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OB > Labor and Delivery > Flashcards

Labor and Delivery Flashcards

1
Q

Amniotic fluid Functions

A

buoyancy, cushion, thermoregulation, protect umbilical cord, sterile environment

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2
Q

What do you chart when the bag of fluid ruptures?

A

color, time, how it ruptured

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3
Q

What does clear amniotic fluid mean?

A

normal fluids

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4
Q

What is a sign of a small amount of meconium in fluid?

A

yellow/brown, thin liquid

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5
Q

What is a sign of a large amount of meconium in fluid?

A

brown, green, thick, potentially chunky

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6
Q

what is meconium?

A

baby poop, sterile

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7
Q

What is the main concern of meconium in the amniotic fluid?

A

Aspiration during initial breath due to it sitting on the vocal cords

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8
Q

What can cause meconium in the amniotic fluid?

A

Stress in utero

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9
Q

What is the difference between SROM and AROM?

A

SROM (spontaneous rupture of membranes)
AROM (Artificial rupture of membranes)

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10
Q

A patient presents with regular contractions that start from the back and wrap to the front. Her contractions get worse when walking and are becoming more frequent. Is she in labor?

A

Yes
She is in true labor

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11
Q

A patient presents with irregular contractions in the lower abdomen and groin. They have not become more intense or more frequent. While walking she states her contractions feel less intense. Is she in labor?

A

No
she is in False Labor

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12
Q

What is the purpose of the Nitrazine test?

A

pH test to determine if fluid is amniotic.
Blue strip= fluids

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13
Q

What is seen through the microscope during a Fern Test?

A

If the fluids are amniotic, they will crystalize as they dry and form a fern shape.

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14
Q

What is the purpose of the Amnisure test?

A

like a pregnancy test, shows either + or - for amniotic fluid

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15
Q

What is a concern with a complete or partial rupture of bag of waters?

A

Infection
No longer sterile environment

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16
Q

What is the first action when a bag of waters ruptures?

A

Pelvic exam to check for a prolapsed cord

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17
Q

What is the main concern if an umbilical cord is prolapsed?

A

Unable to supply fetus with O2
Could wrap around fetus neck

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18
Q

Is a cord prolapse considered a fetal emergency? What is the first step?

A

Yes, could result in fetal death, must go to OR/
Apply upward pressure with fingers on fetal head to relieve pressure off the cord. do not remove fingers.

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19
Q

At what point is a fetal head considered engaged?

A

at a 0 station
There are no gaps between the head and the pelvis

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20
Q

Asynclitism

A

When a fetal head is tilted to one side during labor

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21
Q

What is the nursing diagnosis that is the top priority during cord compression?

A

Impaired Gas Exchange in the fetus

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22
Q

Nursing interventions for impaired gas exchange during cord compression

A

-monitor fetal HR
- check cord
-bedrest
-reposition
-Give O2 to mom
-increase fluids
-stop Pitocin

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23
Q

What is a priority nursing diagnosis for the mother during birth?

A

Risk for infection

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24
Q

Nursing interventions for mom during risk for infection:

A

-maintain sterile field
-reduce # of times entering the vagina
-temp checks Q2
- hydration
-vitals
-assess fluid colors

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25
Q

What is the most common pelvis type in women?

A

Gynecoid (80%)

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26
Q

What are the three factors of pelvis size?

A

inlet, midplevis, outlet

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27
Q

Inlet

A

upper rim
“entrance to tunnel”
side to side

28
Q

Outlet

A

tunnel exit

29
Q

Mid-Pelvis

A

tunnel itself
front to back

30
Q

What is important to maintain during pelvic examinations?

A

consistency of examiner

31
Q

What is considered crowning?

A

a +4 station

32
Q

What does a + or - station mean?

A
  • above 0 station
    + below 0 station
    any higher than -3 is floating
33
Q

What is fetal attitude?

A

flexion or extension

34
Q

What is occiput posterior?

A

“sunny side up”
the occipital is facing the back of the mother
can out pressure on the coccyx and sacrum

35
Q

What is the optimal position for the occipital during labor?

A

Occiput anterior

36
Q

Where would you place the fetal monitor when the fetal back is to the right and head up? head down?

A

up: above the belly button to the right
down: below the belly button to the left

37
Q

What are the 5 P’s of labor

A
  1. psyche of the mother
  2. position of the mother
  3. passageway
  4. passenger
  5. powers
38
Q

Effacement

A

uterine wall takes up the cervix, thins from 0% to 100%

39
Q

Frank Breech

A

sacrum presents, hips flexed, legs extended, most common breech

40
Q

Footling Breech

A

Single or double footling, legs extended, one or both feet presenting

41
Q

Malpresentation

A

Shoulder
transverse lie

42
Q

O:
M:
Sa:
A:

A

Occiput
Mentum
Sacrum
Acromian Process

43
Q

Leopold’s First Maneuver

A

palpate over uterine fundus, determine fetal part the occupies the fundus

44
Q

Leopold’s Second Maneuver

A

Palpate along sides of uterus, determine where the fetal back is

45
Q

Leopold’s Third Maneuver

A

Palpate the lower portion of the abdomen above the pubis symphysis, determine fetal part entering pelvic inlet

46
Q

Leopold’s Fourth Position

A

palpate with fingers towards patient feet, assess for flexion of fetal head

47
Q

Descent during labor

A

downward movement of the presenting fetal part in a transverse position
measured in relation to the ischial spines

48
Q

Flexion during labor

A

pressure on the fetal head forces flexion tightly to chest

49
Q

Internal rotation during labor

A

1.fetal head enters pelvis transverse
2. head rotates from transverse to anterior
3. occiput just below symphysis pubis
4. shoulders are inline with transverse diameter of the pelvic inlet

50
Q

Extension

A

head is delivered as head pivots off maternal symphysis pubis, face emerges from vagina

51
Q

External Rotation during labor

A

shoulder rotation
as the head externally rotates, the shoulders rotate anterior to posterior
-anterior shoulder delivered first

52
Q

Expulsion

A

remainder of body is quickly delivered

53
Q

Primary Powers

A

Uterine contractions

54
Q

Secondary powers

A

Pushing

55
Q

1st Stage of Labor:

A

begins when labor starts, ends w/ cervix fully dilated

56
Q

2nd Stage of Labor:

A

begins w/ complete dilation , ends w/ delivery

57
Q

3rd Stage of Labor:

A

begins w/ fetus, ends w/ delivery of placenta

58
Q

4th Stage of Labor:

A

begins w/ delivery of placenta, ends w/ complete recovery

58
Q
A
59
Q

1st Phase of Labor:

A

Latent: irregular, most comfortable

60
Q

3rd Phase of Labor:

A

Transition: worst, 8-10cm dilated, N,V, pressure, worst time to medicate

61
Q

2nd Phase of Labor:

A

Active: more regular and uncomfortable, best time to medicate

62
Q

Shiny vs. Not side of the placenta:

A

Shiny: baby side
Not: mom side
“dirty duncan, shiny shultze”

63
Q

Why shouldn’t a mother push before she is fully dilated?

A

can cause the cervix to swell and prolong labor, can tear cervix

64
Q

How should you instruct a mother to push once fully dilated?

A

take deep breathe and hold once contraction starts, push while holding the breath for 30 seconds, aim for 3 pushes a contraction. Rest in-between contractions

65
Q

Why is the first 30 minutes after birth the best for feeding?

A

The baby is awake and will “newborn crawl”

OB (12 decks)

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