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48 Cards in this Set
- Front
- Back
what are the 4 P's of labor? |
POWERS |
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mechanisms of labor-data collection
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lightening or dropping of fetus(fetus descends in pelvis 2weeks b4 delivery primipara) (multipara fetus might engage in pelvis after labor) |
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Leopold's manuever
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method of determining the presentation and position of the fetus. aid in location heart sounds. |
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what is the normal fetal HR?
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120-160 beats per minute.
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internal fetal monitoring
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invasive- requires rupturing of the membranes and attaching an electrode to the presenting part of the fetus. |
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variability- FHR
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fluctuations in the baseline FHR. |
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early decelerations
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occurs during contractions as the fetal head is pressed against the pelvis or cervix, return to normal after contraction |
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late decelerations
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nonreassuring patterns that reflect impaired placental exchange and uteroplacental insufficiency |
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variable decelerations
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caused by conditions that restrict flow to the umbilical cord |
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non reassuring patterns are
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tachycardia, bradycardia |
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1st stage of labor(latent stage)
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cervical dilation up to 3cm |
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1st stage of labor(active phase)
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cervical dilation 4 to7 cm |
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1st stage of labor(transition phase)
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cervical dilation8 to 10cm |
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2nd stage of labor
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complete cervical effacement and full dilation, ends w babys birth. |
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3rd stage of labor
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lasts from the birth of the baby until the placenta is expelled.
birth of placenta occurs 5-30 minutes after birth. |
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placenta data collection
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schultze mechanism- the center portion separates first,and its shiny fetal surfaces emerges from vagina |
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After birth of the __, the uterine fundus remains __ and is located __ fingerbreadths __the umbilicus.
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placenta |
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Examine the placenta to verify the __ are intact. Examine the umbilical cord for the presence of __ artery, __ vein.
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membranes |
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4th stage of delivery- description and data collection
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1-4 hours after delivery |
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4th stage of labor interventions
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1. maternal assessments every 15 min-1st hour 30 min- 2nd hour hour-remainig 2hours |
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what site is epidural injected?
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L3-L4
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Epidural
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may cause hypotension, bladder distenstion and prolonged 2nd stage |
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Subarachnoid (spinal)block
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injection site subarachnoid space at L3-L5
usually causes hypotension may cause postpartum headache Mother must lie flat 8to12hours after injection |
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induction
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the chemical or mechanical initiation of uterine contractions before their spontaneous onset for the purpose of bringing about the birth.
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amniotomy
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artificial rupture of membranes performed by the HCP to stimulate labor.
presenting part should be present b4 performed increased risk of prolapsed cord or infection bloody amniotic fluid may indicate abruptio placentae or fetal trauma unpleasant odor=infection |
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external cephalic version (ECV)
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external manipulation of fetus from a breech or shoulder into a vertex presentation. |
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episiotomy
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incision made into the perineum to enlarge the vaginal outlet and facilitate delivery. |
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Forceps delivery
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two double crossed spoonlike articulated blades are used to assist in the delivery of the fetal head.
Check neonate and mother after delivery for injury |
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vacuum extraction
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a cap-like suction device is applied to the fetal head to facilitate extraction. |
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CESAREAN DELIVERY
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birth of fetus through transabdominal incision of the uterus. |
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PROLAPSED CORD
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umbilical cord is displaced between the presenting part and the amnion. or it is protruding through the cervix, causing compression of the cord and compromising fetal circulation. |
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PROLAPSED CORD- data collection
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1.Mother has a feeling that something is coming thru the vagina. |
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PROLAPSED CORD- interventions
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1. Relieve cord pressure immediately |
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precipitous labor and delivery
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labor that last less than 3 hours from the onset of contractions to birth.
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precipitous labor and delivery interventions
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stay with the mother at all times.
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preterm labor- description and intervention
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cervical and uterine contractions occuring between 20-37 weeks.
rupture of amniotic fluids. interventions- focus is on STOPPING LABOR. identify and treat infection, restrict activity, ensure hydration tocolytic may be given to supress labor. |
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premature rupture of the membranes- description
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the spontaneous rupture of amniotic memebrane before the onset of labor.
infection becomes a risk. evidence of fluid pooling in the vaginal vault(nitrazine test is positive) |
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PLACENTA PREVIA- description and 3types
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the placenta is improperly implanted in the lower uterine segment near or over the internal cervical os.
Total (placenta completely covers internal cervical os) Partial (incomplete coverage of the internal os) Marginal (only the edge of the placenta extends to the internal os) |
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placenta previa- data collection
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sudden onset of painless, bright red vaginal bleeding during last half of pregnancy. Suspected when vaginal bleeding occurs after 24 weeks.
Soft, relaxed,nontender uterus |
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placenta previa interventions
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prepare ultrasound to confirm diagnosis.
Avoid vaginal examsand other actions that would stimulate uterine activity Bedrest in left lateral position If bleeding is heavy(c-section may be performed) Prepare RH immuno globulin if mother is RH negative and has not been given injection. |
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ABRUPTION PLACENTAE
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premature separation of the placenta after 20 weeks gestation and b4 the birth of the baby.
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ABRUPTIO PLACENTAE- data collection
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dark red vaginal bleeding(if the bleeding is high in the uterus or minimal there can be a absence of visible blood)
uterine pain/tenderness uterine rigidity severe abd. pain signs of fetal distress and maternal shock(if bleeding is excessive) |
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ABRUPTIO PLACENTAE- interventions
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Place mother in trendelenburg position if indicated.
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placental abnormalities
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placenta accreta(abnormally adherent)
placenta increta(penetrates the uterine muscle itself) placenta percreta(goes all the way through the uterus) |
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placental abnormalities- data collection and intervention
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may cause delayed hemmorhage immediately after birth bc the placenta doesnt separate cleanly.
Interventions- Mon. for hemorrhage, shock prepare client for a hysterectomy if large portion if the placenta is abnormally adherent |
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uterine inversio description and data collection
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uterus turns inside out during delivery or after delivery of placenta.
DC- depression in fundal area, interior of cervix may be seen through the cervix or protuding thru vagina, severe pain, signs of shock, hemorrhage. |
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amniotic fluid embolism
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occurs when the amniotuc fluid contains particles of debris(vernix, hair, skin, cells, meconium). Enters the maternal circulation and causes release of endogenous mediators, thus obstructing maternal pulmonary vessels.
Causes resp depression, circulatory collapes. FATAL TO MOTHER/ if she survives she is likely to have hemorrhage and DIC |
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SUPINE HYPERTENSIVE SYNDROME(vena cava syndrome)
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occurs when the venous return to the heart is impaired by the weight of the fetus.
S/S pallor, clammy, cool damp skin, sweatig. |