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MCN FINALS > MCN 4F > Flashcards

MCN 4F Flashcards

1
Q

Use of stainless instruments or vacuum extraction

A

Mechanical

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2
Q

use of medications

A

Chemical Procedures

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3
Q

Labor has started artificially

Administration of medicines

A

Induction of Labor

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4
Q

Total absence of pain

A

Anesthesia

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5
Q

Abdominal incision in the uterus

A

Cesarean Delivery

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6
Q

Normal Spontaneous Vaginal Delivery

A

Normal Delivery

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7
Q

Obstetrical forceps

Stainless steel and they been sterilized

A

Forceps Delivery

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8
Q

uses vacuum device to assist in extracting delivery

A

Vacuum Extraction Delivery

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9
Q

Increase by rupturing the amniotic membrane and so there will be an escape of amniotic fluid

A

Amniotomy

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10
Q

What do you do when cord prolapse happens or cord escapes vagina?

A

Immediately cover the exposed cord with sterile saline compress to presenting part

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11
Q

Prior to Amniotomy

A

Dorsal recumbent position

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12
Q

After amniotomy

A

Time as to when the amniotic membrane has been ruptured followed by assessing for fetal heart rate

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13
Q

Active Genital Herpes/ Human Papillomavirus

AIDS/HIV

Cephalopelvic Disproportion

Cervical Cerclage

Disabling conditions

Failed induction

Obstructive benign or malignant tumor

Previous cesarean birth

Fear of birth

A

Risk for Operative Delivery: Maternal Factors

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14
Q

Cesarean is advisable because this disease could be transmitted to the baby

A

Active Genital Herpes/Human Papillomavirus

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15
Q

Pelvis is not conducive for normal delivery

A

Cephalopelvic Disproportion

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16
Q

Stitching of the cervix due to cervical weakness

A

Cervical Cerclage

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17
Q

It is when there is attaching of the placenta inside the uterus but is normally positioned near or lower or over cervical opening

A

Placenta Previa

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18
Q

This would put the life of the baby at risk for possible compression of the cord and lack of oxygen

A

Umbilical Cord Prolapse

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19
Q

Placenta Previa

Premature Separation of the Placenta

Umbilical Cord Prolapse

A

Risk for Operative Delivery: Placenta

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20
Q

Macrosomic fetus in breach lie

Extreme low birth weight

A

Risk for Operative Delivery: Fetal

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21
Q

Initiated before the time when it would have occurred spontaneous contractions

Mother has not started labor yet but fetal heart rate is not normal

Done because fetus is endager

A

Induction of Labor

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22
Q

Assisting labor that has started

When contractions become weak, irregular, or ineffective

A

Augmentation of Labor

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23
Q

Pre-eclampsia

Eclampsia

Severe Hypertension

Diabetes

Rh Sensitization

Prolonged ruptured of membranes

Intrauterine growth restrictions and post maturity

A

Indications of Induction of Labor

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24
Q

Onset of high blood pressure and often a significant amount of protein in the urine

A

Pre-eclampsia

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25
Q

When there is incompatibility of Rh between the mother and baby

A

Rh Sensitization

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26
Q

Complete placenta previa

Abrupto Placentae

Transverse Fetal Lie

Prolapsed Umbilical Cord

Prior classic uterine incision that entered uterine cavity

Cephalopelvic Disproportion

Previous Myomectomy

Unknown cause of vaginal bleeding

Invasive Cervical Cancer

Active Genital Herpes

Abnormal FHR patterns

A

Contraindications of Induction of Labor

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27
Q

When there is an attachment of the placenta near or over cervical opening

A

Complete placenta previa

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28
Q

Placenta separates early from the uterus before childbirth

A

Abrupto Placentae

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29
Q

Ultrasound

Pelvimetry

Nonstress Test

Phophatidglycerol

Nitrazine paper or Fern test

CBC and Urinalysis

Vaginal Examination

A

Considerations of Induction of Labor

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30
Q

It is a glycophospholipid that is found in pulmonary surfactant in the membrane

A

Phosphatidglycerol

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31
Q

check if there is a premature rupture of membrane wherein upon testing the vaginal fluid, we detect that there will be a change of color

A

Nitrazine Paper Test

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32
Q

Oxytocin Injection

Amniotomy

Nipple Stimulation

A

Methods of Induction

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33
Q

A synthetic form of naturally occurring pituitary hormone that can be used to initiate labor contractions

A

Oxytocin

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34
Q

Other name for Oxytocin

A

Pitocin

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35
Q

30 is mixed with oxytocin in 1000mL of Ringer’s Lactate

A

Solution

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36
Q

Inadequate uterine contractions

Premature rupture of membranes

Post term pregnancy

Fetal Demise

A

Indications of Oxytocin

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37
Q

CPD, Cord Prolapse, Transverse Lie

Placenta Previa

Prior Classic Uterine Incision

Active Genital Herpes

Invasive Cancer of the Cervix

A

Contraindications of Oxytocin

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38
Q

40-90 mmHg

40-90s

2-3min Interval

1cm/hr

A

Criteria to maintain dose

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39
Q

Uterine Hyperstimulation

Non reassuring fetal heart rate pattern

Suspected uterine rupture

Inadequate uterine response at 20 mU/min

A

Reportable Conditions

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40
Q

Odorless

Clear/Straw

pH: 7-7.5

A

Characteristics of Amniotic Fluid

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41
Q

Increases the efficiency of contractions and therefore increase the speed of labor

A

Advantage of Amniotomy

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42
Q

Puts the fetus at risk for cord prolapse

A

Disadvantage of Amniotomy

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43
Q

Identify rupture of amniotic sac

A

Nitrazine Test

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44
Q

Green to Blue

A

presence of amniotic fluid

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45
Q

Yellow

A

No presence of amniotic fluid

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46
Q

Used to determine if the blood cells are maternal or fetal

Maternal: remains colorless

Fetal: turns purple pink

A

Klelhauer-Betke (Kleihauer-Betke)or Fetal Cell Blood Test

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47
Q

Helps release hormone oxytocin

Shortens labor

Avoids cesarean

A

Nipple Stimulation

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48
Q

Surgical incision of the perineum made to prevent tearing of the perineum

A

Episiotomy

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49
Q

Incision made with blunt-tipped scissors in the midline of the perineum

A

Midline Episiotomy

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50
Q

Less painful

Heals easily

Decreases blood loss

Less postpartum discomfort

A

Midline Episiotomy

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51
Q

Begun in the midline but directed away from the rectum

Creates less danger of a rectal mucosal tear

A

Mediolateral

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52
Q

Surgical repair of injury to the vulva by suturing

A

Episiorraphy

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53
Q

Monitor Vitals

Observe Aeseptic Technique

Support Perineum properly

A

During/Immediate Nursing Responsibilities for Episiotomy

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54
Q

Do perineal care

Apply ice pack or cold compress within three hours

Provide hot sitz bath

Render perilite exposure after 24hrs

A

After/Postpartum Nursing Responsibilities for Episiotomy

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55
Q

Primigravida

Macrosomic Fetus

Output Posterior Position

Forceps or Vacuum Extractor

Shoulder Dystocia

A

Factors that Predispose to Episiotomy

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56
Q

is the change in cervical consistency from firm to soft

A

Cervical Ripening

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57
Q

Prostaglandin E1: Misoprostol (Cytotec)
- encourage faster delivery of the baby since your cervix is ripe and soft to facilitate labor

Prostaglandin E2: Dinoprostone (Cervidil)
- used before induction to ripen

A

Chemical Agents

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58
Q

Laminaria tents

Hydroscopic dilators

Synthetic dilators

Stripping the membranes

A

Mechanical Methods of Cervical Ripening

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59
Q

Natural cervical dilators made from seaweeds

A

Laminaria tents

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60
Q

substances that absorb fluid rom surrounding tissues and then enlarge

A

Hydroscopic dilators

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61
Q

inserted into the endocervix without rupturing the membranes

A

Synthetic dilators containing magnesium sulfate (Lamicel)

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62
Q

separating the membrane from the lower uterine segment

A

Stripping the membranes

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63
Q

Prevent pressure from being exerted on the fetal head

Avoid subdural hemorrhage in the fetus as fetal head reaches perineum

A

Purpose of Forceps Delivery

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64
Q

Mother at Risk

Fetal Conditions

Cessation of progress in the 2nd stage of labor

A

Indications of Forceps Delivery

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65
Q

forceps are applied when the fetal skull has reached the perineum

scalp is visible between the contractions

sagittal sutures is not more than 45 degrees from the midline

A

Outlet Forceps

66
Q

presenting part of the skull must be at a station of +2 or below (+3) but not on the pelvic floor

rotation of the fetal head less than 45 degrees

A

Low Forceps

67
Q

Fetal head must be engaged but the presenting part is above station +2 (+1, 0, -1, -2)

A

Midforceps

68
Q

Membranes must be ruptured

CPD is not present

Cervix must be fully dilated to avert lacerations and hemorrhage

Presenting must be engaged

Woman’s bladder must be empty

A

Conditions before Forceps Delivery

69
Q

Barton

Kielland’s

Piper

Simpson’s

Tarnier’s

A

Types of Forceps Delivery

70
Q

used to rotate fetal head to a more favorable position (ROP-ROA)

A

Barton

71
Q

with short handles and marked cephalic curve

A

Kielland’s

72
Q

used to deliver head in breech position

A

Piper

73
Q

used most commonly as outlet forceps

A

Simpson’s

74
Q

axis traction forceps

A

Tarnier’s

75
Q

Laceration of Vaginal Canal

Cerebral Trauma of the Baby

Low IQ

Increased perinatal morbidity and mortality

A

Complications of Forceps Delivery

76
Q

Birth method involving the attachment of a vacuum cup to the fetal head, using negative pressure to assist in the birth of fetal head

A

Vacuum Extraction Delivery

77
Q

Little Anesthesia

Fever Lacerations of the Birth Canal occur

A

Advantages of Vacuum Delivery

78
Q

causes marked caput that may be noticeable as long as 7days after birth

Tentorial tears from extreme pressure

A

Disadvantages of Vacuum

79
Q

Prolonged Labor

Mother with Cardiopulmonary

Mother with high BP

A

Indications of Vacuum Extraction

80
Q

Preterm (soft skull)

Fetus who undergone scalp blood sampling

A

Contraindications of Vacuum Extraction

81
Q

pressure that is applied to the fetal head

Some under material complications:
Perennial
Vaginal cervical laceration of soft tissue trauma

A

Risk of Vacuum Extraction

82
Q

Cephalohematoma

Scalp Laceration

Subdural Hematoma

A

Newborn Complications

83
Q

turning of the fetus ap from one presentation to another; externally or internally

A

Version

84
Q

externally moving by massaging the client’s abdomen

breech to cephalic

attempted in labor and birth setting after 37 weeks of gestation

Tocolytic agent such as Magnesium sulfate is given to relax the uterus

No contraindications to be happening to manipulate with administration of tocolytic agents

tocolytic agents given IM near buttocks

A

External Cephalic Version

85
Q

Uterine anomalies

Previous cesarean

CPD

Placental Previa

Multifetal

Oligohydramnios (deficiency of amniotic fluid)

Rh incompatibility

unexplained 3rd trimester bleeding

Ruptured amniotic membrane

History of Premature labor

A

Contraindications of External Cephalic Version

86
Q

Continuously monitor FHR esp Bradycadia

Check maternal VS

Ultrasound must be recorded continuously

Assess woman’s level of comfort

A

Nursing Responsibilities of External Cephalic Version

87
Q

Fetus is turned by the physician who inserts a hand into the uterus and changes the presentation

May be used for multifetal

A

Internal Version

88
Q

Lack of Anesthesia

Unskilled healthcare team member in internal podalic version

Retracted cervix or contracted thickened uterus

A

Contraindications for Internal Version

89
Q

Support from a doula or couch doula

Hypnosis

Acupressure

Yoga

A

Nonpharmacologic Methods for Intrapartum Pain Management

90
Q

emphasized the use of relaxation and proper breathing with contractions as well as family support

A

Dick-read method

91
Q

combines relaxation, concentration, focusing, and complex well paced breathing patterns to reduce perception of pain through conditioned response of labor contractions

A

Lamaze Method

92
Q

husband takes a active role in assisting the woman to relax during labor and use correct breathing techniques

A

Bradley Method

93
Q

Given in labor because of analgesia effect

contraindicated in preterm labor

A

Narcotic Analgesics

94
Q

Demerol (meperidine hydrochloride)

Morphine sulfate

Nalbuphine

Fentanyl

Naloxone

A

Narcotic Analgesics

95
Q

has additional sedative and antispasmodic actions

crosses the placental barrier thereby causing fetal depression

A

Demerol (meperidine hydrochloride)

96
Q

narcotic antagonist should be available

A

Naloxone (Narcan)

97
Q

compliments the action of narcotics

A

Sedative-Hypnotics and Ataratics

98
Q

Secobarbital sodium (seconal)

Promethazine (phenergan)

A

Sedative-Hypnotics and Ataratics

99
Q

patient administer doses of IV narcotic analgesics

A

Patient Controlled Analgesia

100
Q

Transmission of electrical impulses/current across the skin

two electrodes are positioned on each side of the abdominal surgical incision

effective in controlling pain

A

Transcutaneous Nerve Stimulation

101
Q

injection of a local anesthesia to block specific nerve pathways interspace

A

Regional Anesthesia

102
Q

injection of bupivacaine (Marcaine) into the subarachnoid space at the level of 3 rd and 4th lumbar interspace

block nerves and suspend sensation and motion to the black nerves and suspend sensation and motion to the lower extremities, perineum and lower abdomen

A

Spinal Anesthesia

103
Q

Hypotension - validation

turn the woman to her left side to reduce a vena cava compression

Spinal Headache - advise lie flat and administer analgesic

Epidural - introduced in epidural space

blocks sympathetic nerve in order to increase contraction strength and blood flow to the uterus

Side Effect: Spinal Headache rarely happens (painless delivery)

A

Major Complications

104
Q

used with heart problem, pulmonary disease

diabetic mother

A

Advantage of Regional Anesthesia

105
Q

Induced hypotension

A

Nursing Responsibilities

106
Q

Injection in the right or left pundendal nerves level with ischial spine

dorsal recumbent

provides relief in perineal

check FHR and maternal bo

2-10 mins for effect and lasts 60 mins

given if there will be a Physiography or the repair of surgical side of episiotomy

A

Local Anesthesia (Pudendal Block/Pudendal Nerve Block)

107
Q

never preferred for childbirth due to hypoxia, possible inhalation of vomitus

A

General Anesthesia

108
Q

Inhalant (nitroud axide, Halothanol)
Intravenous (Penthotal)

A

General Anesthesia

109
Q

Ephedrine - used when blood pressure falls

Atropine Sulfate - dry and respiratory secretions to prevent aspiration

Thiopental Sodium- rapid induction of general anesthetic in an emergency

Succinylcholine - to achieve laryngeal relaxation for intubation in an emergency

Diazepam - controls convulsions

Isoproterenol - reduce bronchospasm

A

General Anesthesia: Drugs that should be readily available

110
Q

done to preserve life of the mother and her fetus

A

Cesarean Delivery

111
Q

Dystocia

Placenta Previa

Fetal Distress

Multiple births

Large tumors of the uterus

Genital herpes or infections

Uncontrolled diabetes or hypertension

A

Indications for Cesarean

112
Q

IV Line

Catheter

Regional/General Anesthesia

A

Prior to Cesarean

113
Q

3-5 day hospital stay

Breastfeed, nap when the baby sleeps, get out of bed

6-8 weeks full recovery

Scar lightens as it heals

A

After Cesarean

114
Q

Scheduled & Emergency Cesarean

A

2 Types of Cesarean Section

115
Q

CPD

Severe Hypertension during pregnancy

Active Genital Herpes

Previous C-section

A

Indications Maternal Factors

116
Q

Transverse fetal lie

breech presentation

fetal distress

extreme low birth weight

macrosomic

multifetus

A

Indications Fetal Factors

117
Q

Placenta previa

Abrupto Placentae

A

Indications Placental Factors

118
Q

Incision made Vertically

A

Classical Incision

119
Q

bigger space

larger version, less trauma

used in placenta previa

A

Advantage for Classical Incision

120
Q

most common type

pfannestiel incision or bikini incision

A

Low Segment Incision

121
Q

less uterine rupture

less blood loss

easier suture

less likely to cause gastrointestinal or postpartum complications

A

Advantages of Low Segment Incision

122
Q

interval between the birth of the newborn and the return of the reproductive organs to their normal nonpregnant state

A

Postpartum Period

123
Q

Contraction of Muscle a fibers

Catabolism - process of converting cells into simpler compounds

Regeneration of uterine epithelium

A

Involution of Uterus

124
Q

T/F: Immediately after the delivery of the uterus is about the size of a grapefruit and weighs 1000g (2.2lbs)

A

TRUE

125
Q

How many hours until the fundus rises about the level of the umbilicus?

A

within 12hours

126
Q

What day does the fundus descends one fingerbreadth per day?

A

2nd Day

127
Q

are composed of vaginal blood tissue and nucleus loss after birth lasting up to 6-8 weeks

A

Lochia

128
Q

1-3 days

Blood with small particles of decidua and mucus

large clots, saturated pad, foul odor

A

Lochia Rubra

129
Q

3-10 days

Serous exudate, leukocytes, erythrocytes, and cervical mucus

Excessive amount, foul smell, continued recurrent reddish color

A

Lochia Serosa

130
Q

10-14 could last until 6 weeks (yellow or white)

leukocytes, decidua, epithelial cells, fat and cervical mucus

Persistent lochia serosa, return to lochia rubra, foul odor, continuing discharge

A

Lochia Alba

131
Q

Immediately after childbirth the cervix is formless, flabby, and open wide

healing is rapud

firm and dilated the first week

A

Cervix

132
Q

Round cervix

A

Nulliparous

133
Q

Cervix shape remain slightly open and appears slitlike

A

Parous

134
Q

Intermittent contractions and are source of discomfort

A

Afterpains

135
Q

Afterpains

A

Ice packs on abdomen

Prone position with pillow under abdomen

136
Q

Cause by episiotomy wound or laceration

A

Perineal Pain

137
Q

Perineal Pain

A

provide ice packs on the 1st 24hrs

Perilite and Hot sitz after 24hrs

Perineal care - prevent infections

Analgesics as ordered

138
Q

Mother experiences diaphoresis

A

Sweating or Excessive Perspiration

139
Q

Sweating or Excessive Perspiration

A

Offer fresh dry gown

Encourage showers

Increase fluid intake

140
Q

Nipple Soreness

A

Rotate breast feeding positions

Instruct mother to use finger to break suction before removing infant

Cold compress

Breast support

141
Q

Urinary Incontinence

A

Kegel exercises

hot tea

running water in sink

pouring water over vulva

142
Q

Mother is focused primarily on her own need for fluid, food, and sleep

1-3 day woman is passive

Major Task: Integrate her birth experience to reality

A

Taking In Phase

143
Q

Mother becomes more independent

3-10 days

Optimum time to teach about baby care

A

Taking Hold Phase

144
Q

Woman finally redefines her new role

Gives up fantasy image and accepts real one

Happens when her own needs are no longer predominate

A

Letting Go Phase

145
Q

Major Role Attainment

A

Anticipatory Stage

Formal Stage

Informal Stage

Positive Stage

146
Q

Concerned about regaining their normal figure and may have unrealistic expectations

A

Concerns on Body Image

147
Q

Baby blues, maternity blues or mild depression

last no longer than 2 weeks

insomnia, fatigue, mood instability, anxiety

A

Postpartum Blues

148
Q

34-35cm Head Circumference

32-33cm Chest Circumference

30-33cm Abdomen

7.5-13cm Midarm

47-52cm Length

2.5-4kg Weight

A

Measurements of a Newborn

149
Q

Bluish black marks that resembles bruises on the sacrum, buttock, arms and shoulders

A

Mongolian Spots

150
Q

Thick white substance that provides protective covering opportunities the fetal skin in the uterus

A

Vernix Caseosa

151
Q

Fine hairs that covers the fetus during intrauterine life

A

Lanugo

152
Q

White spots

1-2mm in size

caused by distention of sebaceous glands

A

Milia

153
Q

sign of Dehydration

A

Sunken Fontanelle

154
Q

Newborn is experiencing Intracranial Pressure/Hydrocephalus

A

Bulging Fontanelle

155
Q

Placement of a newborn with its mother rather than nursery

A

Rooming In

156
Q

father’s developing bond with the newborn

A

Engrossment

157
Q

Position that allows eye to eye contact between the newborn and parent

A

En face

158
Q

Factors that Affect Adaptation

A

Lingering discomfort or pain

Chronic fatigue

Knowledge of infant needs

Available support system

Expectations of newborn

Previous experience with infants

Maternal temperament

Infant characteristics

159
Q

Preparation of Breasts (Mammogenesis)

Synthesis and Lactation (Lactogenesis)

Ejection of Milk (Galactokenesis)

Maintenance of Lactation (Galactopesis)

A

4 Phases in the Physiology of Lactation

160
Q

Composition of Breast Milk

A

Colostrum

Transitional Milk

Mature Milk

161
Q

Initial Goals once the baby is out

A

Airway

Warmth

162
Q

Signs of Respiratory Distress

A

Retractions

Nasal flaring

Cyanosis

MCN FINALS (4 decks)

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