Brainscape's Knowledge GenomeTM

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


See full index

Maternal-Newborn (Josh) > T4 - Labor Birth at Risk (Josh) > Flashcards

T4 - Labor Birth at Risk (Josh) Flashcards

1
Q

What is preterm labor?

A

cervical change and UC after 20 wks and before 38 wks

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

What is preterm birth?

A

any birth occurring b/t 20 wks and 36.6 wks

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

Overdistention of Uterus can cause Preterm Labor.

What causes overdistention of uterus?

A

Multips

Hydramnios

Macrosomic fetus

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

Lifestyle conditions that contribute to Preterm Labor

A

Smoking > 10 cigs/day

Substance abuse (Cocaine)

Standing for long hrs

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

S/S of Preterm Labor

A

UC q 10 mins with or without pain

Abdominal cramping or Pelvic Pressure

Low Backache

Increased vaginal discharge (pink tinged)

Leaking AF

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

What is Fetal Fibronectin?

A

Flue that holds the cervix together

Sample can tell who is likely to go into labor early
***high negative predictive value

Increases before preterm birth

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

When would Fetal Fibronectin predict a preterm labor?

A

if it appears b/t 24-34 wks gestation

***tells who will NOT go into PTL, not who WILL go into PTL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Home mgmt of Preterm Labor

A

Bedrest w/ fetus off of cervix

Empty bladder frequently

Hydration

Left side-lying

Resume activity lightly if symptoms stop

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

Hospital mgmt of Preterm Labor

A

BR on LEFT side

Continuous EXTERNAL FM

IV fluids

Strict I’s and O’s

Tocolytic Therapy to inhibit UC

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

What Tocolytics are given to prevent UC in Preterm Labor?

A

Mag Sulfate

Terbutaline
***Hold if HR > 125

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

When would we stop using Tocolytics for preterm labor?

A

after 34 wks b/c fetus can survive past this point

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

What is the best reason to use tocolytics prior to 34 wks?

A

allows opportunity to administer glucocorticoids to accelerate fetal lung maturity

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

What are the Tocolytics we talked about?

A

Mag Sulfate (CNS depressant)

Terbutaline (raises BP)

Nifedipine (Calcium Channel Blocker)

NSAIDs

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

How do we help mature the lungs of fetus?

A

Glucocorticoids (Betamethasone)

  • **two doses 24-48 hrs before delivery
  • **used 24-34 wks
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is pPROM

A

Preterm Premature ROM

**done before 37 wks

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

AF looks like a — on a slide.

A

fern

***helps differentiate it from semen and urine

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

Regarding pPROM, what is the leading cause of death of fetus and mom?

A

sepsis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Management for pPROM

A

Temp q 2-4 hrs

Modified Bedrest

Kick counts (10 in 1 hr)

NO TUB BATHS

NST, BPP

Avoid vag exams if possible

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

After ROM, when can mom ambulate safely?

A

after fetal head is engaged

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What do you test for after pPROM?

A

Beta Hemolytic Strep (risk to fetus)

21
Q

What is Chorioamnioitis?

A

bacterial infection of amniotic cavity

leads to:

  • maternal fever
  • maternal and fetal tachycardia
  • uterine tenderness
  • foul odor of AF
22
Q

— is a term used to describe any difficult labor or birth.

A

Dystocia

23
Q

What causes Dystocia?

A

Ineffectivity of any one of the 5 P’s of Labor:

  • Powers (UC)
  • Passengers (Fetus and Placenta)
  • Passage
  • Position
  • Psychologic
24
Q

What are the top two reasons that C/S are performed?

A

1: Repeat C/S

25
Q

Hypotonic UC vs. Hypertonic UC:

Which one results in poor labor prognosis if it persists?

A

BOTH

***need normal UC 2-3 mins apart for good labor

26
Q

When are Dysfunctional Labor patterns classified?

A

according to Latent and Active phase of First Stage of Labor

27
Q

When do Hypertonic UC usually occur?

A

Latent Phase of Stage 1

28
Q

Interventions for Hypertonic UC

A

Therapeutic Rest

Warm Shower/Bath

Analgesics

Mild Sedation

29
Q

When do Hyotonic UC usually occur?

A

Active Phase of Stage 1

30
Q

What classifies as Hypotonic UC?

A
31
Q

Interventions for Hypotonic UC

A

Rule Out CPD (Cephalopelvic Disproportion)

Ambulation

Hydrotherapy

Enema

ROM

Nipple Stimulation (oxytocin release)

Pitocin

Position Change

32
Q

— is active labor in which birth occurs within 3 hours of onset of UC.

A

Precipitate Labor

***abrupt increase in UC instead of gradual

33
Q

Risk Factors associated w/ Precipitous Birth

A

Maternal Lacerations / Hematoma

Fetus may become hypoxic r/t short relaxation period b/t UC

Non reassuring EFM patterns (bradycardia and Late Decels)

Intracranial Hemorrhage (fast passage through birth canal)

34
Q

Interventions for Precipitous Labor

A

Side-Lying position to promote perfusion

IV Fluids to maintain BV

O2 per facemask

35
Q

Why would pharmacological measures not usually be used with Precipitous Labor?

A

not enough time for them to take effect

cause respiratory depression in neonate

36
Q

Is meconium always a sign of distress?

A

non necessarily

37
Q

Nulliparous client w/ fetus in breech position almost always has —

A

C/S

38
Q

What is McRoberts Maneuver?

A

thighs flexed sharply against abdomen

opens pelvic curve if shoulder dystonia (shoulders stuck in canal)

39
Q

Which clients at risk for Shoulder Presentation

A

Obesity

Previous Macrosomic baby

Chronic or Gestational DM

Prolonged 2nd Stage of Labor

40
Q

Which presenting position results in longer labor and back pain?

A

Occiput Posterior

41
Q

Maternal Positions that promote head rotation to Occiput Anterior

A 
Knee Chest (rocking pelvis)
***Best

Side Lying (on opposite side of occiput)

Lunges

Squatting

Birth Ball

42
Q

When would a version be attempted?

A

attempt to turn baby in utero

***After 37 wks

43
Q

What do we use to chemically ripen the cervix?

A

Prostaglandin E

44
Q

— cannot be the primary IV fluid.

A

Pitocin

***piggyback it

45
Q

When would we stop Pitocin?

A

UC frequency less than 2 mins

UC duration greater than 240 secs

Fetal destress (Late Decels)

46
Q

What is Uterine Tachysystole?

A

more than 5 contractions in 10 mins over a 30 min window

series of single contractions lasting longer than 2 mins

47
Q

Amniotomy is —, not —

A

augmentation, not induction

48
Q

Terms:

VBAC

TOLAC

ASP

C/S

A

VBAC = Vaginal Birth after Cesarean

TOLAC = Trial of Labor after Cesarean

ASP = Anaphylactoid Syndrome of Pregnancy (AF Embolism)

C/S = Cesarean Section

Maternal-Newborn (Josh) (29 decks)

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