Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
labor complications
BC3-maternity- labor complications
| Question | Answer |
|---|---|
| dystocia | (blank) |
| dystocia | long, difficult , abnormal labor |
| causes of dystocia | dysfunctional labbor, alteration in pelvic structure, fetal causes (size, position), maternal position (best squatting), phychological responses |
| when is dystocia suspected | lack of progress in rate of cervical dilation, fetal decent, or problems with uterine contractions |
| dysfunctional labor | abnormal uterine contractions that prevent dilation, effacement, descent |
| primary dysfunctional labor | hypertonic contractions, anxious primagravida having painful contractions |
| management of primary dysfunctional labor | theraputic rest, analgesics (morphine and demerol) to reduce pain |
| secondary uterine inertia | hypotonic |
| secondary uterine inertia | hypotonic contractions, that decrease in strength dropping uterine tone below normal contractions. occurs in active phase, secondary uterine inerita, most common |
| management of secondary uterine inertia | R/O CPD, goal to increase quality of uterine contractions. rest, fluids for mom, amniotomy, oxytocin, if fetal distress, or CPD (head too big)or CS |
| stage 2 dystocia | ineffective expulsive force- inability to push related to too much anesthesia, fatigue or pain |
| epidural window | 3-7 cm |
| precipitous labor | labor of 3 hours or less, related to lack of resistance in maternal tissue, large pelvis small baby, extra strong contractions, possible uterine rupture, lacerations, ppossible asphyxia to baby |
| alterations in pelvic structure | d/t car wreck, genetic abnormality (rickets, neoplasm, MVA-C-section most often necessary |
| fetal causes of dystocia | fetal size, malpresentation, position, leads to low forceps delivery, vacuum extraction, or c- section |
| hydrocyphallis | water on brain (spinobifida) |
| rickets | lack of vitamin D |
| CPD | usually related to macrosomic infant. shoulder stuck after head born, shoulder dystocia. Mc roberts maneuver to deliver |
| fetal mal position | ROP-LOP change moms position frequently, pressure on sacrum may reduce pain, hands and knee position, or lateral pushing may facilitate birth |
| fetal malpresentation | breech (most common) |
| for Breech management | C-section most often, greatest danger of vaginal delivery is prolapsed cord |
| brow and face presentations | cause L and D complications and sometimes bonding problems if face bruised |
| multiple pregnancies | early diagnosis to improve fetal outcome |
| macrosomic | baby>8lbs 13 oz (bigger baby) |
| high risks associated with multiple pregnancies | premature labor, PIH, abnormal presentation, hydramnios, uterine dysfunction |
| prenatal care for multiple pregnancies | see dr. more often Q 2 weeks in 2nd trimester, Q 1 week in 3rd trimester. |
| position multipple preg. | maternal position can enhance or impede the progress of labor. Having mom restricted to lying on her bed can work against her |
| psyche | anxiety/ stress/ excessive labor result prolonged painful labor. Doulas, coaches, staff, help to relax and enhance positioning and support |
| external cephalic version | attempt to convert fetal position to favorable one, externally, proceedure done under ultrasound, continual monitoring. Give Ritodrine (relax uterus), fetus meneuvered into vertex position, 35 to 38 weeks to turn |
| induction | initiation of uterine contractions before their spontaneous onset for the purpose of bringing on birth |
| indications to induce | PIH (pregnancy induced hypertension) DM, postterm gestation (old placenta) fetal distress, distance from hospital |
| bishop score | compare 5 items, cervical dilation, effacement, position, consistency, station of fetal head |
| bishop scoring | total of 13 possible, 9 or more good for nullipara, 5 or more for a multip |
| chemical & mechanicial methods of induction | cervical ripening, amniotomy. oxytocin, augmentation, episiotomy, pitocin |
| prostaglandin gel (cervidil) | ripening of cervix |
| amniotomy | artificial rupture of membranes, assess fluid for color, consistancy, odor, quantity, record time of rupture, FHR assessed prior and after proceedure (checking for prolapsed cord) maternal temp monitored for infection |
| oxytocin administration | goal to achieve contractions 2-3 min apart lasting 45 seconds. follow strict protocol nurse can give medication, MD responcible |
| pitocin | discontinued if contractions longer than 90 seconds, abnormal fetal HR patterns, significant maternal blood pressure changes. |
| contraindications for induction of labor | any situation in which delivery should not be accomplished or which would cause uterine rupture, or hem., activer herpes, placenta previa, fetal distress |
| augmentation | stimulation of uterine contractions if progress unsatisfactory |
| episiotomy | surgical incision of perineal body done to enhance birth of fetus |
| most commonm episiotomy | midline, with medial-lateral helpful when a longer epis. is necessary. more comfortable , heals quicker |
| forceps delivery | provide traction, rotation |
| low-forceps delivery | facilitate outlet delivery |
| mid-forceps | can deliver head at ischial spine, head must be totally engaged, membranes ruptured, vertex presentation, adequate maternal anesthesia |
| vacuum extraction | suction used to deliver fetal head, intermittent suction |
| Cesarean Delivery | delivery through abdominal uterine incision |
| indications for C section | malpresentation, CPD, fetal distress, placental accidents |
| types of c sections | skin incisions/ transverse (bikini) |
| Ritodrine | med used to relax uterus |
| amniocentesis | to test lung maturity L:S ratio, 35 weeks |
| induction done because | PIH, and sometimes coonvenience |
| vertical incision | transverse, thinnest, least blood loss, preferable for VBAC, best for twins, abnormal presentation, placenta previa, fetal distress, disadvantage, takes longer |
| Nursing care for c section | provide information, support for breastfeeding, encourage and inform momm regarding PCA catheter, TEDS, breathing and coughing and diet |
Created by:
goryan
Popular Nursing sets