Labor & Baby Complications

Question 1

the stimulation of uterine contractions after labor has spontaneously started

Answer 1

Augmentation of labor

Question 2

E1 & E2 prostaglandin

Answer 2

Misoprostol (Cytotec) & Dinoprestone (Cervadil)

Ripens the cervix

Question 3

AROM is used when (amniotomy)

Answer 3

when cervix if favorable for labor if the progress begins to slow

labor usually begins within 12 hrs of labor

Question 4

amniotomy procedures

Answer 4

Painless
elevate hips
Assess baseline (tachycardia is common)
Assess for presence of meconium/blood
assess temp Q2h

Can lead to variable HR (cord compression)

Question 5

s/s of infection

Answer 5

foul smelling odor
increased temperature
tachycardia (maternal + fetal)

Question 6

Oxytocin (Pitocin) how can become harmful for mom/baby

Answer 6

Placental abruption
Uterine rupture
Unnecessary c/s
Nonreassuring FHR
PP hemorrhage
infection
fetal hypoxemia
Acidemia

Question 7

Goal of Oxytocin (Pitocin)

1 miliunit to 1-2 miliunit (slow)

Answer 7

Consistent pattern every 2-3 min lasting 80-90 seconds & strong to palpation

Question 8

Reason for pitocin

Answer 8

start or improve labor

Question 9

Pitocin assessment

Answer 9

FHR every 15 min
every 5 during active pushing phase of 2nd stage of labor
BP every 30-60 min
urine should be 120 mL or more every 4 hrs

Question 10

Uterine tachysystole

Answer 10

1. more than 5 contractions in 10 min or
2. single contractions lasting longer than 2 min or
3. resting interval 1 minute or less

Question 11

indications for forceps

Answer 11

prolonged 2nd stage
fetal distress
abnormal position

Question 12

prolapsed cord is evidenced by

Answer 12

variable decelerations that stay down

Question 13

causes of prolapsed cord

Answer 13

fetus in high station
very small fetus
breech presentations
ROM
transverse lie
Hydraminos (larger gush of fluid)

Question 14

complete sign of prolapsed cord:

Answer 14

cord visible @ vaginal opening

May not be visible but palpable

Question 15

Occult prolapsed cord:

Answer 15

cord slips alongside fetal head/shoulders

Cannot be palpated/seen

Question 16

Occult prolapsed cord is suspected due to

Answer 16

sustained fetal bradycardia

Variable decelerations

Question 17

Terbutaline/Brethine

Answer 17

stops preterm labor (inhibits uterine muscle activity)

Key assessments:
Lungs (pulmonary edema)
HR (tachy)
Chest p! (tachycardia)
FHR: tachycardia

Question 18

Predicting preterm labor

Answer 18

Cervical length 
pPROM in previous birth
fetal fibronectin 
dehydration
infections

Question 19

Criteria for continuation of mag therapy

Answer 19

urine output of at least 30 ml
Presence of DTR
at least 12 bpm

Question 20

Side effects of tocolytics

Answer 20

Tachycardia
Pulmonary edema
Chest pain

monitor for these signs

Question 21

Mag sulfate

Answer 21

quiets uterine activity

Depresses the CNS

Question 22

Monitor what with mag sulfate?

Answer 22

RR
DTR
Urinary output
BP