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NSG 210 > Test 1-Labor, Postpartum, Newborn > Flashcards

Test 1-Labor, Postpartum, Newborn Flashcards

1
Q

What are the cardinal movements of labor?

A 
Flexed attitude (chin to chest)
Engagement, descent, flexion
Internal rotation
Extension
External rotation
Expulsion
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2
Q

How do you assess what position the fetus is in?

A

Leopold’s procedure

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3
Q

What is/are the most important thing/s to do when a mom comes in with ruptured membranes?

A

Check for a prolapsed cord if she reported a gush

Put on a FHM and make sure baby is okay

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4
Q

What do you do if you discover there is a prolapsed cord?

A

Stick your fingers in the vagina to raise the baby’s head and get mom in for a c section

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5
Q

Describe the types of breech positions

A

Footling-foot first
Frank-butt first
Complete-legs crossed
Shoulder/transverse-shoulder presents first or baby is laying longways across the uterus

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6
Q

What are the stages of labor?

A

1: cervix is dilating and effacing
2: pushing/delivery of baby
3: delivery of placenta
4: recovery

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7
Q

What are the phases of labor and in what stage do they occur?

A 
Occur in stage one
Phases:
Latent: 0-3 cm
Active: 4-7 cm
Transition: 8-10
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8
Q

Describe baby’s station

A

Negative number is high, positive is low. 0 station means baby is engaged in the true pelvis (opening of the pelvis)

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9
Q

How often do you monitor a low risk mom in labor?

A

Latent: hourly
Active: q30 min
Transition: q15 mi

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10
Q

How often do you monitor a high risk mom in labor?

A

Latent: q30 min
Active: q15 min
Transition: q5 min

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11
Q

What are the pros and cons of AROM?

A

Pro: baby’s head becomes a mechanical dilator to progress labor
Con: cord prolapse, placental abruption, infection

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12
Q

What do we consider true labor?

A

Contractions every 5 min (10 for a mom with prior births)
Broken water
Contractions radiating from back to belly

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13
Q

What are AROM and SROM?

A

Spontaneous Rupture of Membranes

Artificial Rupture or Membranes

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14
Q

How do you know if her membranes have truly ruptured?

A

Nitrogen’s strip
Ferning test
Amnisure test

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15
Q

What is dystocia?

A

A stop in labor

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16
Q

What is a precipitous labor and why is it bad?

A

A labor that begins and ends with delivery within 3 hours

Trauma to baby’s head and mom’s vag from being forced out so quickly

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17
Q

What is hydrocephalus?

A

Water on the brain causing a large head

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18
Q

What is CPD?

A

Chephalopelvic disproportion-baby’s year is too big to come through mom’s pelvis

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19
Q

What is the position in which a baby can be born vaginally?

A

Cephalic/vertex

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20
Q

What is a precipitous labor and why is it bad?

A

A labor that begins and ends with delivery within 3 hours

Trauma to baby’s head and mom’s vag from being forced out so quickly

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21
Q

What is hydrocephalus?

A

Water on the brain causing a large head

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22
Q

What is CPD?

A

Chephalopelvic disproportion-baby’s year is too big to come through mom’s pelvis

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23
Q

What is the position in which a baby can be born vaginally?

A

Cephalic/vertex

24
Q

What are reasons for postpartum hemorrhage?

A

Decreased uterine tone
Trauma
Placental fragments

25
Q

How do you (most accurately) determine blood loss?

A

Weight anything with blood on/in it

26
Q

What are blood loss parameters for hemorrhage?

A

Vaginal birth: >500 mL during delivery

C/S: >1,000 mL during delivery

27
Q

What is a cause during labor for possible PPH?

A

Pitocin use

28
Q

What is the first line drug of choice for PPH and why? Why might you not use pitocin and what are alternatives?

A
  • Pitocin
  • It causes the uterus to contract down to stop the bleeding
  • If mom was on pitocin for extended time during labor
  • cytotec (Misoprostol) or Hemobate (unless cardiac issue or asthmatic)
29
Q

Best IV gauge for L/D? Why? Which do you never use and why?

A

18(green) or 20(pink)-neither will lyse a cell if blood is needed
22(blue)-will lyse a cell

30
Q

How do you give pitocin?

A

IVPB (never push) diluted in LR
Or
IM injection

31
Q

What is Ketoralac

A

To radio-NSAID lain relief

32
Q

What is Sheehan syndrome?

A

Pituitary gland damage r/t postpartum hemorrhage

33
Q

What are reproductive complications from birth and why do they happen?

A

Uterine displacement because of bladder distention

Bladder distention/urinate retention because of loss of tone

PO Hemorrhage because of tone, trauma, or placental fragments

34
Q

What can cause a precipitous labor?

A

4+ births prior to the current one

Cocaine use

34
Q

What drug relaxes and softens the uterus?

A

Terbutaline

35
Q

Describe fetal presentation.

A

What part of the baby is presenting to you first from the vagina

36
Q

Describe fetal lie.

A

How is the baby lying in the womb

Is the spine on the left or right
Is the occipital bone anterior or posterior

37
Q

What causes variable decels?

A

Cord cord compression

38
Q

What causes early decels?

A

Head compressions

39
Q

What FHR change is okay?

A

Accelerations

40
Q

What causes late decels?

A

Placental perfusion problems

41
Q

What does APGAR stand for?

A 
Appearance
Pulse
Grimace
Activity
Respiratory Effort
42
Q

How is APGAR scored? When is it done?

A

A: 0 for central cyanosis, 1 for acrocyanosis, 2 for full pink color

P: 0 for 0 bpm, 1 for 1-99 bpm, 2 for 100+ bpm

G: 0 for floppy, 1 for barely grimacing with stimulation, 2 for full grimace

A: 0 for floppy and needing resuscitation, 1 for slightly floppy, 2 for screaming and flailing

R: 0 for no effort, 1 for grunting/retractions, 2 for healthy cry

1 min, 5 min and then at 10 if either is <7

43
Q

When do you do compressions on a baby?

A

HR <60

44
Q

What is a respiratory issue r/t labor?

A

Wet lung sounds from too much pitocin

45
Q

What medications are given to most (if not all) newborns at birth?

A

Vitamin K
Hep B vaccine
Erythromycin eye ointment

46
Q

What helps clear baby’s fluid out of his lungs?

A

Force from birth canal

CatecholaMines released due to the stress of labor

47
Q

How much fluid is in a baby’s lungs at birth?

A

30 mL

48
Q

What is special about newborn respirations?

A

They have periods where they stop breathing (not a normal respiratory rate/rhythm but is normal for newborns)

49
Q

What is vernix?

A

White substance on a baby-totally normal

50
Q

What is milia?

A

White dots across the nose

51
Q

What is lanugo?

A

Fine baby hairs (usually on the shoulders and top of back?)

52
Q

What is erythema toxicum?

A

Baby acne

53
Q

What are Mongolian spots?

A

Birthmarks that may look like bruises

54
Q

What are Epstein’s pearls?

A

Calcium deposits in the mouth-totally normal

55
Q

Describe a postpartum assessment

A 
Breasts
Uterus
Bowels
Bladder
Lochia
Epesiptomy/perineum

Homan’s sign
Emotional
Status
Rhogam

56
Q

When is rhogam used?

A

When mom is Rh - and baby is Rh +

NSG 210 (2 decks)

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