Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
93 Cards in this Set
- Front
- Back
|
4 P's
|
Passage
Passenger Powers/Forces Psychosocial considerations |
|
|
pelvic inlet
|
widest part
|
|
|
pelvic outlet
|
becomes more narrow, the part the baby has to squeeze through
|
|
|
pelvic types
|
gynecoid, android, anthropoid, platypelloid
|
|
|
procedure to assess pelvic structure
|
pelvimetry
|
|
|
another name for anterior fontanel
|
bregma
|
|
|
best fetal head presentation
|
suboccipitobregmatic
|
|
|
fetal attitude
|
flexion vs extension
flexion is desired fetal attitude |
|
|
fetal lie
|
longitudinal is desireable, transverse is indication for c/s
|
|
|
head presentation
|
cephalic
|
|
|
cephalic presentations (4)
|
vertex
military sinciput mentum |
|
|
breech presentations (3)
|
complete
frank footling |
|
|
frank presentation can cause this to happen
|
hip dysplasia
|
|
|
breech presentation indication for...
|
c/s
|
|
|
the manipulation of fetus and uterus is called...
|
aversion
|
|
|
what is indicated in different twin presentations?
|
if twin A is cephalic, may do vaginally-- hope other one turns over
there is a study saying don't do all c/s |
|
|
station
|
relationship of presenting part to an imaginary line drawn between the ischial spines of the maternal pelvis
|
|
|
crowing station
|
+5
|
|
|
0 station
|
when presenting part reaches ischial spines
|
|
|
fetal position
|
presenting part? (occiput, mentum, sacrum)
facing left or right of mother's pelvis? Facing anterior, posterior or transverse? |
|
|
ROA
|
facing mom's back, occiput presentation, fetus' back facing mom's right side
|
|
|
Leopold's maneuvers
|
1. top of uterus,
2. middle, 3. above symphisis pubis, 4. coming from top, hands around uterus |
|
|
best position for occiput posterior fetus
|
hands and knees- baby is hanging down, gravity allows it to move and its more likely to flip over. also less pressure on mom's back
|
|
|
causes of "back labor"
|
OP position
|
|
|
less desirable Occiput posterior interventions
|
vacuum assisted birth, forceps assisted birth
|
|
|
cardinal movements (5)
|
1. Descent/flexion
2.internal rotation 3. extension 4. external rotation/shoulder rotation 5. expulsion |
|
|
decent/flexion- common term, explanation
|
also called lightening, when baby descends. flexion is in order to become smaller to fit through
|
|
|
internal rotation
|
baby rotates slightly to the mom's back
|
|
|
extension
|
neck extends as baby comes out (back of head, top of head, face)
|
|
|
external rotation
|
see head turn to the side to get shoulders out (anterior shoulder first)
|
|
|
primary and secondary forces of labor
|
primary- contractions
secondary- abdominal muscle pushing |
|
|
preterm labor is associated with what infection
|
UTI
|
|
|
what medications affect the smooth muscle of the uterus
|
calcium channel blockers
beta blockers asthma medications narcotics (these can also be used to stop preterm labor) |
|
|
whats the name of the inner opening of the cervix
|
internal oss
(sphincters keep it closed tightly) |
|
|
what hormone makes the cervix NOT conducive to sp
|
progesterone- makes a thick mucous plug, prevents entrance of microbes
|
|
|
who is indicated for an indirect coombs test?
|
a Rh negative mother with an Rh positive baby; the indirect coombs tests for antibodies to the Rh antigen
|
|
|
which test screens for neural tube defects and downs syndrome?
|
alpha-fetal protein
|
|
|
during which trimester can you test for genetic anomalies?
|
2nd trimester
|
|
|
what does the bishop score include/determine?
|
dilation
effacement station cervical consistency cervical position determines whether an induction of labor may be successful (highest possible score is 13, 3 pts for each) successful if for primips the score is greater or equal to nine multips successful induction if score is greater than 5 |
|
|
qualifications of bishop score
|
position:
0 if posterior, 3 if anterior consistency: 0 if firm, 3 if soft effacement: 0 if 0-30%, 3 if >= 80% dilation: 0 if <1cm, 3 if >= 5cm fetal station: 0 if -3, 3 if +1 or lower |
|
|
what are some medications used for cervical ripening?
|
prostaglandins (cytotec, cervidil, prepidil) placed in vagina & mom lays flat for 4 hours
|
|
|
what is Cytotec used for?
|
cervical ripening
|
|
|
what are prostaglandins used for in labor?
|
cervical ripening
|
|
|
what are some mechanical methods of cervical ripening?
|
30cc foley balloon into intracervical canal to put pressure on cervix;
laminaria- hydroscopic substances that absorb fluid and enlarge, thus putting pressure on cervix to dilate it... placed for 6-12 hours then removed |
|
|
in how many hours is it desirable for a woman to deliver after ROM?
|
within 24 hours is most desirable
|
|
|
what detail about fetal position is needed in order to AROM?
|
presenting part needs to be engaged to prevent a prolapsed cord
|
|
|
what does COAT stand for?
|
in the assessment of amniotic fluid,
color odor amount time |
|
|
another name for AROM
|
amniotomy
|
|
|
what vital sign is most indicative of an infection after ROM?
|
increased heart rate, in one or both mom/baby
|
|
|
why is sexual intercourse a way to induce pregnancy?
|
semen has prostaglandins that ripen cervix
|
|
|
what role does castor oil play in pregnancy?
|
can take it to induce labor; gets bowels moving
|
|
|
why can nipple or breast stimulation induce labor?
|
it stimulates oxytocin release similar to when a woman is breastfeeding and oxytocin is released
|
|
|
how should oxytocin be hung IV?
|
piggyback- in case you need to turn down the pitocin and increase fluids
|
|
|
what is the goal for contractions?
|
2-3 minutes apart lasting 40-60 seconds
|
|
|
desired intrauterine pressure?
|
50-60 mmHg
|
|
|
what is the name for uterine overstimulation?
|
tachysystole
|
|
|
what can tachysystole cause?
|
uterine rupture and fetal hypoxia r/t overstimulation of uterus
|
|
|
order of priorities in fetal distress r/t oxytocin
|
1. turn off oxytocin
2. turn mom to side, give o2 3. call doctor |
|
|
what may differ in oxytocin admin to pt w/ preeclampsia?
|
may have fluid restrictions
|
|
|
indications for amnioinfusion
|
variable decels r/t cord compression (increased volume takes pressure off cord)
oligohydramnios thick meconium (Thins out fluid, less risk for baby) |
|
|
process of amnioinfusion includes...
|
RL or NS infused through an intrauterine pressure catheter to increase fluid volume
|
|
|
ways to prevent episiotomy (5)
|
perineal massage
kegel exercises during preg natural pushing side-lying position warm compress |
|
|
types of forceps applications (3)
|
outlet- fetal head on perineum- most common
low- fetal skull at or above +2 station midforceps- fetal head engaged but not as far as 2+ |
|
|
vacuum assisted birth is preferred over forceps, but what damage can it have on fetus?
|
cephalohematoma
scalp lacerations subdural hematoma |
|
|
indications of c/s (9)
|
breech or malpresentation
prior uterine surgery placenta previa, abruption fetal intolerance to labor multiples mother's medical condition labor issues- failure to progress, cephalo pelvic disposition cord prolapse (emergency!) active herpes lesion |
|
|
why do you need to be cautious when administering oxytocin for a vbac pt?
|
higher risk of uterine rupture
|
|
|
what medications are contraindicated for a vbac pt?
|
cytotec/cervical ripening medications; increased risk of uterine rupture
|
|
|
occurrence of ovulation?
|
14 days before the next period
|
|
|
cycle: when hormones are low...
|
the menstrual cycle occurs
|
|
|
estrogen cervical mucous in relation to sperm
|
guides sperm through becasuse it is thin
|
|
|
progesterone mucous in relation to sperm
|
hostile, stops sperm from passing through cervix
|
|
|
temperature difference in ovulation
|
during ovulation the cervical temperature increases by 1/2 degree
|
|
|
how many days does it take to move fertilized eggs down the fallopian tube?
|
5-7 days
|
|
|
where does fertilization occur?
|
the outer third of the fallopian tube
|
|
|
how long does an egg live for?
|
24 hours
|
|
|
how long does a sperm live for?
|
72 hours
|
|
|
what is hCG?
|
human chorionic gonadotrophin: produced by the chorionic villi by 10 days post ovulation
the corpus luteum receives hcg from the embryo. hcg tells the corpus luteum to produce more progesterone to promote implantation hcg keeps corpus luteum alive; once placenta is in place, don't need it, thus hcg stops increasing by the end of the first trimester |
|
|
what is the name of the inner placental membrane?
|
amnion- contains amniotic fluid
|
|
|
what is the name of the outer placental membrane?
|
chorion
|
|
|
what are the average amounts of amniotic fluid at 10, 20 and 40 weeks?
|
at 10 weeks- 30mL
at 20 weeks- 350mL at 40 weeks- 500-1000mL *amniocentesis cannot be done until at least 15 weeks because there is not enough fluid before then! |
|
|
what hormone regulates glucose metabolism?
|
human placental lactogen (hpl)
|
|
|
what is Nagele's Rule?
|
to calculate EDD, from the date of the first day of the last period subtract 3 months and add 7 days
|
|
|
TPAL
|
term over 37 wks
preterm 20-37 abortion- termination before 20 weeks living |
|
|
probable signs of pregnancy
|
objective signs seen by an examiner, not diagnostic:
chadwick's sign goodell's sign hegar's sign |
|
|
presumptive signs of pregnancy
|
signs that are subjective for the woman:
excessive fatigue, urinary frequency, amenorrhea, n/v, breast changes, quickening (18-20 wks) |
|
|
chadwick's sign
|
color change in vaginal mucosa
|
|
|
goodell's sign
|
softer cervix on palpation
|
|
|
hegar's sign
|
isthmus of uterus is more compressible and softer
|
|
|
diagnosis of pregnancy
|
1. fetal heartbeat
2. fetal movement 3. visualization via ultrasound |
|
|
in how many weeks does the uterus reach the symphisis pubis?
|
12 weeks
|
|
|
in how many weeks does the uterus reach the umbillicus?
|
20-22 weeks
|
|
|
physical changes of the vagina during pregnancy
|
connective tissue loosens
leukorrhea increased acidity |
|
|
physical changes of breasts during pregnancy
|
pigment changes
mongomery's follicles enlarge development and proliferation of ductal system |
