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25 Cards in this Set
- Front
- Back
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When does care of labor begin? |
with regular contraction that increase in frequency strength and duration presence of bloody show indicating mucous plug has passed with evidence of ROM (rupture of membranes) |
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What's in the initial interview |
primary complaint, time and onset of contraction level of pain bloody show status of membranes = ninrazine test birth plan, infant feeding, pain management, baby's physician evaluation of prenatal care, education, cultural factors, assess for substance use |
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What is the difference between true labor and false labor? |
in true labor the cervix will change: dilation and effacement |
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What do we tell mom's to do if they are experiencing Braxton hick's contraction? |
drink a glass of water try voiding lay on your left side |
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What are leopold's maneuvers? |
deep palpation of the abdomen to determine: number of fetuses presenting part fetal lie & attitude degree of descent location of PMI |
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What is the PMI |
point of maximim impulse location on the abdomen where the FHT is heard the loudest |
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FHR |
usually heard below mother's umbilicus should be between 110-160 |
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What is the first intervention after ROM? |
assess fetal heart tones for changes |
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If we hear the FHT above the mother's umbilicus what might this tell us about the fetus? |
It's in the breech position |
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When should the FHR be assessed? |
immediately after ROM any change in contraction pattern before and after medication administration before and after any procedures |
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How are contractions assessed? |
palpation of funds internal or external monitors woman's report assess frequency, duration, intensity, and resting tone |
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What is significant about the uterine resting tone? |
this is the tension in the uterine muscle between contractions |
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What will the FHR do during contractions? |
it will increase contractions = constrictions |
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How do we do a vaginal examination? |
use sterile gloves with a lubricant using the index and middle finger insert into the vagina and assess dilation, effacement, position of cervix presenting part, position, station status of membranes |
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How often should mom void? |
every 2 hours full bladder can impede descent moms can be catheterized if they are unable to void |
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What does it mean to labor someone down? |
inducing labor and contractions too fast contractions are too close together and we're not seeing changes in the cervix may slow the oxytocin drip |
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What is pitocin? |
synthetic oxytocin (Oxytocin is responsible for creating uterine contractions) administered IV |
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What is APGAR |
rapid assessment for the need of resuscitation each item scored at 1 min and again at 5 min 5 minute score correlates with the degree of risk for neonatal morbidity and mortality Heart rate >100 Respirations - good cry muscle tone - flexed reex irritability - cry color - completely pink get you a score of 10 which is the best |
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Perineal lacerations 1st and 2nd degree |
1st - superficial tear, scratch 2nd - tear into the muscle, might have been cut |
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Perineal Laceration 3rd and 4th |
3rd - laceration reaches top of anal sphincter 4th - laceration goes completely through anal sphincter and rectal wall |
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What is an episiotomy? |
incision made in the perineum to enlarge vaginal opening something we need to be assessing for edema and bleeding can be middling or medialateral |
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What methods can reduce the risk of tearing |
anything that can help stretch the perineal tissue warmth, manual support, massage, kegels different position to reduce pressure |
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What is the third stage of labor? |
delivery of the placenta major risk is hemorrhage or retained placental fragments these fragments need to be removed for future pregnancies and complications |
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Normal newborn assessments/vitals |
respirations: 30-60 apical pulse: 120-160 temp: above 98.7 skin: pink to acrocyanosis |
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Nursing management of the newborn |
maintain airway (ABC's) examine umbilical cord maintain body temp >98.7 complete ID methods therapeutic interventions - erythromycin ointment - vitamink K (IM) for clotting factors |
