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Nursing School > NUR 360 - Exam 2 > Flashcards

NUR 360 - Exam 2 Flashcards

1
Q

true labor

A

CERVICAL CHANGE
regular, frequent contractions
bloody show
fetus descends into true pelvis

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2
Q

false labor

A

NO CERVICAL CHANGE
painless, irregular contractions
NO bloody show

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3
Q

where are fetal heart sounds heard in cephalic position?

A

lower abdomen

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4
Q

where are fetal heart sounds heard in breech postition?

A

above umbilicus

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5
Q

pitocin action

A

stim uterine contractions for inductions and given postpartum to prevent/treat hemorrhage

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6
Q

pitocin considerations

A

continuous fetal monitoring
- tachy, uterine rupture, abruptio placenta

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7
Q

chronic hypertension

A

HTN before pregnancy for before 20 weeks
reading of 140/90 twice 4 hours apart and not stablizing

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8
Q

preeclampsia

A

HTN with proteinuria or signs of organ damage (severe features) after 20 wks

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9
Q

eclampsia

A

preeclampsia with seizures

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10
Q

HELLP syndrome

A

Hemolysis, Elevated Liver enzymes, Low Platelet count; a severe form of preeclampsia

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11
Q

management of Chronic Hypertension, Preeclampsia, Eclampsia, HELLP

A

Mag Sulfate, antihypertensives, early delivery

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12
Q

risk of multiple gestation

A

preterm labor, C/S, HTN disorders, placenta previa, PP hemorrhage

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13
Q

dystocia

A

difficult labor due to contractions, dilation, descent, and pelvic shape

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14
Q

pelvic dystocia

A

abnormal shape of pelvis

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15
Q

soft tissue dystocia

A

placenta previa, benign fibroid tumor, distended bladder

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16
Q

hypotonic labor dystocia

A

inefficient contractions - Pit or artificial ROM

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17
Q

hypertonic labor dystocia

A

delivering too fast - uterine rupture, laceration of birth canal, fetal distress - call MD

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18
Q

contraindictions for pitocin

A

too many contractions, fetal distress

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19
Q

pitocin complications and actions

A

hyperstimulation, HTN, N/V, arrythmias, fluid volume issues

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20
Q

preterm labor risk factors

A

metabolic diseases, infection, increased maternal age, smoking/drugs, violence, low maternal weight prepregnancy, previous PTL, uterine issues, recurrent cervical dilation, placental issues, multiple gestation, PROM

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21
Q

signs of onset preterm labor

A

contractions, “period-like” cramps, low back pain, discharge w foul odor, urinary freq.

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22
Q

interventions for preterm labor

A

terbutaline, tocolytics, corticosteroids for baby, bed rest, hydration

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23
Q

gate control theory + example

A

new pain distracts from exisiting pain ex. injecting saline to distract from labor pains

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24
Q

endogenous biochemical theory + example

A

once pain gets to a ceratin level brain releases morphine-like chemical that reduces pain ex. oxytocin in brain decreases labor stress

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25
Q

fear/tension theory

A

pain will increase with fear and tension - nurses have the biggest impact on this theory

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26
Q

cognitive control theory

A

dissociation- focus on something nonpainful
interference- focus on something not related at all

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27
Q

when to reassess pain

A

1 hour after PO med
20 min after IV med

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28
Q

systemic meds

A

opioids, analgensic potentiators, antiemetics

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29
Q

side effects of systemic meds

A
  • resp. depression
  • slow labor
  • sedation
  • cross the placenta
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30
Q

contraindictions for systemic meds

A
  • allergies
  • resp. issues
  • myasthenia gravis
  • addiction
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31
Q

opioids analgesics

A

stadol, nubain, demerol, fentanyl

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32
Q

analgesic potentiators

A

phenergan and vistaril

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33
Q

action of analgesic potentiators

A

antiemetics, relaxation, increase effectiveness of analgesics

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34
Q

opioids antagonist

A

narcan

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35
Q

when to give systemic meds

A

early in labor to avoid fetal resp depression

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36
Q

anesthesia

A

block sensation

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37
Q

analgesia

A

decrease pain

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38
Q

fetal kick counts

A

10 movements in 2 hours

39
Q

FHR baseline

40
Q

absent variability

A

0
- fetal distress
- hypoxia/acidosis

41
Q

minimal variability

A

< 5
- sleep pattern
- anomalies
- meds
- neuro problem
- gest. age less than 32 weeks

42
Q

moderate variability

A

6-25
- normal

43
Q

marked variability

A

> 25
- fetal over compensation
-early hypoxia/distress

44
Q

accelerations

A

increase of 15 bpm lasting 15 seconds
- normal after 32wks
- mature autonomic nervous system
- good fetal O2 reserve

45
Q

early decels

A

head compression - identify labor progress

46
Q

late decels

A

utero-placental insufficiency - execute intervention

47
Q

variable decels

A

cord compression - change position

48
Q

prolonged decels

A

fetal hypoxia/injury - position, fluids, 10L o2 if ordered, tocolytics

49
Q

sinusoidal

A

severe fetal anemia

50
Q

category I

A

110-160
- accelerations moderate
- NO late/variable decelerations

51
Q

nonstress test

A

need 2+ accelerations in 20 minutes that increase by 15bpm and last for 15 seconds to be reactive

52
Q

contraction stress test

A

3 contractions in 10 mins needed
negative = normal
- no late decels
positive = problem
- 50% of time late decels present

53
Q

contraindictions for CST

A
  • placenta previa
  • suspected placental abruption
54
Q

VEAL CHOP MINE

A

V- variable - C - cord comp. - M - move patient
E- early - H - head comp. - I - identify labor
A- acceleration - O - okay! - N - nothing
L- late - P - placental insufficiency - E- evacuate fetus

55
Q

how to test for ROM

A
  • nitrazine paper
  • ferning
56
Q

assessment priotities after ROM

A
  • FHR monitoring
  • check for infection
  • fluid color + quantity
57
Q

when is AROM performed

A

during active labor

58
Q

how is AROM performed

A

provider goes in with hook

59
Q

oxytocics

A

drugs that stimulate labor; pitocin

60
Q

tocolytics

A

drugs that inhibite contractions; Mg Sulfate, terbutaline, nifedipine

61
Q

stage 1 labor

A

begins - dilation + effacement + contractions
ends- 10 cm dilation

62
Q

latent

A

early
0-3cm

63
Q

active

64
Q

transition

65
Q

stage 2 labor

A

begins: onset of pushing
ends: birth of baby

66
Q

stage 3 labor

A

begins: birth of baby
ends: delivery of placenta

67
Q

stage 4 labor

A

begins: delivery of placenta
ends: stable status

68
Q

fundal assessments

A

q15 min PP

69
Q

lochia assessments

A

q15 min PP

70
Q

bladder assessments

A

empty prn and remove epidural to restore sensation

71
Q

frank breech

A

butt down, face front, straight legs

72
Q

full breech

A

facing moms back, legs bent

73
Q

single footed breech

A

foot poking out of cervix - C/S

74
Q

external cephalic version

A

procedure to turn the baby to a head-first position

75
Q

ECV contraindictions

A

Active labor, cardiac disease,metabolic diseases, ROM, and uterine anomalies

76
Q

nursing considerations for ECV

A

monitor fetus + mom, prep C/S if necessary

77
Q

nursing assessments for magnesium sulfate

A
  • change in LOC
  • DTR’s
  • Ins and outs
  • vitals
  • lung and heart sounds
    HOURLY
78
Q

nursing considerations for magensium sulfate

A
  • NO methergine
  • frequent assessment
  • delay next pregnancy
79
Q

signs of magnesium toxicity

A
  • resp depression
  • absent reflexes
  • hypotension
80
Q

placenta previa

A

low-lying, partial, and complete placement with painless bright red bleeding

81
Q

nursing management for placenta previa

A
  • no vaginal exams
  • bed rest w BR privledges if no bleeding
  • ultrasound surveillance
  • have blood ready
  • risk of hemorrhage and C/S
82
Q

placental previa complications

A

fetal distress or death
fetal hypoxia
PTL

83
Q

placenta previa risk factors

A

male fetuses, large placenta, minority women

84
Q

placental abruption

A

premature seperation of all/part of placenta - sudden onset - dark red PAINFUL bleeding

85
Q

placental abruption complications

A

hypovolemic shock or DIC
hemorrhage
fetal hypoxia

86
Q

nursing management of placental abruption

A
  • side lying position
  • monitor for shock
  • C/S prep
  • possible hysterectomy if uterus wont contract
  • poor fetal prognosis
87
Q

types of placental abruption

A
  1. marginal abruption external hemorrhage
  2. central abruption concealed hemorrhage
  3. complete abruption
88
Q

descent

A

head enters inlet in occiput transverse

89
Q

flexion

A

head flexes chin to chest

90
Q

internal rotation

A

head rotates occiput transverse to occiput anterior

91
Q

extension

A

head passes under pubic bone

92
Q

restitution

A

birth of head - turns to realign w shoulders

93
Q

external rotation

A

shoulders rotation to anteroposterior position

94
Q

expulsion

A

birth of rest of body - anterior shoulder first

Nursing School (18 decks)

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