OB Flashcards
What is the calculation for expected date?
(LMP) + 7days - 3 months
first day of LMP=last menstrual period
Calculations pregnancy wt.
Weeks gestation -9lb
-Pt. only gains 3lb in 12 weeks/3 months (1st term)
-total wt. gain during pregnancy= 28lb +/-3lb
Quickening felt at?
(Kicking)
16-20 wks
FHR audible at?
8-12 wks
Office visits pattern
0-28 wks: 1x month
28-36 wks: every 2 wks
36-birth: every week
Fetal Position entering the birth canal
ROA best
LOA 2nd
Stages of delivery: Stage 1 what occurs
Labor
-Uterine contractions dilute & efface cervix
Stages of delivery: Stage 2 what occurs
Delivery of baby
Stages of delivery: Stage 3 what occurs
Delivery of placenta
Stages of delivery: Stage 4 what occurs
Recovery
2hr long
What are the 3 phases of Stage 1 labor
- Laten
- Active
–> 5-7cm, every 3-5min, lasts 30-60sec, moderate pain, Pain management (nursing action) - Transition
–>nursing action check dilation, help with breathing/pain
What are signs of Uterine Tetany, Uterine Hyperstimulation, & Indicate stopping Pitocin
Contractions longer than 90 sec or more frequent than every 2 min
Stage 2: Delivery Baby nursing actions
- Delivery head
- Clear baby airway, Mouth then nose
- check for nuchal cord (cord around neck)
- Deliver shoulders/body
- Apply ID on baby before leaving room
Stage 3: Delivery placenta nursing actions
- Make sure whole placenta was delivered
- check AVA in placenta–> 3 vessels (2 A & 1V)
Stage 4: Recovery
First 2 hours after birth
-4 things to do, 4 times an hours (q15min), in the 4th stage
1. Vitals: monitor for s/s shock (BP down, HR UP, look pale, cold, clammy)
2.Fundal assessment boggy=message, displaced=catheterize
3. check peri pad for bleeding amount–> 100% saturated in 15 min=problem
4. Roll her over: Check for bleeding underneath mom
—>Vitals, fundus, pads, roll
S/s of Shock
BP Down (BP down, Rates UP, cold)
HR UP
RR UP
Pale/Cold/Clammy
Complications of Labor
-Painful back labor nursing interventions
- Put pt. knees to chest (on 4s)
- Push–> sacral counterpressure (fist into sacrum)
Complications of labor Nursing interventions
-Prolapsed Cord
Cord comes out first
-Push head (not cord) back up
-knee-chest position
Complications of labor Nursing interventions
-All other complications
LION
-L:Left side lying position
-I: Increase IV solution
-O: Oxygenate
N: Notify HCP
-Unless on Pitocin then Stop first then LION (position 1st thing then)
Fetal Complications
-Low FHR
Intervention:
–LION, Stop Pitocin if running
Normal Fetal HR
120-160bpm
Fetal Complications
-Low Variability (FHR stay same)
Intervention:
–LION, Stop Pitocin if running
Fetal Complications
-Late Decels
Placental Insufficiency
Intervention:
-LION, Stop Pitocin
Fetal Complications
-Variable Decels
Prolapsed Cord
Intervention:
–Push Head (not cord) up
–Knee to chest position
What causes Early Decels
Head compressions (just document)
When should postpartum assessment be done
Every 4-8hr
What 3 postpartum assessments must be performed on
Uterus
Lochia
Extremities–> monitor for thrombo. preform calf circumferences
Lochia colors
Rubra: red
Serosa: pink (semi pink)
Alba: Clear/white
Saturating pad in 15min bad
What are some Tocolytics (stop labor)
- Terbutaline (cause maternal tach)
- Mag-sulfate(slows uterine contraction & everything down)
What are some Oxytocic’s (start labor)
- Oxytocin (monitor for uterine hyperstimulation)
- Methergine (cause maternal HTN)
What are some fetal lung maturity meds
Betamethasone (given to mom BEFORE baby born)
Survanta (Surfactant) given to baby
