Brainscape's Knowledge GenomeTM

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


See full index

OB > Week 2 Augmentation of labor > Flashcards

Week 2 Augmentation of labor Flashcards

1
Q

Describe the pathway of fetal prostaglandin and placental oxytocin

A
  • Cortisol from the mother stimulates the fetal hypothalamus
  • The fetal hypothalamus releases CRH
  • The CRH stimulates the release of cortisol form the adrenal glands
  • Cortisol causes the release of Prostaglandins and placental oxytocin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is induction?

A

Induction is the artificial starting of labor

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

What is augmentation?

A

When the mother is already having active contractions and needs a bit more help

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

Inductions are associated with higher risks of ____

A

C-sections

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

The risk of a csection during induction is reduced if ____

A

The cervix is dilated at least 2cm and somewhat effaced

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

What are some indications for induction?

A

When it is deamed medically necessary

  • Hostile interuterine environment
  • SROM at term without labor
  • Post-term pregnancy
  • Chorioaminonitis (infection and inflammation of amniotic sac
  • HTN
  • Placental abruption
  • Medical conditions (DM, renal disease, heart disease)
  • Fetal demise
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Why is HTN an indication of induction?

A

Because it causes vasoconstriction and will restrict blood flow to fetus

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

What are the two largest risks involved with elective inductions?

A
  • 2X risk of needing Csection

- Risk of Neonatal respiratory complications

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

Calculating an accurate _____ is critical if an elective induction is to be done

A

Gestational age

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

Current recommendations suggest waiting until ___ weeks to induce labor electively

A

40-41

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

When is augmentation considered?

A

When labor has begun spontaneously but progress is slow or stopped. Even if contractions are adequate

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

What is used to augment labor?

A

Oxytocin

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

What are some contraindications of induction or augmentation?

A
  • Placenta Previa
  • Vasa Previa
  • Umbilical cord prolapse
  • active gen. herp.
  • Abnormal presentations
  • Previous uterine surgery
  • overdistention of uterus
  • Severe maternal diseases
  • fetal presentation above pelvic inlet
  • inability to monitor fetal status
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the function of pitocin?

A

It is oxytocin and it acts to strengthen contractions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is Placenta Previa?

A

The placenta is over the birth canal

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

What are some of the major risks of inducing or augmenting labor?

A
  • Excessive uterine activity
  • Uterine rupture
  • Maternal water intoxication
  • Chorioamnionitis
  • PPH
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Why does using oxytocin increase the risk of maternal water intoxication?

A

-The solution used to dilute it is hypotonic

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

Prior to labor agumentation or induction, a ___ assessment must be done

A

Cervical

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

______ system is used to estimate cervical readiness for labor

A

Bishop scoring

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

What 5 aspects does the bishop score look at?

A
  • Cervical dilation
  • Effacement
  • Consistency
  • Position
  • Fetal station
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Vaginal birth is more likley with a bishop score of ____ or higher

A

8

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is cervical ripening?

A
  • Softening the cervix to make it more likely to dilate during labor,
  • It is done before induction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Cervical ripening is recommended with a bishop score of ___ or less

A

4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is used to pharmacologically induce labor?

A

Prostaglandin PGE2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is the drug name for Prostaglandin PGE2?

A

Misoprostol (Cytotec)

26
Q

How is Misoprostol (Cytotec) administered?

A

-Vaginally

27
Q

With higher doses of Misoprostol (Cytotec), there is a risk for ____

A

Uterine tachysystole

28
Q

If Uterine tachysystole after administering Misoprostol (Cytotec) what are the interventions?

A
  • Side-lying position
  • O2 non-rebreather 10L
  • give a tocolytic
29
Q

After administering Misoprostol, the patient should remain _____ for ____

A

Recumbent for 30 minutes

30
Q

Misoprostol (Cytotec) is contraindicated in women with ___

A

previous cesarean or other uterine surgery

31
Q

What are the three mechanical methods to induce labor?

A
  • Transcervical balloon catheter
  • Membrane stripping
  • Placement of hydroscopic inserts
32
Q

Spontaneous labor from membrane stripping can occur _____

A

within 48 hours

33
Q

____ needs to be assess prior to and throughout administration of Oxytocin

A
  • Uterine activity

- FHR

34
Q

Where should Oxytocin be infused?

A

Closest to the IV insertion site

35
Q

_____ become desensitized with prolong use of Oxytocin

A

Oxytocin receptor sites

36
Q

Why does the rate of oxytocin need to be reduced after active labor begins?

A

to decrease the receptor site saturation

37
Q

What is the MOA of pitocin?

A

Stimulates uterine smooth muscle – strength, duration, and frequency of UC

38
Q

Oxytocin has ____ and ____ properties.

This increases the risk of ___

A

Vasoactive and Antidiuretic

-Water intoxication

39
Q

Why does uterine sensitivity to oxytocin increase during gestation?

A

Because of increasing prostiglandins

40
Q

Pitocin is a ____ medication and requires ____

A

High alert

-Duel verification

41
Q

What is the common low does of pitocin?

what rate is it increased?

A
  1. 5 to 2 miliunits/min

- Increase dose in 1 to 2 milliunits/min increment every 15 to 40 minutes

42
Q

Pitocin is given after birth as well. Why?

A

-To prevent PPH via contractions in the uterus

43
Q

The rate of pitocin for controling PPH is

A

20-40 milliunits/min

10-40 units is diluted into 1000ml of solution

44
Q

If there is no iv acess, ____ units of pitocin is given via ___

A

10 units

IM injection

45
Q

What is the rate of absorption of pitocin for IV

A

1 minute

46
Q

What is the rate of absorption of pitocin for IM

A

3-5 minutes

47
Q

How is pitocin excreted?

A

Renal

48
Q

What is considered a “good” freq. of contractions?

A

every 2-3 minutes lasting 40-90 seconds

49
Q

Do not induce labor if the child is not in ___ presentation

A

Cephallic

50
Q

What needs to be assessed prior to inducing labor?

A
  • presentation
  • FHR
  • UA
  • VS
  • intake and output
51
Q

What is considered a elevated resting tone?

A

firm with palpation or >20 to 25 mm HG if measured with intrauterine pressure catheter

52
Q

Montevideo units over ___ are considered bad

A

300-400

53
Q

What is considered a normal fundus height postpartum?

A

At or 1 finger height above umbilicus

54
Q

What three aspects of the fundus are assessed postpartum?

A
  • Firmness
  • Height
  • Deviation
55
Q

If the uterus is deviated after birth. It could mean that ____

A

The bladder is full

56
Q

If the uterus is boggy after birth, what should be done?

A

Massage until firm

57
Q

How can prolonged use of pitocin affect the post partum uterus?(induced/augmented labor)

A

It can causes fatigue of the uterine muscle. This leads to poor contraction strength r/t saturated oxytocin receptors and a risk for PPH

58
Q

When observing postpartum lochia, what three things should be assessed?

A

Color, quantity, presence of clots

59
Q

How often are post partum VS taken?(induced/augmented labor)

A

q15

60
Q

We monitor post partum breath sounds. WHy?(induced/augmented labor)

A

To rule out water toxicity and pulm edema

61
Q

What two postpartum assessment findings would be an automatic call to the provider?

A
  • Uterus fails to remain contracted

- Bright red or clots in lochia

OB (14 decks)

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