yap/last minute t2 Flashcards

1
Q

how would a baby present in umbilical cord prolapse?

A

Bradycardia & variable decels

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2
Q

interventions for umbilical cord prolapse?

A

remove pressure off cord

  • hold baby help upward to remove compression
  • mom in trendelenburg/knees to chest
  • 10L oxygen w/ nonrebreather
  • admin tocolytic
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3
Q

what is placenta previa?

A

placenta covers cerix/cervical opening
bright red blood & painless

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4
Q

effect of p previa on fetus?

A

decreased variability & bradycardia

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5
Q

what is placental abruption?

A

Premature detatchment of placenta

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6
Q

p abruption effect on baby?

A

bradycardia / decreased variability

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7
Q

uterine dystocia does what?

A

stall labor

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8
Q

result of hypertonic uterine dystoica?

A

fetal hypoxia

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9
Q

what is hypertonic uterine dystocia?

A

too many contractions, too strong & painful
dont change cervix

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10
Q

what is hypotonic uterine dystocia

A

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

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11
Q

what is chorioamniontitis?

A

infection of membranes surrounding fetus

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12
Q

risks for chorioamnionitis?

A

prolonged membrane rupture (24hr)
multiple vag exams

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13
Q

rupture of uterus presentation? maternal V/S

A

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

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14
Q

immediate intervention for uterine rupture?

A

C/S

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15
Q

strip presentation for uterine rupture?

A

pain w/ tachysystole, abrupt start & fetal bradycardia

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16
Q

interventions for shoulder dystocia?

A

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

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17
Q

oblique transverse lie baby presentation?

A

fetus lies sideways/diagonally

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17
Q

complications of breeches

A

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

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18
Q

4 indications for induction

A

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

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18
Q

what is a patient with oligohydramnios @ risk for?

A

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

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19
Q

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

A

Breathe/ blowing breaths

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20
Q

some things that can cause tachysystole?

A

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

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21
Q

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

A

crowning

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22
Q

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

A

polyhyrdramnios

23
Q

intervention for polyhydramnios & a high station?

A

Bed rest

24
Q

mg sulfate reversal

A

Ca Gluconate IM

25
Q

s/sx of mg toxicity?

A

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

26
Q

what is shoulder dystocia?

A

Head has passed thru but shoulder are stuck/hung up

27
Q

sign of shoulder dystocia?

A

turtle sign – perform mcRoberts

28
Q

hemorrhage maternal signs?

A

BP drop
RR increase
Pulse increase

29
Q

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

A

modified sims

30
Q

birthing balls do what?

A

help rotate the baby - especially from OP to OA

31
Q

Other name for misoprostol? & what does it do?

A

cytotec
cervical ripening agent

32
Q

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

A

Dinoprostone (gel)

33
Q

when to not give cervical ripening?

A

Bleeding
Breech
Unruptured membrane

34
Q

what does Oxytocin/Pitocin do?

A

Stimulate contractions after labor has begun

35
Q

what should nurse watch out for in mom with oxytocin?

A

tachysystole
uterine rupture

36
Q

what is Amniotomy?

A

Artifical rupture of membrane

37
Q

what is augmentation of labor?

A

Enhancing uterine contractions after spontaneous labor to improve progress

38
Q

chemical augmentation of labor?

A

Oxytocin

39
Q

mechanical augmentation of labor?

A

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

40
Q

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

A

BP
RR
Urine output

41
Q

assess for what during/after pain management

A

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

42
Q

primary tocolytics used in labor (2)

A

mg sulfate
terbutaline

43
Q

when to give terbutaline?

A

uterine tachysystole

44
Q

what is the most common sedative used in labor?

A

Seco
mild sedation w/in 15

45
Q

what sedative/anxiety medication can cause jaundice?

A

prometh/phenergen

46
Q

meconium stained fluid can be indicative of what?

A

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

47
Q

what to monitor on fetus for meconium stained?

A

FHR & pattern
Thickness of mecon fluid

48
Q

thick meconium fluid would call for what?

A

amnioinfusion

49
Q

deep variables r/t oligo could require what intervention?

A

amnioinfusion

50
Q

indication to turn down/stop amnioinfusion

A

rigid abdomen
hypotension
bradycardia

51
Q

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

A

fetus is vertex presentation

52
Q

what conditions cant receive oxytoxin/pitocin?

A

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

53
Q

labs to run on abruptio placentae? & why

A

CBC, PT, electrolytes

increased risk of bleeds

54
Q

what to document with vacuum/forceps?

A

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

55
Q

when cant you use the vacuum?

A

baby with fetal blood scalp sampling

56
Q

what is an amnio fluid embolism?

A

amnio fluid enters maternal circulation = resp distress & CV collapse

57
Q

contraindications to cervadil?

A

Bleeding/transverse position