2155 Ob/mcc Exam 1 Part 13

Front 1

Other non-medical interventions for shoulder dystocia include: Replacing the head into the vagina and having an emergency C/S, this is the ? maneuver.

Back 1

Zavanelli

Front 2

The non-medical intervention for shoulder dystocia where the baby is rotated using fundal pressure and lateral pressure on the posterior shoulder is the ? maneuver

Back 2

Woods corkscrew

Front 3

Interventions for shoulder dystocia where the baby's clavicle is cut are very ? used, it is called a ? there is also a procedure where the moms symphysis pubis is cut called a ? it is not performed in the U.S. only in 3rd ? countries and this can cause multiple problems.

Back 3

rarely,
cleidotomy,
symphysiotomy,
world

Front 4

If there is a prolapsed cord this is an ? b/c it is potentially ? Risk factors for prolapsed umbilical cord include High ?, ? fetus, ? presentation, ? lie, Poly-?

Back 4

emergency, fatal, station,
small,
breech,
transverse,
polyhydramnios

Front 5

S/S of prolapsed cord include, the cord is ? outside of the vagina, it is ? upon vaginal exam. If the prolapse is occult we may seen signs of ? which means ? on the FHRM.

Back 5

visible,
palpated,
variable decels, bradycardia

Front 6

What should the RN do if there is a prolapsed cord:
1- This is an ? situation call for ?
2-Get ready for a ? unless birth is imminent.
3- Relieve ? pressure using ? to chest, hips up head down( the ? maneuver), Use a gloved hand to ? the fetus off of the cord.
4- We should put the pt in a ? position, and we may possibley administer ? if the order is given. We can wrap the umbilical cord in warm ? towels.

Back 6

Emergency, Help,
C/S,
cord, knees, McRoberts,
elevate, trendelenberg
O2, Terbutaline, saline

Front 7

If a VBAC is performed e.g.- a ?-C/S is performed, we may see a ruptured ?

Back 7

vertical, uterus

Front 8

If there is a rupture of the uterus with no previous C/S it may be due to a high ?, abdominal ?, tachy-?, and hyper-?, or a CPD(?).

Back 8

parity,
trauma,
systole,
tonia,
Cephalopelvic Diproportion

Front 9

S/S of uterine rupture= Abd ?/?, chest pain between the ? or upon inspirtation, Hypovolemic shock=↓?, ↑?, ?, ?, or we may see impaired fetal O2 on the FHRM when we see ? and, ↓ ? we may also see ? of uterine contractions on the Toco, We may not see excessive external ?

Back 9

pain,tenderness,
scapulas, ↓BP, ↑HR, cool, pallor,
late decels & ↓ variability,
cessation, bleeding

Front 10

For management/prevention of Uterine tear we should use the med ? cautiously or ? it if pt is at risk.
Stabilize the ?/? if suspected Uterine Rupture,
An emergency ? will be performed if maternal or fetal life is in jeopardy.

Back 10

Pitocin, discontinue,
woman/fetus,
C/S

Front 11

Dysfunctional labor is labor that doesn't result in normal ?,?, or fetal ? Dysfunctional labor may be related to the 3 P's which are ?,?,?

Back 11

effacement, dilationd, descent,
The Powers of labor,
The Passenger,
The Passage

Front 12

A post partum hemorrhage is blood loss over ? ml is vaginal birth or ?ml if C/S birth, this occurs in 4% of births.

Back 12

500ml,
1000ml

Front 13

PP hemorrhage, in 75%-80% of births is due to ? S/S of this are Difficult to ? uterus, Soft or ? feel when located. The uterus may ? up with massage but ?'s when massage is stopped.

Back 13

Uterine Atony,
palpate,
boggy,
firm, relaxes

Front 14

Predisposing factors for pp hemorrhage include ? of the uterus, multi-?, use of tocolytic drugs such as ?, or overuse of oxytotic meds such as ?, ? labor, ? labor, use of ? during delivery.

Back 14

overdistension,
parity, MgSO4,
Pitocin, Precipitate, Prolonged,
forceps

Front 15

Why would MgSO4 be a cause of pp hemorrhage?

Back 15

MgSO4 is a vasodilator, it will cause veins to remain unconstricted, the opposite of what we need in the uterus after delivery.

Front 16

Why would the overuse of oxytotic meds such as pitocin cause pp hemorrhage?

Back 16

excessive use of Pitocin during labor sets a woman up for immediate postpartum uterine atony—with sometimes unacceptable amounts of blood loss in accompaniment.

Front 17

Nursing management for pp hemorrhage: The RN can ? the uterus, have pt empty her ?, rapid infusion of ?, parenteral administration of the meds ? or ?, IV replacement of ?/?, ? compression of the uterus.

Back 17

massage, bladder, Pitocin, Methergine, Hemabate,
fluids/blood, bimanual

Front 18

When the RN uses one hand at the symphysis pubis to support the Uterus and the other hand to massage, this is a normal technique called ? massage. It the RN inserts one hand into the vagina and compresses the uterus on the outside with the other hand through the abdominal wall this is the ? technique.

Back 18

fundal,
bimanual fundal massage

Front 19

Hemabate(Carboprost Tromethamine) is classified as a ? and its therapeutic class is as an ?, it is used for stopping bleeding during ? The normal dosage is ?mcg IM, repeated every ?-? min prn, max dose of ?

Back 19

prostaglandin,
oxytotic, pp hemorrhage,
250mcg,
15-90min,
2mg

Front 20

Use hemabate caustiously in pts with Asthma, diabetes, ?/?-tension, ?/? disease, seizure ?'s, previous uterine ?

Back 20

hypo/hypertension, renal/hepatic, disorders, surgery

Front 21

Methergine(Methylerbonovine) is classified as an ? it is used for ? the normal dose is ?mg IM q ?-?hrs max of ? doses. This drug should never be used during ? Contradictions for use are ?, severe ?/? or ? disease. Prior to administration check the pts ?

Back 21

oxytotic,
pp hemorrage,
0.2mg q 2-4, 5doses,
pregnancy, HYPERTENSION, renal/hepatic,
coronary, BP

Front 22

Laceration of the Birth Canal are classified in ? to describe amt of tissue involved, this is the second most cause of ?

Back 22

degrees,
hemorrhage

Front 23

A laceration that involves superficial vaginal mucosa or perineal skin is a ? degree.

Back 23

1st

Front 24

A laceration that involves superficial vaginal tissue or perineal skin plus deeper tissue, may include muscle of the perineum is a ? degree laceration.

Back 24

2nd

Front 25

A laceration that involves superficial vaginal mucosa or perineal skin plus deeper tissues that may include muscle of the perineum plus the anal spinchter is a ? degree laceration.

Back 25

3rd

Front 26

A laceration that involves superficial vaginal mucosa or perineal skin plus deeper tissued like muscle of the perineum plus anal sphincter plus rectal mucosa is a ? degree laceration.

Back 26

4th

Front 27

A couple of other lacerations that can occur are ? near the urethra and caused difficulty with ? Also there can be a laceration of the ? wall.

Back 27

periurethral,
urination,
vaginal