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60 Cards in this Set

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