Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

RNC-OB > Obstetrical Procedures > Flashcards

Obstetrical Procedures Flashcards

1
Q

What is a 1st degree perineal laceration?

A

Superficial perineal skin or vaginal mucosa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is a 2nd degree perineal laceration?

A

Perineal muscles and facia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is a 3rd degree perineal laceration?

A

Anal sphincter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is a 4th degree perineal laceration?

A

Rectal mucosa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What do you need to know about episiotomy?

A

Midline or mediolateral (MLE inc 3rd/4th lac)

Comparable to 2nd degree lac

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Is vacuum or forceps easier on mom/baby?

A

Vacuum easier on mom

Forceps easier on baby

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the prerequisites for an operative vaginal delivery?

A 
Engaged fetal vertex
Ruptured/fully dilated 
Precisely known position
Drained bladder
Informed consent
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the indications for an operative vaginal delivery?

A

Prolonged second stage
Immediate/potential fetal compromise
Category II or III tracing
Shorten 2nd stage for maternal benefit (exhaustion, cardiopulmonary or cerebrovascular disease)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is considered prolonged 2nd stage in nulliparous/multiparous women?

A

Nulliparous: lack of continuing progress for 3 hours with analgesia, 2 hours without

Multiparous: lack of continuing progress for 2 hours with analgesia, 1 hour without

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is an outlet operative vaginal delivery?

A

When the scalp is visible at the introitus without separating labia

Fetal skull has reached pelvic floor

Saggital suture in AP diameter or left/right occiput anterior/posterior

Rotation does not exceed 45 degrees

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is a low operative vaginal delivery?

A

Leading point of fetal skull is > or = +2, not on pelvic floor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is a midforceps delivery?

A

Station is above +2, head engaged

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the most serious complications of a forceps delivery?

A

Perineal and rectal lacerations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are common complications with a vacuum delivery?

A

Ceohalohematomas or worse hematomas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

A vacuum should not be used in fetuses less than ___ weeks

A

34

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

When should a vacuum be stopped?

A

3 pulls over 3 ctx with no progress
3 pop offs without obvious cause
30 minutes elapsed time (some say 20)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are indications for a cesarean birth?

A 
Concern for maternal/fetal well-being
Vaginal birth not possible/appropriate 
Placenta previa
Malpresentation
Multiples
Fetal intolerance
Labor dystocia
Preexisting medical conditions
Obstetric complications
Maternal request (only after 39wks)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What types of skin/uterine incisions are done for a cesarean section?

A

Vertical or pfannenstiel (bikini) on skin

Low transverse, low vertical, classical, T, or J on uterus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the maternal risks with a cesarean section?

A 
Injury to adjacent organs (mostly bladder/bowel)
Hemorrhage
Wound infection
VTE
inc risk in future pregnancies
20
Q

What are the fetal risks with cesarean section?

A

RDS

iatrogenic prematurity

21
Q

What is the overall success rate for TOLAC in the U.S.?

A

60-80%

22
Q

What is an ideal TOLAC candidate?

A 
One or two previous low transverse c/s
Adequate pelvis
No other uterine scars or rupture
Physicians immediately available during active labor
Capable of continuous EFM
23
Q

What is suspicious for uterine rupture?

A

Prolonged decels with severe variables
Inc bleeding
Hypotension
Tachycardia

24
Q

What are the different options for mechanical cervical ripening?

A

Laminaria (seaweed absorbs water, expands)

Lamicel/dilipan (polymers absorb water, expand, may cause production of prostaglandins

Balloon catheters (foley or cook)

25
Q

What is prostaglandin E1?

A 
Cytotec 
25mcg
Cheap
Don't redose if 2 or more ctx in 10 min
Contraindicated with prior uterine surgery
26
Q

What is prostaglandin E2?

A

Cervidil
Continual release- need continuous EFM
remove after 12 hours
Expensive

27
Q

What are options for mechanical induction of labor?

A

Membrane stripping- digital separation of chorioamniotic membrane from cervix to release prostaglandins and endogenous oxytocin

Amniotomy- can inc occurrence of infection and variable decels

28
Q

What is the half life and plasma steady state of oxytocin?

A

10-15 minutes

40 minutes

29
Q

What do you need to know about oxytocin infusion?

A

Should be stopped when labor is established
Given via pump, IV piggyback to lowest port
Continuous EFM
AWHONN recommends 1:1 nursing care

30
Q

What do you do if you have tachysystole and a category I tracing?

A 
Reposition
IVF bolus
Wait 10-15 minutes
Decrease by half
Reposition
IVF bolus
Wait 10-15 minutes
Turn off
31
Q

What do you do if there is tachysystole and a category II or III tracing?

A

Stop oxytocin

32
Q

Once tachysystole is resolved after stopping oxytocin, what do you restart at?

A

Off for less than 30 minutes? Restart at half

Off for 30 minutes or more? Restart at initial

33
Q

How is oxytocin similar to ADH?

A

Can cause electrolyte imbalance resulting in water intoxication

34
Q

What are the opioid analgesia options in labor?

A

Demerol- can cause resp depression
Nubain- less resp depression, more sedation
*not to be given to opiate dependent pts
Stadol- similar to Nubian, pseudosinusoidal
Fentanyl- fast onset, short acting

35
Q

Can an epidural cause a maternal fever?

A

Yes

36
Q

Does an epidural increase the need for pit?

A

Yes

37
Q

Does an epidural increase the length of second stage?

A

Yes

38
Q

What is local infiltration?

A

Local injected into perineum, labia, vagina

39
Q

What is paracervical anesthesia?

A

Anesthetic injected into cervix
Profound fetal bradycardia
Rarely used

40
Q

What is pudendal anesthesia?

A

Local anesthetic injected just below ischial spines

41
Q

A bishop score of ___ or more indicates need for cervical ripening

A

5

42
Q

What do you need to know about external cephalic version?

A

Done between 37-39 wks
Rh negative women need rhogam
65% success rate
Forward roll more successful than backflip
Tocolysis does not significantly improve success

43
Q

What are the bishop scores given for effacement?

A

0-30: 0
40-50: 1
60-70: 2
80 or more: 3

44
Q

What are the bishop scores given for dilation?

A

0: closed
1: 1-2cm
2: 3-4cm
3: 5 or more cm

45
Q

What are the bishop scores for station?

A

0: -3
1: -2
2: -1
3: +1, +2

RNC-OB (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions