Labor And VD Care Flashcards

1
Q

Bishop scoring system. >8 cervix is favorable for induction

Scoring system.

Dilation

Posistion of Cervix

Effacement

Station

Cervical Consistency

A

Dilation
O. closed
1.1-2 cm
2. 3-4 cm
3. 5-6 cm

Posistion of Cervix

  1. Posterior
  2. Mild posistion
  3. Anterior

Effacement

  1. 0-30%
  2. 40-50%
  3. 60-70%
  4. 80%

Station

  1. -3
  2. -2
  3. -1,0
  4. +1,+2

Cervical Consistency

  1. Firm
  2. Medium
  3. Soft
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2
Q

Posistion of Cervix that indicates processing towards labor

A

Anterior cervix

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3
Q

Normally before preggers the cervix is located in a (posterior/anterior) position?

As labor progesss at 37-38 weeks it shifts to midline

As a mother is progressing towards labor the cervix is located (posterior/anterior)

A

Pre preggers cervix is located posterior

Before labor is it Anterior

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4
Q

Process of stimulating uterine contractions before natural labor begins, with the goal of delivering the baby.

A

Induction

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5
Q

Dif between Induction & Augmentation of labor

A

Induction Starts the labor process

Augmentation is when labor already started and increases strength, duration, or frequency of contractions

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6
Q

Reasons to induce labor

A

Post-term pregnancy: When a pregnancy extends beyond 41-42 weeks, due to less Amniotic fluid

PROM happens but labor hasn’t started

preeclampsia or gestational diabetes

Fetal concerns:
Intrauterine growth restriction (IUGR)
Low amniotic fluid (oligohydramnios)

Infection: Chorioamnionitis,

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7
Q

Induction methods

Mechanical

Hormonal

A

Mechanical: Foley bulb or Cook catheter

Hormone: Misoprostol / Pitocin

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8
Q

Cook Cervical Ripening Ballon

1st preform ______

To confirm Singleton, Vertex Presentation, and rule out partial / complete Placenta Previa / Placenta Percreta

Explain the terms

A

Ultrasound

Singleton = 1 baby
Vertex Presentation = head first in cervix pointed toward birth canal (Determine by US or Leopold Maneuver)

Placenta Previa = Placenta covers the cervix either partially or completely

Placenta percreta severe form of placenta accreta. Placenta invades through the uterine wall and may attach to other organs like the bladder.

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9
Q

PAINFUL contractions with ACTIVE cervical change

A

Labor

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10
Q

How do you know labor has begun

A
  1. Regular Contractions
    Regular, consistent contractions.

Occur every 3-5 minutes.
Last 30-60 seconds each.
Grow in intensity and frequency over time.

Differ from early, sporadic contractions (like Braxton Hicks), which are irregular and mild.

  1. Cervical Changes
    Labor truly begins when the cervix starts to dilate (open) and efface (thin out).
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11
Q
  1. Number of pregnancies lnclude all pregnancies regardless of outcome including Current pregnancy
  2. Number of pregnancies (not babies) delivered after 37 weeks
  3. Number of pregnancies (not babies) delivered between 20 and 36 6/7 weeks
  4. Any fetal loss that occurs before 20 weeks
  5. Number of babies born living
  • Multiples are only counted in the Living number
A
  1. Gravida
  2. Term
  3. Preterm
  4. Abortions
  5. Living
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12
Q

3 main nursing objectives of L&D nursing

A
  1. Establishing therapeutic relationship
  2. Maternal assessment include labor progression
  3. Fetal assessment
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13
Q

All part of what?

EFM
VS
SVE
EDC
GTPAL/OB History

Meds & Allergy

Leopold Maneuver/ US

Last food intake

Meds, herbs, drugs

Birth plan, pain management plan, support person involvement

LABS & PIV (NEEDS ORDER): CBC, T&S, PLT, Bloodtype / Rh, UA protein, VDRL

A

Maternal assessment: Admissions

T&S (type and screening) Blood type

PLT = Platelets

UA protein = Urine analysis Protein

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14
Q

Why LR instead of 0.9NS

A

LR maintain stable Ph longer

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15
Q

Ideal posistion of the fetua

A

Vertex presentation

Head-down in the mother’s pelvis, with the back of the head (occiput) facing the front of the mother’s pelvis. This is also known as the cephalic presentation, specifically in the occiput anterior (OA) position.

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16
Q

Nitrazine…

A

Checks pH of (amniotic) fluid

17
Q

Ph and color of ruptured membrane fluid

A

> 6.5 basic

Dark blues

18
Q

Nursing Diagnosis for ROM

A

Risk for infection r/t ROM

19
Q

How often to check temperature after ROM

Delivery within _____

A

2hr temp check

Delivery within 24hrs

20
Q

5 Ps of Labor

A

Passenger
Passageway
Powers
Posistion
Psychological Response

21
Q

Breech Presentation:

Definition: The baby’s buttocks or feet are positioned to be delivered first.
Types:

Frank Breech: ________

Complete Breech: _________

Footling Breech: _________

A

Frank Breech: Baby’s legs are up near the head, with the buttocks closest to the birth canal.

Complete Breech: The baby’s knees are bent, and both feet and buttocks are positioned to come out first.

Footling Breech: One or both feet are positioned to exit the birth canal first.

22
Q

Definition: The baby is lying horizontally in the uterus, with the shoulder or back facing the birth canal.
Complications: This position makes vaginal delivery impossible and almost always requires a C-section.

A

Transverse Lie

23
Q

The baby’s face is the first part presenting in the birth canal.
Brow Presentation: The baby’s forehead is the presenting part.
Challenges: These presentations can cause labor to stall because the widest part of the head is entering the pelvis, leading to longer or more difficult deliveries.

A

Face or Brow Presentation:

24
Q

Definition: The baby’s head is down but facing the mother’s abdomen (back-to-back position).
Challenges: This position can cause back labor and may require assistance (e.g., forceps or vacuum) or even a C-section if the baby doesn’t rotate to an anterior position.

A

Occiput Posterior (OP):

25
Q

Types of pelvis.

Which is better for birthing babies

A

Gynaecoid = Wider & Broader / Less prominent ischial spines

Android = Longer Sacrum / Narrower Sub-pubic arch

26
Q

Involuntary contractions can vary in

A

Duration
Intensity
Frequency

27
Q

Peanut Ball ….

A

Used to promote dilation & decent with well positioned baby.

Use while mother is in bed, probably due to epidural

28
Q

Stages of labor 1st stage

Cervix dilates from _____ to _____

Begins with _____
Ends with _____

Includes 3 phases

A

Cervix dilates from 0 - 10 cm

Begins with contractions
Ends with complete dilation of Cervix

3 phases Latent, Active, Transitional

29
Q

Stage 1 of labor

Describe the 3 phases

Dilation, Contraction Regularness, Strength, Frequency, Duration

A
  1. Latent Phase:
    Dilation: 0-3 cm
    Regularness: Irregular
    Strength: Mild/ Mod
    Frequency: 5 - 30 mins
    Duration: 30 - 45 seconds
  2. Active Phase:
    Dilation: 4 - 7 cm
    Regularness: Regular
    Strength: Moderate/ Strong
    Frequency: 3 - 5 mins
    Duration: 40 - 70 seconds

Transitional phase:

Dilation: 8 -10cm
Regularness: Regular
Strength: Very Strong
Frequency: 2 -3 minutos
Duration: 45 - 90 secs
(Clinet will often state: They need to make a BM)

30
Q

Stage 2 of labor is called the Pushing Stage

Begins….
Ends….

Nursing actions

A

Begins complete dilation of Cervix (10cm)

Ends Delivery of baby

Nursing Action: q5min assessment of fetal HR

Coach through pushing and posistion changes

Record delivery time and posistion

Assessment of bladder & straight catherization

31
Q

Describe how a woman should push…

A

Push like your pooping

32
Q

FAVD (Forecep assisted vag delivery)

Due to exhaustion or fetal distress. Damage is more likely to occur to…

VAVD

A hoover shopvac is used to suction child out. More risk to…

A

Mother

Child

33
Q

Stage 3 aka…

Begins with …
Ends with…

A

Placental delivery

Begins delivery of baby
Ends Delivery of placenta

34
Q

Placental Delivery

Umbilical cord lengthens (then)
Record time placenta gushes out

Be ready with …. (this medication)

A

Cord lengthns then gushes blood
Pitocin

35
Q

Administer Pitocin 10 - 20 units IV 1000mL LR, 20 - 40 tts/min, rate adjusted for uterine firmness

When….

A

After delivery of placenta

36
Q

Stage 4: Early postpartum & passage of lochia

Recovery phase q15min assessment

Including

A

Repair of lacerations

Fundal assessment & vigorously massage

Assessment of Lochia

VS

Highest risk of PPH

Cord blood to lab to determine Cord gas and possibly baby blood type

37
Q

Afterhead crowns the woman should do this…

A

Stop pushing / Slow down the birth to avoid laceration

38
Q

Hand placement for active delivery

A

Hand supporting perineum

Other hand on top of babies head

39
Q

( Misoprostol / Pitocin)

Used for cervical ripening and labor induction.

It can also be used to manage postpartum hemorrhage and induce abortions.

( Misoprostol / Pitocin) is a synthetic form of the hormone oxytocin and is used to induce or augment labor, strengthen labor contractions, and manage postpartum hemorrhage.

A

Misoprostol is primarily used for cervical ripening and labor induction, particularly in cases where the cervix is not ready for labor (unfavorable cervix). It can also be used to manage postpartum hemorrhage and induce abortions.

Pitocin is a synthetic form of the hormone oxytocin and is used to induce or augment labor, strengthen labor contractions, and manage postpartum hemorrhage.