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Exam 4 (Spring) > Labor and Delivery > Flashcards

Labor and Delivery Flashcards

1
Q

T/F Labor: Contractions are irregular

A

False labor

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2
Q

T/F Labor: Contractions keep coming no matter what you do

A

True labor

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3
Q

T/F Labor: Contractions steadily get stronger

A

True labor

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4
Q

T/F Labor: Contractions get stronger with ambulation

A

True labor

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5
Q

T/F Labor: Contractions do not get closer together with time

A

False labor

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6
Q

T/F Labor: Pain is usually felt only in the front

A

False labor

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7
Q

T/F Labor: Contractions come at regular intervals and get closer together

A

True labor

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8
Q

T/F Labor: Contractions are often weak and tend to stay that way

A

False labor

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9
Q

T/F Labor: Contractions, if strong, are followed by weaker ones

A

False labor

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10
Q

T/F Labor: Contractions last 30-90 seconds

A

True labor

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11
Q

T/F Labor: Pain usually starts in the back and moves to the front

A

True labor

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12
Q

T/F Labor: Contractions before 24 weeks might be accompanied by vaginal spotting

A

True labor

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13
Q

T/F Labor: Braxton Hicks contractions do not dilate the cervix

A

False labor

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14
Q

1st stage of labor

A

Cervix reaches full dilation

Longest phase

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15
Q

Latent phase of 1st stage of labor

A

Contractions become more frequent and stronger
10-12 hours for woman with children
20 hours for primagravida

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16
Q

Active phase of 1st stage of labor

A

From 3-4 cm to 8-9 cm

5 hours in 1st time mothers

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17
Q

2nd stage of labor

A

Mother actively pushes baby out
Delivery of the baby

1st time mothers - 2-3 hours
2nd babies + - often less than 1 hour

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18
Q

3rd stage of labor

A

Begins immediately after the birth of the baby

Ends with delivery of the placenta

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19
Q

4 “P” Components of Labor

A

Passageway
Passenger
Power
Psyche

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20
Q

Assessment of Documentation of Membranes

A 
Intact 
Ruptured 
ROM 
SROM 
AROM 
PROM 
Gush or trickle

Greenish color indicates meconium is in danger

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21
Q

Primary nursing responsibilities of the membrane

A

Document time, color, and odor o fluid as a baseline

Continue to observe

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22
Q

Once the membrane ruptures, the danger is:

A

Infection

Note color and odor of amniotic fluid

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23
Q

How should amniotic fluid look?

A

Clear with occasional white particles

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24
Q

The lecitihin/sphinhomyelin radio is used to:

A

determine fetal lung maturity

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25
Q

Surfactant is a mixture of:

A

Lipids
Proteins
Lecithin - makes surfactant mixture more effective
Sphingomyelin

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26
Q

What is an episiotomy?

A

Perineal incision to enlarge the vaginal outlet

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27
Q

Molding of fontanels:

A

Head is molded during delivery

WIll return to normal in a few days

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28
Q

Presentation of the descending fetus:

A

fetal part that enters the pelvis first

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29
Q

Position the descending fetus:

A

position of baby’s occiput relative to mom’s pelvis

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30
Q

Lie of the descending fetus:

A

position of baby’s body relative to mom’s spine

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31
Q

Attitude if the descending fetus:

A

flexion

32
Q

Leopold’s Maneuvers:

A

Helps determine position and lie of the baby

33
Q

1st Leopold’s Maneuver

A

What is in the fundus?

34
Q

2nd Leopold’s Maneuver

A

Where is the fetal back?

35
Q

3rd Leopold’s Maneuver?

A

What is in the pelvis?

36
Q

4th Leopold’s Maneuver?

A

What is presenting?

37
Q

Normal HR of fetus?

A

120-160

38
Q

4 things to assess of fetal heart tones

A

HR
Variability (beat-to-beat, long term)
Accelerations
Decelerations

39
Q

Accelerations in fetal heart tones are:

A

expected

40
Q

Late decelerations in fetal heart tones are:

A

bad

41
Q

Variability in a fetus’ hear tones is a good indication of:

A

fetal wellness

42
Q

Variable deceleration:

A

transient series of decelerations that vary in intensity, duration, and relation to uterine contraction

43
Q

Late deceleration:

A

in fetal HR monitoring, a transient decrease in HR occurring at or after the peak of uterine contraction may indicate fetal hypoxia or possible utero-placental insufficiency

44
Q

Oxytocin (Pitocin) stimulates and produces what?

A

Stimulates uterine smooth muscle

Produces uterine contractions

45
Q

Oxytocin (Pitocin) induces and controls what?

A

Induces labor

Controls post partum bleeding

46
Q

(2) maternal and (1) infant oxytocin complication:

A 
Maternal 
   -coma 
   -seizures 
Infant 
   -intracranial hemorrhage
47
Q

If the mother has a prolapsed cord, what do you do?

A

Place her in knee-chest position

48
Q

Determine contractions by what 3 things?

A

Intensity
Duration
Frequency

49
Q

Optimal Contractions (4)

A

Involuntary
Shortening of uterine fibers
Endogenous oxytocin
Every 3-5 minutes x 60 seconds

50
Q

When using narcotics, monitor for signs of maternal and fetal:

A

distress closely

51
Q

Schedule II drugs for labor:

A

Morphine

Fentanyl

52
Q

Mixed agents (narcotic agents) for pain management for labor:

A

Stadol

Nubain

53
Q

What to monitor with epidural blocks:

A

Hypotension

Urinary retention

54
Q

Epidural block is placed where?

A

Under dura and arachnoid membranes

55
Q

What does an epidural block?

A

Transmission of pain impulses

56
Q

Who does the epidural block?

A

Anesthesiologist

57
Q

Spinal patch is used for:

A

C-Section

58
Q

How should the mother lie after a spinal patch?

A

Flat

Prevents HA

59
Q

Mother loses all feeling below where after spinal patch?

A

Below the block

60
Q

Spinal patch acts quickly and requires more/less medicine than an epidural?

A

less

61
Q

2 adverse effects of spinal patch:

A

Hypotension (more severe than epidural block)

Urinary retention

62
Q

Nursing care for patient undergoing adverse effect of spinal patch:

A

Analgesics
Oral and IV fluids to relieve HA
Bed rest

63
Q

Epidural is injected into:

A

the epidural space

64
Q

Can an epidural be used with a C-section?

A

Yes

65
Q

How dilated must the cervix be for an epidural?

A

4 cm

66
Q

3 reasons you cannot give an epidural?

A

Abnormal clotting
Infection present
Hypovolemic

67
Q

Nursing care for post-op epidural:

A

Hypotension (extreme drop)
Urinary retention
Catheterize if full bladder
Monitor VS according to hospital policy

68
Q

Pudendal block works by:

A

Injecting pudendal nerves with a local anesthetic just before vaginal birth

69
Q

Who administers a pudendal block?

A

Nurse-midwife or MD

70
Q

Adverse effects of pudendal blocks:

A

Vaginal hematoma
Abscesses
Allergic reaction

71
Q

Nursing care for pudendal blocks:

A

Check for allergies

Consider pain and hematoma

72
Q

When is the pudendal block administered?

A

Just before vaginal birth

73
Q

Risk of general anesthesia for C-Section?

A 
Aspiration (mother) 
Respiratory depression (baby)
74
Q

APGAR

A 
Heart rate 
Respiratory effort 
Muscle tone 
Reflex irritability 
Color 
Done at 1 minute and 5 minutes after birth 
(Note time of birth)
75
Q

Narcotic drug of choice for pain relief during labor when cervix is <4 cm dilated?

A

Meperidine

Exam 4 (Spring) (12 decks)

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