• Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
Front

How to study your flashcards.

Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key

Up/Down arrow keys: Flip the card between the front and back.down keyup key

H key: Show hint (3rd side).h key

image

PLAY BUTTON

image

PLAY BUTTON

image

Progress

1/60

Click to flip

Card Range To Study

through

60 Cards in this Set

  • Front
  • Back
What are the 5 P's of labor?
Power
Passage
Passenger
Psyche of Mother
Position
What are the names of ....
Contraction of increasing intensity
Peak of the contraction
Decreasing intensity of contraction
Increment
Acme
Decrement
What is the body part relation of contraction intensity?
Nose-Chin-Forehead
What is the obstetrical conjugate?
measurement of the outlet for the baby
What is the best type of pelvis for giving birth?
gynecoid
Upright/Lateral Position does what?
improves uteroplacental circulation
encourages stronger contractions
increases maternal comforts
decreases FHT abnormalities
OVERALL MUCH BETTER
Squatting during the ____ stage will cause what?
straightening of long axis
better bearing down reflex
increase oxytocin release
The mechanisms of labor(movements of baby) include what in the correct order?
descent, engagement, flexion, internal rotation, extension, restitution, external rotation->EXPULSION
How can you tell if a mother is in true labor vs. false labor?
In False Labor, contractions will get better by walking, there is no cervical change, and the discomfort is mainly in the abdomen
Stage 1 of labor includes what 3 parts characterized by what measurement of the cervical dilation?
Early-0-3
Active- 3-8
Transition- 8-10
Stage 2 of labor is the what stage?
The pushing and birthing stage
Stage 3 of labor is made up of what?
Delivery of the placenta
Stage 4 of labor is made up of what?
1st hours of recovery
Early phase of Labor Times: Contractions, Overall Time
Contractions-20-40 seconds every 3-30minutes
Time- nulli-8.6-20 hours
multi- 5.3-14hours
Active Phase of Labor Times: Contractions, Overall Time
Contractions-60-90seconds every 2-3 minutes
Time- nulli-4.6, multi-2.4
Transition Phase of Labor Times:
Contractions, Overall Time
Contractions- 60-90seconds every 1-2 minutes
Time- nulli <3hours, multi- <30min
Systemic Changes in Response to Labor
increase in BP(can be due to supine position)
Increased pulse
increased O2 demand
Increased RR
Increased Temperature
WBC increases
Blood glucose decreases
Sleep States of Baby during Labor
Baby can sleep up to 40 minutes at a time- this is the quiet state
The active state is the time at which the baby is not sleeping
Normal FHR of Fetus
110-160
To determine tachycardia/bradycardia, you must assess FHT for how long?
at least 10 minutes
Causes of Fetal Tachycardia
maternal fever, infection, dehydration, betasympathomimetic drugs(terbutaline, ritodrine, atropine), prolonged fetal stimulations, early fetal hypoxia, chronic hypoxemia, prematurity, fetal anemia
Tx of Fetal Tachycardia
increase uterine blood flow, decrease uterine activity, give o2, fluids
Cause of Fetal Bradycardia
Supine position, hypotension, maternal hypothermia, Post dates, prolonged umbilical cord occlusion, decompensated fetus, hypothermia
Normal variabilityof Fetus
6-25bpm
Periodic accelerations with contractions are often associated with what?
breech position
Types of Decelerations
episodic, periodic, repetitive
Early Decelerations
due to head compression(stim vagal nerve), fetal head rotation or 2nd stage descent
BENIGN
no intervention is required
Later decelerations
gradual onset where peak occurs after the peak of contraction
due to uteroplacental insufficiency causing hypoxia
can be reflex late or metabolic late
Later Decelerations-Reflex late
due to something hospital has done
resolves with nursing interventions
*VARIABILITY IS PRESENT
Late Decelerations- Metabolic Lates
do not resolve with nursing interventions
Late Decelerations- Nursing interventions
improve oxygenation and decrase uterine activity
change mom's position, give o2, increase fluids, correct hypotension
Differentiate between metabolic lates vs. reflex lates
Both are caused by decreased uteroplacental O2 transfer and result in FHR decelerations. metabolic results in acidemia and myocardial depression causing the FHR decels.
Variable Decelerations
abrupt drop and quick return to baseline
due to cord compression
Variable Decelerations- Interventions
improve umbilical circulation by changing position,
VEAL CHOP
Variable- Cord Compression
Early- Head compression
Accelerations- Oxygenation
Late- Placental Perfusion Problems
Characteristics of nonreassuring FHT pattern
late decels, absence of variability, prolonged decelerations, marked bradycardia, lates w/ tachycardia
15x15 rule
In antepartum testing, accelerations 15 above baseline lasting for at least 15 seconds
*Contraction Stress Test
*Negative- if no lates present
*Positive- lates w/ 50% of contractions
Dr. C. Bravado
Define Risk
assess Contraction
Baseline RAte
Variability
Accelerations
Decelerations
Overall
PURRRR- Stage I Care
Position
Urination
Relaxation
Respiration
Rest
Reassurance
Nursing assessment time for each stage
Stage I- Q30(Q15High Risk)
Stage 2- Q15
Stage 3- Q5
Stage 4- Q15
Major Side Effects of Epidural
Maternal Hypotension
Pruritis
Urinary Retention
Normal APGAR Score
8-10
<4 needs resuscitory efforts
Fundus Location during Stage IV
btw umbilicus and symphysis
What is the difference between Hypertonic/Hypotonic Labor?
Hypertonic occurs before 4cm, is painful and is usually not effective
Hypotonic occurs after 4cm dilation and typically has no change in cervix within 2 hours time
Induction of labor can often result in increasing chance of what?
decels and % of cord prolapse
What are the maternal and fetal side effects of Pitocin?
Hyperstimulation of uterus, uterine rupture, nonreassuring FHR patterns, water intoxication

Hyperbilirubinemia, trauma from rapid birth
When is Pitocin not recommended to be used?
Severe preeclampsia
CPD
malpresentation
preterm infant
rigid, unripe cervix, fetal distress
What is important to note regarding contractions in pt's on Pitocin?
contractions >60 seconds in length are not good and should result in D/C of pitocin
What are the risks of precipitous labor and birth?
abruptio placenta, meconium stained fluid, and low APGARS
as well as PP hemorrhage
What is the difference in symptoms between abruptio placentae and placenta previa?
previa-quiet and has pain only if in labor
abruptio- sudden onset w/severe and steady pain
What is the most common cause of postpartum hemorrhage?
Uterine atony
VEAL CHOP- explain it
Variable-Cord Compression
Early-Head Compression
Acceleration-Oxygenation
Late-Placental Perfusion Problems
What are the nursing interventions for each type of deceleration?
Early-NONE
Late- change position, give O2, increase fluids, DC pitocin, correct hypotension
Variable- Essentially same as late but main is improve umbilical circulation
What are the indications of mag toxicity?
<30cc output
RR<12
What is the indication of Terbutaline?
stop preterm labor
What are the side effects of Magnesium Sulfate?
Maternal Resp Depression, Cardiac Arrest
FHT variability due to decreased cerebral perfusion causing lethargy, hypotonia thus causing a lower APGAR score
What is the DOC to mature the fetal lung?
betamethasone or dexamethasone
Systemic responses to Preeclampsia?
visual changes and hyperreflexia
What is HELLP?
hemolysis, elevated liver enzymes, low platelet count
associated with severe preeclampsia