OB CLINICAL FINAL Flashcards
Assessment of a
laboring mother
and recognition of
an imminent
delivery
Thorough assessment
and recognition
(name three clinical
manifestations) of the
process involved.
1
Regular, Painful Contractions: These contractions increase in intensity, duration, and frequency. Typically, in the active phase of labor, contractions become 3-5 minutes apart and last 60-90 seconds.
Assessment of a
laboring mother
and recognition of
an imminent
delivery
Thorough assessment
and recognition
(name three clinical
manifestations) of the
process involved.
2
Cervical Dilation and Effacement: As labor progresses, the cervix dilates (opens) and effaces (thins out). A full dilation of 10 cm is necessary for delivery. Assessing cervical changes is key to recognizing whether the laboring mother is ready to push.
Assessment of a
laboring mother
and recognition of
an imminent
delivery
Thorough assessment
and recognition
(name three clinical
manifestations) of the
process involved.
3
Descent of the Fetal Head: As labor progresses, the presenting part (usually the fetal head) descends into the birth canal. This is often assessed through vaginal examination and can indicate imminent delivery when the head is low and visible.
Implement
appropriate nursing
interventions
(minimum of three)
in the labor process
Detailed and correct
interventions (3) for
the process involved.
1
Monitor Contractions and Fetal Heart Rate: TOCO
Continuous or intermittent monitoring of contractions and fetal heart rate helps assess labor progress and the well-being of the fetus. If abnormalities are noted, timely interventions (like changing maternal position, oxygen administration, or medication) are warranted.
Implement
appropriate nursing
interventions
(minimum of three)
in the labor process
(50 points)
Detailed and correct
interventions (3) for
the process involved.
2
Call the doctor on to get orders to Provide Pain Management: Administering analgesia or anesthesia (e.g., epidural, IV pain medications) as ordered to help manage the pain associated with labor. You should also provide non-pharmacological comfort measures like positioning, breathing techniques, and relaxation.
Implement
appropriate nursing
interventions
(minimum of three)
in the labor process
(50 points)
Detailed and correct
interventions (3) for
the process involved.
3
Assist with Positioning and Breathing: Encourage the laboring mother to change positions frequently to facilitate fetal descent and manage discomfort. Breathing techniques, such as deep breathing or patterned breathing, help in managing pain and maintaining focus.
Effective
communication
with patient and/or
family members
while implementing
interventions
(50 points)
Makes meaningful
communication and
effectively during the
labor process
1
Make Meaningful and Reassuring Communication: Provide consistent updates on the progress of labor. Explain the procedures or interventions being done, why they’re necessary, and offer reassurance and support. Make sure to address any questions or concerns the laboring mother or her family may have.
Effective
communication
with patient and/or
family members
while implementing
interventions
(50 points)
Makes meaningful
communication and
effectively during the
labor process
2
Provide Emotional Support: Labor can be a stressful and anxious time. Offer comfort by validating their feelings and reassuring them that the team is there to help. For example: “You’re doing great. We’re here to support you through every step of this.”
Effective
communication
with patient and/or
family members
while implementing
interventions
(50 points)
Makes meaningful
communication and
effectively during the
labor process
3
Include the Family: Encourage family members to be present and involved, providing updates and instructions on how they can assist. Keep them informed about the labor process and how they can best support the patient.
Assessment and
recognition of the
signs and symptoms
of an obstetrical
patient having
postpartum
hemorrhage
(50 points)
Thorough assessment
and recognition
(name three signs and
symptoms) of the
disease process
involved.
1
Excessive Vaginal Bleeding: This is the most obvious sign. Bleeding that soaks through more than one pad per hour or the rapid onset of bright red bleeding after the initial stages of delivery could indicate hemorrhage.
Uterine Atony: A soft or “boggy” uterus upon palpation, which indicates that the uterus is not contracting effectively to clamp down on blood vessels.
Assessment and
recognition of the
signs and symptoms
of an obstetrical
patient having
postpartum
hemorrhage
(50 points)
Thorough assessment
and recognition
(name three signs and
symptoms) of the
disease process
involved.
2
Tachycardia (Increased Heart Rate): As the body responds to blood loss, the heart rate increases to compensate. A sustained elevated heart rate (typically greater than 100 beats per minute) can be an early indicator of shock due to blood loss.
Assessment and
recognition of the
signs and symptoms
of an obstetrical
patient having
postpartum
hemorrhage
(50 points)
Thorough assessment
and recognition
(name three signs and
symptoms) of the
disease process
involved.
3
Hypotension (Low Blood Pressure): As hemorrhage progresses, blood volume decreases, leading to hypotension. This may present as dizziness, weakness, or fainting. A drop in systolic blood pressure below 90 mmHg is a critical sign of shoc
Identify three
immediate
interventions for an
obstetrical patient
having postpartum
hemorrhage
(50 points)
Detailed and correct
interventions (3) for
the disease process
involved.
1
Fundal Massage and Uterine Stimulation: If uterine atony (lack of muscle tone) is suspected, perform a fundal massage to stimulate contractions and promote uterine tone. A firm uterus will help constrict blood vessels and reduce bleeding.
Identify three
immediate
interventions for an
obstetrical patient
having postpartum
hemorrhage
(50 points)
Detailed and correct
interventions (3) for
the disease process
involved.
2
Administer IV Fluids and Blood Products: Start an intravenous (IV) line with normal saline or lactated Ringer’s solution to support circulatory volume. If blood loss is significant, prepare for the transfusion of blood products (e.g., packed red blood cells, platelets) to replace lost blood.
Identify three
immediate
interventions for an
obstetrical patient
having postpartum
hemorrhage
(50 points)
Detailed and correct
interventions (3) for
the disease process
involved.
3
Medications to Promote Uterine Contraction: Administer uterotonics such as oxytocin (Pitocin) to help the uterus contract and stop excessive bleeding. Other medications may include methylergonovine (Methergine) or misoprostol (Cytotec).
Identify 3
medications
(generic and brand)
name) in
anticipation of
having postpartum
hemorrhage
(50 points)
Detailed and correct
medications (3) for
the disease process
involved.
1
Oxytocin (Pitocin): This is the first-line drug to stimulate uterine contractions and prevent postpartum hemorrhage. It is commonly administered intravenously or via injection after delivery.
Identify 3
medications
(generic and brand)
name) in
anticipation of
having postpartum
hemorrhage
(50 points)
Detailed and correct
medications (3) for
the disease process
involved.
2
Methylergonovine (Methergine): This is an ergot alkaloid used to promote uterine contraction. It is typically administered intramuscularly and is used when the initial uterotonics like oxytocin are insufficient.
Identify 3
medications
(generic and brand)
name) in
anticipation of
having postpartum
hemorrhage
(50 points)
Detailed and correct
medications (3) for
the disease process
involved.
3
Misoprostol (Cytotec): A prostaglandin that can be given orally, sublingually, or rectally. It promotes uterine contractions and is an effective second-line treatment for PPH, especially in cases where other medications are not effective.
Assessment and
recognition of the
signs and symptoms
of a newborn
complication -
Jaundice
(50 points)
Thorough assessment
and recognition
(name three signs and
symptoms) of the
disease process
involved.
1
Yellowing of the Skin and Sclerae (Eyes): The most common and obvious sign of jaundice is the yellowing of the skin, particularly on the face, and the whites of the eyes (sclerae). This yellow color is due to the buildup of unconjugated bilirubin in the blood.
Assessment and
recognition of the
signs and symptoms
of a newborn
complication -
Jaundice
(50 points)
Thorough assessment
and recognition
(name three signs and
symptoms) of the
disease process
involved.
2
Poor Feeding and Lethargy: Newborns with jaundice may be more lethargic than usual and may have difficulty feeding. This is because high bilirubin levels can affect the baby’s energy levels and appetite.
Assessment and
recognition of the
signs and symptoms
of a newborn
complication -
Jaundice
(50 points)
Thorough assessment
and recognition
(name three signs and
symptoms) of the
disease process
involved.
3
Dark Urine and Pale Stools: High bilirubin levels can affect the urinary and gastrointestinal systems. The urine may appear darker than normal (brownish), and stools may be pale or clay-colored due to the lack of bile in the intestines.
Identify three
immediate
interventions for a
newborn
complication -
Jaundice
(50 points)
Detailed and correct
interventions (3) for
the disease process
involved.
1
Phototherapy (Light Therapy): Phototherapy is the primary treatment for jaundice. The newborn is placed under a special light that helps break down bilirubin in the skin. This is typically done in a hospital setting where the baby is placed in a bassinet under blue light or using fiber-optic blankets.
Identify three
immediate
interventions for a
newborn
complication -
Jaundice
(50 points)
Detailed and correct
interventions (3) for
the disease process
involved.
2
Frequent Feeding (Breastfeeding or Formula Feeding): Encourage the newborn to feed frequently, as this helps promote bowel movements that excrete bilirubin. Both breastfeeding and formula feeding can help reduce bilirubin levels by increasing hydration and promoting stooling.
Identify three
immediate
interventions for a
newborn
complication -
Jaundice
(50 points)
Detailed and correct
interventions (3) for
the disease process
involved.
3
Exchange Transfusion (for Severe Jaundice): In cases of severe jaundice, especially if bilirubin levels are critically high, an exchange transfusion may be required. This procedure involves replacing the baby’s blood with donor blood to rapidly reduce bilirubin levels and prevent complications like kernicterus.
Identify three
patient/family
teaching involved in
newborn
complication -
Jaundice
(50 points)
Detailed and correct
patient teaching (3)
for the disease
process involved.
1
Importance of Frequent Feeding: Teach parents the importance of frequent breastfeeding or bottle-feeding (every 2-3 hours), as this helps prevent and manage jaundice by promoting the elimination of bilirubin through stool.
Identify three
patient/family
teaching involved in
newborn
complication -
Jaundice
(50 points)
Detailed and correct
patient teaching (3)
for the disease
process involved.
2
Signs of Severe Jaundice: Educate the family on signs that may indicate worsening jaundice, such as yellowing that spreads to the baby’s chest, arms, or legs, or if the baby is lethargic and not feeding well. Parents should know when to seek medical attention.
Identify three
patient/family
teaching involved in
newborn
complication -
Jaundice
(50 points)
Detailed and correct
patient teaching (3)
for the disease
process involved.
3
Phototherapy at Home (if applicable): If the baby requires phototherapy at home (using a portable bili-blanket), explain the proper use of the device, how to monitor bilirubin levels, and when follow-up appointments should occur. Teach the family how to monitor the baby’s skin for any changes or reactions during therapy.
