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NCLEX > Problems with Labor and Delivery > Flashcards

Problems with Labor and Delivery Flashcards

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1
Q

Premature rupture of the membranes

A

Spontaneous rupture of the membranes prior to the onset of labor. Infection risk.

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2
Q

Interventions for prolapsed umbilical cord

A
  1. Trendelenberg’s position
  2. Administer 02
  3. Monitor for fetal hypoxia
  4. Elevate presenting part if it is on top of cord
  5. Prepare for immediate birth
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3
Q

Placenta Previa

A

When the placenta adheres to the lower uterus - marginal, partial or total blockage of cervix.

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4
Q

Symptoms of placenta previa

A
  1. Bright red vaginal bleeding
  2. Painless
  3. Uterus is soft and relaxed
  4. Fundal height is larger than expected for gestational age
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5
Q

Interventions for placenta previa

A
  1. Ultrasound
  2. Avoid vaginal examinations
  3. Maintain side lying bedrest
  4. Monitor bleeidng
  5. Administer fluid and blood products as required
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6
Q

Abruptio placentae

A

Premature separation of the placenta from the uterine wall after 20 weeks gestation and before delivery.

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7
Q

Symptoms of abruptio placentae

A
  1. Abdo pain
  2. Dark red vaginal bleeding
  3. Uterine pain/tenderness
  4. Uterine rigidity
  5. Fetal distress
  6. Possible maternal shock
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8
Q

Interventions for abruptio placentae

A
  1. Assess for excessive bleeding, enlargement of fundal height and pain
  2. Bed rest
  3. Administer fluids/blood products
  4. Prepare for birth (vaginal if possible)
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9
Q

Supine hypotension (vena cava syndrome)

A

Occurs when venous return to the heart is impaired by the weight of the fetus on the vena cava.

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10
Q

Symptoms of supine hypotension

A
  1. Dizziness
  2. Hypotension
  3. Pale
  4. Tachycardia
  5. Sweating, cool damp skin
  6. Fetal distress
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11
Q

Placenta accreta

A

Abnormally adherent placenta

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12
Q

Placenta increta

A

Placenta penetrates the uterus

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13
Q

Placenta percreta

A

Placenta perforates the uterus. Intervention for hemorrhage and shock. Prepare for possible hysterectomy.

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14
Q

Preterm labor

A

Between 20 and 37 weeks gestation.

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15
Q

Precipitous Labor

A

Labor which lasts less than 3 hours

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16
Q

Dystocia

A

Difficult, prolonged or excessively painful labor. Occurs due to problems with contractions, fetus, bones or tissues of the maternal pelvis. Can result in maternal dehydration, infection, fetal injury or death.

17
Q

Recognizing dystocia

A
  1. Excessive abdo pain
  2. Labor which does not progress
  3. Fetal distress
  4. Maternal and fetal tachycardia
  5. Abnormal contraction pattern.
18
Q

Amniotic fluid embolism

A

Escape of the amniotic fluid into maternal circulation. Debris from the fluid can lodge in the maternal pulmonary arterioles and be fatal.

19
Q

Recognition of amniotic fluid embolism

A
  1. Respiratory distress
  2. Cyanosis
  3. Fetal bradycardia
20
Q

Intervention for amniotic fluid embolism

A
  1. A-E assess and treat
  2. Administer fluids & blood products
  3. Stabilize the patient
  4. Prepare for delivery after stabilized
21
Q

Fetal distress

A
  • FHR 160 bpm
  • Meconium stained amniotic fluid
  • Fetal hyperactivity
  • Progressive decline in baseline FHR variability
  • Severe, variable decelerations in FHR
22
Q

Interventions for fetal distress

A
  1. Mothering lateral position
  2. Provide 02
  3. Discontinue pitocin
  4. Monitor vitals
23
Q

Recognizing intrauterine fetal demise

A
  1. Loss of movement
  2. Undetectable FHR
  3. Lowered Hb, hematocrit and platelet levels
  4. Prolonged bleeding and clotting time
24
Q

Ruptured uterus

A

Can be partial or complete tear due to the stress of labor.

  • abdo pain
  • contractions stop
  • rigid abdome
  • absent FHR
  • signs of shock
25
Q

Interventions for ruptured uterus

A
  1. Monitor and treat for shock

2. C-section & possible hysterectomy

26
Q

Uterine inversion

A

Uterus which is partially or completely turned inside out.

27
Q

Symptoms of uterine inversion

A
  1. Fundal depression
  2. Signs of shock
  3. Severe pain
  4. Hemorrhage evident
28
Q

Interventions for uterine inversion

A
  1. Monitor for hemorrhage and signs of shock

2. Return uterus to correct position (may require laparotomy)

NCLEX (48 decks)

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