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94 Cards in this Set
- Front
- Back
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DIC definition
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- characterized by increased coagulation
- formation of thrombi in microcirculation - hemorrhage - tissue and cellular ischemia |
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respiratory symptoms of DIC
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Dyspnea, cyanosis, increased RR
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Bruising
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Sign and symptom of DIC
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DIC
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DIsseminated Intravascular Coagulopathy
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Pain and swelling of the joints
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Sign and symptom of DIC
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Bleeding from Mucous membranes
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Sign and symptom of DIC
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N/V and severe abdominal pain
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Sign and symptom of DIC
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Restlessness, confusion, seizure, coma, shock
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Sign and symptom of DIC
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abruptio placenta
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Risk factor for DIC
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sepsis
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Risk factor for DIC
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Intrauterine fetal death
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Risk factor for DIC
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Amniotic fluid embolism
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Risk factor for DIC
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severe PIH and HELLP
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Risk factor for DIC
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Retained placenta
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Risk factor for DIC
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Recent injury or trauma
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Risk factor for DIC
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Value of fibrinogen ------------- with DIC.
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decreases
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Value of platelets -------------- with DIC
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decreases
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PT and PTT are -------------- with DIC
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prolonged
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there is an -------------------- in fibrin - degradation products
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increase
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T/F
C-Section is not indicated in the patient w/ DIC. |
False
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Hypoxia
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Implications for fetus when mother has DIC
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Acidosis
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Implications for fetus when a mother has DIC
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Hypotension
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Implications for fetus when mother has DIC
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Renal failure
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Sign of shock
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Respiratory depression
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Sign of shock
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Altered LOC
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Sign of shock
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Rising thready pulse rate and falling blood pressure
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Sign of shock
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Pale clammy skin
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Sign of shock
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T/F
Oxygen is administered via Nasal Cannula in the patient with DIC |
false
oxygen is administered via Face mask non-rebreather |
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administration of heparin
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management intervention of the patient with DIC
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shoulder dystocia
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any birth in which maneuvers in addition to lateral traction and episiotomy are required to deliver the shoulder
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obesity
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factors predisposing mother to shoulder dystocia
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multiparity
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factors predisposing mother to shoulder dystocia
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postdates
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factors predisposing mother to shoulder dystocia
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prior history of macrosomic babies
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factors predisposing mother to shoulder dystocia
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midpelvic delivery
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factors predisposing mother to shoulder dystocia
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prolonged second stage
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factors predisposing mother to shoulder dystocia
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DM
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factors predisposing mother to shoulder dystocia
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Brachial plexus palsy
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common fetal complication from shoulder dystocia
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seizure
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common fetal complication associated with shoulder dystocia
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asphyxia
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common fetal complication with shoulder dystocia
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fracture of the humerus ans clavicle
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common fetal complication related to shoulder dystocia
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Problems with power in shoulder dystocia
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hyper and hypo tonic uterine dysfunction
precipitous labor |
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Problems with passenger
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occiput posterior position
breech presentation multifetal pregnancy macrosomia structural abnormalities |
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problems with passage way
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pelvic contraction
obstructions in maternal birth canal |
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problems with psyche
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psychological distress
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What is the first sign of shoulder dystocia ?
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retraction of fetal head
"turtle sign" |
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McRoberts Position
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1. flex thighs
2. pull patients knees toward ears |
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Zavanelli Maneuver
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C-section w/ cephalic replacement
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What is the management Mnemonic for shoulder dystocia?
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HELPER
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HELPER
What does H stand for? |
Call for HELP
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HELPER
What does E stand for? |
Cut a generous EPISIOTOMY
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HELPER
What does L stand for? |
Position LEGS in McRoberts position
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HELPER
What does P stand for? |
Apply suprapubic PRESSURE
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HELPER
What does E stand for? |
ENTER and perform Rubin and Wood-Screw maneuver
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HELPER
What does R stand for? |
Remove posterior arm
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what are the three things you avoid in shoulder dystocia?
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pressure on the fundus
excessive downward traction to baby's head Twisting or bending of neck |
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Gaskin's Maneuver puts the woman in what position?
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Gets the woman on a hands and knee position ?
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Zavanelli Maneuver
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cephalic replacement followed by cesarean delivery
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T/F
hx of SAB predisposes you to having an incompetent cervix? |
True
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T/F
Cerclages are not used in cases of Incompetent cervixes to stop preterm cervical dilatation |
false
they are used |
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What happens to the cerclage in a cesarean birth
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sutures left in place
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What happens to the cerclage in a vaginal birth
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sutures removed before term
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Women with cerclages should be instructed to report what two things?
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ROM
labor contractions |
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Why are tocolytic medications used in PROM?
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supress uterine contractions
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How does the nurse maintian good uterine blood flow in the patient with a PROM?
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position her on her left side
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Cord Prolapse is -------- ---------- ------- --------.
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obstetric emergency demanding immediate attention
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immediate management of umbilical cord prolapse is determined by what three factors?
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fetal viability
fetal maturity presence of any lethal anomalies |
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In the case of a cord prolapse emergency delivery is recommended for what type of fetus?
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mature and normally formed
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If the cervix is not completely dilated what offers the best chance for a favorable fetal outcome in a patient with a prolapsed cord
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C- Section
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Onset of uterine rupture is marked by --------- -------- ----------.
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sudden fetal bradycardia
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T/F
The nurse must be prepared for urgent C-section in a uterine rupture |
true
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multiparity
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factor contributing to precipitous birth
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large pelvis
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factor contributing to precipitous birth
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previous precipitous birth
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factor contributing to precipitous birth
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small fetus in a favorable position
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factor contributing to precipitous birth
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strong contractions
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factor contributing to precipitous birth
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uterine hyperstimulation from excess Pitocin
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factor contributing to precipitous birth
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loss of coping ability
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implication for precipitous birth
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laceration of cervix, vagina, or perineum
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implication for precipitous birth
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postpartum uterine atony
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implication for precipitous birth
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atony
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lack of normal tone or strength
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hemorrhage from undetected laceration or atony
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implication for precipitous birth
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fetal stress of hypoxia from intense uterine contractions
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implication for precipitous birth
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fetal cerebral trauma from rapid descent
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implication for precipitous birth
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fetal pneumothorax from rapid descent
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implication for precipitous birth
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What is a nursing plan for precipitous labor?
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identify client at increased risk
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accelerated labor progression in a multipara is dilation of ------ ---- in one hour.
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>2cm
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Accelerated labor progression in a nullipara is -------- ----------- in one hour.
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>1.2 cm
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what is one thing to avoid in a client with precipitous labor?
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uterine hyperstimulation
*careful oxytocin dosing* |
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Postterm labor
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pregnancy continuing past end of 42 weeks gestation
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How often does a postterm woman have a NST?
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2x a week
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How often does the postterm woman have cervical examinations?
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once a week
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T/F
The woman with a postterm baby should count fetal movements daily. |
true
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