Womens- Chapter 10, Chapter 12, 13

Front 1

Reasons for antepartal fetal assessment

Back 1

detect congenital anomolies
evaluate condition of the fetus
*amneocentesis
*ultrasonography

Front 2

Ultrasonography

Back 2

projected through the abdomen or vagina
2 dimensional images showing sturctures of different densities

Front 3

3 levels of Obstetric Ultrssound

Back 3

Basic
Comprehensive
Limited

Front 4

Basic Ultrasound

Back 4

general survery of the fetus, placenta and amniotic fluid quantity

Front 5

Comprehensive Ultrasound

Back 5

"extended"
ordered if abnoralities are found
targets the questionable findings

Front 6

BPP

Back 6

Bio-phsical Profile
FHR
fetal breathing
movements
gross fetal movement
fetal muscle tone
amniotic fluid volume

Front 7

Amniotic Fluid Volume

Back 7

> 10 = reassuring
< 5 = oligohydramnios

Front 8

Hematopoetic System changes
Hg level of 10.5 g/dl
Hct of 33%

Back 8

500 mL max normal blood loss during vaginal birth
clotting factors are elevated

Front 9

Fetal Placental Circulation

Back 9

exchange hapens during the interval of contractions
usually has enough on reserve

Front 10

Fetal Protective Mechanisms

Back 10

Fetal Hg
High Hg and HCT levels
high cardiac output

Front 11

Cardiovascular Fetal Changes

Back 11

110-160 bpm

Front 12

Pulmonary Fetal Changes

Back 12

production of fetal lung fluid decreases, absorption into lungs increases

Front 13

Catecholamines

Back 13

Epi and NE
stimulate cardiac contraction
quicken clearance of lung fluid
temperature regulation

Front 14

Powers

Back 14

Contraction
maternal pushing efforts

Front 15

Passage

Back 15

maternal pelvis and soft tissues
-softening of the cartilage linking

Front 16

Passenger

Back 16

Fetal head

Front 17

Biparietal diameter

Back 17

9.5 cm in a term fetus

Front 18

Normal fetal attitude

Back 18

FLEXION
head towards chest
arms and legs over thorax
back is curved in c shape

Front 19

Presenting part

Back 19

the part that first enters the pelvis
CEpahlic, Breech, Shoulder

Front 20

CEphalic Presentation VAriations

Back 20

Vertex- MIlitary- brow- face

Front 21

Breech position

Back 21

buttocks enter first
- Frank
- Full
-Footling

Front 22

Shoulder Presentation

Back 22

C-section is necessary

Front 23

Occiput

Back 23

vertex position

Front 24

Chin

Back 24

reference point in a face presentation

Front 25

Sacrum

Back 25

used for breech presentations

Front 26

Onset of Labor

Back 26

Increases in:
- Prostaglandin
-Oxytocin
- Oxytocin Receptors
- stretching pressure, irritation of the uterus

Front 27

Braxton HIcks COntraction

Back 27

contractions become more noticeable and painful
keep you up at night...

Front 28

Lightening

Back 28

breathing more easliy once the fetus drops toward the pelvic inlet
urination increases

Front 29

Cervix

Back 29

softens by Relaxin
increased water content

Front 30

Bloody Show

Back 30

mix of thick mucus and pink or dark brown blood--expulsion of mucous plug

Front 31

small weight loos before labor

Back 31

2.2-6.6 kg or 1-3 lbs

Front 32

True Labor

Back 32

contractions cause progressive change in the cervix
increase in effacement and dilation occurs

Front 33

First Stage of Labor

Back 33

Effacement & Dilation
onset of contractions-->complete dilation
Longest

Front 34

Active Phase

Back 34

dilates 1 cm / hour

Front 35

Latent Phase

Back 35

first 3 cm of cervical dilation
long
unnoticed
effacement
fetal position change
discomfort in back

Front 36

Active Phase

Back 36

pace of labor increases
4-7 cm dilated
fetus descends and internal rotation occurs

Front 37

Transition phase

Back 37

8-10 cm dilated
strong contractions

Front 38

Second Stage ( Expulsion)

Back 38

"labor"

Front 39

Third STage ( Placental)

Back 39

Schultz Mechanism- shiny, fetal side presents first
Duncan mechanism- rough/ maternal side first

Front 40

FOurth Stage

Back 40

physical recovery

Front 41

Abortion

Back 41

before 20 weeks

Front 42

Nursing During admission

Back 42

establish therapeutic relationship
assess condition of mom and fetus

Front 43

Reassuring FHR

Back 43

11o-160 bpm
regular rhythym
accelerations present
absence of decelerations

Front 44

Mom's VItals

Back 44

BP 140/90= hypertension
Temp aboce 38 C = infection

Front 45

Fetal Assessment

Back 45

FHR
COlor and odor of amniotic fluid
time of rupture of membranes

Front 46

Labor Status

Back 46

Contractions ( palpation)
dilation, effacement, fetal station and position ( vaginal)

Front 47

Lab Tests often used

Back 47

Hematocrit
Urine- protein and glucose levels

Front 48

prolapsed cord

Back 48

compression and interruption of blood flow through

Front 49

normal amniotic fluid

Back 49

clear with bits of vernix ( creamy white fetal skin lubricant)

Front 50

Cloudy, yellow amnitoic fluid
foul-smelling

Back 50

infection

Front 51

Green Amniotic fluid

Back 51

fetus passed meconium before birth

Front 52

Amniotic quanityt

Back 52

> 1000 mL = large
500-1000 moderate
trickle= scant

Front 53

INtake and output

Back 53

suprapubic area palpated every 2 hours

Front 54

Reduce fetal oxygen, nutrient and waste exchange

Back 54

maternal hypo/hypertension
maternal fever
strong and long contractions
compression of umbilical cord

Front 55

Nursing Responsibilities

Back 55

promote normal placental function
observe for and report problems to the physician

Front 56

Maternal positioning

Back 56

primary measure to promote placental function during normal labor

Front 57

Urge to push

Back 57

cervix is fully dilated
effaced
fetus descends to 1+ station and internally rotates

Front 58

pushing against a cervix complications

Back 58

edematous cervix
lacerated cervix