Med-Surg

Front 1

largest part on a infant?

Back 1

head

Front 2

lie

Back 2

relationship between long axis of fetus and long axis of mother (cephalocaudal)

Front 3

presentation

Back 3

part of fetus that enters pelvis first

Front 4

attitude

Back 4

1. degree of flexion fetus assumes in utero
2. normally head flexed foward-arms and legs flexed

Front 5

effacement

Back 5

thinning out of cervix

Front 6

dilation

Back 6

external OS enlargement,
10cm-complete ( then push),

Front 7

what to remember with effacement and multipara and primipara?

Back 7

occurs before dilation on primipara, at same time as dilation in multipara

Front 8

FHR

Back 8

normal rate is 120-160 (110 at term)

Front 9

abnormal amniotic fluid

Back 9

1. blood
2. green fluid- indicates meconium ( affect resp at birth)
3. fluid cloudy or yelow w/odor- indicates infection

Front 10

contractions

Back 10

three phases of strength:
1. increment: increasing
2. peak/acme: greatest
3. decrement: decreasing

Front 11

what are the 4 P's

Back 11

1. powers
2. passage
3. passenger
4. psyche

Front 12

position

Back 12

relationship of presenting part to specific quadrant of the maternal pelvis

Front 13

what side is best for a pregnant women?

Back 13

left -lateral promotes good maternal fetal circulation

Front 14

if a pregnant women is walking through the hall and her water breaks, what do u do?

Back 14

if ambulating and ROM occurs, return immediately to be evaluated-assess FHR

Front 15

duration

Back 15

time from beginning of CTX to end of same CTX
if >90 sec, notify MD

Front 16

frequency

Back 16

timed from beginning of one CTX to beginning next CTX
should not be closer than 2 mins.

Front 17

EBL

Back 17

normal for VD <500cc
<1000cc for C/S

Front 18

what is a precipitated birth

Back 18

1. born in < than 3hrs
2. labor begins abruptly, intensifies quickly
3. may cause uterine rupture, cervicel lacerations or hematoma
4. places fetus at risk for hypoxia
5. may result in birth injuries such as, intracrania hemorrahge, or nerve damage

Front 19

true labor

Back 19

1. regluar CTX
2. becomes more intense, freg, last longer
3. intesify w/walking
4. boody show
5. progressive cerivcal changes
6. low back pain (abdomen/thighs)

Front 20

false labor

Back 20

1. irregular CTX
2. no cervical changes
3. relieved by walking
4. no bloody show
5. pian (low abdomen/groin)
6. abe to sleep thru contrations

Front 21

when can u use internal modes?

Back 21

when membranes have ruptured and cervix is 1-2cm dilated

Front 22

what are early decals?

Back 22

sign of fetal head compression or dilating of cervix- quickly returns to baseline ( no interventions ness.- good decal)

Front 23

what is variable (V,W or U shaped)

Back 23

begins/ends abruptly - indicates fetal cord compression, nuchal cord, or inadequate fulid ( may need to respotion pt, or start amnioinfusion)

Front 24

what are the variability rates for minimal, moderate, marked

Back 24

minimal: <5bpm
modrate 6-25bpm (good O2)
marked >25 bpm (good O2)

Front 25

if the fundus is deviated to the right, what do u do?

Back 25

ask the pt to void

Front 26

how long do u have to do the apgar score

Back 26

1-5 mins after birth

Front 27

apgar score of 8-10

Back 27

no action continued observation

Front 28

apgar score 4-7

Back 28

may need gentle stimulation

Front 29

apgar score 3 or less

Back 29

requires aggressive resuscitation

Front 30

where is the first temp taken for the infant and why

Back 30

rectally, to ensure the anus is open

Front 31

what do the nurses apply on the infants eyes to prevent eye infection

Back 31

erythromycin

Front 32

what do u clean the umbilical cord with and how often

Back 32

with alcohol and several times a day

Front 33

how may arteries and veins do the umbilical cord has

Back 33

(AVA) 2 arteries and 1 vein

Front 34

if fundus is higher than umbilicus, soft/boggy what do u do

Back 34

massage it

Front 35

where is the normal fundus at

Back 35

below umbilicus, firm and mid-line-

Front 36

how much does the fundus shrink per day

Back 36

1 finger width

Front 37

why do u give pitocin after labor

Back 37

give after delivery of placenta to prevent postpartum hemorrhage

Front 38

what is a FSE

Back 38

picks up true FHR, IUPC, measures the strength of CTX

Front 39

IUPC

Back 39

intrauterine pressure catheter

Front 40

FSE

Back 40

fetal scalp electrode

Front 41

why do we want the pt to have an empty bladder during labor

Back 41

a full bladder may impede descent of fetus

Front 42

what signs to look for when hemorrhage

Back 42

abnormal amount of blood loss
elevated HR, decreased BP, narrow pulse pressure is first sign of shock

Front 43

late-non reassuring

Back 43

starts at peak of CTX, end well after CTX ends, O2 at 10ml/min ( face mask) , turn off pitocin, administer tocolytics

Front 44

when is time of birth noted

Back 44

once the feet are out (everything)

Front 45

flexion

Back 45

fetal head movement that helps it pass through pelvis

Front 46

internal rotation

Back 46

head enters pelvis diagonally, flexes as it touches pelvic floor and rotates until just below symphonies pubis

Front 47

extension

Back 47

as head passes under symphysis, it changes from flexion to extension to allow it to fit through pelvis

Front 48

external rotation

Back 48

when head is born, spontaneously turns to one side as it realigns with shoulders and rotates within pelvis

Front 49

lightening

Back 49

movement of fetus and uterus down into pelvic cavity-makes breathing easier towards end of pregnancy

Front 50

engagement

Back 50

entrance of widest diameter of presenting part into true pelvis- often happens before onset of labor in primipara and in multipara may occur until well into labor, zero station

Front 51

powers

Back 51

contractions- primary power during 1st stage

Front 52

maternal pushing

Back 52

secondary power

Front 53

when does mother push

Back 53

when cervix is completely effaced and dilated, mother pushes with each CTX-helps propel fetus through pelvis; should not push before compeletey dialted and effecaed

Front 54

passage

Back 54

route fetus travels from uterus through cervix and vagina to external perineum

Front 55

what pelvic type is most favorable for birth

Back 55

gynecoid

Front 56

passenger

Back 56

consist of fetus with placenta, amniotic fluid, amniotic membranes

Front 57

what is the most common : transverse or longitudinal

Back 57

longitudinal because fetus parallel to mother's spine

Front 58

leopholds maneuver

Back 58

method used to palpate fetal position

Front 59

occiput

Back 59

how head positioned if fetus is in cephalic vertex presentation

Front 60

sacrum

Back 60

breech presentation

Front 61

mentum

Back 61

face presentation

Front 62

pelvis is divided into 4 quadrants

Back 62

R/L anterior
R/ posterior
ex: LOA-back of fetal head to left side of mother, occiput ( head) is presenting, and anterior in pelvis; if OP, pt will c/o "back pain"

Front 63

psyche

Back 63

birth is described in emotional terms; anxiety causes stress compounds to be released from adrenal glands (catecholamines) that inhibits CTX and direct blood away from placenta

Front 64

braxton hicks

Back 64

irregular CTX; start early in pregnancy, not true CTX ( no cervical changes) helps position fetus in the uterus

Front 65

increased vaginal discharge

Back 65

fetal pressure ; should not cause itching or irritation

Front 66

bloody show

Back 66

pink or dark brown tinged mucus - effacement/dilation slightly (no reason for the hospital);

Front 67

energy spurt

Back 67

called nesting-small weight loss; before onset of labor

Front 68

ruptured membranes

Back 68

risk for prolapsed cord and infection; may happen before labor begins

Front 69

CTX

Back 69

contractions

Front 70

ROM

Back 70

ruptured membranes

Front 71

station

Back 71

level of presenting part to ischial spines

Front 72

minus station

Back 72

head not engaged

Front 73

zero station

Back 73

head engaged

Front 74

plus station

Back 74

head is below ischial spines

Front 75

dirty Duncan

Back 75

mother's side

Front 76

shiny Schultz

Back 76

fetal side