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Maternal OB > week 5 > Flashcards

week 5 Flashcards

1
Q

a nurse is caring for a client who is in labor and is experiencing incomplete uterine relaxation between hypertonic contractions. the nurse should identify that this contraction pattern increases the risk for which of the following complications?
1. prolonged labor
2. reduced fetal oxygen supply
3. delayed cervical dilation
4. increased maternal stress

A
  1. reduced fetal oxygen supply
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2
Q

what position helps the fetus rotate

A

hands and knees

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3
Q

preterm labor is defined as

A

uterine contractions & cervical change that occur between 20 to 36 weeks and 6 days

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4
Q

very preterm labor occurs

A

before 32 weeks

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5
Q

fetal fibronectin testing (FFP)

A

testing of a protein that indicates inflammation

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6
Q

interventions for preterm labor

A

LEFT side
no sex
fetal tachycardia
modified bed rest w bathroom privileges

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7
Q

Nifedipine

A

CCB that suppresses contractions by inhibiting calcium from entering smooth muscles

cannot be taken w magnesium sulfate

adv effect is orthostatic hypotension

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8
Q

Magnesium sulfate

A

suppresses contractions by relaxing smooth muscles

*monitor for MG toxicity = deep tendon reflexes

antidote = calcium gluconate

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9
Q

nifedipine can not be administered with

A

magnesium sulfate

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10
Q

antidote for magnesium sulfate

A

calcium gluconate

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11
Q

terbutaline

A

inhibits uterine activity & relaxes smooth muscle

0.25mg SC Q4hrs for 24 hours

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12
Q

indomethacin

A

NSAID that suppresses contractions by blocking prostaglandins

*increased risk of closing ductus arteriosus
** admin less than 32 weeks only

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13
Q

indomethacin for labor can only be used in patients

A

less than 32 weeks gestation

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14
Q

nifedipine, magnesium sulfate, terbutaline, and indomethacin can not be administered in

A

patients with active bleeding

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15
Q

Betamethasone

A

enhances fetal lung maturity & surfactant position

24 hours to be effective
2 x IM’s 24 hours a part
@ least 24 hrs before delivery

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16
Q

interventions following rupture of membrane

A

assess for prolapse umbilical cord
- abrupt variable decels
- prolonged decels

obtain cultures for strep, chlamydia, & gonorrhea

17
Q

lab tests for rupture of membranes

A

+ nitrazine paper - BLUE - 6.5 to 7.5

+ ferning test

18
Q

anaphylactoid syndrome of pregnancy and s/s

A

emergency - embolism/ infiltration of amniotic fluid into maternal circulation

s/s = dic, resp. distress, sob, chest pain

19
Q

risk factors for a prolapsed umbilical cord

A

rupture of membrane
abnormal fetal presentation
transverse lie
small for gestational age
hydroamino
multifetal pregnancy

20
Q

s/s of prolapse umbilical cord

A

*VARIABLE DECELS
reports feeling it
excess activity to sudden stop
visible @ introitus

21
Q

interventions for prolapsed umbilical cord

A
  1. call help & stay w patient
  2. STERILE GLOVE W FINGER APPLYING PRESSURE ON EITHER SIDE OF CORD
  3. reposition - knee to chest, trendelenberg, & side-lying w towel under hip
  4. apply warm sterile saline towel to visible cord
22
Q

s/s of meconium stained amniotic fluid

A

GREEN thick/thin fluid
variable / late decels

23
Q

risk for meconium stained amniotic fluid

A

more than 38 weeks gest age
breech presentation
umbilical cord compression
hypoxia

24
Q

fetal distress

A

FHR < 110 or >160
decreased or no variability

25
Q

interventions for fetal distress

A

LEFT side
STOP OXYTOCIN
admin O2 & IV fluids

26
Q

Mc Robert’s maneuver

A

legs pushed up knee to chest during labor

27
Q

dystocia

A

dysfunctional labor related to the 5 P’s

28
Q

s/s of dystocia

A

hypotonic uterus
hypertonic uterus (tachysystole) = >5 UC in 10 min
occiput posterior position

29
Q

oxytocin

A

used to augment labor & strengthen contractions

NOT USED FOR HYPERTONIC CONTRACTIONS

30
Q

precipitous labor

A

labor lasting less than 3 hours from onset of contractions to time of delivery

31
Q

risk factors for precipitous labor

A

hypertonic uterine dysfunction
oxytocin stimulation
multiparous client

32
Q

interventions for precipitous labor

A

apply light pressure to perineal area and fetal head pressing upward toward vagina – eases expulsion

33
Q

uterine rupture

A

rupture of uterine wall, peritoneal cavity, and or broad ligament = internal bleeding

34
Q

s/s of uterine rupture

A

sharp pain
feels “ripping” or “tearing”
tenderness
hypovolemic shock

Maternal OB (8 decks)

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