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AP III > OB (6/10) > Flashcards

OB (6/10) Flashcards

1
Q

fetal HR can be dopplered as early as _________ wks but difficult to continuously monitor until around _______ wks

A

10; 24

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2
Q

what are the 2 worst things you can see on a fetal heart rate monitoring strip

A
  1. no variability
  2. late deceleration
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3
Q

cause of variable deceleration

A

cord compression

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4
Q

intervention for variable deceleration

A

reposition - left uterine displacement

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5
Q

cause of early deceleration

A

head compression

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6
Q

intervention for early deceleration on Fetal heart strip

A

no intervention necessary

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7
Q

cause of late deceleration

A

placental insufficiency

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8
Q

intervention for late deceleration

A

assess why:

  1. stop pitocin
  2. give fluids
  3. give O2
  4. reposition
  5. possible C/S if persists
  6. elevate legs
  7. vaginal exam by RN/OB
  8. terbutaline if hyperstimulation is present
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9
Q

an acceleration on fetal heart strip is defined as __________________

A

abrupt increase in FHR of at least 15 bpm and lasting at least 15 seconds

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10
Q

early deceleration will have decrease in fetal HR by __________ bpm

A

10-24

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11
Q

deceleration of FHR that is a mirror tracing of the contraction = ____________

A

early deceleration

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12
Q

vaginal bleeding during labor could indicate

A

abruption

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13
Q

preterm labor is defined as

A

any labor before 38 weeks

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14
Q

fever in labor is indicative of

A

chorioamnionitis

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15
Q

tx for chorioamnionitis

A
  1. abx.
  2. tylenol
  3. amniotic infusion
  4. delivery
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16
Q

Tx for shoulder dystocia

A

McRoberts maneuver: push moms legs up super high and someone else places suprapubic pressure

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17
Q

tx for retained placenta

A

D & C

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18
Q

tx for postpartum hemorrhage

A

pitocin

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19
Q

what are the different intrapartum fetal assessments

A
  1. ultrasound (bedside or radiology)
  2. non-stress test (on L&D)
  3. biophysical profile “BPP”
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20
Q

ultrasound fetal assessment can assess what things?

A
  1. fetal viability
  2. presentation
  3. size
  4. weight
  5. placental location
  6. cervical length
  7. structural anomalies
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21
Q

fetal nonstress test

A
  1. external detection of FHR and fetal movement in relation to uterine contraction
  2. fetal heart tracing for 30 -40 minutes
22
Q

what are the components of the fetal nonstress test

A
  1. baseline FHR
  2. baseline FHR variability
  3. presence of accelerations
  4. presence of periodic or episodic accelerations
  5. changes of FHR pattern over time
23
Q

what are the three results you may get from a fetal nonstress test

A
  1. reactive
  2. non-reactive
  3. uncertain
24
Q

when is the fetal nonstress usually performed

A

near term

25
Q

what is the fetal vibroacoustic stimulation test

A

response of FHR to acoustic stimulation

26
Q

what is a fetal contraction stress test

A

they give pitocin to see the FHR response to contraction

27
Q

fetal biophysical profile is conducted using _________________ and evaluates what 5 fetal parameters

A

ultrasound;
1. fetal breathing
2. gross fetal body movement
3. fetal tone
4. heart rate acceleration
5. amniotic fluid volume over 30-40 minutes

28
Q

each of the 5 parameters on a fetal biophysical profile receives a score between ________________

A

0-2

29
Q

a fetal biophysical profile score of 8-10 = ________________

A

reassuring

30
Q

a fetal biophysical profile score of 4-6 = _______________

A

suspicious

31
Q

a fetal biophysical profile score of 0-2 = ___________________

A

nonreassuring

32
Q

pain in stage 1 labor is due to changes in the _______________ & ___________

A

lower segment of uterus; cervical dilation

33
Q

pain in the late 1st stage & 2nd stage of labor is due to __________________________

A

distension of the pelvic floor, vagina, and perineum

34
Q

what is the cranial boundary of the epidural space

A

foramen magnum

35
Q

what is the caudal boundary of the epidural space

A

sacrococcygeal ligament

36
Q

what is the anterior boundary of the epidural space

A

posterior longitudinal ligament

37
Q

what is the lateral boundary of the epidural space

A

vertebral peduncles

38
Q

what is the posterior boundary of the epidural space

A

ligamentum flavum and vertebral laminae

39
Q

T/F: the epidural space is not really a structure

A

true - it is a potential space

40
Q

characteristics of epidural that makes in ideal labor analgesic

A
  1. technique is safe for mom and baby
  2. does not interfere with labor and delivery process
  3. provides flexibility in response to changing conditions
  4. provides consistent pain relief
  5. long DOA
  6. minimal s/e
  7. minimizes ongoing demands of anesthesia providers time
41
Q

T/F: the epidural space is a series of discontinuous compartments that become continuous when potential space separating compartments is opened up by fluid or air

A

true

42
Q

what level block is necessary for C/S anesthesia

A

T4

43
Q

what level block is necessary for adequate labor analgesia

A

T10

44
Q

what is sacral sparing block

A

block that does not cover the S2-S4 region, so pt experiences pain on delivery/can feel foley catheter after epidural is placed

45
Q

layers you pass through when trying to place epidural

A
  1. skin
  2. SubQ
  3. supraspinous ligament
  4. interspinous ligament
  5. ligamentum flavum
46
Q

what are the advantages of the loss of resistance technique for epidural placement

A
  1. simplicity
  2. reliability
  3. speed
47
Q

loss of resistance technique for epidural, what can be used in the syringe?

A
  1. air
  2. NS
  3. both
48
Q

hanging drop technique is usually reserved for ___________________

A

cervical injections

49
Q

how far should the epidural catheter be threaded into the epidural space

A

4-6 cm

50
Q

if I am placing an epidural catheter and I lose resistance at 5 cm, where will I leave my catheter at the skin?

A

10 cm

AP III (20 decks)

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