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60 Cards in this Set
- Front
- Back
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What are the fetal danger signs of pregnancy?
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high or low fetal heart rate
meconium staining hyperactivity fetal acidosis |
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What are the maternal danger signs of pregnancy?
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rising or falling BP
abnormal pulse inadequate/prolonged contrac abnormal lower abd contour Pathological retraction ring |
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The englargement or widening of the cervical canal.
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Dilation
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shortening and thinning of cervix
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Effacement
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relationship of presenting part of fetus to level of ischial spines
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Station
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Normal fetal heart tones
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120-160bpm
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Follows pattern of contractions, usually occur late in labor, and are due to head compressions.
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Early Decelerations
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Unpredictable; indicates cord compression
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Variable Decelerations
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Delayed 30 to 40 sec after onset of contraction and continue beyond; indicate uteroplacental insufficiency
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Late Decelerations
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Contractions are mild and short; 20 to 40 sec; effacement occurs; dilation 0 to 3cm
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latent phase of stage 1
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Dilation occurs more rapidly-4 to 7 cm; contractions stronger-40 to 60 sec
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Active phase of Stage 1
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Contractions reach peak; occur q 2 to 3 min.; last 60 to 90 sec; maximum dilation of 8 to 10cm
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Transition phase of Stage 1
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Period of full dilation to birth of infant.
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2nd Stage of Labor
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Care of Woman in 1st Stage
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Respect Contraction Time
Promote change of positions promote voiding offer support respect and promote support person support pain management effor |
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Surgical incision of perinium to prevent tearing and release pressure on fetal head.
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Episiotomy
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Artificial rupture of membranes w/ an amnihook; must be dilated to 3cm
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Amniotomy
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Signs of True Labor
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Begin irregular/become reg.
felt lower back;sweep around continue despite activity increse dur., freq., inten. achieve cervical dilation |
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False labor
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begin/remain irregular
remain confined to abdomen often disappear w/ amb/sleep do not increse;d,f, or i do not achieve cervical dil. |
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Describes the degree of flexion a fetus assumes during labor or relation to fetal parts to each other.
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Attitude
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Complete flexion; spinal column bowed forward; head flexed forward-chin to sternum; present smallest anteriorposterior diameter of skull to pelvis
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Good Attitude
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Chin not touching chest; "military position";widest anteriorposterior diameter presents(occipital frontal)
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Moderate Attitude
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Back arched; neck extended
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Poor
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presents "brow" of head to birth canal
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Partial
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Psychological factors influencing pain:
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fear, anxiety, worry, expectation of pain, body image, and self-efficiency
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Common Narcotics Given:
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Demerol(mep. hydrochloride)
morphine sulfate Nubain(nalbuphine) Sublimaze(Fetanyl) Stadol(butorphanol tartrate) |
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Where is the epidural anesthetic agent placed?
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inside the ligamentum flavum in the epidural space
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Adverse Fetal Reactions to Epidural include:
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FHR decelerations
symptoms of flaccidity bradycardia hypotension |
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What is the number one risk to women receiving an epidural?
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Hypotension
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What nursing intervention would you perform if a woman was suffering from hypotension?
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Raise her legs, administer oxygen, and increase IV fluids
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Maternal Reasons for C-sec
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Active genital herpes
AIDS or HIV positive status cephalopelvic disproportion cervical cerclage disabilities failed induction/ftp |
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Placental Reasons for c-sec
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placenta previa
premature rupture of placenta umbilical cord prolapse |
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Fetal reasons for c-sec
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compound conditions
extreme low birth weight fetal distress major fetal abnormalies multigestation or conjoined transverse fetal lie |
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Increased resting tone of more than 15mmHg; Occur most freq. in latent phase; due to no repolarization; more painful
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Hypertonic Contractions
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Number of Contractions usually low or infrequent; resting tone less than 10mmHg; strength does not rise; most apt to occur active phase; risk for postpartal hemorrhage
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Hypotonic Contractions
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This is when a loop of cord slips down in front of presenting fetal part:
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Prolapsed Cord
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Adverse reactions to Oxytocin(Pitocin)
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nausea, vomiting, cardiac arrhythmias, uterine hypertonicity, tetanic contractions, uterine rupture, severe water intoxication, fetal bradycardia
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Contractions so strong that woman gives birth with only a few, rapidly occurring contractions. Labor completed in less than 3hrs.
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Precipitate Delivery
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Baby is face up; occiput directed diagonally and posteriorly; fetal head must rotate 135 degrees; increases risk of cord prolapse; back labor association
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Occiput posterior position
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Occurs when amniotic fluid is forced into an open maternal uterine blood sinus through some defect in the membranes or after membranes rupture or partial placental separation:
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Amniotic Fluid Embolism
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What are the signs/Symptoms of Amniotic Fluid Embolism?
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Woman experiences sharp pain, inabiity to breathe, becomes pale and then turns bluish gray.
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One or more accessory lobes connected to main placenta by blood vessels; lobes may be retained; appears torn at edge or torn blood vessels extend beyond placenta:
What form of Placental Anomalie is this? |
Placental Succnenturiata
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Fetal side of placenta covered with chorion; umbilical cord midpoint; large vessels spread out; end abruptly where chorion fold back onto surface:
What type of placental anomalie is this? |
Placenta Circumvallata
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Cord inserted marginally:
What type of placental anomalie is this? |
Battledore placenta
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Cord separates into small vessels that reach placenta by spreading across fold of amnion; frequently found in multiple gestation; associated with fetal anomalies:
What type of placental anomalie is this? |
Velamentous insertion of the cord
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Vessels of velamentous cord insertion cross cervical os and deliver before fetus;
What type of placental anomalie is this? |
Vasa previa
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An unusually deep attachment of the placenta to the uterine myometrium:
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Placenta Accreta
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Occurs at junction of upper and lower segments of the uterus; warning sign that severe dysfunctional labor is occurring:
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Pathological Retraction Ring
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The woman's pelve or birth canal is called:
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Passage
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The fetus is referred to as the:
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Passenger
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Uterine and cervical factors are referred to as the:
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Powers
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Emotions and feelings are referred to as the:
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Psyche
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What does the 1st manuever of of Leopold's Manuever's determine?
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Whether the fetal head is down or breach in the fundus.
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What does the 2nd manuever do?
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locates the back of fetus
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What does the 3rd Manuever do?
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finds the part of the fetus at the inlet and determines mobility
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What does the 4th manuever do?
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determines fetal attitude and degree of extension into pelvis
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Measured from bridge of nose to occipital prominence; appr. 12 cm
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Occipitofrontal Diameter
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Smallest anterior posterior diameter; appr. 9.5cm; from the inferior aspect of occiput to center of anterior fonanelle
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Suboccipitobregmatic Diameter
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widest anteroposterior diameter appr. 13.5cm; measured from chin to fontanelle
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Occipitomental Diameter
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Comfort meaures in labor include:
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Provide ice chips
moist cloth or lip balm cool cloth for persperations change or straighten linens |
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Preoperative teaching/preventing complications....
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Explain all procedures
Allow questions teach incentive spirometer teach frequent turning early ambulation |
