yap/last minute t2

Question 1

how would a baby present in umbilical cord prolapse?

Answer 1

Bradycardia & variable decels

Question 2

interventions for umbilical cord prolapse?

Answer 2

remove pressure off cord

• hold baby help upward to remove compression
• mom in trendelenburg/knees to chest
• 10L oxygen w/ nonrebreather
• admin tocolytic

Question 3

what is placenta previa?

Answer 3

placenta covers cerix/cervical opening
bright red blood & painless

Question 4

effect of p previa on fetus?

Answer 4

decreased variability & bradycardia

Question 5

what is placental abruption?

Answer 5

Premature detatchment of placenta

Question 6

p abruption effect on baby?

Answer 6

bradycardia / decreased variability

Question 7

uterine dystocia does what?

Answer 7

stall labor

Question 8

result of hypertonic uterine dystoica?

Answer 8

fetal hypoxia

Question 9

what is hypertonic uterine dystocia?

Answer 9

too many contractions, too strong & painful
dont change cervix

Question 10

what is hypotonic uterine dystocia

Answer 10

ineffective contraction pattern
(less than 2-3 contractions/10min)

Question 11

what is chorioamniontitis?

Answer 11

infection of membranes surrounding fetus

Question 12

risks for chorioamnionitis?

Answer 12

prolonged membrane rupture (24hr)
multiple vag exams

Question 13

rupture of uterus presentation? maternal V/S

Answer 13

rigid abdomen, tachycardia, low BP & increases RR
dark red blood

Question 14

immediate intervention for uterine rupture?

Answer 14

C/S

Question 15

strip presentation for uterine rupture?

Answer 15

pain w/ tachysystole, abrupt start & fetal bradycardia

Question 16

interventions for shoulder dystocia?

Answer 16

mcRoberts
suprapubic pressure
birthing ball to help prevent (change position)

Question 17

oblique transverse lie baby presentation?

Answer 17

fetus lies sideways/diagonally

Question 17

complications of breeches

Answer 17

umbilical cord prolapse
placental abruption
cord compression = fetal hypoxia (variables)

Question 18

4 indications for induction

Answer 18

Gestational diabetes
Pre-eclampsia (!!)
Gestational hypertension
Chorioamniontits

Question 18

what is a patient with oligohydramnios @ risk for?

Answer 18

Deep variables –> cord compression
Nuchal cord –> fetal hypoxia

Question 19

advice for a pt below 10 cm who during a contraction feels the need to push?

Answer 19

Breathe/ blowing breaths

Question 20

some things that can cause tachysystole?

Answer 20

too much pitosin
dehydration
cervical ripener (cervadil)
fetal hypoxia
U rupture

Question 21

how to tell when mom is in 2nd stage/ready for delivery?

Answer 21

crowning

Question 22

what patient is more likely to have cord prolapse (amnio related)

Answer 22

polyhyrdramnios

Question 23

intervention for polyhydramnios & a high station?

Answer 23

Bed rest

Question 24

mg sulfate reversal

Answer 24

Ca Gluconate IM

Question 25

s/sx of mg toxicity?

Answer 25

decreased LOC decreased RR (<12) decreased deep tendon reflexes

Question 26

what is shoulder dystocia?

Answer 26

Head has passed thru but shoulder are stuck/hung up

Question 27

sign of shoulder dystocia?

Answer 27

turtle sign -- perform mcRoberts

Question 28

hemorrhage maternal signs?

Answer 28

BP drop RR increase Pulse increase

Question 29

if epidural mom cant hold weight & has prolapsed cord, what position should she be put in?

Answer 29

modified sims

Question 30

birthing balls do what?

Answer 30

help rotate the baby - especially from OP to OA

Question 31

Other name for misoprostol? & what does it do?

Answer 31

cytotec cervical ripening agent

Question 32

other name for Cervidil (insert) & what does it do?

Answer 32

Dinoprostone (gel)

Question 33

when to not give cervical ripening?

Answer 33

Bleeding Breech Unruptured membrane

Question 34

what does Oxytocin/Pitocin do?

Answer 34

Stimulate contractions after labor has begun

Question 35

what should nurse watch out for in mom with oxytocin?

Answer 35

tachysystole uterine rupture

Question 36

what is Amniotomy?

Answer 36

Artifical rupture of membrane

Question 37

what is augmentation of labor?

Answer 37

Enhancing uterine contractions after spontaneous labor to improve progress

Question 38

chemical augmentation of labor?

Answer 38

Oxytocin

Question 39

mechanical augmentation of labor?

Answer 39

Amniotomy Nipple stimulation shower/tub immersion (no warmer than 100.4)

Question 40

what V/S to focus on during/after pain management?

Answer 40

BP RR Urine output

Question 41

assess for what during/after pain management

Answer 41

sensation & movement in extremities position changes to prevent injury check neonate for respiratory depression (opioid use only)

Question 42

primary tocolytics used in labor (2)

Answer 42

mg sulfate terbutaline

Question 43

when to give terbutaline?

Answer 43

uterine tachysystole

Question 44

what is the most common sedative used in labor?

Answer 44

Seco mild sedation w/in 15

Question 45

what sedative/anxiety medication can cause jaundice?

Answer 45

prometh/phenergen

Question 46

meconium stained fluid can be indicative of what?

Answer 46

fetal distress (post date) or from fetal positioning = ok

Question 47

what to monitor on fetus for meconium stained?

Answer 47

FHR & pattern Thickness of mecon fluid

Question 48

thick meconium fluid would call for what?

Answer 48

amnioinfusion

Question 49

deep variables r/t oligo could require what intervention?

Answer 49

amnioinfusion

Question 50

indication to turn down/stop amnioinfusion

Answer 50

rigid abdomen hypotension bradycardia

Question 51

on cervical exam, if feeling a diamond shape what is occuring/established?

Answer 51

fetus is vertex presentation

Question 52

what conditions cant receive oxytoxin/pitocin?

Answer 52

U cord prolapse placenta previa transverse fetal lie ** hx of CS

Question 53

labs to run on abruptio placentae? & why

Answer 53

CBC, PT, electrolytes increased risk of bleeds

Question 54

what to document with vacuum/forceps?

Answer 54

how much suction how many times (3 is pop off limit) length

Question 55

when cant you use the vacuum?

Answer 55

baby with fetal blood scalp sampling

Question 56

what is an amnio fluid embolism?

Answer 56

amnio fluid enters maternal circulation = resp distress & CV collapse

Question 57

contraindications to cervadil?

Answer 57

Bleeding/transverse position