Unit 2: NURSING CARE OF THE CLIENT EXPERIENCING A HIGH RISK OR WITH COMPLICATIONS DURING LABOR AND DELIVERY Flashcards
Is defined as long, difficult or abnormal labor.
Dystocia
5P’s during Labor and Delivery
Power Passenger Passageway Psyche Position
During hypotonic uterine contraction s resting tone of uterus remains at less than _____
10 mmHg
During hypertonic uterine contractions resting tone of uterus increase at more than than _____
15 mmHg
Hypotonic contraction occurs at the ___ phase of labor while hypertonic contractions occur at the __ phase of labor
Active
Latent
Is a constriction ring between a woman’s thickened
upper contractile uterine segment and thinned lower
uterine segment.
Pathologic uterine (Bandl’s ring)
Occurs when uterine contractions are so strong a woman
gives birth with only a few ,rapidly occurring contractions,
a labor that is completed in fewer than 3 hrs.
Precipitate Labor
-cervical dilatation that occurs at a
rate of 5cm or more/hour in primipara or 10 cm/hour in
multipara
Precipitate Dilatation
Is the chemical or mechanical
initiation of uterine contractions before their spontaneous
onset
Induction of labor
is the stimulation of uterine
contractions after labor has started spontaneously but
progress is not effective
Augmentation of labor
What should be the woman’s Bishop score indicating that the cervix is ready for birth and should respond to induction of labor
8 or greater
Term for when the cervix is ready for dilatation
Ripe cervix
Hormones used to ripen the cervix (20
Prostaglandin E1 and E2
Is an artificial rupture of membranes (AROM); it is used when the condition of cervix is favorable (ripe)
or used to augment labor if the progress begins to
slow.
Amniotomy
Preterm birth is any birth that occurs before the completion of _____weeks of pregnancy or uterine contractions
and cervical changes occurring between ___weeks of pregnancy.
37
20 and
37
A biochemical marker to predict preterm labor. This are glycoproteins found in plasma and
produced during fetal life. They appear in the cervical canal early in
pregnancy and then again in late pregnancy.
Their appearance between 24 and 34 weeks of gestation predicts labor.
Fetal fibronectins
Is a form of estrogen produced by the fetus that is present in plasma at 9 weeks of gestation. Levels have been shown to
increase before preterm birth.
Salivary Estriol
Agents that inhibit contractions of
myometrial smooth muscles
Tocolytics
Examples are betamethasone and dexamethasone, given
as intramuscular injections to the mother
to accelerate fetal lung maturity.
Antenatal glucocorticoids
A post term , postmature or postdate pregnancy is one that extends beyond the end of ___ weeks gestation.
42
Occurs when uterus undergoes more strain than
it is capable of sustaining
Uterine rupture
2 primary presenting signs of uterine inversion
hemorrhage,
shock and pain
What type of uterine inversion?
a smooth mass will be palpated through the dilated
cervix
Inverted fundus may lie within the uterine cavity or
vagina
Partial
What type of uterine inversion?
A large, red, rounded mass protrudes from the vagina
Complete
Occurs when amniotic fluid containing particles of
debris ( vernix , hair, skin cells or meconium )is forced
into an open maternal uterine blood sinus through
some defect in the membranes or after membranes
rupture or partial premature separation of placenta.
Amniotic fluid embolism
In the process of fusion, or in one of the first cell
divisions, the zygote divides into two identical
individuals.
These twins have one placenta, one chorion,
two amnions, and two umbilical cords.
Monozygotic Twins
Known as nonidentical or fraternal twins.
Accounts for two thirds of twin births
This result from fertilization of two separate
ova by two separate spermatozoa.
Double ova twins have two placentas. two
chorions, two amnions, and two umbilical
cords
Dizygotic twins
Term for when a fetal head presenting at a different angle
than expected.
Asynclitism
Macrosomia is when the fetus weighs more than
4000 to 4,500
grams (9 10lbs)
When the head appears on the perineum
crowning ) but the head retracts with each
contractions instead of protruding with each
contraction, a manifestation of anencephaly
Turtle sign
A technique where pressure is applied directly
posteriorly and laterally above the symphysis
pubis
Mazzanti technique
A technique where pressure is applied obliquely
posteriorly against the anterior shoulder
Rubin technique
A maneuver where the woman’s legs are
flexed apart, with her knees on her abdomen.
This maneuver causes the sacrum to straighten,
and the symphysis pubis rotates toward the
mother’s head; the angle of pelvic inclination is
decreased, freeing the shoulder. Suprapubic
pressure then can be applied at this time.
Mc Robert’s Maneuver
A maneuver having the woman move to a
hands and knees position
Gaskin maneuver
Is the placenta that has one or more accessory
lobes connected to the main placenta by blood
vessels.
Placenta succenturiata
The fetal side of the placenta is
covered with chorion
Placenta circumvallata
A placenta where the cord is inserted
marginally rather than centrally.
Battledore placeenta
The cord, instead of entering the placenta
directly, separates into small vessels that reach
the placenta by spreading across a fold of amnion.
This type of cord is most frequently found with
multiple gestations.
The problem with this type is the fetal blood
supply will be insufficient thus associated with
fetal anomalies.
Velamentous insertion of the cord
, the umbilical vessels of a
Velamentous cord insertion cross the cervical os
and therefore deliver before the fetus.
Vasa previa
Is an unusually deep attachment of the placenta
to the uterine myometrium so deeply the
placenta will not loosen and deliver.
Placenta accreta
Is the narrowing of the anteroposterior diameter of the pelvis
Contracted inlet
It is the narrowing of the transverse
diameter of the pelvis
Contracted outlet
Is an attempt to turn the fetus from breech or shoulder to
cephalic presentation before birth.
External Cephalic version
Comprises a series of maneuvers
performed prior to breech extraction to
deliver the fetus within a persisted
transverse lie in the second stage of labor.
Internal podalic version
forceps are applied after the
fetal head is at a +2 station or more
Low Forceps birth
forceps are applied after the fetal
head is engaged but at less than +2 station
Mid forceps birth
Forceps applied when the fetal head has
reached the perineal floor and its scalp is visible
between contractions.
Outlet forceps delivery
Forceps performed when the baby’s head is
not yet engaged
High forceps delivery
Type of CS where the incision is made
vertically through both the abdominal skin and the uterus.
Classic Cesarean Incision
commonly referred to as low transverse uterine incision and a
Pfannenstiel skin incision, Misgav Ladach or a “bikini”
Low segment Cesarean Incision
