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OB > Labor and Delivery > Flashcards

Labor and Delivery Flashcards

1
Q

Uterine contractions and cervical changes that occur between 20 wks and 37 wks

A

Preterm labor

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2
Q

UTI
Vaginal infections
chorioamnionitis
previous preterm birth
multifetal pregnancy
low socioeconomic status
smoking
substance abuse

A

Risk factors for Preterm labor

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3
Q

Cervical changes could include

A

Shortening , softening thinning or dilation of cervix

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4
Q

Mucus plug prevents bacteria if ruptured …

A

have to deliver with in 24 hours d/t risk for infection

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5
Q

domestic violence
DM
HTN
incompetent cervix
placenta previa or abruption
frequent conception
dehydration

A

risk factors for preterm labor

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6
Q

Lower back pain
pressure in pelvis
cramping in abdomen
vaginal discharge (increase or change)
bleeding
cervical dilation

A

Manifestations of Preterm labor

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7
Q

Braxton hicks vs Real labor

A

Braxton hicks go away with water or rest 1-2 hours, lay on left side
Real increases with exercise

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8
Q

Cervical cultures
CBC
UA
Fetal Fibronectin

A

lab test for Pre term labor

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9
Q

Swab of cervical secretions to detect protein that bond amniotic sac to uterus

determine imminent preterm labor and birth

low levels= possible preterm = stop labor and tx underlying issues
hydration, bedrest , tx infection

A

Fetal fibronectin testing

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10
Q

Terbutaline
Magnesium Sulfate
Indomethacin
Betamethasone

A

Preterm labor medications

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11
Q

Relaxes smooth muscle
PO or Subcut

Monitor Pulse + 120 HOLD

not used prior to 24wks or beyond 34wks

A

Terbutaline

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12
Q

Relaxes smooth muscle of the uterus, stopping contractions
IV by RN
Monitor signs of toxicity

CALCIUM GLUCONATE antidote

A

Magnesium sulfate

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13
Q

NSAID, suppress preterm, blocking the production of prostaglandin, stopping contractions

Used LESS than 32wks,
after 32wks affect closure of ductus arteriosus

With food to prevent GI upset

monitor postpartum hemorrhage if delivery while taking drug - reduces platelet aggregation

short term use

Stop if Respirations less than 12 or urine output less than 30

A

Indomethacin

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14
Q

Glucocorticoid IM - Promote fetal lung maturity and surfactant

2 doses given 24 hours apart

A

Betamethasone

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15
Q

spontaneous rupture of membranes ONE hour PRIOR to true labor

A

PROM

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16
Q

Spontaneous rupture of membranes after 20wks or before 37 wks -labor do not have to follow

A

PPROM

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17
Q

Infection

A

Risk factor for PROM and PPROM

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18
Q

Gush of fluid
maternal fever
increase maternal or fetal HR
Foul smelling fluid or vaginal discharge

A

Manifestations of PROM or PPROM

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19
Q

prolapsed cord
placenta abruption
cord compression

A

With PROM or PPROM clients have a increased risk for

20
Q

activity restrictions
no sex
hydration
s/s of infection
monitor fetal Heart rate and contractions

A

Nursing care for preterm labor

21
Q

decrease in deep tendon reflexes, changes in mental status and Decreased RR

A

MG toxicity

22
Q

Nitrazine paper test
Amnisure test

A

lab test for PROM and PPROM

23
Q

asses pH of leaked fluids

vaginal fluids: yellow to light green
Amniotic/cervical mucus: Darker green/blue

False positives with blood, soap, semen, infection or intermittent

A

Nitrazine Swab

24
Q

Fetal fibronectin in Vag = PROM (present with any disruption)
Alfa fetoprotein in vag fluids suggest rupture
blood may cause false positive

A

Amnisure test for PROM/ PPROM

25
Q

Prepare for delivery
determine cervical dilation
assess FHR and contraction pattern
maintain bedrest
monitor vital signs

A

Nursing care for PROM/PPROM

26
Q

Confirm gestational age
assess fetal well being
uterine activity
cervical changes
monitor temp and vital signs

PROM and atleast 36 wks go into labor with in 24 wks of rupture

If earlier delivery may be delayed if possible to administer steroid for fetal lung maturity

Goal is prevent infection and deliver healthy infant

A

Nursing care once confirmation of ROM

27
Q

used to treat infections or as prophylaxis

A

medications with ROM
Ampicillin

28
Q

Low constant backache r/t relaxing of pelvic muscles
Lightening (dropping of fetal head) usually 2-4 wks prior -cause waddle in walk
contractions (mild/irregular similar to menstrual cramps, lower back to abdomen)
bloody show (vaginal discharge with thick mucus like with blood tinged streaks)
energy burst (nesting)
GI changes (N/V)
ROM

A

Client in labor

29
Q

Power
Passage
Passenger
Psyche
Position

A

Components of birth process

30
Q

involuntary uterine contractions that increase in intensity and regularity dilating and thinning
(effacement) the cervix

Ferguson reflex is the reflex to push upon complete dilation during delivery

A

Power

31
Q

The clients pelvis

A

Passage

32
Q

Fetus

A

passenger

33
Q

mind set of client

A

psyche

34
Q

assist in dilation and effacement of cervix

A

Uterine contractions

35
Q

time from beginning of one contraction to the beginning of next

A

frequency of contraction

36
Q

length of contraction

A

duration of contraction

37
Q

strength of contraction at peak

mild - tip of nose
moderate - pushing out chin
firm- pushing top of forehead

A

intensity of contraction

38
Q

tone of the uterus between contraction

A

Resting Tone of contraction (Soft or Firm)

39
Q

stretching of the cervical OS to allow fetal passage

A

Cervical dialtion

40
Q

thinning and shortening of the cervix

Primigravida = cervix thins then completely dilate

multigravida= dilate and thin when the cervix is nearly completely dilated

A

Cervical Effacement

41
Q

using the ischial spines as ) station, the descent of the fetus can be measured
position above the ischial spines is (-) and below is (+)

A

Fetal station

42
Q

Fetal head is down and presenting part (chin to chest)

chin out neck straight

brow enters pelvis 1st with neck extended

face enters pelvis 1st

A

cephalic/ vertex
sinciput
brow
facial

fetal presentation

43
Q

Feet of the fetus presenting part (fetal feet)

one foot presenting

both feet present

A

footling breech
single footling
double footling

fetal presentation

44
Q

buttocks presenting part with hip flexed and feet toward head

buttocks with legs crossed

A

frank breech
complete breech

fetal presentation

45
Q

shoulder presenting

A

shoulder presenting

46
Q

the relationship of the presenting part of the maternal pelvis related to the skull and portion of the occipital bone and its position anterior or posterior to the pelvis and direction facing the mothers buttocks

described with 3 letters ex. LOA

Occiput anterior/posterior

A

Fetal position

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