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RN Spring 2021 > Maternity Ch. 8 > Flashcards

Maternity Ch. 8 Flashcards

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1
Q

What hormones stimulate contractions?

A

Prostaglandins and oxytocin

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2
Q

What happens as placenta ages?

A

Begins to breakdown, triggering initiation of contractions

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3
Q

Lightening

A

descent of the fetus into true pelvis; normally around 2 weeks before term

-Feels she can breathe better but causes urinary frequency due to bladder pressure

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4
Q

Braxton-Hicks

A

Irregular UC’s and do not cause cervical change

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5
Q

True labor

A

regular UC with cervix dilation and effacement

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6
Q

5 P’s

A 
● Powers (the contractions) 
● Passage (the pelvis and birth canal) 
● Passenger (the fetus) 
● Psyche (the response of the woman) 
● Position (maternal postures and physical positions to facilitate labor)
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7
Q

Frequency

A

● Frequency: Time from beginning of one contraction to the beginning of another. It is recorded in minutes (e.g., occurring every 3 to 4 minutes).

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8
Q

Duration

A

● Duration: Time from the beginning of a contraction to the end of the contraction. It is recorded in seconds (e.g., each contraction lasts 45 to 50 seconds).

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9
Q

Intensity

A

● Intensity: Strength of the contraction

  • Done during a contraction
  • Nose +1
  • Chin +2
  • Forehead +3
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10
Q

What two powers are for external monitoring

A

Frequency and duration

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11
Q

what power is for internal monitoring

A

Intensity

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12
Q

How to place toco?

A

palpate area that has no fetus

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13
Q

What must be done for before internal monitor is used?

A

Membrane must be ruptured

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14
Q

Why do we want to know the intensity of a contraction?

A

b/c we want to see cervical change

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15
Q

What is one purpose of internal monitoring?

A

May need to do an aminoinfusion

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16
Q

Phases of Contractions (Powers): Increment phase

A

Ascending or buildup of the contraction that begins in the fundus and spreads throughout the uterus; the longest part of the contract

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17
Q

Phases of Contractions (Powers): Acme phase

A

Peak of intensity but the shortest part of the contraction

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18
Q

Phases of Contractions (Powers): Decrement phase

A

Descending or relaxation of the uterine muscle

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19
Q

What is dilation and how big is it?

A
  • enlargement or opening of the cervical os

- 10 cm = cervix can no longer be palpated on vaginal exam

20
Q

What is effacement?

A

Shortening and thinning of the cervix

21
Q

Longitudinal lie

A

Baby and mom are parallel

-Needed for vaginal birth

22
Q

Transverse lie

A

Baby is perpendicular

-Can not be delivered vaginally

23
Q

True vs False Labor

A

True:

  • Contractions bring cervical effacement and dilation
  • UC are regular and increase in frequency and intensity

False:

  • US are irregular with no cervical change
  • Hydration, laying down, or sedation slows or stops contractions
24
Q

SROM/AROM

A

Spontaneous/Artificial rupture of membranes

  • Can occur before but normally during labor
  • With fluids gone = increase risk of infection
  • Need to deliver within 24 hours
  • If at home and this happens go to hospital
  • Go to ER if having intense pain or bloody show
25
Q

TACO

A

-assessment of rupture of membranes

Time/Amount/Color/Odor

26
Q

Techniques to confirm rupture of membranes

A
  • Speculum = rapid test
  • Ferning = Fluid sample placed on slide
  • Amnisure = rapid test
  • Nitrazie = will turn blue (done at bedside)
27
Q

Normal FHR

A

110-160

28
Q

Fetal Tachycardia

A

above 160 for 10 mins or longer

29
Q

Fetal Bradycardia

A

Below 110 for 10 mins or longer

30
Q

Goal of external fetal monitoring

A

is to interpret and continually assess fetal oxygenation to prevent significant fetal acidemia while minimizing unnecessary interventions and promote family centered-care

31
Q

What to do is baby is bradycadiac?

A

Check moms radial pulse because could be picking up moms HR (do this before getting water or side laying)

ALSO

Check mom for vaginal bleeding and abnormal pain because s/s of placenta aburpto

32
Q

Category 1 FHR

A

= well oxygenated

33
Q

When to use scalp electrode vs when not to

A

when to use = if baby moves too much or when mom moves too much or is obese

When not to use = if mom has gonorherra/ HIV/ herpes/ Group B Strep

34
Q

What to do if FHR is erratic?

A

Mom and baby will move around so may need to adjust toco to get better reading

35
Q

First stage of labor

A

onset of labor to complete cervical dilation (10 cm)

36
Q

Second stage of labor

A

Burst of energy and urge to push

37
Q

Third stage of labor

A

Delivery of baby to delivery of placenta

  • Once placenta is delivered give bolus of oxytocin to decrease bleeding
  • Assess placenta (AVA and completely out; not in pieces/no abnormality)
38
Q

Meds used to prevent PPH?

A

Oxytocin (pitocin)
Methylergonvine (Methergine)
Thromethamine (Hemabate)
Misoprostol (Cytotec)

Given during third stage

39
Q

Fourth stage of labor

A

Immediate PP

  • Skin to skin
  • Assess lochia
40
Q

Phases of First stage of labor

A
  1. Early/latent phase: Excited; mild UCs, up to 5cm
  2. Active phase: dilate up to 7 cm; more intense/regular UCs, fatigue
  3. Transition phase: 8-10 cm dilated, completely effaced, empty bladder b/c gets in the way of passageway, shortest/most difficult phase
41
Q

What to assess for mom with epidural?

A

Assess bladder often b/c can’t she feels like she has to void

42
Q

Ferguson’s Reflex

types?

A

urge to bear down

  • Mother instated: mom feels urge to push
  • Delayed bearing down: let baby come down on own; sitting mom up saves energy
  • Active direct pushing: nurse letting mom push
43
Q

APGAR

A 
Appearance 
Pulse 
Grimace
Activity 
Respiratory
44
Q

Given to baby after birth

A

Hep B
Vit K
Erythromycin ointment on eyes

45
Q

What to do before giving mom epidural?

A
  • Give bolus b/c risk of hypotension
  • Assess mom (Monitor VS)
  • Assess baby (Monitor on strip for 20 mins before and after)
46
Q

Basic principles when using analgesia include:

A

● Labor should be established.
● Medication should provide relief to the woman with minimal risk to the baby.
● Neonatal depression may occur if medication is given within an hour before delivery.
● Women with a history of drug abuse may have a lessened effect from pain medication and require higher doses.

47
Q

Basic principles for anesthesia include:

A

● Local anesthesia is used at the time of delivery for episiotomy and repair.
● Regional anesthesia is used during labor and at delivery.
● Regional anesthesia includes the pudendal block, epidural block, and spinal block.
● Regional or general anesthesia is used for cesarean deliveries.

RN Spring 2021 (7 decks)

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