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Maternity > Week 3 > Flashcards

Week 3 Flashcards

1
Q

5 P’s

A

Passenger
Passageway
Powers
Position
Psychological

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2
Q

closure of A fontanelle

A

18 mo

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3
Q

closure of P fontanelle

A

6-8 weeks

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4
Q

in the fetus the occipital bone is larger meaning

A

when baby is placed flat it pushes head down
- watch airway

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5
Q

sagittal suture can be felt for

A

direction of fetus

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6
Q

fetal presentation

A

part of the fetus that lies closest to the internal os of the cervix

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7
Q

what do we normally want to present

A

head
- occipital

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8
Q

Vertex

A

head down

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9
Q

breach

A

butt down

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10
Q

shoulder

A

shoulder down

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11
Q

proven pelvis

A

had a vaginal birth before

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12
Q

CPD

A

cephalopelivc disproortion
- head is not going through pelvis good

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13
Q

fetal lie

A

relation of the long axis of the fetus to the long axis of the mother
- spines

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14
Q

fetal attitude

A

relation of the fetal body parts to one another

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15
Q

normal fetal attitude

A

general flexion with the chin flexes onto chest and the extremities flexed into the abdomen

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16
Q

why do we need to know fetal position

A

where to put the monitor

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17
Q

Liapolds can determine

A

lie
attitude
presentation

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18
Q

fetal station

A

measure of the degree of descent of the presenting part through the birth canal

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19
Q

what is 0 station

A

at the ischial spine

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20
Q

more engaged

A

more than 0
+

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21
Q

less engaged

A
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22
Q

+ 4/5 =

A

birth is imminent

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23
Q

why is squatting or sitting on a. ball good

A

open hips and push baby down

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24
Q

4 types of pelvis

A

gynecoid
android
anthropoid
platypelloid

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25
Q

normal female pelvic shape

A

gynecoid

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26
Q

effacement

A

the thinning and shortening of the cervix

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27
Q

dilation

A

force of contraction and pressure from presenting part make diameter expand from closed <1cm to complete 10 cm

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28
Q

primary vs secondary powers

A

primary: uterus contractions
secondary: maternal bearing down

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29
Q

Ferguson reflex

A

feeling the urge to push

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30
Q

why do we like left side lying

A

takes pressure off main vessels

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31
Q

anxiety and fear in birth

A

stimulates catacholmines release which causes ineffective contractions and dysfunctional labor

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32
Q

muslim possible culture requests

A

female only staff
very modest

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33
Q

jewish possible culture requests

A

kosher diet

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34
Q

Asian possible culture requests

A

fish and rice prepared by mom

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35
Q

Hispanic possible culture requests

A

evil eye
touch while giving compliment

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36
Q

TRUE ACTIVE LABOR

A

DILATION
EFFACEMENT
AND DESCENT OF FETUS

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37
Q

preceding labor
-primips

A

uterus drops 2 weeks before term

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38
Q

preceding labor
-multips (dropping)

A

may not happen until true labor is in process

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39
Q

why might we see bloody show

A

small capillaries on cervix rupture

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40
Q

Braxton hicks

A

practice contractions

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41
Q

factors involved with onset of labor

A

oxytocin

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42
Q

pressure on the cervix releases

A

oxytocin

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43
Q

production of prostaglandins do what

A

soften the cervix and dilate

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44
Q

labor

A

process of moving fetus, placenta, and membranes out of the uterus through birth canal

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45
Q

how many stages of labor

A

4

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46
Q

false vs true labor

A

true
- increase frequency of contractions
- back pain and radiates to front
- contractions continue with sleep
- walking increases contractions
- PROGRESSIVE EFFACTMENT

false
- decrease in frequency
- lower abdomen pain
- disappears with sleep
- NO CHANGE IN CERVIX

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47
Q

1st stage of labor

A

onset of contractions to full dilation

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48
Q

1st stage
- latent

A

0-5 cm

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49
Q

1st stage
- active

A

6 cm and up

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50
Q

once you get to 6cm

A

1 cm every hour

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51
Q

2nd stage

A

cervix is dilated to birth of infant

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52
Q

3rd stage

A

birth of infant to birth of placenta

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53
Q

4th stage

A

birth of placenta to 2 hours PP

54
Q

7 cardinal movements

A

engagement
descent
flexion
internal rotation
extension
external rotation
expulsion

55
Q

not coping with pain

A

crying
moving
can’t focus
jitters
sweating

56
Q

is coping

A

eyes closed
rhythmically breathing
rotating hips

57
Q

fatigue does what

A

decreases woman’s ability to cope effectively with contraction pain

58
Q

do we give heat with epidural

A

no because no sensation

59
Q

opioids do what to maternal vital signs

A

decrease HR, RR, BP

60
Q

why is fent good

A

short half life
fewer neonatal effects

61
Q

what do we give 15 to 30 mins before anesthesia

A

fluid bolus (500cc)

62
Q

what does fluid bolus do

A

decrease the potential for hypotension caused by sympathetic blockade

63
Q

disadvantages to spinal anesthesia

A

hypotension
impaired breathing
operatie birth more likely

64
Q

spinal headache caused by

A

accidentally punctured the dura
“wet tap”
- treatment is blood patch

65
Q

maternal labs for epidural

A

platelets
- lesss than 100,000 bad and cannot get epidural

66
Q

wedge under hip does what

A

displaces the uterus and gets it off major vessels

67
Q

cricoid pressure

A

helps visualize vocal cords for intubation
also helps prevent aspiration

68
Q

more movement is better because

A

helps change babies position

69
Q

side effects of anesthesia

A

hypotension
N/V
itchy skin
urinary retention
HA
increase temp

70
Q

fetal wellbeing during labor is measured by

A

the response of fetal heart rate to the uterine contractions

71
Q

contractions reduce the blood flow through the maternal vessel which

A

decrease O2 content in the maternal blood

72
Q

does FHR monitoring decrease neonatal morbidity

A

false

73
Q

abnormal fetal HR

A

hypoxia

74
Q

Pitocin does that equal high or low risk mom

A

high risk

75
Q

we use intermittent auscultation in a

A

low risk pt

76
Q

components of external monitoring

A

ultrasound transducer
Toco transducer

77
Q

ultrasound transducer measures

A

fetal HR

78
Q

where is the ultrasound transducer placed

A

on fetal back
- use leipolds to find that

79
Q

toco transducer measures

A

contractions

80
Q

where is the toco transducer placed

A

on fundus

81
Q

components of internal monitoring

A

spiral electrode
intrauterine pressure catheter

82
Q

spiral electrode

A

HR
screwed into head

83
Q

intrauterine pressure catheter

A

amount of pressure in the uterus
monitors contractions

84
Q

why do we want moms pulse ox on

A

so we know we are picking up baby heart tones and not moms

85
Q

normal fetal HR range

A

110-160

86
Q

bradycardia (less than 110) causes

A

hypoxic
drugs
vasovagal

87
Q

tachycardia (greater than 160) causes

A

maternal fever
infection
fetal anemia

88
Q

variability tells us

A

if we got good oxygenation during labor

89
Q

4 categories of variability

A

absent
minimal
moderate
marked

90
Q

absent variability

A

no range
- m acid
- fetal sleep cycle

91
Q

minimal variability

A

less than 5 BPM above or below baseline

92
Q

moderate variability

A

6-25BPM above or below
normal acid base balance

93
Q

what type of varaibilty do we want

A

moderate

94
Q

marked variability

A

over 25BPM above or below
- fetal anemia or chorioamnionitis

95
Q

accerlations indicate

A

fetal well being/adequately oxygenation
- we want accelerations

96
Q

accerlation criteria terms and before 32 weeks

A

at least 15BPm increase for at least 15 sec
32: at least 10 BPM increase for at least 10 sec

97
Q

decorations

A

decrease in FHR characterized by their shapes and timing relationship to contractions

98
Q

early decels

A

response to vital head compression

99
Q

late decels

A

uteroplacental insufficiency

100
Q

variable decal

A

umbilical cord compression or prolapse

101
Q

prolonged deceleration

A

more than 2 min but less than 10 min

102
Q

contractions frequency

A

time from beginning of one cxn to beginning of next cxn, measured in mintues
- cxn in 10 min window averaged over 30 mins

103
Q

tachysystole

A

> 5 cxn in a 10 min window, averaged over 30 mins
- bad because HR goes down and the fetus is not being perfused = acidosis

104
Q

resting tone

A

normal intrauterine pressure between cxn or in absence of cxn
- allows the uterine vessels to give blood flow to the placental allowing the fetal exchange of repritory gases which enhanced fetal oxygenation

105
Q

VEAL CHOP

A

variability
early
accerlated
late

cord
head
okay
perfusion

106
Q

if we have variable what do we do

A

the cord is not perufsing enough so we want to slow labor down and stop pit

107
Q

Category 1
- HR
- Variability
- decels

A

normal HR (110-160)
moderate variability
absent decels

108
Q

category 2
- HR
- Variability
- decels
- accelerations

A
  • bradycardia/tachycarida
  • minimal or absent variability
  • recurrent decels
  • no accelerations in response to fetal stimulation
109
Q

category 3
- HR
- Variability
- decels

A
  • nonreasuring FHR pattern associated with hypoxemia (bradycardia)
  • absence of baseline variability
  • recurrent or late decels
  • sinusoidal pattern
110
Q

what happens if you have category 3

A

emergency delivery

111
Q

where do we draw cord ABG

A

arterial

112
Q

intrauterine resuscitation acronym

A

LIONS PIT

113
Q

LIONS PIT

A

stop pit

left side
IV open
oxygen ?
notify MD
stop
PIT

114
Q

what does stoping pit do

A

maximize uterine blood flow and placental perfusion

115
Q

amnioinfusion

A

due to decrease amniotic fluids and we replace it to help cushion baby

116
Q

tocolytic therapy is used for

A

tachysstole

117
Q

TRUE ACTIVE LABOR

A

CERVICAL DILATION
EFFACEMENT
DESCENT OF FETUS

118
Q

first stage of labor

A

begin with regular contractions and ends with full cervical effacement and dilation
latent: 0-5cm
active: >6cm
- 1cm for every hour after 6

119
Q

EMTALA

A

emergency medical treatment and active labor act
- a woman is considered to be in true labor until a qualified provider determines that she is not
- stablize mom and baby and then transport

120
Q

what do we need to do when membrane is ruptured spontaneously or artificially

A

time
color: normal is clear
odor: abnormal is foul

FETAL HR if decreased then might be cord issue and have to do C

121
Q

by the time of rupturing and delivery is how long due to infection risk

A

18 hours

122
Q

leopolds determines

A

lie
attiutde
presentation

123
Q

3/70%/-2

A

dilation 3
effacement 70%
staton -2

124
Q

station of what means birth is imminent

A

+ 4/5

125
Q

we need a station of what before we can rupture the membrane

A

-3

126
Q

moms should void every

A

2hours

127
Q

full bladder can

A

prevent fetal descent in the labor process

and prevent uterine clamping down in the PP

128
Q

APGAR

A

1, 5, 10

129
Q

nuchal cord

A

wrapped around neck

130
Q
A

Maternity (15 decks)

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