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1538 - Test 2 (Reproduction + Human Development) > Labor & Delivery + Labor Pain > Flashcards

Labor & Delivery + Labor Pain Flashcards

1
Q

V > C
E > H
A > O
L > P

A

V = variable decelerations > C = cord compressions
NOT OK

E=early decelerations > H = Head compressions
OK!!

A= accelerations > O= OK

L= late decelerations > P= placental insufficiency
NEVER OK!!! EMERGENCY

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2
Q

Ongoing nursing care in the _____ of intrapartum includes:

  • *every 30 min >
  • vital signs
  • *every 15-30 min >
  • FHR pattern
  • uterine activity & show
  • maternal mood & affect

**vaginal exams for cervical change

A

Ongoing nursing care in the ACTIVE PHASE of intrapartum includes:

  • *every 30 min >
  • vital signs
  • *every 15-30 min >
  • FHR pattern
  • uterine activity & show
  • maternal mood & affect

**vaginal exams for cervical change

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3
Q

_____ is infusion of room-temperature isotonic fluid (usually normal saline or lactated Ringer’s solution) into the uterine cavity if the volume of amniotic fluid is too little.

A

AMNIOFUSION is infusion of room-temperature isotonic fluid (usually normal saline or lactated Ringer’s solution) into the uterine cavity if the volume of amniotic fluid is too little.

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4
Q

What is amniotic fluid embolism (Anaphylactoid syndrome of pregnancy)

A

Amniotic fluid embolism is when fetal debris enters maternal circulation

  • *causes 5-10% maternal deaths
  • *22-61% of mothers die; 80% of fetus’ die
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5
Q

What are the FRIST S/S of Amniotic Fluid Embolism?

A

What are the FRIST S/S of Amniotic Fluid Embolism?

DYSPNEA + SEVERE HTN

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6
Q

Amniotic Fluid Evaluation:

A

amniotic fluid is very BASIC
if membranes are intact, the swab will be YELLOW
if membranes are ruptured, the swab will be BLUE

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7
Q

_____ or ____ can both cause a FALSE + on an amniotic fluid evaluation swab.

A

BLOOD or SEMEN can both cause a FALSE + on an amniotic fluid evaluation swab.

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8
Q

Causes of FETAL BRADYCARDIA include:

A
  • atrioventricular dissociation (heart block)
  • structural defects
  • viral infections
  • medications
  • fetal heart failure
  • maternal hypoglycemia
  • maternal hypothermia
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9
Q

What methods are used for cervical ripening?

A

CYTOTEC which cannot be removed
CERVADIL which can be removed
COOK DOUBLE BUBBLE CATH with can be removed

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10
Q

Hypoxemia causes the FHR to _____

A

Hypoxemia causes the FHR to DROP

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11
Q

When is the best time to administer a narcotic analgesic via IV to the patient in the labor and delivery unit?

  • during the latent phase of labor
  • during the active phase of labor
  • just before delivery
  • upon admission to the unit
A

When is the best time to administer a narcotic analgesic via IV to the patient in the labor and delivery unit?

-during the active phase of labor

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12
Q

____ __ ____ means difficult labor abnormally slow progress of labor.

A

DYSTOCIA OF LABOR means difficult labor abnormally slow progress of labor.

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13
Q

What nursing interventions are required for early decelerations?

A

NONE! Early decelerations are OK and expected because of the contraction compressing the fetal head.

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14
Q

What can cause early decelerations?

A

Causes of early decelerations include:

  • *head compression resulting from the following:
  • uterine contractions
  • vaginal examination
  • fundal pressure
  • placement of internal mode of monitoring
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15
Q

When is ECV not used/contraindicated

A
  • uterine abnormalities
  • 3rd trimester bleeding
  • multifetal gestation
  • oligohydraminos
  • nuchal cord
  • previous C/S
  • obvious cephalopelvic disproportion
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16
Q

Is lightening the maternal sensation of fetal movement in the abdomen?

A

NO - FALSE:

Lightening is the dropping of the fetus into the birth canal, only occurs during a woman’s first pregnancy!

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17
Q

Can an external uterine TOCO monitor accurately reflect the pressure of uterine contractions in mmHg which can be calculated into MVU’s?

A

NO!!! TOCO monitors can only track the duration of the contractions NOT the pressure/strength

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18
Q

Is external cephalic version is an option for all breech pregnancies?

A

NO! there are many contraindications for ECV!

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19
Q

What is the FERGUSON REFLEX?

A

FERGUSON REFLEX is the uncontrollable urge to push!

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20
Q

What is the FETAL ATTITUDE?

A

FETAL ATTITUDE is the relationship of fetal parts to the fetus itself.

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21
Q

What is considered fetal bradycardia?

A

Fetal bradycardia is a FHR with less than 100 BPM

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22
Q

What is FETAL LIE?

A

FETAL LIE is the relationship of fetal axis to the maternal axis

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23
Q

What is considered fetal tachycardia?

A

Fetal tachycardia is a FHR with more than 160 BPM

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24
Q

What causes late decelerations?

A
  • uterine tachysystole
  • maternal supine HTN
  • epidural or spinal anesthesia
  • placental previa
  • placental abruption
25
Q

What causes late decelerations?

A
  • uterine tachysystole
  • maternal supine HTN
  • epidural or spinal anesthesia
  • placental previa
  • placental abruption
  • hypertension disorders
  • postterm gestation
  • intrauterine growth restriction
  • diabetes
  • intraamnioic infection
26
Q

What is the clinical significance of LATE DECELERATIONS?

A
  • abnormal pattern associated with fetal hypoxemia
  • acidemia
  • low APGAR scores
  • considered ominous if persistent and uncorrected
27
Q

nursing interventions for LATE DECELERATIONS

A

Nursing interventions for LATE DECELERATIONS:

  • discontinue oxytocin if infusing
  • assist women to lateral position (side lying)
  • administer oxygen at 10L/min by nonrebreather mask
  • correct maternal hypotension by elevating legs
28
Q

In a shoulder presentation, the ______ is closest to the cervical opening.

A

In a shoulder presentation, the SCAPULA is closest to the cervical opening.

29
Q

Ongoing nursing care in the _____ of intrapartum includes:

  • *every 5-30 min >
  • vital signs
  • *every 5-15 min >
  • FHR pattern
  • *every 10-15 min>
  • uterine activity & show
  • maternal mood & affect
  • *vaginal exams for cervical change
  • *assess each contraction and bearing down effort
A

Ongoing nursing care in the SECOND STAGE of intrapartum includes:

  • *every 5-30 min >
  • vital signs
  • *every 5-15 min >
  • FHR pattern
  • *every 10-15 min>
  • uterine activity & show
  • maternal mood & affect
  • *vaginal exams for cervical change
  • *assess each contraction and bearing down effort
30
Q

What is shoulder dystocia?

A

SHOULDER DYSTOCIA is when the shoulder cannot pass through the pelvic arch
**THIS IS AN EMERGENCY!

31
Q

What are treatments for shoulder dystocia?

A

Treatment for shoulder dystocia include:

  • suprapubic pressure
  • McRoberts maneuver - knees to chest
  • ***DO NOT APPLY FUNDAL PRESSURE
32
Q

What is a S/S of shoulder dystocia?

A

S/S of shoulder dystocia include:

  • the turtle sign
  • no external rotation
33
Q

What is UTERINE TACHYSYSTOLE?

A

Uterine tachysystole is when the uterus contracts MORE THAN 5 times in 10 minutes

34
Q

What does expected uterine activity look like?

A
  • Contractions every TWO - FIVE minutes
  • Contractions lasting less than NINTY SECONDS
  • MORE THAN THIRTY SECONDS between contractions
  • FIVE or fever contractions in TEN MINUTES averaged over a THIRTY minute window
35
Q

What is considered the first stage of active labor?

A

The FIRST STAGE of active labor is 4-7CM DILATED!

36
Q

What is considered the transition phase of the first stage of labor?

A

The TRANSITION PHASE of labor is 8-10CM DILATED!

37
Q

When do the fontanels of the fetal head close?

A

Anterior closes at 18 MONTHS

Posterior closes at 6-8 WEEKS

38
Q

What is closest to the cervical opening with a breech presentation?

A

In a BREECH PRESENTATION the SACRUM is the closest to the cervical opening!

39
Q

What types of fetal presentations are there?

A
  • Cephalic (head)
  • Breech (butt)
  • Shoulder (shoulder)
40
Q

Once the bag of waters is ruptured, the FIRST thing you do is_______

**Plummeting ___ indicates ___

A

Once the bag of waters is ruptured, the FIRST thing you do is CHECK FHR!!!

**Plummeting FHR indicates CORD PROLAPSE!!

**THIS IS THE #1 PRIORITY!!!

41
Q

What to do if the cord prolapses?

A

CALL FOR HELP! NOTIFY THE HCP!!!!

42
Q

What are the 3 phases of the 1st stage of labor!?

A

early (latent)
active
transition

43
Q

Mechanisms of labor happen in this EXACT order:

A
  • engagement
  • descent
  • flexion
  • internal rotation
  • extension
  • restitution and external rotation
  • expulsion
44
Q

In fetal attitude, ___ is when everything is stretched out. This is common in ___ babies!

A

In fetal attitude, EXTENSION is when everything is stretched out. This is common in PRETERM babies!

45
Q

First Stage
Second Stage
Third Stage
Fourth Stage

A

First stage: ends with full cervical effacement + dilation
Second stage: ends with fetal expulsion
Third stage: ends with placental expulsion
Fourth stage: return to maternal homeostasis

46
Q

In fetal attitude, ___ is when everything on the fetus is flexed except for the chin.

A

In fetal attitude, FLEXION is when everything on the fetus is flexed except for the chin.

47
Q

What are the 4 sutures of the fetal head > front to back

A

Frontal, Coronal, Sagittal, Lamboid

FCSL

48
Q

What are the types of fetal attitude?

A

General flexion
Flexion
Extension

49
Q

What to know about epidurals?

A

Frequently HYPOTENSION with epidural; so a bolus of IV FLUIDS are given 30 MINUTES before administration

50
Q

What is the landmark in determining the station of the fetus?

A

ISCHIAL SPINES

51
Q

Leopold’s maneuver #1

A

TOP OF MATERNAL BELLY

52
Q

Leopold’s maneuver #2

A

SIDES OF MATERNAL BELLY

53
Q

Leopold’s maneuver #3

A

BOTTOM OF MATERNAL BELLY

54
Q

Leopold’s maneuver #4

A

BABIES HEAD

55
Q

_____ help you determine what position the baby is in and where to put the FHR monitor

A

Leopold’s maneuver help you determine what position the baby is in and where to put the FHR monitor

56
Q

In terms of fetal position, ____ is the easiest delivery?

A

In terms of fetal position, LOA is the easiest delivery

LOA = baby head down, occipital bone presenting, babies spine facing left

57
Q

Early (latent) phase of the 1st stage of labor is

A

Early (latent) phase of the 1st stage of labor is UP TO 3 CM

58
Q

In a _____ _____ the back of the head is closest to the cervical opening

A

In a VERTEX PRESENTATION the back of the head is closest to the cervical opening

1538 - Test 2 (Reproduction + Human Development) (14 decks)

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