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Mat-Child Nursing > objective 4 > Flashcards

objective 4 Flashcards

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1
Q

a normal physiological process that involves the health of the mother and a fetus
It involes the welfare of two patients and the use of skills from medical-surgical and pediatric nursing, psychosocial and communication skills, and specific skills involved in obstetrical care

A

child birth

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2
Q

what are the factors affecting L&D?

A

Preparation
Professional help
Place
Procedures
People

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3
Q

what are the 5 Ps?

A

powers
passage
passenger
maternal position
psyche

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4
Q

what are the powers?

A

uterine contractions
maternal pushing

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5
Q

what are the 3 phases of contractions?

A

increment
peak
decrement

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6
Q

beginning of one contraction until beginning of next

A

frequency

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7
Q

how long the contractions last (40-50secs)

A

duration

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8
Q

approximate stregnth of the contraction
mild,moderate, and strong or firm

A

intensity

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9
Q

When the cervix is 10cm dilated, female adds voluntary pushing to involuntary contractions which bring the babe down and out
2nd stage involves boht powers

A

maternal pushing

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10
Q

false pelvis
true pelvis

A

bony pelvis

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11
Q

upper flaring part

A

fale pelvis

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12
Q

lower part

A

true pelvis

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13
Q

Yield more readily to the forces of contractions and pushing efforts in women who have had a previous vaginal birth

A

soft tissue

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14
Q

he fetus along with the placnta and amniotic membranes

A

passenger

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15
Q

Composed of several bones separated by strong connective tissues called sutures

A

head

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16
Q

where sutures meet

A

fontanelles

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17
Q

diamond-shaped area formed by the intersection of four sutures (closes 12-18 months)

A

anterior fontanelle

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18
Q

tiny triangular depression formed by the intersection of 3 sutures (closes by end of 2 months)

A

posterior fontanelle

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19
Q

Describes how fetus is oriented to mothers spine

A

lie

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20
Q

what are the types of lie?

A

longitudinal
transverse
oblique

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21
Q

Degree of flexion and extension

A

attitude

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22
Q

head flexed forward and arms and legs flexed

A

flexion

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23
Q

prolongs descent…longer labor

A

extension

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24
Q

Refers to the fetal part that enters the pelvis first
Cephalic (head)
Shoulder
Breech

A

presentation

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25
Q

has a significant impact on the progress of labor

A

maternal position

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26
Q

A woman’s mental state can affect the course of labour
Promote a positive childbearing experience, including as many of the family’s birth expectations as possible
The woman’s cultural and individual values influence how she will cope with childbirth

A

psyche

27
Q

what are the signs of impending labor?

A

Braxton hicks contractions
Lightening
Cervical changes
Vaginal discharge ‘bloody show’
Energy spurt
Weight loss & flu like symptoms
Rupture of membranes

28
Q

Contractions irregular, do not increase in frequency, duration and intensity
Walking relieves discomfort/contractions
Discomfort in abdomen and groin
Bloody show usally not present
No change in effacement or dilation of cervix

A

false labor

29
Q

Regular contractions, frequent, longer and more intense
Contractions become stronger and more effective with walking
Discomfort in lower back and lower abdomen
Bloody show is often present
Progressive effacement and dilation of the cervix occr

A

true labor

30
Q

how do know when to do to the hospital?

A

Ruptured membranes
Bleeding other than bloody show
Contractions
1st pregnancy: 14-5, regular for 1 hour, lasts approx. 60 secs
2nd pregnancy: q5-7 min, regular for 1 hour
Decreased fetal movement

31
Q

Cervix dilation 0-3cm
Contractions: q5-30 mins, 30-45 sec long; mild to moderate
Mom is happy, laughing, excited

A

latent (early) phase

32
Q

Cervix dilation: 4-10cm
Contractions: 12-5 min apart, 40-90secs, long moderate to strong
Mom is anxious, less social, rejects support, legs tremor, irritable

A

active phase (approx 2-8hrs)

33
Q

Full dilation (10cm) to birth (last 30 mins to 2 hrs or more)
Contractions: strong, every 2-3 mins, lasting 60-90secs
Contractions function to push baby out of mothers body
Bulging perineum, uncontrollable urge to push

A

stage 2: delivery of the fetus (10cm to birth)

34
Q

Duration: 5-30mins
Contractions: intermittent, mild to moderate
Umbilical cord is cut
Observe for signs of placental separation

A

stage 3: deliver of placenta

35
Q

1-2 hours after birth
Uterus remains midline, firmly contracted at or below umbilicus level
Lochia rubra saturates perineal pad (no more than 1pad/hour)
Cramping may occur
Observe for clots larger than toonies
Women may have shaking chills

A

stage 4: recovery

36
Q

what are the nursing responsibilities during birth?

A

Prepare the deliver instruments and infant equipment
Perineal scrub
Admin meds
Provide initial care to infant
Assess apgar score
Assess infant for obvious abnormalities
Examine the placenta
Identify mother and infant
Promote parent-infant bonding

37
Q

what are the phases of care of the newborn?

A

Phase 1 (birth-1hr)
Usually in delivery room
Phase 2 (1-3hrs)
In nursery or postpartum unit
Phase 3 (2-12hrs)
Usually in PP unit if rooming-in with the mother

38
Q

“Station” describes level of presenting part in pelvis
Estimated in cm
Level of ischial spine: zero station
Above ischial spine: minus stations
Belove ischial spine: plus stations

A

decent

39
Q

Reaches ischial spines or pelvic inlet (station 0 or lower)

A

engagement

40
Q

Contractions increase fetal head flexion until chin is on chest

A

flexion

41
Q

When the fetus enters the pelvis the occiput is oriented to the occiput is oriented to the mothers Rt or LT side
Head turns until occiput is directly under symphysis pubis

A

internal rotation

42
Q

Head changes from flexion to extension
Head swings anteriorly as it extends with each maternal push

A

extension

43
Q

When head born, shoulders are not in line with head
Head and shoulder turn to realign

A

external rotation

44
Q

Anterior shoulder delivers, posterior should, quickly followed by the rest of the body

A

expulsion

45
Q

what are the nursing response to FHR patterns?

A

Position changes
Decrease oxytocin
VS
Use altered pusing and breathing techniques in the second stage of labor
Increase IV fluids
Admin oxygen 6L/min

46
Q

what are the nonpharmacological nursing interventions?

A

Skin stimulation
Positioning-encourage frequent position changes
distraction/diversion-music, imagery, TV
Thermal stimulation
Heat
Cold
Breathing techniques-remind them of prenatal classes

47
Q

block pain without loss of consciousness

A

analgesics

48
Q

enhance effectiveness of; or counteract side effects of analgesics

A

adjuncts

49
Q

blocks pain and motor responses

A

anesthetics

50
Q

what are examples of analgesics?

A

Morphine sulphase: best given in early labor
Demerol: not recommended unless person has allergy to morphine
Fentanyl: rapid onset, short duration
Nubain: avoid use in women with known addictions

51
Q

what are examples of adjuncts?

A

Narcan: reverses respiratory depression
Gravol: antiemetic
Nitronox: inhaled anesthetic, decreases awareness of pain

52
Q

The pudendal block is often used for episiotomies, vacuum- assisted, and/or low forceps deliveries
There is usually a delay between the injection and the onset of action
The injection is made on both sides of the perineal area prior to delivery
The medication bathes the nerves

A

pudendal block

53
Q

Often a combo of local anesthetics w/ a small dose of opioids- this yields a quicker onset of action and a longer-lasting pain relief; with minimal loss of movement
The women can sometimes ambulate and assume any position
Med constantly infuses through a catheter via an infusion pump
CAUTION: hypotension and urinary retention

A

epidural (epidural space)

54
Q

Much smaller amount of drug is needed to achieve the anesthesia when compared with the epidural
Also anesthesia occurs quickly and is much more profound; in addition to lasting longer than the epidural method
Loss of movement and sensation below the level of the ‘block’
One-shot block as opposed to continuous infusion via a catheter
Used for C-sections
CAUTION: hypotension and urinary retention

A

spinal (subarachnoid)

55
Q

best given in early labor

A

morphine

56
Q

not recommended unless person has allergy to morphine

A

demerol

57
Q

rapid onset, short duration

A

fentanyl

58
Q

avoid use in women with known addictions

A

nubain

59
Q

reverses respiratory depression

A

narcan

60
Q

inhaled anesthetic, decreased awareness of pain

A

nitronox

61
Q

Exhausted from pushing
Ineffective pushing
If mothers condition warrants it

A

forceps

62
Q

Soft suction cup attached to suction
Cup placed over baby occiput
Suction applied with contraction
Scalp edema

A

vacuum extraction

63
Q

Removal of infant through incision in abdominal and uterine wall

A

C-section

Mat-Child Nursing (21 decks)

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