Labor & Delivery Flashcards
In True Labor are contractions regular or irregular ?
Regular
In True Labor, due contractions increase or decrease in frequency and duration ?
Increase
In True Labor, where does Discomfort in the back radiate too ?
Radiates to the abdomen
In True Labor, what happens to the pain level with a change in activity ?
It increases
In False Labor, what are the contractions like ?
Irregular
Braxton Hicks - which usually go away if movement by mom, etc
In False Labor, where is the discomfort ?
The abdomen (just in front)
In False Labor, what happens to the pain with a change in activity ?
The pain decreases
With Premature labor or preterm labor, contractions occur when ?
Occur with dilation, between 20 and 37 weeks
What is the goal with Premature labor or preterm labor ?
Goal = Stop the labor
What things will often stop preterm labor ?
- Treating any existing vaginal or UTI’s
- Hydrating the mom
A client in Premature Labor or Preterm labor will be on what ?
Bedrest
What are medications that may be prescribed in premature labor or preterm labor ?
- Magnesium Sulfate (IV) - relaxes the uterus
- Betamethasone (IM) - a steroid that helps the fetal lungs mature
- Terbutaline (SQ)
- Indomethacin (PO)
- Nifedipine (PO)
How should you position a client receiving Epidural Anesthesia ?
Lying on the left side, legs flexed, & proper over the bedside table
When is Epidural Anesthesia given ?
In Stage 1, 3 to 4cm dilation
Does a headache usually accompany Epidural Anesthesia ?
No
What is a Major complication of Epidural Anesthesia ?
Hypotension
monitor BP closely
Because Hypotension is usually a complication with Epidural Anesthesia, what is given ?
IVF’s
Bolus with 1000mL of NS or LR
Vena Cava compression will do what to venous return ?
Decrease it
If venous return is decreased d/t vena cava compression, what will the result be ?
It will reduce CO and BP & if BP is decreased then placental perfusion also decreases
What should a client who received Epidural Anesthesia do ?
Alternate position from side to side Hourly (in semi-fowlers)
What should you not forget to check in a patient who received an Epidural Anesthesia ?
Don’t forget to check their Urine output and assess the bladder
What do clients receiving Oxytocin need, in regards to care ?
Need one-on-one care (Don’t leave the client!)
What complications should you be alert for in a client reviewing Oxytocin ?
- Hypertonic Labor
- Fetal distress
- Uterine rupture
Why is a Uterine rupture a possible complication in a client receiving Oxytocin ?
The uterus may rupture due to rupture of the scar from a previous C-section
What type of Moms are at risk for Uterine rupture ?
Vaginal Birth After C-Section moms
In a Client receiving Oxytocin, you want a contraction rate of what ?
A contraction rate of 1 every 2 to 3 minutes with each lasting 60 seconds
When should Oxytocin be discontinued ?
- When the contractions are too often,
- The contractions last too long
OR - With any sign of fetal distress
How is Oxytocin hung ?
Oxytocin is piggy backed into a main IV
so when you discontinue the oxytocin, make sure you do not turn off your main IV fluid
What position should the client receiving oxytocin be placed ?
Any position Except Flat on their back
How will you position the client receiving Oxytocin if the client has any unreassuring fetal heart tones (ex: fetal bradycardia) ?
Put the client on her LEFT SIDE to enhance uterine perfusion
What should be done with the Oxytocin infusion if late decelerations occur ?
Turn it off
Where is IV oxytocin given ?
At the lowest IV port, incase it needs to be turned off quickly, the patient will get less of it
Oxytocin is a what ?
High alert medication
When giving Oxytocing to a client, what things should you label ?
Always label both the IV bag with an oxytocin sticker and the IV tubing and ports
How should you administer Oxytocin ?
Only administer oxytocin with its own bag and close all clamps before you remove the tubing from the pump
How should you discontinue Oxytocin when you’re done with it ?
Remove the IV bag and all the tubing from the room
