review of exam 2 Flashcards
What are the 5 p’s?
Passenger
passageway
powers
position
psychological response
What are the 2 passengers in pregnancy ?
fetus and placenta
What is the passageway in pregnancy ?
birth canal
what are the 2 powers in pregnancy ?
primary - contractions
secondary - bearing down (pushing)
What does position mean in pregnancy ?
how the mom is position to give birth, like she is sitting down, laying down etc
what is the psychological response in pregnancy ?
mom stress levels, how she feels, etc
How does the baby pass through the cervix into the birth canal ? through like which process?
the molding of the fontanels
what does fetal presentation mean ?
the way fetus is presenting to us, so like is it OA/OP, breech etc
Usually the molding of the fontanels fix within a couple of what?
days
when the baby comes out, the fontanels are molded into what shape?
a cone head shape
what does cephalic fetal presentation main?
vertex, head first
what is brow cephalic fetal presenting?
forehead coming out, like the eyebrow coming-out
what does breech fetal presentation mean?
presenting part is the sacrum
butt or feet
what does shoulder fetal presentation mean ?
the shoulder is coming out, scapula presenting
why do you think, breech or like shoulder, brow fetal presentation is bad and we end up doing a c-section for these moms?
because their isn’t enough pressure to dilate the cervix to push the baby and placenta through
it can lead to severe pain and potential neurologic damage
what is the function of uterine contractions?
to help dilate the cervix
what are the 3 things we look out for in uterine contractions?
duration : how long
frequency : how often
intensity : how strong
what is foot lane breech mean?
the feet coming out first
what is frank breech mean?
butt going out first
how can we tell when we are having some form of breech?
the head is always heard, everything else would most likely be feeling soft
what is the best fetal position for birth?
OA
what does LOA AND ROA mean?
chin down, but the back of head is facing the left or right side of mom
What does LOP and ROP mean?
chin up, but the chin is facing the left or right side of mom
what is the distinguishing figure to tell you have OA position?
diamond shape
what is the distinguishing figure to tell you have OP position?
Y shape
what does fetal attitude mean?
the relation of the fetal body parts to one another
flex or extended
what does fetal lie mean?
the relation of the long axis ( spine ) of the fetus to the long axis ( spine ) of the mother
lying down/side to side
head down or head up
what is the best fetal attitude for birth ?
flexing
why is the fetal attitude extending not the best for birth ?
fontanells won’t properly mold
what is fetal position ?
head down
head up
again that OA or OP
what does fetal station mean ?
how far the baby has descended into the birth canal to the ischial spine
engagement usually corresponds to what?
0 station
what is the second best pelvic type?
anthropoid
( human shape )
what are the 4 pelvis types ?
gynecoid
android
anthropoid
platypellpoid
what is the best pelvic type?
gynecoid
( pumpkin shape )
android looks like what ?
platypelloid looks like what ?
alien
platepus
the android and platypelloid pelvic shape types usually result in what for mothers?
c-sections
what does effacement mean ?
cervix stretches and gets thinner the more we go into labor and the contractions help dilate it
what is Ferguson reflex?
an eager to wanna bear down and push the baby out
what does labor mean?
process of moving fetus, placenta and membranes out of the uterus and through the birth canal
what are 2 signs of preceding labor ?
lightening or dropping
bloody show
what are the 2 true labor starts?
plug of mucous/blood
amniotic sac ruptures
what are true labor contractions?
cervix dilates
like the contractions are starting To dilate the cervix open
when does the first stage of labor start and end ?
onset of regular uterine contractions to full dilation of the cervix
what is latent phase of first stage of labor?
irregular contractions
what is active phase of first stage of labor?
regular contractions
when does third stage of labor start and end?
from the birth of the newborn until the placenta is delivered
when does second stage of labor start and end?
from the time cervix is fully dilated to the birth of the newborn
when does the fourth stage of labor start and end?
from the placenta is delivered until the mother is in a stable condition or 1 hour after giving birth
what is normal fetal heart rate?
110-160bpm
mechanism of labor
1. engagement
2. descent
3. flexion
4. internal rotation
5. extension
6. external rotation
7. expulsion
what is visceral pain?
comes from the internal organs
deep squeeze
early first stage of labor
what is the best breathing method for patient in labor ?
lamas breathing
pattern breathing method
what is somatic pain?
comes from the skin, muscles and soft tissues
said to be sharp pain usually near birth of child
what happens to fetal circulation and respirations when the fetus is born?
PDA and formen Ovale closes and the baby breathes just like the rest of us
what is effleurage ?
circle massage
what is counter pressure ?
putting pressure on the back where it mainly hurts in women
what does sedatives mean ?
relieve anxiety
induce sleep
prolonged early phase to promote sleep
can opioids cross the placenta?
and how does it affect baby ?
yes, so be careful it can make baby become lazy and prolong labor
anesthesia and analgesia defintion?
relaxations and pain reliever
why do we not give opioids when the mom is wanting to push even though she is in a lot of pain?
because baby becomes lazy and we want mom to push the baby out
what do we want at the bedside if mom is on an opiate?
narcan
opidate reversal
what are the 3 epidural side effects?
respiratory depression
hypotension
thrombocytopenia
before epidural, since we know it causes hypotension, what are we gonna do to avoid it?
give a bolus 500cc to 1000cc to avoid it
if we give an epidural, and mom has a spinal headache, how do we treat it?
blood patch
we always want to assess mom pain by using what?
pain scale
what must be maintained to prevent fetal compromise ?
oxygen supply
what does fetal compromise mean or like what is the goal when we are assessing it?
normal or abnormal patterns of baby
how do we get a baseline of the fetal heart rate?
10mintues segment
there must be 2 minutes of interpreable data
what does variability mean in this case?
shows healthy nervous system indications
what is tachycardia for fetal heart rate?
anything above 160
what are the 4 causes of tachycardia in fetus?
prolong cord compression
umbilical cord prolapsed
morphine
heart abnoramilites
how do we fix tachycardia in fetus?
side lying
oxygen
iv fluids
reposition uterus
what is bradycardia in fetus ?
anything elbow 110
what is the 5 main causes of bradycardia in fetuses?
maternal fever
infection
fetal hypoxia
stimulants
hypothyroidism
accelerations are what
indications of fetal well being
acceleration must be what?
15 beats for 15 seconds above baseline
VEAL CHOPS say it
variable declarations
= cord compression
early decelerations
= head compression
accelerations
= okay
late decelerations
= placental insufficneiy
for late decelerations we want to follow the anagram LIONS which is?
side lying
iv fluids
oxygen
notify provider
surgery
how are we gonna treat variable decerlatiosn ? (3)
knee chest
trendelenburg positon
aminofusion
( this is said to help with the cord float around )
amniofusion is usually given to patients with what?
oligohydraminios
too little amniotic fluid
any component is abnormally we are gonna take corrective measure to improve what?
fetal oxgentation
intrauterine resuscitation
what are the big 2 things we are gonna do for fetal intrauterine resuscitation?
side lying ( lateral position )
IV fluids
( oxygen typically too )
I forgot to put up top this section
vaginal exam
wanna feel the ischial spine
when the baby hasn’t passed the ischial spine
its negative 1-5
when its passed the ischial spine
its postivie +1-5
VERY IMPORANT WHEN MEASURING THIS
THE FONTANELLS WILL STRECH OUT AND TRICK US INTO BELIEVING ITS LOWER
ALWAYS IMPORTANT TO TRACE FINGERS BACK AND FEEL FOR THE SUTURE LINES TO PROPERLY INDICIATE WHERE THE BABY IS AT.
