Test 2 C/S Flashcards
1 Reason
Reasons for C/S
Labor arrest Dilation Stops
Nonreassuring fetal tracing Cat 2 or 3
Malpresentation Breech, Transverse, Occoput posistion
Multiple gestation
Maternal/fetal reasons
Preeclampsia
Maternal request
C/S Increased Risk
Maternal/ Infant
Infection 5 - 20x
Hemorrhage
Urinary tract trauma
Paralytic ileus
Anesthesia (aspiration)
Infant
Transient Tachypnea
Laceration / Trauma
It is recommended that mothers wait at home until True Labor begins then go to the hospital
T or F
T
This will prevent C sections
Walking helps the most
Regular, strong contractions that are occurring every 5 minutes or less, lasting for at least a minute each, for a period of at least an hour, or if her water breaks, regardless of contraction strength
Before giving Pitocin what should the uterus state be…
Ripe
Thinned out
Give misoprostol to ripe the cervix
What would be a good candidate for TOLAC/VBAC
When the last birth was theyes babies fault they couldn’t be born vaginal.
Breech baby / Issues with fetal heart tones
Decrease C section rate most in which type
Nulliparous women with a term, Singleton baby in vertex posistion delivered without C Section
Transient respiratory morbidity is higher in CS than VB why?
Fluid in lungs
Vag birth squeezes the fluid out of the lungs
CS Urgency Time frame
Scheduled
Unscheduled Add-On
Urgent
STAT
Scheduled: Planned preassigned date
Unscheduled Add-On: Non emergency Wait until patient is 6Hrs NPO
Urgent: Decesion to incision time <30 min
STAT: Deceaion to incision <10 min
Home CS prep the night before
NPO Past midnight
Reg meds (sip water)
Diabetic meds esp important (Insulin drip in OR)
NO SHAVING WITH REG RWZOR
SHOWER night before
Hibiclens (Chlorhexidine)
Remove all metal (rings ect)
Prep OP CS Orders
CBC T&S
IV 18 G
INTRADERMAL Lidocaine PRN for IV start
LR 125 cc / hr
500cc Bolus prior to spinal anesthesia
Antibiotic 1 - 2 G Cephalexin
<80KG = 1G / >80Kg = 2G
Bicitra (Sodium citrate) Neutralize Stomach Acid & Nausea. Taste Sour
So not to aspirate Acid contents
SCDs during C/S
Foley?
What does the ElectroCautery ground pad do? LOCATION?
Yes
Yes
Purpose: Prevents electrical burns by dispersing the current over a larger surface area as it exits the body.
Placement: thigh or buttock good skin contact, far from bony prominences, metal implants, and the surgical site
Difference between a Spinal & Epidural
Spinal injects all meds at once
Epidural stays in and continue to infuse
If woman is in labor for 24 hours which procedure is added to the C/S
This procedure wouldn’t be done if it was a scheduled CS
Betadine perineal area
Chlorohexiden wipe on abdominal area will be tinted orange. Explan to mom why orange
Ok
Lower Transverse Cesarean are the typical
Why would a classical be used?
Past vertical scar from surgery and surgeon wants to use the same entry
CS layers (7)
Studying all Friday may provide us A’s
Skin
Adipose
Fascia - possible adhesions if R C/S
Muscle
Peritoneum
Uterus
Amniotic sac- May feel pressure / tugging when baby born. No pain
_____ is used to protect the ballder from the scalple.
Bladder blade
This will happen right before uterine incision before baby is pull3d out
Circulating RN responsibility
4 counts: Instruments, Sponges, Needles
Documention: Team members, Times, Delivery/baby information
Calculate QBL
Ensure sterile field
Is oxytocin continued in the PACU?
Yes
If PCA or Duramorph - morphine-like (Intrathecal route -Spine) monitor for…
Respiratory depression/ effectiveness of pain control
What are priority assessment in the PACU 2 HRS postop
Fundal height/ Lochia
______ involves holding a pillow, blanket, or specially designed splinting device firmly against the surgical site when coughing, sneezing, or moving.
Splinting
Most effective birth control method
Implantation 0.05 failure rate
Top 5 most effective birth control methods
Implantation 0.05
IUD 0.2 - 0.8
Sterilization 0.15 - 0.5
Injection 6
Pill 9
Failure rate of condom
18%
Fetal Hypoxemia causes
Brady / Tachycardia
Tachycardia
Accelerations have this time to reach their peak amount
<30 seconds
Abrupt
Cephopelvic disproportion happens with which deceleration…
Early 😀
How often is mom having contractions
Is called….
Is measured how? What units?
CORRECT
UC frequency
Range (From beginning of one contraction to beginning of next)
Minutes
EX 2 - 3 minutes
How long do the contractions last?
Is called…
How to measure? Which units?
Duration
Range (From beginning to end)
Seconds
EX 50 - 100 Seconds
How long must contraction be to be considered a contraction
Atleast 40 seconds
Describe ideal uterus resting tone between contractions
Soft & non tender
BMI
<18.5
18.5 - 24.9
25 - 29.9
>30
Total preggers weight gain?
Weekly 2nd & 3rd trimester
<18.5 ( 28 - 40)
18.5 - 24.9 (25 - 35)
25 - 29.9 (15 - 25)
>30 (11 - 20)
<18.5 (1lb week)
18.5 - 24.9 (1lb week)
25 - 29.9 (0.5 lb week)
>30 (0.5 lb week)
Fre
A rise of ____ % in hCG over 48 hours can be considered normal
35%
Pregnancy
Presumptive symptoms
Probable symptoms
Positive
Presumptive symptoms
Fatigue
N/V
Urinary frequency
Amenorrhea
Breast changes
Probable symptoms
Chadwick sign: Bluish vag, cervix, vulva
Goodell sign: softening vag portion of cervix from Vascularization
Hegar sign: Softening of cervical isthmus (Cervical portion between uterus & vag)
POSITIVE Hcg TEST
Positive: IUP Intrauterine pregnancy on US, Fetal heart tones / movements
Diastasis recti….
Separation of the rectus abdominal abs
Match these words to the appropriate trimester
Identify with the mother role
Prepares for birth
Ambivalent
Ambivalent 1st
Identify with the mother role 2nd
Prepares for birth 3rd
Which week does a primitive heart beat start
3rd
All major organ systems formed Most vulnerable to Teratogens
3 - 8
Heart begins to pump
Arms and legs bud
Facial features beginning to form
Weeks….
5 - 8
Extremities developed
External Genital differentiated
Weeks
9 - 12
Fetus begins to move
Urine begins to form
Weeks….
13 - 16
Meconium begins to collect in bowel
Weeks
17 - 20
Skin wrinkled, red, vernix, lanugo
Lungs begin to dev surfactant
Weeks
21 - 24
Eyes partially opened
Respiratory system still imature
Weeks
25 - 28
Toe nails present
Testies descended
Weeks
29 - 32
Skin thicker, less wrinkled
Subcutaneous fat accumulation
Excelente chance for survival
33 - 36
Baby gains fat
Nails extend beyond nail bed
Weeks
37 - 40
AFI range indicative of fetal well being
8 - 20
Which fetal cord structure carries blood woth the most O²
Umbilical vein
Connects the pulmonary artery & descending aorta
Ductus Arteriosus
Which shunt closes first
Foramen Ovale (minutes)
Which shunt causes a Murmur to be heard.
When does it close
Ductus Arteriosus
Gradually 15 - 24 hrs
Routine & Non routine
1st prenatal visit
1st trimester screening
Correct
1st prenatal visit
Pregnancy test
Blood/urine test
Dating ultrasound
1st trimester screening
Maternal blood serum: Checking for chromosomal abnormalities (Downs)
Nuchal Translucency Test: This is an ultrasound that measures the clear space at the back of the fetal neck. Increased thickness in this nuchal translucency can be associated with a higher risk of chromosomal abnormalities, like Down syndrome, as well as congenital heart defects.
Non - Routine
Cell free DNA: Screening Test checks maternal blood for Chromosomal abnormalities
Chorionic Villus Sampling: Diagnostic
Small piece of the placenta is removed and cells analyzed to diagnose chromosomal abnormalities
VDRL , RPR
Test for…
Syphilis
Taking OTC vitamins is the best practice for baby health
T or F
F
Only take prescribed vitamins
Reflexes disappear in this order give dates
Rooting
Moro
Palmar / Plantar
Babinski
Sucking
Rooting 3 - 4 months
Moro 5 - 6 months
Palmar / Plantar 2 -3 & 8 -9 months
Babinski 8- 9 months
Sucking 12 months
Abnormal reasons why no reflexes
Rooting
Moro
Palmar/Plantar
Babinski
Sucking
Rooting: Premature, neurological, drugs
Moro: Absent CNS dysfunction
Palmar/Plantar: Neurological defects
Babinski: bilateral CNS / Unilateral Nerve damage
Sucking: Premature, neurological, drugs
Age infant to sit with support?
Age to sit by themselves?
6 - 8
8 - 12
Which age for object permence
8 - 12 months
____ is given to preggers mom in the 3rd trimester to prevent whooping cough
Dtap vaccine
Pregnancy related mortality ratio
Which groups are most likely to die
Black
Indians
White
Asians
Latinos
____ % of PRMR can be prevented
60%
Which ethic considerations is most important
Nonmalifence
_______ is the principle that all people are of equal moral worth and deserve equal rights, opportunities, and resources.
Egalitarianism
Placental Placement and considerations
Anterior
Posterior
Previa
Low laying
Anterior: Feels less kicks and harder to measure heart rate
Posterior: Desired, easier to feel movements and measure HR
Previa: avoid strenuous task / Bedtime rest / C/S maybe needed if during 3rd
Low laying: Low but not covering cervix. Will move up as uterus expands
Does the morning after pill affect a 1 month old fetus?
No, only stops implantation
