Q

True or False: Pitocin should be placed on the closet port to the patient?

A

True

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18
Q

What is the definition of tachysystole?

A

> 5 contractions in a 10-minute period averaged over a 30-minute segment

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19
Q

What is the best amount of time for reperfusion for the fetus?

A

45 seconds - 1 minute

20
Q

What are the three things that be decreased with adequate labor support?

A

Labor dystocia, operative vaginal deliveries, and c-section rates

21
Q

What are two things that the nurse should watch for when a patient gets a Pudendal Block?

A

Hematoma and infection at the injection site

22
Q

What are the 5 P’s for labor success?

A

Power, Passenger, Pathway, Psyche, and Positioning

23
Q

What are some side effects of having a precipitous delivery?

A

Placental abruption, postpartum hemorrhage, tissue lacerations, and shoulder dystocia

24
Q

What are the four types of Breech presentation/

A
  1. Complete: legs wrapped around the body (crisscross applesauce)
  2. Incomplete: legs extended at hip or foot
  3. Frank: feet close to head/ towards the shoulders
  4. Footling: one or both legs presenting before the buttocks
25
Q

Which of the breech positions are most optimal for a vaginal- breech delivery?

A

Frank or complete breech presentation

26
Q

Which forceps are used for breech deliveries?

A

Piper forceps

27
Q

What is a risk with a breech delivery?

A

Cord prolapse

28
Q

What are some risks with a version?

A

Rupture of membranes, placental abruption, fetal bradycardia, and fetal/maternal hemorrhage

29
Q

What is considered a compound presentation?

A

This is where a fetal extremity presents along side the presenting part

30
Q

What is the definition of a shoulder dystocia?

A

The head-to-body delivery time is >60 seconds OR the use of maneuvers.
This is where the anterior shoulder is logged under the pubic bone.
This is a bone problem, not a tissue problem!

31
Q

Which two maneuvers relieve 70-80% of shoulder dystocias?

A

McRoberts and Suprapubic pressure.

32
Q

True or false an episiotomy can relieve a shoulder dystocia?

A

False: This is done to make more room for the physician.

33
Q

How long does a fetus have until acidemia is a high risk?

A

5 minutes- but this also depends on the status of the fetus prior to the delivery.

34
Q

True or False: a fundal pressure can be used to resolve a shoulder dystocia?

A

False: fundal pressure is not allowed to be given by the nurse during a delivery (Nurse Practice Act)

35
Q

What is the biggest risk to the newborn from a shoulder dystocia?

A

Brachial plexus palsy

36
Q

What are maternal risk factors for a shoulder dytocia?

A

Abnormal pelvic anatomy, gestational diabetes, short stature, excessive weight gain, previous shoulder dystocia

37
Q

What are fetal risk factors for a shoulder dystocia?

A

Suspected macrosomia, male fetus

38
Q

What is the difference between preterm labor and preterm contractions?

A

Preterm labor: dilation of the cervix after 20 weeks and before 37 weeks
Preterm contractions: contractions after 20 weeks and before 37 weeks but the cervix does not dilate.

39
Q

What are the most common risks for Preterm labor?

A

Multiples, previous preterm deliveries, uterine or cervical abnormalities, and infection

40
Q

What is Fetal Fibronectin?

A

This is produced by fetal cells- this can be detected in maternal blood, amniotic fluid, and cervicovaginal secretions

41
Q

When can a fetal fibronectin test be performed?

A

This can be done between 22-35 weeks

42
Q

What does a positive fetal fibronectin mean? What does a negative result mean?

A

Negative: this means you are not going to go into preterm labor in the next 2 weeks.
Positive: does NOT mean that you are going to go into preterm labor in the next 2 weeks.

43
Q

True or False: if you do a fetal fibronectin test outside of the recommended weeks, it is normal for the result to be positive?

A

True: if the test is done outside of the 22-35 weeks, it is normal for the test to be positive.

44
Q

True or False: Bedrest is recommended for preterm labor?

A

False: Bedrest has not been proven to be effective in delaying delivery. This has been shown to decrease calcium, lose muscle tone, and both mom and baby will lose weight

45
Q

What are risk factors for having a prolapsed cord?

A

Multiparous, polyhydramnios, and breech presentation

46
Q

At which point should a peri-mortem c-section be performed in the event of an AFE?

A

4 Minutes of maternal resuscitation and baby born by 5 minutes

RNC OB (21 decks)

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