OB test 13 Flashcards

1
Q

Hypertonic uterine dysfunction

A

contractions Q 1-1/2 minutes, duration 90 sec, baseline 10mmhg.
Dilation and effacement does not progress.

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2
Q

Hypotonic uterine dysfunction

A

contractions Q 7 minutes, 50 sec duration, intensity increases 25mmhg.
Initially good labor, uterus tires at 4 cm dilation.

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3
Q

Precipitous labor

A

rapid, less than 3 hours.

Problem- trauma to mom or baby.

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4
Q

prolonged labor

A

exceeds normal time >20 hrs.

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5
Q

Arrested labor

A

progress stops, fetal descent stops.

Cause- CPD, fetal malproportion

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6
Q

CPD

A

cepelopelvic disportion- baby head cannot fit

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7
Q

Shoulder dystocia

A

baby descends and should gets stuck behind symphysis pubis.

Tx- suprapubic pressure, mcroberts manuter (keens to chest), woodys screw manuver- turn baby.

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8
Q

Velamentous intersion

A

cord divides before connecting to the placenta.

Risk- hemorrhage, increase risk compression.

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9
Q

Abnormal cord length

A

long- inc nuchal cord/knots

short- conpression, abrupt placenta

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10
Q

Prolapsed cord

A

ROM before presenting part is snug in pelvis.
Risk- cord rushes out with water
tx- get presenting part off cord, rish C/S

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11
Q

Succenturiate placenta

A

accessory lobe. Continues to bleed after delivered placenta (fundus will be firm)
Risk- can detach=hemorrhage

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12
Q

Circumvallate placenta

A

double fold of anmion and chorion. Sec surface are for blood vessels to perfuse.
risk fetal dealth, SGA, premature

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13
Q

Battledorf placenta

A

cord insterts at margin= poor circulation

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14
Q

Placental infarcts/calcification

A

Ca deposits= old placenta

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15
Q

Placenta previa

A

implants lower uterine segment. WILL LEAK BLOOD.
Mom anemic, hemorrage during preg.
DR MUST CHECK, not a RN

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16
Q

Abruptio placenta

A

premature separation of normally implanted placenta after 20 wks
S&S- pain btw contraction, late decals.

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17
Q

Amniotic fluid embolism

A

amniotic fluid enter materal blood. S&S- resp distress, brain, dyspnea, hypotension

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18
Q

Sedative (ambien, phenergan, benadryl)

A

used during false/early labor. FETUS greatly effected.

Admin at peak of contraction- fetus will be less effected

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19
Q

Pudendal- regional anesthesia

A

nerve, either side of perineum. relief perineal stretching. No used often.

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20
Q

General anasthesia

A

Emergeny C/S, crosses placenta. prepare for fetal resussitation.

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21
Q

Spinal anasthesia

A

subarachnoid space, mom can’t move legs.

SE- spinal HA

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22
Q

Epidural anastheais

A

block motor and sensory perception. Can limit ability to push and need to void.

23
Q

Bishop score

A

predict inducibility- higher= better

24
Q

Amniotomy

A

prostaglandins release when ROM occurs

Risk- prolapse cord, infection

25
Q

Membrane stripping

A

digitally frees membranes of amnoitic sac from lower segment of uterus around cervical os.
Prostaglandin release, labor in 48 hrs.

26
Q

Cervidil

A

prostaflandin prep in vag insert. slow rate

27
Q

Prepidil

A

intracervical gel, release prostaglandin faster. increase vag delivery in 24 hrs.

28
Q

Misoprostol

A

synthetic prostaglandin. intervaginal tab

29
Q

Oxytocin

A

IV, stim contraction that produce cervical changes and fetal descent.

30
Q

Version

A

turn fetus in uterus from undesirable to desirable prosition.

31
Q

External cephalic version

A

moves baby by palpating on abdomen external abdomen (no past c/s, placenta previa)

32
Q

Internal/podalic version

A

used with multiple gestation to deliver second twin.

Med to relax uterus, ob grabs feet and pulls to feet presentation

33
Q

Episiotomy

A

surgical incision of the perineum.
midline- downwarn towards sphincter
mediolateral-45 degree angle on left or right

34
Q

Forceps

A

used for any conditiont hat threatens mom or fetus that can be relieved by birth OR shorten 2nd stage

35
Q

Criteria for forceps

A
fully dilated
head engaged
mom bladder empty
adequate anathema
ROM
continuous external fetal monitoring
36
Q

Vaccume assisted birth

A

criteria- ROM, head fits, lithotomy position.

NO if- face presentation, CPD, premature, scalp blood samping, small fetus

37
Q

VBAC

A

vaginal birth after cesarean.

NPO, anasthesiologist and OR dr avalible, NO classical incision.

38
Q

Caput Succedaneum

A

Localized swelling of scalp.

39
Q

Cephalhematoma

A

subperiosteal hemorrhage. Bleeding

40
Q

Diffuse scalp hemorrhage

A

bleeding into scalp. Severe swelling.

Transfusion PRN, neuro assess.

41
Q

Subcutaneous fat necrosis

A

Localized lesion, inflammation of subQ tissue. Firm lesion. resolves 6-8 wks

42
Q

Abrasions/lacerations

A

forceps, C/S accidental cut, fetal scalp monitor.

tx- clean, abx, watch S&S of infection.

43
Q

Petechaie/ecchymosis

A

nuchal/mechanical device.

Observe hyperbilirubinemia

44
Q

Subconjunctival hemorrhage

A

Presure during delivery. Resolves 1-2 wks

45
Q

Retinal hemorrhage

A

Head compression.

1-5 days

46
Q

Brachial plexus

A

lateral traction on neck .
C5-T1 innerate arm- stretched
INC risk with asphyciated baby (dec tone)

47
Q

Erbs palsy

A

C5&C6
arm limp at side, internal oration, arm extended, finger and arm flexed. (Waiter exspecting money form)
Moro- fingers move, arm does not

48
Q

Klumpke

A
C8-T1
Weakness wrist and fingers
hand paralyzed
Moro- shoulder moves, hand does not.
SPLINT TO PREVENT CLAW DEFORMITY
49
Q

Phernic nerve paralysis

A

C4-C5
Dec breath sounds on affected size, labored reap.
Better in 6 weeks.
PRN support (O2, vent)

50
Q

Facial nerve injuries

A

Pressure from position or delivery

2wk-2mth recovery

51
Q

Fractures

A

Dec movement, tender, palpable, deformity, normal moro

Tx- pain management, careful handling

52
Q

Torticollis-sternocleidomastoid muscle injury

A

hyper extension during delivery. hematoma formation=shortens muscle
tx- passive stretching 6 m, then surgery.

53
Q

Spinal cord injury

A

Rare, breech