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Quarter 4 finals > WH final > Flashcards

WH final Flashcards

1
Q

Labor

A

Contractions that result in progressive DILATION and EFFACEMENT of the cervix

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2
Q

Effacement

A

thinning of cervix

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3
Q

Station

A

Placement of presenting part in maternal pelvis in relation to ISCHIAL SPINES

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4
Q

DIRECT eval for Rupture of Membranes (3)

A

Fern
Amniosure
Nitrazine paper

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5
Q

SUPPORTIVE eval for Rupture of Membranes

A

Amniotic Fluid Index or “AFI” done by Ultrasound

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6
Q

Nitrazine testing

A

vaginal pH

not very specific, not used often

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7
Q

Fern testing

A

Air dried sample of fluid examined under microscope

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8
Q

Amniosure

“point of care test”

A

VERY SPECIFIC

requires only small sample

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9
Q

Fetal station

A

position of baby’s head in the ischial spine

0 is at the ischial spine

Cephalic station is +1

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10
Q

Stage 1 of labor

further divided into two phases

A

Contractions accomplish COMPLETE Dilation and Effacement

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11
Q

Latent phase of Stage 1

A

slower, less predictable

0-5 cm dilation

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12
Q

Active phase of Stage 2

A

faster, more predictable

5-10 cm dilation

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13
Q

Stage 2 of labor

A

Expulsion of fetus

BABY IS BORN

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14
Q

Stage 3 of labor

A

Placenta becomes detached from uterine wall and expelled

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15
Q

Stage 4 of labor

A

MANY HEMODYNAMIC CHANGES in momma

2 hours post delivery of placenta

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16
Q

Which stage of labor differs by both race and parity?

A

Stage 2- complete dilation and expulsion of the fetus

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17
Q

Order of cardinal movements of labor

A 
Engagement
Flexion
Descent
Internal rotation
Extension
External rotation

one fluid movement

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18
Q

Major complication of 3rd stage of labor

A

Hemorrhage

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19
Q

How long does stage 3 of labor last?

A

30 min or less
often aided by doc

delivery of placenta

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20
Q

Complications of 3rd stage

A

HEMORRHAGE
retention of placenta
uterine inversion

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21
Q

Signs of Placental separation

A

Uterus rises in abdomen
Globular configuration
Gush of blood
Lengthening of umbilical cord

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22
Q

4th stage of labor

A

2 hours postpartum
“Transfusion” from the now contracted uterus

Particularly critical time for women with Cardiovasc or Pulm dz

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23
Q

Progress of Labor

3 “Ps”

A

Power: maternal pushing efforts, uterine contractions

Passenger: size and position of fetus

Passage: size and shape of maternal pelvis

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24
Q

Uterine contractions

A

increase in FREQUENCY and INTENSITY d/t prostaglandins

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25
Q

Adequate labor is considered

A

3-5 contractions within 10 min

averaged over 30 min

26
Q

External tocodynamometer

A

measures

  • frequency
  • duration
27
Q

INTERNAL tocodynamometer

A

measures

  • frequency
  • duration, AND
  • intensity
28
Q

Macrosomic infant

A

> 4,500 grams

29
Q

Posterior fontanel

A

TRIANGULAR shaped

30
Q

ANTERIOR fontanel

A

DIAMOND shaped

31
Q

True labor

A

regular intervals, increasing in frequency

cervical dilation

back/abd discomfort

labor pattern NOT altered by pain meds

32
Q

CEFM

A

Continuous elecronic fetal monitoring

external: US transducer on abdomen
internal: scalp electrode on baby

33
Q

Baseline fetal heart rate

A

110-160 bpm

34
Q

Early decelearation

A

physiologic

d/t head compression

35
Q

Variable deceleration

A

d/t cord compression

36
Q

Late deceleration

A

d/t fetal hypoxia

BAD, omnious sign

37
Q

Basic Antepartum Testing
-done to evaluate a high risk fetus

worried about Fetal Acidosis

A

Fetal kick counts
Non stress testing
Contraction stress testing
Biophysical profile

38
Q

Biophysical profile

US eval of 4 things:

A

Amniotic fluid assmt
Gross fetal mov
Tone
Fetal “breathing”

39
Q

Contraction stress test

Negative results

A

Reassuring (good)

3 contractions in 10 min with NO late deceleration

40
Q

Contraction stress test

Postitive results

A

Non-reassuring (bad)

late decelerations or sig variable decel with >50% of contractions in 10 min period

41
Q

First deg obs laceration

A

Involved vaginal mucosa or perineal skin, but NOT underlying tissue

42
Q

2nd deg obs laceration

A

Involves underlying subQ tissue

but NOT rectal

43
Q

3rd deg obs laceration

A

through Rectal SPHINCTER, but not rectal mucosa

44
Q

4th deg obs laceration

A

INTO Rectal mucosa

45
Q

Ways to induce labor

A 
Prostaglandin 
Misopristol
Pitocin
Stripping membranes
Amniotomy (rupture of membranes)
46
Q

Induction risks

A 
Dec oxygen
Fetal hypoxia/acidosis
Unfavorable cervix
Cord prolapse
Infection
47
Q

Bishop scoring

how successful will an induction be?

A

0-4 = likely a FAILED induction

48
Q

What type of anesthesia for a C section?

A

Spinal-

regional anesthesia via one-time injection into spinal canal

49
Q

Puerperium

A

6 wks postpartum

50
Q

What happens to cervix in puerperium

A

Uterus involutes from 1000 to 50-100

51
Q

How long to stay in hospital after vaginal birth?

A

1-2 days

52
Q

How long to stay in hospital after C section?

A

2-4 days

53
Q

Postpartum exam occurs

A

4-6 weeks after birth

54
Q

Which pelvic shape is BEST suited for vaginal delivery?

A

Gynecoid

55
Q

Spontaneous separation of placenta should occur within what time phrame after vaginal delivery?

A

30 min

56
Q

What type of decelerations are physiologic?

A

Early

are OK

57
Q

What type of twins have a genetic pre-D?

A

Dizygotic
“fraternal”

this type is less risky too

Diamniotic/Dichorionic

58
Q

Identical twins are not influenced by

A

Assistive Reproductive Technology

59
Q

Monozygotic have same risks as dizygotic PLUS

A

Twin-twin transfusion risk

60
Q

Twin-twin transfusion syndrome

A

happens in Monochorionic/Diamniotic pregnancy

61
Q

Twin-twin transfusion

A

imbalance in fetal-placental circulation, one twin transfuses the other

Quarter 4 finals (11 decks)

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