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OB Class Notes > OB Class 2 > Flashcards

OB Class 2 Flashcards

0
Q

False labor contractions

A

inconsistent
changing activity doesnt alter contractions
activity may decrease them

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1
Q

4Ps of labor

A

Passage
Passenger
Power
Psyche

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2
Q

true labor contractions

A

consistent
increasing frequency, duration and intensity
walking tends to increase contractions

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3
Q

discomfort of false labor

A

abdomen and groin

more annoying that painful

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4
Q

discomfort of true labor

A

begins in lower back and sweeps around to the abdomen like a girdle
feels like menstrual cramps

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5
Q

warning signs that labor is near

A 
braxton hicks contractions
lightening
increased clear nonirritating vaginal secretions
energy spurt "nesting"
small weight loss of 1-3lbs
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6
Q

First stage of labor

A

stage of dilation

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7
Q

1st stage: stage of dilation

3 stages

A

latent
active
transition

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8
Q

latent phase

A

0-3cm
contractions 10min apart
bloody show
ROM: gush of fluids

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9
Q

active phase

A

4-7cm
change in cervix
contractions 5min apart
***not encouraged to push

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10
Q

transition phase

A

6-10cm
contractions frequent and close together
increased pressure on rectum and perineum

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11
Q

2nd stage of labor

A

begins with complete cervical dilation and ends with delivery of baby

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12
Q

2nd stage of labor

A 
contractions 2min apart (60-90 sec long)
feel of vulva splitting
pain radiate to back and legs
urge to push
avoid valsalva (decreases fetal oxygen)
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13
Q

3rd stage of labor

A

delivery of placenta

have mother nurse baby to stimulate contraction of uterus to prevent hemorrhage

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14
Q

when to present to the hospital or birth center

A 
contractions of increasing regularity/ frequency/ duration/ intensity
Nullipara: 5min apart for 1hr
Multipara: 10min for 1hr
ROM: with or w/o contractions
Bleeding: bright red blood w/o mucus
decreased fetal movement
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15
Q

assessment for fetal oxygenation

A

FHR
contractions
amniotic fluid characteristics
maternal VS

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16
Q

interventions to promote fetal oxygenation

A

promoting placental function
:maternal position
:AVOID SUPINE

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17
Q

APGAR score

A 
A: acitivity
P: pulse
G: grimace (reflex irritability)
A: appearance (skin color)
R: respirations
18
Q

APGAR scoring

A

0: absent
1: present but not adequate
2: within normal

19
Q

APGAR scoring: severely depressed

A

sever depressed: 0-3

***infant needs resuscitation

20
Q

APGAR scoring: moderately depressed

A

moderately depressed: 4-6

***stimulate by rubbing the infants back while administering oxygen

21
Q

APGAR scoring: excellent condition

A

excellent condition: 7+

***support infants spontaneous efforts and continue to observe

22
Q

fluctuations in the baseline FHR that cause the printed line to have an irregular wavelike appearance rather than a smooth flat one

A

baseline FHR variability

23
Q

temporary increase in FHR that peaks at least 15bpm above the baseline and last at least 15sec

A

accelerations

24
Q

accelerations occur with

A 
fetal movement
vaginal exams
contractions
mild cord compression
***accelerations are a reassuring sign reflecting the fetus has a responsive CNS
25
Q

early decelerations occur with

A

contractions

***not associated with compromis

26
Q

nadir of FHR

A

low point

  • **occur at same time the contraction peaks
  • **usually no lower than 30-40bpm
27
Q

late decelerations caused by

A

impaired exchange of oxygen and waste in the placenta
cause of uteroplacental insufficiency
***not reassuring

28
Q

variable decelerations caused by

A

conditions that reduce flow thru the umbilical cord

***fall and rise abruptly with relief of cord compression

29
Q

can receive an epidural

A

5-7cm
effacement 100%
contractions close together

30
Q

epidural side effects

A 
prolonged 2nd stage of labor
ineffective/ no urge to push
bladder distention
hypotension
spinal headache
31
Q

station meaning

A

the closer to being born (+)

the farther from being born (-)

32
Q

3/50/-1

A

dilation/ effacement/ station
dilation up to 10cm
effacement up to 100%
station: more positive

33
Q

opioid analgesics

A

crosses placental barrier if given to mother to close to time of delivery can cause resp. depression in neonate

34
Q

opioid analgesics given only with

A
  • labor well established

- vaginal exam shows cervical dilation of 4cm at minimum and fetus engaged

35
Q

dont give opioid IV when

A

in labor at 9cm

***causes fetal compromise

36
Q

epidural and spinal regional analgesia

A

use of short acting opioids administered as a motor block into epidural and intrathecal space w/o anesthesia
***still allow pt to sense contractions and maintain ability to bear down

37
Q

side effects of epidural and spinal regional analgesia

A

hypotension

  • **elevated temp
    resp. depression
38
Q

Epidural block dont give at

A

0-3cm

39
Q

epidural block give at

A

4-7cm
***dont give past 7cm
pt has to stick back out which causes baby to move down leading to urge to push
increased risk in harm w/ multibirth

40
Q

epidural block

A

local anesthetic w/ an anlagesia injected into epidural space
eliminates all sensation from level of umbilicus to thighs

41
Q

spinal block

A

local anesthetic injected into subarachnoid space into spinal fluid
can be done with analgesia
eliminates all sensations from level of nipples to feet
***not used for labor

42
Q

postpartum headache from cerebral spinal fluid leak

A

place pt in supine position
recieve autologous blood patch from pharmacy
wait 6-12hrs before standing to prevent leakage

OB Class Notes (7 decks)

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