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;
108 Cards in this Set
- Front
- Back
|
WHAT ARE SOME PROBLEMS RELATED TO CHILDBIRTH
|
UTERINE DYSTOCIA
PRECIPITOUS LABOR POST-TERM PREGNANCY FETAL MALPOSITION OR MALPRESENTATION MACROSOMIA PLACENTAL, AMNIOTIC OR CORD PROBLEMS |
|
|
DYSTOCIA
|
DIFFICULT LABOR R/T DYSFUNCTIONAL UTERINE CONTRACTIONS.
|
|
|
DESCRIBE THE CONTRACTIONS THAT OCCUR WITH DYSTOCIA
|
CONTRACTIONS THAT ARE UNCOORDINATED
IRREGULAR IN STRENGTH, TIMING OR BOTH |
|
|
WHAT IS THE RESULT OF THE INEFFECTIVE UTERINE CONTRACTIONS THAT OCCUR WITH DYSTOCIA
|
INEFFECTIVE CERVICAL DILATION
PROLONGED LABOR |
|
|
HYPERTONIC LABOR CONTRACTIONS
THE RESTING TONE OF THE MYOMETRIUM INCREASES OR DECREASES? |
IINEFFECTIVE UTERINE CONTRACTIONS OF POOR QUALITY
OCCUR IN THE LATENT PHASE OF LABOR THE RESTING TONE OF THE MYOMETRIUM INCREASES CONTRACTIONS BECOME MORE FREQUENT, BUT INTENSITY MAY DECREASE CONTRACTIONS ARE PAINFUL AND INEFFECTIVE IN DILATING AND EFFACING THE CERVIX LEADS TO A PROLONGED LATENT PHASE |
|
|
RISKS TO MOM WITH HYPERTONIC LABOR PATTERN
|
INCREASED DISCOMFORT
PHYSICALLY EXHAUSTED EMOTIONALLY DISCOURAGED DEHYDRATED POOR COPING |
|
|
RISKS TO FETUS WITH HYPERTONIC LABOR PATTERN
|
CEPHALOHEMATOMA
CAPUT SUCCEDANEUM NON REASSURING FETAL STATUS POOR BLOOD FLOW TO AND FROM PLACENTA (CAN LEAD TO ABRUPTION OF PLACENTA) |
|
|
CLINICAL MANAGEMENT OF A PATIENT WITH HYPERTONIC LABOR
|
BED REST
SEDATION (PHENERGAN, STADOL) AMNIOTOMY (ARTIFICIAL RUPTURE OF MEMBRANE) PITOCIN IV HYDRATION |
|
|
HYPOTONIC LABOR
|
OCCURS AFTER LABOR HAS BEEN ESTABLISHED (USUALLY IN ACTIVE PHASE).
CHARACTERIZED BY FEWER THAN 2-3 CONTRACTIONS IN A 10 MINUTE PERIOD CAN BE DUE TO MALPOSITION OF FETUS OR LARGE FETUS |
|
|
RISKS TO MOM WITH HYPOTONIC LABOR PATTERN
|
EXHAUSTION
FATIGUE POOR COPING INFECTION (GREATEST RISK) |
|
|
WHAT IS THE GREATEST RISK TO THE FETUS WITH HYPOTONIC LABOR?
|
INFECTION
|
|
|
CLINICAL MANAGEMENT OF HYPOTONIC LABOR PATTERN
|
ACTIVE MANAGEMENT OF LABOR WHICH INCLUDES:
AMNIOTOMY TIMED CERVICAL EXAMS (DONE BETWEEN CONTRACTIONS) AUGMENTED LABOR WITH PITOCIN IV HYDRATION CAREFUL MONITORING OF FETUS EMOTIONAL SUPPORT |
|
|
CAUSES OF HYPOTONIC LABOR
|
OVERSTRETCHED UTERUS FROM A TWIN GESTATION
LARGE FETUS HYDRAMINIOS GRAND MULTIPARITY BLADDER OR BOWEL DISTENTION CPD |
|
|
IF MECONIUM IS PRESENT IN ANY CIRCUMSTANCES, WHAT IS THAT INDICATIVE OF?
|
FETAL DISTRESS
|
|
|
WHY SHOULD CERVICAL EXAMS BE LIMITED?
|
RISK OF INFECTION
|
|
|
PRECIPITOUS LABOR AND BIRTH
|
LABOR THAT LASTS LESS THAN 3 HOURS
RAPID DESCENT OF THE PRESENTING PART RESULTING IN BIRTH UNEXPECTED, SUDDEN AND OFTEN UNATTENDED BIRTH |
|
|
FACTORS THAT CONTRIBUTE TO PRECIPITOUS LABOR AND BIRTH
|
MULTIPARTITY
PREVIOUS PRECIP BIRTH SMALL FETUS LARGE PELVIS |
|
|
RISKS OF PRECIPITOUS LABOR TO MOTHER
|
LOSS OF COPING ABILITIES
LACERATIONS AMNIOTIC FLUID EMBOLISM POSTPARTAL HEMORRHAGE LACERATIONS OF CERVIX AND/OR PERINEUM |
|
|
RISKS OF PRECIPITOUS LABOR TO FETUS
|
FETAL DISTRESS
POOR UTEROPLACENTAL PERFUSION CEREBRAL TRAUMA PNEUMOTHORAX (COMPRESSED CHEST WALL W/ PRESSURE) |
|
|
NURSING CARE MANAGEMENT FOR A WOMAN IDENTIFIED AT RISK FOR PRECIPITOUS BIRTH
|
MONITOR CLOSELY THE LAST FEW WEEKS OF PREGNANCY
IF THE CERVIX BEGINS TO SOFTEN SHE MAY BE ADMITTED FOR INDUCTION IN THE HOSPITAL SHE SHOULD BE MONITORED CLOSELY KEEP AN EMERGENCY BIRTH PACK ON HAND NURSE STAYS IN CONSTANT ATTENDANCE PROVIDE COMFORT AND QUIET BE ALERT TO DANGERS OF PITOCIN OVERDOSE D/C PITOCIN IF ACCELERATED LABOR PATTERN OCCURS TURN WOMAN ON L SIDE TO IMPROVE UTERINE PERFUSION ADMINISTER O2 MONITOR FETUS FOR S/S HYPOXIA OR NONREASSURING FETAL STATUS |
|
|
POST-TERM PREGNANCY
|
EXTENDING MORE THAN 42 WEEKS PAST THE FIRST DAY OF LMP
|
|
|
RISKS OF POSTTERM PREGNANCY TO MOM
|
LGA INFANT (MACROSOMIA)
INCREASED INCIDENCE OF FORCEPS-ASSISTED, VACUM ASSISTED, OR CESAREAN BIRTH INCREASED PSYCHOLOGICAL STRESS PROBABLE INDUCTION OR CS |
|
|
WHAT IS THE MOST IMPORTANT FACTOR IN DETERMINING WHETHER OR NOT TO INDUCE
|
GESTATIONAL AGE OF INFANT.
|
|
|
AT WHAT WEEK IS THE PLACENTA REACHING ITS MAXIMUM FUNCTION
|
38
|
|
|
WHEN DOES THE PLACENTA STOP SUPPORTING THE FETUS
|
40 WEEKS
|
|
|
RISKS OF POSTTERM PREGNANCY TO FETUS
|
DECREASED PLACENTAL PERFUSION
FETAL DISTRESS OLIGOHYDRAMNIOS MECONIUM ASPIRATION MACROSOMIA R/T HYPOTHERMIA AND HYPOGLYCEMIA |
|
|
TYPES OF FETAL MALPRESENTATION OR MALPOSITION
|
OCCIPUT POSTERIOR (OCCURS 5% OF THE TIME)
BROW PRESENTATION (0.02%) FACE PRESENTATION (<0.2%) BREECH PRESENTATION (3-4%) SHOULDER PRESENTATION TRANSVERSE LIE (0.3%) COMPOUND PRESENTATION 90.5%) |
|
|
TYPES OF BREECH
WHAT HAPPENS WHEN A FETUS IS IN BREECH PRESENTATION? |
FRANK BREECH - BUTTOCKS PRESENT
COMPLETE BREECH - BUTTOCKS AND FEET PRESENT FOOTLING BREECH - FEET PRESENT BREECH GENERALLY RESULTS IN AN AUTOMATIC CS UNLESS LABOR HAS PROGRESSED TOO FAR. |
|
|
MOST COMMON FETAL MALPOSITION
|
OCCIPUT POSTERIOR
THE HEAD IS DIRECTED TOWARD THE BACK OF THE MATERNAL PELVIS. DURING LABOR, 90-95% OF OP FETUSES ROTATE TO AN OCCIPUT-ANTERIOR POSITON. |
|
|
CLINICAL MANAGMENT OF FETUS AND MOM WHEN MALPOSITION OCCURS
|
CLOSE MONITORING
POSITION CHANGES FOR MOTHER MAY HELP POSSIBILITY OF EXTERNAL CEPHALIC VERSION CAREFUL MONITORING OF FHT, AMNIOTIC FLUID, FETAL DISTRESS, CORD PROLAPSE, ESPECIALLY WITH BREECH POSSIBILITY OF MIDLIINE EPISIOTOMY FORCEPS MAY BE REQUIRED FOR POSTION CHANGE AND/OR DELIVERY CS MAY BE REQUIRED |
|
|
MACROSOMIA - WHAT IS THE WEIGHT
|
MORE THAN 4000G
|
|
|
INCIDENCE OF MACROSOMIA IS GREATER IN?
|
GENETIIC HISTORY
MALE INFANTS IDM'S PROLONGED GESTATION GRAND MULTIPAROUS |
|
|
WHAT IS THE MAJOR CAUSE OF CPD (CEPHALO-PELVIC DISPROPORTION)
|
MACROSOMIA
|
|
|
WHAT ARE SOME MEDICAL INTERVENTIONS FOR THE PATIENT WITH A MACROSOMIC INFANT?
|
IDENTIFY BEFORE ONSET OF LABOR
MONITOR FOR S/S DYSTOCIA ASSISTED BIRTH OR CS MAY BE NECESSARY |
|
|
RISKS TO MOTHER WITH MACROSOMIC FETUS
|
CPD
DYSFUNCTIONAL LABOR PP HEMORRHAGE LACERATIONS |
|
|
RISKS TO MACROSOMIC FETUS
|
FETAL DISTRESS AND MECONIUM ASPIRATION
SHOULDER DYSTOCIA. ERBS PALSY HYPOGLYCEMIA HYPOTHERMIA |
|
|
WHAT ARE SOME TYPES OF ASSISTED BIRTH
|
FORCEPS-ASSISTED
VACUUM ASISTED VACUUM EXTRACTOR |
|
|
CONDITIONS THAT MUST BE MET BEFORE FORCEPS AND VACUUM ASSISTED BIRTH CAN BE PERFORMED
|
FULLY DILATED CERVIX
ROM +2 STATION CEPHALIC PRESENTATION NO CPD EMPTY BLADDER (MAY BE GIVEN A CATH) *WITH VAC, INTERMITTENT TRACTION IS APPLIED WITH CONTRACTIONS |
|
|
CLINICAL MANAGEMENT WITH MACROSOMIC FETUS
|
CLOSE MONITORING DURING LABOR FOR EARLY DECELS, FETAL DESCENT
PROVIDE SUPPORT AND ENCOURAGEMENT FOR LABORING MOM AND PARTNER MONITOR FOR POSTPARTAL COMPLICATIONS SUCH AS HEMORRHAGE RT UTERINE ATONY ADMINISTER IV OXYTOCIN POST DELIVERY |
|
|
NON-REASSURING FETAL STATUS
|
O2 SUPPLY IS INSUFFICIENT TO MEET THE NEEDS OF THE FETUS, THEREBY CAUSING HYPOXIA AND ACIDOSIS
|
|
|
CAUSES OF NON-REASSURING FETAL STATUS
|
CORD COMPRESSION
UTEROPLACENTAL INSUFFICIENCY |
|
|
S/S OF NON-REASSURING FETAL STATUS
|
FETAL BRADYCARDIA
PERSISTANT LATE DECELS PROLONGED OR VARIABLE DECELS WITHOUT A RETURN TO BASELINE MECONIUM STAINED AMNIOTIC FLUID. |
|
|
WHAT TYPE OF MONITORING MAY BE USED WHEN THERE IS NON-REASSURING FETAL STATUS
|
INTERNAL MONITORING
|
|
|
INTERVENTIONS R/T NON-REASSURING FETAL STATUS
|
DETERMINE CAUSE
CORRECT ANY MATERNAL HYPOTENSION IV HYDRATION STOP OXYTOCICS OXYGEN VIA MASK IS ADMINISTERED TO MOM EMOTIONAL SUPPORT CS MAY BE NECESSARY |
|
|
PLACENTA PREVIA
|
PLACENTA IS IMPLANTED IN LOWER PORTION OF UTERUS-COMPLETELY OR PARTIALLY COVERING THE CERVICAL OS
PLACENTA IS SUPPOSED TO BE IMPLANTED IN UPPER 2/3 OF FUNDUS |
|
|
CAUSE OF PLACENTA PREVIA
|
UNKNOWN, BUT MORE FREQUENT IN MULTIPS AND WOMEN WITH PREVIOUS HX OF PP
|
|
|
WHAT IS AN INDICATOR OF PLACENTA PREVIA
|
BRIGHT RED VAGINAL BLEEDING IN LAST TRIMESTER
|
|
|
HOW IS PLACENTA PREVIA DX CONFIRMED
|
U/S USUALLY CONFIRMS
DO NOT DO A VAG EXAM BECAUSE IT COULD CAUSE HEMORRHAGE AND DISRUPT THE PLACENTA |
|
|
TREATMENT FOR PATIENT WITH PLACENTA PREVIA
|
EMERGENCY DELIVERY VAGINALLY OR C/S
GENERALLY, IT'S DX VERY EARLY AND SOMETIMES IT CORRECTS ITSELF |
|
|
WHAT CONDITIONS WILL INDICATE THAT A C/S IS NECESSARY IF PLACENTA PREVIA IS PRESENT
|
IF FETAL PRESENTING PART IS OBSTRUCTING BLOOD FLOW FROM PLACENTA DURING DESCENT
|
|
|
WHEN CAN PLACENTA PREVIA BE TREATED WITH MEDICATION
|
WHEN IT IS DISCOVERED BEFORE 37 WEEKS OR IF BLEEDING IS MINIMAL
|
|
|
WHAT IS THE GOAL FOR TREATMENT OF A PATIENT WITH PLACENTA PREVIA
|
DELAY DRUG TREATMENT UNTIL 37 WEEKS
BEDREST NO RECTAL/VAGINAL EXAMS MONITOR BLOOD LOSS, PAIN, UTERINE CONTRACTIONS MONITOR FHR MONITOR MATERNAL VS, H&H IV'S, T & X MATCH, TRANSFUSE IF NECESSARY NEWBORN IS MONITORED CLOSELY (ANTEPARTAL VISITS, U/S, BIOPHYSICAL PROFILE MORE FREQUENTLY) |
|
|
PLACENTA ABRUPTIO
|
PREMATURE SEPERATION OF THE PLACENTA FROM THE UTERINE WALL PRIOR TO DELIVERY, CAUSING BLEEDING FROM THE UTERINE WALL.
MORE COMMON LATER IN PREGNANCY |
|
|
HIGHEST INCIDENCE OF PLACENTA ABRUPTIO
|
WOMEN WITH:
HTN PIH (PREG. INDUCED HTN) HYDRAMINOS MULTIPLE PREGNANCIES AFTER AMNIOTOMY (CAUSES A SUDDEN CHANGE IN INTRAUTERINE PRESSURE) TRAUMA COCAINE ABUSE |
|
|
PLACENTA ABRUPTIO CLASSIFICATIONS
|
CENTRAL
MARGINAL COMPLETE |
|
|
CENTRAL ABRUPTION
|
BLEEDING IN CENTER OF PLACENTA
CHARACTERIZED BY: CONCEALED BLEEDING AND RIGID ABDOMEN, SEVERE PAIN AND SHOCK |
|
|
MARGINAL ABRUPTION
|
BLEEDING PASSES BETWEEN UTERINE WALL AND FETAL MEMBRANES
CHARACTERIZED BY: DARK BLEDING AND PAIN |
|
|
COMPLETE ABRUPTION
|
MASSIVE VAG. BLEEDING, RIGID ABD., PROFOUND SHOCK, FETAL DISTRESS
TX: C/S STAT |
|
|
WHAT IS THE MOST SIGNIFICANT SYMPTOM OF AN ABRUPTION
|
PAIN
|
|
|
WHEN A PATIENT IS SUFFERING FROM AN ABRUPTION, WHAT ARE GUIDELINES FOR CARE
|
MONITOR FHR FOR STRESS
U/S TO CONFIRM - NO VAG EXAM EMERGENCY C/S GIVE EMOTIONAL SUPPORT TO FAMILY (POSSIBILITY OF HYSTERECTOMY) POOR PROGNOSIS FOR FETUS (1/3 DIE OF HYPOXIA) MONITOR FOR DIC |
|
|
WHAT VERY SERIOUS PROBLEM CAN OCCUR WITH AN ABRUPTION
|
A DIC (DISSIMINATED INTRAVASCULAR COAGULATION) CAN OCCUR.
DIC - A LARGE AMOUNT OF THROMBOPLASTIN IS RELEASED INTO MATERNAL BLOOD SUPPLY DUE TO DAMAGE TO UTERINE WALL CAUSED BY ABRUPTION. THE THROMBOPLASTIN CAUSES DEVELOPMENT OF DIC AND HYPOFIBRINOGENEMIA (LOW FIBRIN). AS A RESULT THE BLOOD WILL NO LONGER COAGULATE AND HEMORRHAGE AND HEMORRHAGIC SHOCK COULD OCCUR. IF NOT CORRECTED QUICKLY, IT COULD BE FATAL TO MOM. |
|
|
PROLAPSED CORD
|
CORD COMPRESSION CAUSES FETAL HYPOXIA (INCREASED VARIABLITY AND/OR INTENSE DECELS WITH CONTRACTIONS)
|
|
|
INTERVENTIONS REQUIRED FOR PROLAPSED CORD
|
IMMEDIATE INTERVENTION REQUIRED
BEDREST AFTER ROM (HEAD SHOULD BE ENGAGED BEFORE ROM) WATCH FOR S/S OF FETAL DISTRESS LATE DECELS, INCREASING VARIABILITY |
|
|
EMERGENCY CARE FOR PROLAPSED CORD
|
O2
FHM MANUAL DECOMPRESSION (FINGERS IN VAG TO RELIEVE PRESSURE AND WATCH MONITOR TO SEE IF YOU ARE RELIEVING COMPRESSION) KNEE-CHEST POSTION FOR MOM CS |
|
|
AMNIOTIC FLUID COMPLICATIONS
|
POLYHYDRAMINOS
OLIGOHYDRAMNIOS AMNIOTIC FLUID EMBOLISM |
|
|
NORMAL AMOUNT OF AMNIOTIC FLUID
|
800-1000 ML @ 36-37 WEEKS
|
|
|
POLYHYDRAMNIOS
|
MORE THAN 2000 ML OF FLUID
MOST COMMON IN DIABETIC MOM INCREASED RISK OF C/S BIRTHS MAY BE CHRONIC OR ACUTE ASSOCIATED WITH MATERNAL DIABETES, RH SENSITIZATION AND MULTIPLE PREG. ASSOCIATED WITH FETAL MALFORMATIONS AND PRETERM BIRTHS PROLAPSE CORD CAN OCCUR |
|
|
OLIGOHYDRAMNIOS IS ASSOCIATED WITH WHAT?
|
ASSOCIATED WITH POSTMATURITY, PLACENTAL INSUFFICIENCY, FETAL MALFORMATION, ESPECIALLY RENAL.
|
|
|
MANAGEMENT OF POLYHYDRAMNIOS
|
U/S AND AMNIOCENTESIS USED TO MANAGE (FLUID CAN BE DRAWN OUT WITH AMNIOCENTESIS)
|
|
|
MANAGEMENT OF OLIGOHYDRAMNIOS
|
CLOSE MONITORING OF FETUS VIA BPP, SERIAL U/S, NST
AMNIOFUSION MAY BE PERFORMED AFTER ROM (ADDING NORMAL SALINE TO INCREASE AMNIOTIC FLUID) |
|
|
AMNIOTIC FLUID EMBOLISM
|
DIRE EMERGENCY (ONLY 40% RECOVER FROM ACUTE PHASE)
TEAR IN AMNION COMBINED WITH CONTRACTIONS CAUSES FLUID TO SEAP INTO MATERNAL CIRCULATION. FLUID CAN TRAVEL TO LUNGS AND CAUSE A SUDDEN ONSET OF RESPIRATORY DISTRESS MAY OCCUR AFTER PRECIPITOUS BIRTH HIGHER INCIDENCE IN PREECLAMPSIA S/S CHEST PAIN,DYSPNEA,CYANOSIS,FROTHY SPUTUM,TACHYCARDIA,HYPOTENSION, MASSIVE HEMORRHAGE |
|
|
WHAT ARE THE INDICATIONS THAT A C SECTION MAY NEED TO BE PERFORMED
|
COMPLETE PLACENTA PREVIA
CPD (CEPHALOPELVIC DISPROPROTION - FETUS LARGER THAN PELVIC DIAMETERS) ABRUPTIO PLACENTA ACTIVE GENITAL HERPES UMBILICAL CORD PROLAPSE FAILURE TO PROGRESS IN LABOR FETAL DISTRESS |
|
|
TYPES OF SKIN INCISIONS FOR A C/S
|
TRANSVERSE-MADE ACROSS THE LOWEST AND NARROWEST PART OF THE ABD. ONCE HEALED IT'S ALMOST INVISIBLE. LIMITATIONS OF THIS TYPE IS THAT IT DOES NOT ALLOW FOR EXTENSION OF THE INCISION IF NEEDED
VERTICAL-MADE BETWEEN THE NAVEL AND THE SYMPHYSIS PUBIS. THIS TYPE IS QUICKER AND PREFERRED IN CASES OF NON-REASSURING FETAL STATUS WHEN RAPID BIRTH IS INDICATED, WITH PRETERM OR MACROSOMIC INFANTS, OR WHEN THE WOMAN IS OBESE. TRANSVERSE REQUIRES MORE TIME TO MAKE AND HEAL, SO IF TIME IS OF THE ESSENCE, THE PHYSICIAN MAY DO A VERTICAL. |
|
|
RISKS OF CS
|
INCREASED RISK OF BLEEDING
INCREASED RISK OF BLOOD CLOTS INCREASED RISK OF INFECTION RISK OF PLACENTA PREVIA IN SUBSEQUENT PREG. RISK OF ABRUPTIO PLACENTAE IN SUBSEQUENT PREG. INCREASE IN FETAL DEMISE INCREASE IN NEONATAL RESPIRATORY DISTRESS |
|
|
GUIDELINES FOR C/S CARE
|
PROVIDE SUPPORT FOR PARENTS
VERTICAL VS HORIZONTAL INCISION VS, WOUND CARE, MONITOR LOCHIA ANALGESIA MONITOR FOR HYPOTENSION MONITOR URINE OUTPUT, COLOR, QUALITY (THEY SHOULD GET 125 ML OF FLUID/HR, SO THEY SHOULD HAVE CLEAR,YELLOW URINE) |
|
|
WHAT CRITERIA SHOULD BE MET BEFORE A VBAC - VAGINAL BIRTH AFTER CECAREAN
|
PT AGREES WITH VBAC
PREVIOUS TRANSVERSE INCISION BENIGN POSTOP COURSE CURRENT COURSE IN UNCOMPLICATED RISK OF UTERINE RUPTURE |
|
|
WHAT ARE SOME PROCEEDURES THAT MAY BE PERFORMED TO ASSIST IN BIRTH OF AN INFANT
|
VERSION
AMNIOTOMY CERVICAL RIPENING LABOR INDUCTION AMNIO INFUSION EPISIOTOMY FORCEPS-ASSISTED BIRTH VACUUM ASISTED BIRTH C/S VBAC |
|
|
VERSION
EXTERNAL VERSION |
TURNIING OF THE FETUS
EXTERNAL CEPHALIC VERSION-FETUS CHANGED FROM BREECH TO CEPHALIC EXTERNALLY. PT. IS GIVEN TERBUTALINE TO RELAX UTERUS AND U/S IS USED TO GUIDE. WAIT UNTIL 36 WEEKS GIVE NST RIGHT AFTER |
|
|
CERVICAL RIPENING
|
PROSTAGLANDIN PLACED ON THE CERVIX TO ALLOW FOR CX SOFTENING
PREPIDIL, CERVIDIL, MISOPROSTOL (CYTOTEC) |
|
|
CONTRAINDICATIONS TO USING CERVICAL GEL
|
MATERNAL ASTHMA
SCAR TISSUE IN UTERUS BLEEDING PLACENTA PREVIA FETAL DISTRESS |
|
|
2ND MOST IMPORTANT FACTOR IN DETERMINING WHETHER OR NOT TO INDUCE LABOR
|
CERVICAL RIPENING
|
|
|
DEFINE INDUCTION
|
STIMULATION OF UTERINE CONTRACTIONS BEFORE THE SPONTANEOUS ONSET OF LABOR, WITH OR WITHOUT RUPTURED FETAL MEMBRANES, FOR THE PURPOSE OF ACCOMPLISHING BIRTH.
|
|
|
BEFORE INDUCTION IS ATTEMPTED, WHAT MUST BE ASSESSED TO INDICATE THAT BOTH MOM AND FETUS ARE READY FOR INDUCTION?
|
GESTATIONAL AGE
CERVICAL READINESS |
|
|
COMMON INDICATIONS FOR INDUCTION
|
DM
PREECLAMPSIA PROM HISTORY OF PRECIPITOUS BIRTH POSTTERM GESTATION ABRUPTIO PLACENTA W/O INDICATION OF NONREASSURING FETAL STATUS IUGR |
|
|
CONTRAINDICATIONS OF INDUCTION
|
FETAL MATURITY
CLIENT REFUSAL UNSTABLE CONDITION OF MOM OR FETUS |
|
|
NURSING MANAGEMENT OF PATIENT INDUCED WITH OXYTOCIN
|
PIGGYBACK INTO LOWEST PART OF PORT OF LR
GOAL: ACHIEVE STABLE CONTR. Q 2-3 MINUTES, LASTING 40-60 SEC. D/C FOR FETAL DISTRESS, CONTR. MORE FREQ. THAN Q2 MIN, DURATION OF CONTR. EXCEEDS 60 SEC, INSUFFICIENT RELAXATION OF UTERUS B/T CONTR. RISKS: UTERINE RUPTURE,RAPID LABOR AND BIRTH, WATER INTOXICATION |
|
|
S/S OF H20 INTOXICATION ASSOCIATED WITH OXYTOCIN USE
|
SEEING SPOTS
INCREASED BP TACHYCARDIA |
|
|
EPISIOTOMY/EPISIORHAPPHY INDICATIONS
|
THOUGHT TO MINMIZE LACERATIONS
MACROSOMIA FORCEPS ASSISTED DELIVERY |
|
|
WHAT ARE SOME TIPS TO HELP REDUCE INCIDENCE OF ROUTINE EPISIOTOMIES
|
KEGEL EXERCISES
PERINEAL MASSAGE AVOID LITHOTOMY POSITION SIDE-LYING FOR PUSHING WARM COMPRESSES IF A WOMAN HAS GOOD PELVIC TONE, STRETCHABILITY OF PERINEUM, AND LESS USE OF SEDATIVES/NARCOTICS DURING LABOR, THESE FACTORS MAY ALSO PREVENT EPIS. |
|
|
POST-EPISIOTOMY TREATMENT
|
ICE PACKS
TUCKS EPIFOAM WITCH HAZEL PADS AMERICAINE SPRAY ANALGESICS ANTIINFLAMMATORY MEDS SITZ BATHS STOOL SOFTENERS GOOD HYGEINE (VERY IMPT) |
|
|
PERINEAL LACERATIONS AND LEVELS
|
TEARING TO THE PERINEAL, VAGINAL WALL CERVIX, AND LOWER UTERINE SEGMENT DURING CHILDBIRTH.
1ST DEGREE-EXTENDS THROUGH SKIN 2ND DEGREE-EXTENDS THROUGH MUSCLE 3RD DEGREE-EXTENDS TO ANUS 4TH DEGREE-EXTENDS INTO RECTAL WALL |
|
|
WHAT ARE SOME POSTPARTUM COMPLICATIONS
|
POSTANESTHETIC PROBLEMS
PP HEMORRHAGE PP INFECTIONS PP CARDIOMYOPATHY PP THROMBOSIS PP ECLAMPSIA PP PPSYCHOSIS |
|
|
PUERPERIUM PERIOD
|
PERIOD OF 42 DAYS FOLLOWING CHILDBIRTH AND EXPULSION OF PLACENTA AND MEMBRANES.
GENERATIVE ORGANS USUALLY RETURN TO NORMAL DURING THIS TIME |
|
|
HOW LONG DOES INVOLUTION USUALLY TAKE
|
6 WEEKS
|
|
|
WHAT ARE SOME PP PROBLEMS RELATED TO ANESTHESIA
|
RESPIRATORY PROBLEMS
HYPOTENSION HEADACHE (SPINAL HEADACHE) DVT (HUGE PROB., IF + HOMANS SIGN, BED REST UNTIL DVT RULED OUT) BLADDER ATONY |
|
|
PP HEMORRHAGE CAUSES
|
UTERINE ATONY (MOST COMMON CAUSE)
LACERATION/EPISIOTOMY RETAINED PLACENTAL FRAGMENTS HEMATOMAS UTERINE INVERSION COAGULATION DISORDERS OR LOW PLATELETS |
|
|
EARLY PP HEMORRHAGE
|
OCCURS IN 1ST 24 HOURS AFTER BIRTH
CAUSES: ABSENCE OF UTERINE CONTRACTIONS WHICH LEADS TO SIGNIFICANT BLOOD LOSS LACEERATIONS OF GENITAL TRACT OR EPISIOTOMY RETAINED PLAC. FRAGMENTS VULVAR, VAG, OR SUBPERIOTONEAL HEMATOMAS UTERINE INVERSION COAGULATION DISORDERS |
|
|
LATE PP HEMORRHAGE
|
24 HOURS TO 6 WEEK AFTER BIRTH
SUBINVOLUTION RETAINED PLACENTAL FRAGMENTS (MOST COMMON CAUSE OF PP HEM) FUNDAL HEIGHT FAILS TO REDUCE APPROPRIATELY |
|
|
UTERINE ATONY
|
MOST COMMON CAUSE OF PP HEM.
RELAXATION OF UTERUS CAUSED BY: OVERDISTENTION OF UTERUS RAPID OR PROLONGED LABOR OXYTOCIN AUGMENTATION GRAND MULTIPARITY DRUGS THAT RELAX UTERUS FIBROIDS |
|
|
WHAT IS A GOOD INDICATOR THAT PP HEM. MAY BE OCCURING
|
MORE THAN 4 SATURATED PADS/HOUR
|
|
|
NURSING CARE FOR PP HEM
|
DETERMINE CAUSE
ASSESS FUNDUS, LOCHIA, BLADD, V/S HAVE PT VOID (REGIONAL ANESTHETICS REDUCE BLADD TONE) MASSAGE BOGGY FUNDUS (MAY NEED OXYTOCICS-PITOCIN,METHERGINE) PELVIC EXAM (LOOK FOR LACERATIONS/REPAIR) MAY NEED D AND C FOR RETAINED PLACENTA |
|
|
PP THROMBOEMBOLYTIC DISEASE
|
THROMBOUS FORMATION IN A SUPERFICIAL OR DEEP VEIN, USUALLY IN LEGS. IT CAN LEAD TO PULMONARY EMBOLUS
|
|
|
RISK FACTORS OF THROMBOEMBOLYTIC DISEASE
S/S |
HX OF DVT
EDEMA LOW-GRADE CHILLS PAIN POSSIBLY DX IMPENDENCE OF PLETHYSMOGRAPHY |
|
|
TX FOR THROMBOEMBOLYTIC DISEASE
|
STRICT BED REST
TEDS IV HEP AND WARAFIN FOR 2-6 MONTHS POSSIBLY ANTIBIOTIC THERAPY |
|
|
UTI PP - WHY ARE PP MOMS AT INCREASED RISK AND WHAT ARE SOME CAUSES
|
INCREASED RISK DUE TO NORMAL POSTPARTAL DIURESIS
INCREASED BLADD CAPACITY DECREASED BLADD SENSITIVITY FROM STRETCHING/TRAUMA INHIBITED CONTROL OF BLADD FOLLOWING GEN/REG ANESTHESIA CONTAMINATION FROM CATH |
|
|
MASTITIS
|
INFECTION OF BREAST CONNECTIVE TISSUE THAT OCCURS PRIMARILY IN LACTATING WOMEN
USUALLY PRESENTS AFTER 1 WEEK PP USUALLY ONLY 1 BREAST AFFECTED |
|
|
S/S MASTITIS
|
TENDER, RED, SWOLLEN BREAST
HOT BREAST FEVER AND ACUTE ILLNESS TX: ANTIBIOTICS, CONTINUE BREAST FEEDING OR PUMPING, WARM COMPRESSESS, ANAGLGESICS |
|
|
PP MOOD DISORDER
|
OCCURS 50-80% OF NEW MOMS
BABY BLUES PP PSYCHOSIS PP DEPRESSION |
