Labor And Delivery Flashcards
14 hours total
1st contractions change your cervix
Ends when completely dilated
Is what stage of labor
1st stage
Ends with explosions of the fetus
Pushing at 10cm dilated
Is what stage of labor
2nd stage
Delivery of placenta
Take up to 30 min
Is what stage of delivery
3rd stage
Recovery
As soon as the placenta is passed start VS
Bonding
Breast feeding
Is what stage of delivery
4th stage of delivery
Mechanisms of labor
Flexion- fetal head movement to help pass
Internal rotation- head enters pelvis diagonally
Extension- as head passes symphysis change from flexion to extension
External rotation- head is born spontaneously, baby rotates
If amniotic fluid is green indication
indicates meconium (fetal BM in utero)
●can affect respiration at birth
Resuscitation team have to be present
Fluid cloudy or yellow with offensive odor
indicates infection
nitrazine test
turns dark blue if amniotic fluid
Fern test
sample of amniotic fluid with cotton-tipped swab, smear on slide and view under microscope-looks like fern leaves
Cervical ripening agents
Cervadil,
Prostin,
Cytotec- cause miscarriage in early pregnancy
laminaria -is a seaweed substance that swells within the cervix, dilating it slightly
Monitor 2hours after receiving for contractions
Artificial oxytocin
Stimulates uterine
Pitocin
treatment postpartum hemorrhage
Methergine- contraindicated pt. Cardiac disease, hypertension, increased BP
Hemabate- contraindicated pt. W/asthma give with limodil causes diarrhea
causes relaxation of smooth muscles
CNS depressant
Magnesium sulfate
Antidote- Ca gluconate
Action
●alters perception of pain
Use
●pain relief
Stadol
opiod antagonist, rapid acting
Narcan
Anesthesia for child birth
Local-lidocaine Epidural-catherter remain intact Local- Pudendal- Spinal-injection of medication catheter is removed, use for c/s General-loss of consciousness
Non Pharmacologic Coping
Dick Read ●Fear, tension, pain cycle Bradley Method ●Slow abdominal breathing Lamaze ●Teaches conditions to respond to Gate control theory ●Massage, fingertip pressure, heat/cold Relaxation ●Massage, water Hypnosis Diversion
Complications of labor
Dystocia- baby body part to big to come out/ mc Roberts maneuver
Hypotonic labor-ctx to weak to be effective labor
Ineffective maternal push-mom can’t push
Hypertonic labor-frequent ctx no change in cervix(terbutaline)
CPD cephalopelvic disppoportion- enlarge head
Abnormal position- breech, face position
Cord prolapse- cord comes out first baby head suppresses it
Precipitate birth- born outside medical facility
Uterine rupture-
Hemorrhage
Inversion
Amniotic fluid embolism
suction cup placed over fetal head, vacuum applied
Can only use 3 times, when cap come off
Vacuum extraction
If vacuum don’t work use ____ to help escort baby down. Do not pull on baby.
Forceps
If pt. Had a previous c section and come in for natural birth this is called
TOLAC - trail to labor after c section
VBAC
Vaginal birth after c section
Rpt c/s
Repeated c section
Umbilical cord consist of
AVA
Whartons jelly
Baby side of the placenta is called
Shiny Shultz
Placenta side is called
Beefy side
Dirty Duncan
When baby first come out you want to
Skin to skin contact
(Stabilize BP, temp,vs) helps to facilitate breastfeeding
Clamp and cut cord
Most important baby comprising
Cold stress
Dry and warm
Baby lose heat by
Convection- air passing/ cool breeze
Conduction- warm to cold surface
Radiation- heat leaves
1st few hours after birth the baby will receive which 2 medications
Erythromycin- eye drops
VIT. K
A baby should be washed _____ unless mom has HIV, hepatitis, corial then it’s done immediately
12-24hours after birth
Check baby’s frontenal for
Dehydration
Stages of labor
Stage one- dial ati on til pt. 10cm
Stage 2- expulsion of baby
Stage3- expulsion of placenta
Stage 4- recovery
What is the most accurate way to discribe contractions
5 min apart with change in cervix 3 to 6 cm
Vomiting and nausea are caused by
Hormone changes
If a pt has a history of methadone use do not give them
Neubaine
Pt is suppose to urinate
Every 2-3 hours if not catherter is placed
ABGAR is first performed ___ after birth. Then ___ after that. If less then 7 perform again in 5 min(10min) keep performing till MD orders otherwise.
1 min
5min
4 P’s of labor
Power- contractions
Passage- route infant takes
Passenger- fetus/ baby
Psyche- mental state( most variable)
Pelvis position most favorable for birth
Gynecoid
Best candidate to deliver at home
Pt with no complications
Pt plans to deliver at home. Cord becomes present when water breaks what do you do.
Call 911
Take baby’s head hold it off cord
What are Braxton hicks
Not intense contractions
Do not cause cervix change
If pt has GBS would you break their water
No can cause baby to go into respiratory distress if they pass infection
Greatest influence on birth is
Culture
Medication that rippen cervix
Cevidal, cytotec
If pt is diabetic do baby come out extra fat
No
