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Term 3 OB/PEDS/MED SURG 2 > Ob quiz 2 labor and birth, care of woman w/complications during labor and delivery > Flashcards

Ob quiz 2 labor and birth, care of woman w/complications during labor and delivery Flashcards

1
Q

The 4 P’s of the birth process

A
  • Powers
  • Passage
  • Passenger
  • Psyche
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2
Q

The 2 powers of labor are?

A
  • uterine contractions
  • maternal pushing
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3
Q

cervical effacement is expressed as ?

A

percentage of its original length

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4
Q

the amount of cervical dilation is expressed in ?

A

Centimeters

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5
Q

The nurse should promptly report contraction duration longer than?

A
  • 90 seconds or intervals shorter than 60 seconds and frequency closer than 2 minutes.
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6
Q

Why should the nurse report long lasting, short interval timed contractions?

A
  • placenta doesnt get enough oxygen carrying blood, when the uterus is tightly contracted. (fetal oxygen supply)
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7
Q

2 reasons why the sutures and fontanelles of fetal head are important in the birthing process?

A
  • allows for shaping, accomodation to size and shape of maternal pelvis.
  • Provides landmarks to determine how the fetus is oriented within the mothers pelvis.
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8
Q

RSA

A

Right sacrum anterior- breech

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9
Q

LMT

A

Left mentum transverse- face presentation

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10
Q

ROA

A

Right occiput anterior-most common

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11
Q

LOP

A

Left occiout posterior- back labor

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12
Q

key difference between real and false labor

A

change in cervical effacemant/dilation

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13
Q

3 phases of 1st stage of labor

A
  • Latent- 1-4 cm 4-6 hours
  • Active- 4-7 cm and effacement 2-6 hours
  • Transition- 7-10 cm complete effacement 2-6 hours
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14
Q

Typical maternal behaviours during 1st stage of labor

A
  • Latent- cooperative, alert, talkative, welcomes diversions, frequent urination, thirst.
  • Active- apprehensive, anxious, introverted, less social, focused on breathing, prespires, flushing, wants pain relief.
  • Transition- irritable, rejects support person, introverted, wants to give up, restless, leg tremors, fears losing control, want pain relief.
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15
Q

Typical maternal behaviours durng 2nd stage of labor

A
  • Bulging perineum
  • passage of stool
  • spontaneoud pushing or urge
  • states baby is coming
  • exausted
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16
Q

Third stage bmaternal behaviours

A
  • Elation
  • Relief
  • tremors
  • increased energy
  • curious about baby
  • desires to nurse baby
  • minimal pain with placental expulsion
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17
Q

Fourth thage maternal behaviours

A
  • time for parents and new baby to get aquainted
  • mother nurses baby
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18
Q

Nornal fetal heart rate

A
  • 110-120
  • 150-160
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19
Q

Characteristics of abnormal amniotic fluid

A
  • cloudy yellow fluid-infection
  • strong odor-infection
  • meconium-possible meconium aspiration for baby
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20
Q

Assessments reportable to MD by nurse

A
  • temp: 110.4>
  • blood pressure: 140/90 > or <90 for systolic
  • FHR: outside of 110-120/150-160
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21
Q

Baseline Fetal HR of 125 during labor is?

A

Normal for term fetus

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22
Q

When assessing duration of contraction by palpation, it is time by?

A

bef=ginning of one contraction, to the end of the same contraction

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23
Q

during normal labor, contraction usually become?

A

more frequent and longer duration

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24
Q

when the fetus is cephalic in presentation, the amniotic fluid is expected to be?

A

clear

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25
Q

The thinning of the cervix during labor is called?

A

Effacement

26
Q

Fetal descent during labor is measured in relation to the mothers?

A

Ischial spines

27
Q

When the placenta is delivered with the fetal side presenting, its called?

A

Schultze

28
Q

A nurse should learn to evaluate the progress of labor by methods other than vaginal examination, primarily because vaginal examination increases?

A

risk of infection

29
Q

whicj=h maternal position should be avoided during labor?

A

supine

30
Q

VBAC should be observed during labor, particularily for signs of ?

A

uterine rupture

31
Q

the priority observation during the fourth stage of labpor is ?

A

vaginal bleeding

32
Q

amniotic fluid usually turns a PH swab or paper?

A

dark blue

33
Q

Effleurage

A

Stroking of the abdomen, thighs, or other body parts

34
Q

Endorphins

A

internal substance similar to morphine

35
Q

Focal point

A

Intense concentration on an object

36
Q

pain threshold

A

Least amount of stimulation that a person perceives as painful.

37
Q

Pain tolerance

A

maximum amount of pain one is willing to bear

38
Q

Physical factors that cause pain during labor

A
  • Dilation and stretching of cervix
  • reduced uterine blood supply during contraction
  • Pressure of fetus on pelvic structures
  • Stretching of vagina and perineum
39
Q

How do physical factors influence womans pain during labor

A
  • Cervical readiness- prelabor changes can help cervix efface and dilate more readily.
  • Pelvic size and shape- how readily fetus descends, may favor normal fetal positiion or remain in unfavorable position.
  • Labor intensity- Short, intense may cause more pain.
  • Maternal fatigue- decreased pain tolerance and ability to use coping skills.
  • Fetal presentation and position- unfavorable adds pressure on sensitive areas and may prolong labor.
40
Q

umbilical cord protruding from the vagina, what should you do?

A
  • displace fetus upward by maternal position in knee chest or trendelenburg.
  • placing mother on side with hips elevated on pillows
41
Q

Severe back pain during labor?

A

baby is facing the back

42
Q

Degrees of lacerations

A
  • 1st degree- involves the superficial vaginal mucosa or prineal skin
  • 2nd degree- involves the vaginal mucosa, perineal skin, and deeper tissues of perineum.
  • 3rd degree- same as seconf degree, plus involves the anal sphincter.
  • 4th degree- extends through the anal sphincter and into the rectal mucosa.
43
Q

Fetal bradycardia

A
  • FHR is less than 110 bpm for 10 minutesor longer
  • Cause- fetal hypoxia, maternal hypoglycemia, materb=nal hypotension, or prolonged umbilical cord compression.
44
Q

fetal tachycardia

A
  • FHR above 160 that last 2-10 minutes or longer.
  • cause- maternal fever or dehydration
45
Q

decreased or absent variability

A
  • little fluctuations in rate
46
Q

Late Decelerations

A
  • decrease in FHRbegins after contraction starts and persists after contraction is over.
47
Q

Vaariable decelerations

A
  • FHR falls abruptly to less than 60 bpm, lasting 60 seconds or more, and the return to baseline is prolonged.
48
Q

Abnormal uterine activity

A
  • more than 5 uterine contractions in q 10 minute period; duration more than 60 seconds relaxation between contractions.
49
Q

nitrizine test

A
  • test performed if its unclear if membranes rupture
  • nitrizine paper is a ph paper. alkaline amniotic fluid turn darg green-blue or dark blue
50
Q

Nursing care during birth

A
  • prep the delivery intruments and infant equipment
  • doing the perineal scrub preparation
  • administering drugs to the mother or infant
  • providing initial care to the infat such as suctioning, drying the skin, placing infant on warmer
  • assessing infants apgar scores
  • examining the placenta to be sure its intact and records if it was expelled schultze or duncan
  • any abnormalities of the placent, cord or insertion site need to be reported asap
  • assessing infant for obvious abnormalities
  • making a note if infant has a stool or urinates
  • Identifying mother and infant with like numbered id bracelets
  • promoting infant bonding by holding, breastfeeding and exploring baby
51
Q

nursing care during labor

A
  • Monitor the fetus- FHR patterns and amniotic fluid
  • inspection of amniotic fluid- the membranes amy rupture spontaneously or by amniotomy- insect for foul odor, yellow color or meconium.
  • Monotoring the woman- vital signs- temp q 4 hrs, BP, RR, HR q hour
  • Contractions- by palpation or contimuous EFM- normal contractions are fewer than 5 in a 10 minute period for 30 minutes
  • Progress of labor- vaginal examination periodically to determine how labor is progressing.
  • I & O- time and approximate amount of urine is recorded, may not sense full bladder, must be assessed q 2 hrs for bladder fullness and bulge above symphisis pubis
  • response to labor- breathing and relaxation techniques and supports adaptive responses
52
Q

evaporation heat loss of the newborn

A
  • keep thermoregulation of newborn by immediately drying baby to prevent heat loss through evaporation of amniotic fluid from skin.
53
Q

newborn hypothermia

A
  • cause hypoglycemia because bodu uses more glucose to generate heat
  • causes cold stress because body increases metabolic rate to produce heat causing incresed respirations and oxygen demand, baby cant supply the o2 needs causing hypoxia
54
Q

contradiction to an epidural block

A
  • abnormal blood clotting
  • an infection on injection site or systemic infection
  • hypovolemia
55
Q

how soon after delivery can mother get MMR vaccine?

A

Immediately after birth

56
Q

preterm 35 wk labor, reportable findings

A

everything

57
Q

quickening

A

fetal movement felt by mother

58
Q

fibronectin

A

protein secretion from fetal mebranes that leaks in ti vaginal secretions, if uterine activity, infection or dilation of 2 cm or more occurs

59
Q

preterm infant risks

A
  • exposure to diethylstilbestrol DES
  • underweight
  • chronic illness such as diabetes or hypertension
  • dehydration
  • preeclampsia
  • previous preterm labor or birth
  • previous pregnancy losses
  • uterine/cervical abnormalities or sx
  • uterine distention
  • abdominal sx during pregnancy
  • infection
  • anemia
  • preterm premature rupture of membranes
  • inadequate prenatal care
  • poor nutrition
  • age younge than 18 or older than 40
  • poor education
  • poverty
  • smoking
  • substance abuse
  • chronic stress
  • multifetal presentation
60
Q

internal fetal scalp monitor

A
  • membranes must be ruptures and dilation of 1-2 cm for insertion of device.
  • small disposobal spiral electrode is inserted
61
Q

organism is a leading cause of perinatal infections that result in a high neonatal mortality rate, and can be found in the women’s rectum, vagina, cervix, throat, or skin

A

group B strep

Term 3 OB/PEDS/MED SURG 2 (13 decks)

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