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OB

Review of intrapartum

QuestionAnswer
Five signs of labor Lightening, Braxton hicks contractions, Increased bloody show, Burst of energy
True labor vs False labor True labor- regular rhythmic contractions that intensify with ambulation, pain in the abdomen sweeping around from the back and cervical changes False labor-irregular rhythm, abdominal pain that decreases with ambulation
What results from hyperventilation in labor? Respiratory alkalosis instruct pt to breath into a paper bag or cupped hand
Maternal changes in the transition phase of labor Irritability and unwillingness to be touched but dont want to be left alone, n/v, and hiccupping
When should a laboring client be examined vaginally Prior to analgesia and anesthesia to rule out cord prolaps,e to determine labor progress and to determine when pushing can begin
Define cervical effacement Shortening of cervix expressed in percentages (0-100%)
Where is the FHR best heard Fetal back in vertex, OA postions
Normal FHR during labor 110-160 bpm
Normal maternal BP, pulse and temp during labor <140/90 <100 bpm <100.4
Four nursing actions for second stage of labor Ensure cervix is completely dilated before pushing is allowed Assess FHR with each contraction Teach woman to hold breath for no longer than 10 sec Teach pushing techniques
Three signs of placental separation Gush of blood Lengthening of cord Globular shape of uterus
When should the postpartum dosage of Pitocin be admin? Why? Immediately after placenta is delivered to prevent post partum hemorrhage and atony.
Contraindication to use of Methergine Hypertension
Five symptoms of resp distress in the new born Tachypnea, dusky color, flaring nares, retractions and grunting
If meconium was passed in utero what nursing action must be taken? Arrange of immediate ET tube observation to determine te presence of meconium below the vocal cords
Good apgar score 7-10
Major cause of maternal death when gen. anesthesia is admin Aspiration of gastric contents
What is the first sign to observe for hypotension in a laboring patient after she receives epidural? Hypotension resulting from vasodilation below the block, which pools blood in the periphery, reducing venous return
Three actions to take if hypotension occurs in a laboring client Turn client to left side Admin O2 by mask at 10L/min Increase speed of IV infusion
Define fourth stage of labor 1-4 hrs after delivery of placenta
Actions to prevent post partum hemorrhage Massage the fundus gently and keep the bladder emptied
Nursing actions when a soft boggy uterus is palpated Perform fundal massage
Symptoms of hypovolemic shock Pallor, clammy skin, tachycardia, lightheadedness and hypotension
How often should the nurse check the fundus during the fourth stage of labor? Q 15 mins x 1 hr Q 30 mins x 2 hr if normal delivery.
Latent phase of labor From beginning of true labor to 3-4cm dilation. Client will be mildly anxious, mild contractions, initially 10-20 mins apart 15-20 sec duration
Active phase of labor 4-7 cm dilation; Client will have increased anxiety, discomfort, unwillingness to be left alone, moderate to severe contractions ( 2-3 mins apart 30-60sec duration)
Transition phase of labor 8-10 cm dilation; Client will experience sudden nausea, hiccups, extreme irritability and unwillingness to be touched, severe contractions (1 1/2 mins apart, 60- 90 sec duration)
Created by: roseiv2014