Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

ENRP Exam 1 > Labor and Delivery > Flashcards

Labor and Delivery Flashcards

1
Q

labor

A

progressive cervical dilation resulting from regular uterine contractions that occur at least every 5 minutes and last 30-60 seconds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

false labor

A

also called Braxton-Hicks contractions

irregular contractions without cervical change

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

which pelvic shapes have good prognosis for delivery?

A

gynecoid (50% of females)

anthropoid (20% of females)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

which pelvic shapes have bad prognosis for delivery?

A

android (30% of females)

platypelloid (3% of females)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

typical obstetric exam

A 
fetal lie (longitudinal vs transverse vs oblique)
fetal presentation (breech vs vertex)
cervical exam
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

leopold maneuvers

A

series of 4 maneuvers for palpating fetal lie and presentation in the uterus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

cervical dilation

A

check at the level of internal os

ranges from closed to 10 cm dilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

cervical effacement

A

thinning of cervix occurs and is reported as a % change in length

range is thin = 100% effaced

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

cervical station

A

degree of descent of the presenting part of the fetus

measured in cm from presenting part to ischial spines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

cervical consistency and position

A

used to calculate Bishop score??

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

first stage of labor

A

onset of true labor to complete cervical dilation

latent phase and active phase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

first stage latent phase

A

the period between onset of labor and is characterized by slow cervical dilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

first stage active phase

A

associated with faster rate of dilation and usually begins when cervix is dilated to 6 cm

*admit for labor at this stage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

duration of first stage

A

6-18 hours for primapara (1.2 cm/hour)

2-10 hours for multipara (1.5 cm/hour)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

management of first stage

A 
maternal position - may ambulate or encourage left lateral recumbent position
IV fluids
Labs - CBC and T&S
obtain vitals q1-2 hrs
provide adequate analgesia
fetal monitoring 
uterine activity
vaginal exams
amniotomy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

fetal monitoring during first stage

A

external monitoring
q30 mins for uncomplicated pregnancy
q15 mins for complicated pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

how is uterine activity monitored?

A

external tocodynamometer

internal pressure catheter - useful with oxytocin augmentation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

amniotomy

A

artificial rupture of membranes

*breaking the mother’s water

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

benefits of amniotomy

A

augment labor

allow assessment of meconium status

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

risk of amniotomy

A

cord prolapse

prolonged rupture is associated with chorioamnionitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

second stage of labor

A

characterized by descent of the presenting part through the maternal pelvis and culminates delivery

mother has desire to bear down during each contraction

increased bloody show

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

duration of second stage

A

primapara w/ epidural = 2 hrs
primapara w/o epidural = 3 hours
multipara w/ epidural = 1 hour
multipara w/o epidural = 2 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

cardinal fetal movements of labor

A 
engagement
descent
flexion
internal rotation
extension
external rotation
expulsion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

management of second stage

A 
avoid supine position 
bearing down
continuous fetal monitoring
vaginal exams
delivery of fetus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

episiotomy indications

A

likelihood of spontaneous laceration seems high

to expedite delivery by enlarging the vaginal outlet

26
Q

most commonly performed episiotomy

A

midline

27
Q

describe the modified Ritgen maneuver for head delivery

A

fingers of the right hand are used to extend the head while counterpressure is applied to the occiput by the left hand

allows for more controlled delivery

28
Q

first degree perineal laceration

A

superficial lac involving vaginal mucosa and/or the perineal skin

29
Q

second degree perineal laceration

A

lac extending into the muscles of the perineal body but does not involve the anal sphincter

30
Q

third degree perineal laceration

A

lac extends into or completely through the anal sphincter but not into the rectal mucosa

31
Q

fourth degree perineal laceration

A

lac involves the rectal mucosa

32
Q

third stage of labor

A

interval between delivery of infant and delivery of placenta

typically lasts 2-10 minutes

33
Q

what is the dx if the placenta is not delivered within 30 minutes?

A

retained placenta

34
Q

classic signs of placental separation

A

gush of blood from the vagina
lengthening of the umbilical cord
fundus of the uterus rises up
change in shape of the uterine fundus from discoid to globular

35
Q

management of third stage

A

look for lacerations
monitor uterine bleeding
repair episiotomy or spontaneous lacerations
inspect the placenta

36
Q

management of fourth stage of labor

A

monitor patient closely
vitals
uterine fundal checks and assess for vaginal bleeding
postpartum hemorrhage commonly occurs during this time

37
Q

risk factors for postpartum hemorrhage

A

uterine atony
retained placenta
unrepaired lacerations

38
Q

cervical ripening

A

facilitating the process of cervical softening, thinning, and dilating to reduce the rate of failed inductions

39
Q

induction of labor

A

the process by which labor is induced by artificial means

40
Q

augmentation of labor

A

artificial stimulation of labor that has already begun

41
Q

indications for induction

A 
abruptio placentae
chorioamnionitis
fetal demise
preeclampsia/eclampsia
gestational HTN
premature rupture of membranes
postterm pregnancy
maternal conditions
unstable fetal presentation
acute fetal distress
placental previa or vasa previa
previous C-section or uterine surgery
42
Q

components of Bishop score

A 
cervical dilation
cervical effacement
station
cervical consistency
cervical position
43
Q

bishop score < 6

A

unfavorable

44
Q

bishop score > 8

A

probability of vaginal delivery after labor induction is similar to that of spontaneous labor

45
Q

cervical ripening agents

A

dinoprostone (prost E2)
misoprostol (prost E1)
mechanical dilation

46
Q

what is the only drug that is FDA approved for labor induction and augmentation?

A

pitocin

47
Q

pitocin complications

A

uterine tachysystole
antidiuretic effect
uterine muscle fatigue
increased risk of postpartum hemorrhage 2˚ to atony

48
Q

major concern for use of obstetric analgesia

A

may decrease uterine blood flow if hypotension occurs

*IVFs given prior to regional anesthesia to mitigate risk

49
Q

uterine contraction pain pathway

A

T10-L1

50
Q

pelvic floor, vagina and perineum pain pathway

A

S2-S4

51
Q

regional anesthesia

A

partial or complete loss of pain sensation below T10 level

lidocaine + narcotic
epidural
spinal

52
Q

anesthesia options in labor

A 
nonpharmacologic methods
parenteral
regional
local
general
53
Q

nonpharmacologic methods of anesthesia

A 
lamaze
emotional support
back massage
hydrotherapy
acupuncture

*these don’t work just take the drugs you dumb bitch

54
Q

parenteral anesthesia

A

morphine, fentanyl, meperidine and nalbuphine

more effective in the first stage of labor

55
Q

risk of parenteral anesthesia

A

opioids can cross placental barrier = neonatal respiratory depression

*give that baby some Narcan

56
Q

epidural

A

most effective form of pain relief for labor

catheter is placed in the epidural space for continuous infusion of anesthetic agents

57
Q

benefits of regional anesthesia

A

highly effective
mother remains alert and awake
mother remembers the experience
rarely requires local anesthesia for lacerations

58
Q

side effects of regional anesthesia

A 
hypotension (10%)
spinal headaches (1-2%)
fever
spinal hematoma
spinal abscess
59
Q

contraindications for regional anesthesia

A 
maternal coagulopathy
heparin use
untreated maternal bacteremia
increased ICP
skin infection over site of needle placement
60
Q

local anesthesia

A

lidocaine to perineum prior to episiotomy or lac repair

pudendal block

61
Q

general anesthesia

A

propofol most commonly used - must have airway management

used for emergent cases of rapid delivery

62
Q

risks of general anesthesia

A

16 fold increased risk of maternal mortality

inhaled anesthetics cross placenta = neonatal respiratory depression

ENRP Exam 1 (20 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions