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107 Cards in this Set

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what does the gatecontrol theory explain?

how pain impulses reach the brain for interpretation

what are endorphins?

natural body substances similar to morphine..they increase during pregnancy and reach a peak during labor

what is amniotomy?

artificial rupture of the membranes

what is efflurage?

a techniques that stimulates the large-diameter nerve fibers that inhibit painful stimuli traveling through the small-diameter nerve fibers.

what do regional anesthetics do?

block sensation from a localized area without causing a loss of consciousness

what do general anesthetics do?

they cause a loss of consciousness and sensation of pain

when are narcotic analgesics avoided?

if birth is expected in one hour

what is used to reverse respiratory depression?
Naloxone (Narcan)
what drugs enhance the pain-relieveing action of analgesics and reduce nausea?

adjunctive drugs
what are the meninges three layers? (membranes around the spinal cord)

-dura mater


-arachnoid matter


-pia matter

where is the epidural space located?

between the dura matter and the inside bony covering of the brain or spinal cord

where is the subdural space located?

between the dura matter and the arachnoid matter

where is the subarachnoid space located?

between the arachnoid matter and the pia matter

where are local and pudenal blocks given?

in the vagina

what type of birth is the pudenal bloack used for?

vaginal births

when is a pudenalblock given?

just before birth

what are adverse effects of a pudendal block?


-a vaginal hematoma


-possibly an abcess


when does a women have effects from an epidural test dose?

if it is in the wrong spot

what does numbness or loss of movement mean after a test does of epidural is given?

that the dura matter was probably punctured and the drug was entered into the subarachnoid space.
what are symptoms that suggest injection into a vein?

numbness around the mouth, ringing in the ears, visual disturbances, or jitterness

what position should a pregnant women avoid?

supine posistion

what happens if the dura is punctured?

a relatively large amount of spinal fluid can leak from the hole,which may result in headache

when is an epidural block not used?


-abnormal blood clotting


-an infection in the area of injection or a systemic infection


-hypovolemia (inadequate blood volume)


what are common side effects from an epidural block?


maternal hypotension and urinary retention




what are the main adverse reactions from a subarachnoid block?

hypotension and urinary retention

what is a blood patch?

the woman's blood (10 mL to 15mL) is withdrawn from her vein and injected into the epidural space in the area of the subarachnoid puncture (provides relief from headache)

what can reduce placental blood flow?

hypotension

what may reduce sensation of rectal pressure?

an epidural block

what is amnioinfusion>

injection of warmed sterile saline or lactated Ringer's solution into the uterus via an intrcraniel pressure catheter during labor after the membranes have ruptured
what is oligohydramnios?

lower-than-normal amount of amniotic fluid
what does amnioninfusion do?

replaces the "cushion" for the umbilical cord and relieves the variable decelerations of the fetal heart rate that may occur during contractions when decreased amniotic fluid ispresent

what is an amniotomy?

artificial rupture of membranes (AROM)

why is amniotomy done?

to stimulate contractions (usually contractions that have already begun)
what complications may occur with amniotomy?

prolapse of the umbilical cord, infection, abruption placentae
what is augmntaion?

the stimulation of contractions after they have begun naturally

what is induction?

the intentional initiation of labor
what is the Bishop score used for?

the asses the staus of the cervix in determining its response to induction

what is cervical ripening?

when the women's cervix is soft, partially effaced, and beginning to dilate
what does prostaglandin do?

commercially prepared vagina insert that softens the cervix when applied before labor induction

what is laminaria?

a narrow cone of a substance that absorbs water and is known as an "osmotic dilator", it sweels inside the cervix and causes cervical dilation
what does stimulating the nipples cause?

the release of oxytocin

why can fetal compromise occur?

because blood flow to the placenta is reduced if contractions are excessive

why does water intoxification sometimes occur?

becauses oxytocin inhibits the excretion of urine and promotesfluid retention

what are the most common signs of fetal compromise?

fetal HR outside the normal range, late decerations, and loss of variability

what is version?

method of changing the fetal presentation, usually from breech to cephalic
what are the two methods of version?


-external (most common)


-internal

when is external version done?

after 37 weeks

what is internal version?

it is an emergency procedure

what is chignon?

circular edema on the infants sccalp

what is dystocia?

a term used to describe a difficult labor
what is puerperium?

the 6 weeks following childbirth (4th trimester)
what hormones fall in the 3rd stage of labor?

blood levels of placental hormones, human placental lactogen, human chorionic gonadotropin, estrogen, and progesterone

what does involution mean?

the changes that the reproductive organs, particularly the uterus undergo after birth to return them to their preprganancy size and condition

how long does it take for the uterus to return to its prepregnant state?

5 to 6 weeks

what does subinvolution mean?

the failure of the uterus to return to its prepregnant state within 6 weeks

when is the uterine lining shed during pregnancy?

when the placenta detaches it is fully healed in 6 to 7 weeks

where can the fundus be felt as soon as the placenta is shed?

at the midline

when should the fundus no longer be palpable?

by ten days postpartum

what is lochia?

vaginal discharge after delivery

what is lochia rubra?

red, it last about 3 days after birth

what is lochia serosa?

pinkish, it last from the 3rd to 10th day

what is lochia alba?

mostly mucus and clear, it last from the 10th day to the 21st day after birth

why should a poorly contracted uterus be messaged?

to prevent hemorrhage

what medications are given to stimulate uterine contractions?


-oxytocin (Pitocin)


-methylergonovine (merthergine)


whatare rugae?

vaginal folds

when do rugae reappear after birth?

3 weeks

when does the vagina regain its prepregnancy form?

within 6 weeks

what causes a rise in follicle-stimulating-hormone?

delivery of the placenta when estrogen and progesterone is stopped

when does the menstrual cycle return?

6 to 8 weeks if not breastfedding

can ovulation occur with or without menstrual bleeding?

yes

how are the breast for the first 3 days?

full and soft

when do the breast become firm and lumpy and why?

by the third day because blood flow increases and milk production begins

when do breast of the nonursing mother return to normal size?

1 to 2 weeks

how much blood is lost in vaginal birth

500mL

hpow much blood is lost in cesarean birth?

1000mL

are blood clotting factors high during pregnancy?

yes

when do WBCs return to normal?

12 days after birth

what does a high pulse rate often indicate?

hypovolemia

when does kidney function return to normal?

a month after birth

when does the gastrointestinal system resume normal activity?

shortly after birth when progesterone decreases

what is diastasis recti?

longitudinal abdominal muscles that extend from the chest to the symphis pubis are seperated

when should a women not get pregnant for 1 month?

after receiving the rubella vaccine

when are staples and strips removed?

3 days after surgery

what are the 3 phases of transition?


-0 to 30 minutes


-30 minutes to two hours


-2 to 8 hours

what is the normal temp of the term infant?


-36 to 36.5 C (96.8 to 97.7 F; skin


-36.5-37 C (97.7 to 98.6; axillary)

what are the four ways heat is lost?


-evaporation (of liquids from the skin)


-conduction (direct skin contact with a cold surface)


-convection (heat away from the body by drafts)


-radiation (being near a cold surface, not in direct contact with it


why do newborns loose heat directlt after birth?

because amniotic fluid evaporates from their body

how long may newborns not urinate for?

for the first 24 hours, and occasionally for the first 48 hours

how is gestational age assessed?

through the Ballard form
what is the normal range of BP in an infant?

65-95 systolic and 30-60 diastolic

what is a two vessel cord associated with?

other internal anomalies, often the genitourinary tract

what do the veins look like on an umbilical cord?

a flattened cyclinder that does not project from the cut surface
when does the cord usually fall off?
in 10-14 days after birth
what indicates hypoglycemia in an infant?

40mg/dL

what is a PKU test?

screens for abnormalities

why do infants have a large number of erythrocytes?

because they live in a low-oxygen environment in utero

what do erythrocytes release into the bloodstream?

bilirubin

what is milk productions three phases?


-colostrum (produced for first few days after birth)


-transitional milk (7-10 days after birth)


-mature milk (14 days after birth) (bluish color)

how long after birth should breastfeeding not be delayed for?

6 hours

when does a infant swallow with every suck?

after 4 days

what is the "let down" reflex?

a tingling sensation with milk dripping from breast when a feeding is due

how many times does infant nurse breast a day?

8-10 times at 10-15 minutes each time

what are examples of "cows milk" based formulas?

similac and enfamil

what are soy or protein hydrolysate formulas?

nutremingen

what are examples or soy formulas?

prosobee and isomil

how often do you burp infant while feeding?

every 1 to 1.5 ounces
how long should douches and tampons not be used for?

until the 6 week check-up