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OB unit 1
| Question | Answer |
|---|---|
| labor is... | any change in the cervix due to regular contractions happening over a short period of time (not yesterday or last week) |
| labor can be... | dilation OR effacement, doesn't need to be both |
| dilation is... | opening of cervical os |
| effacement is... | drawing up of lower uterine segment |
| critical 5 P's of labor | passenger, passage, position, psychosocial, physiological |
| vaginal not possible for what hip shape | android (manly) |
| vaginal birth possible for what hips shapes | gynecoid (best), anthropoid, platypoid |
| besides hip shape, other factors impacting passage include... | excess soft tissue/ state of bony parts (such as sacral prominence) |
| early molding may signify... | cephalopelvic disproportion- head too big to fit through pelvis of mom |
| best presenting part is... | head (firm, good cork, even pressure for cervical ripening) |
| fetal lie is either... | longitudinal or transverse |
| normal fetal attitude presenting smallest diameter is... | flexed |
| biggest diameter for vertex presentation | BPD (biparietal) |
| face presentation indicates what attitude? | extended |
| ideal breech is... | frank (both legs up, because bum is best cork) |
| external version | manipulate presentation of fetus |
| incomplete breech vs complete | incomplete is one foot up, complete is both feet down |
| engagement | largest diameter at inlet of pelvis |
| engagement for multiparous woman happens | during labor instead of weeks before for primiparous |
| when BPD is at inlet | presenting part (vertex)is at station 0 (ischial spines) |
| failure to progress from negative station to positive one | might indicate CPD (cephalopelvic disproportion) |
| station | presenting part's relation to ishial spines (-3 to +3) |
| position is RMA | right mentum anterior (extended attitude) |
| position is LOP | left occiput posterior (flexed attitude) |
| position is LST | left sacrum transverse (breech) |
| contractions should not be longer than | 90 seconds |
| contraction should not occur more than | every two minutes, no more than 5 in 10 minutes |
| total contractions in 30 min divided by 3 is | average in 10 minutes- should not exceed 5! |
| contractions are | fetal airway obliterators! (squeeze cord) |
| normal fetal HR | 110-160 |
| accelerations | normal and healthy- must be at least 15 bpm for 15 seconds |
| late decelerations might indicate | poor oxygenation |
| spontaneous pushing/ Feguson reflex at what station? | about +2 |
| open glottis pushing | preferred, pushing with reflex on exhale |
| closed glottis pushing/ valsalva | not EBP, fetal oxygen deprivation |
| Pitocin sites on uterus mature at... | 40 weeks= contractions! (prostaglandins, uterine stretching, and dehydration also cause contractions) |
| PROM is | premature rupture of membranes- natural is SROM |
| AROM is | artificial rupture of membranes |
| complete dialtion | 10 cm |
| real vs false labor contractions | real are lower in abdomen and in back |
| catecholamines in labor | contribute to energy burst |
| WBC count in labor | goes up to 25,000 to 30,000/mm3 |
| blood glucose in labor | goes down due to energy requirements of cells |
| stages of labor depend solely on... | cervical DILATION |
| 0 to 3.99 cm, 4 to 7.99 cm, 8 to 10 cm (stage one of labor) | phase one, phase two, phase three (latent, active, transition) |
| complete dilation to birth of fetus | stage 2 of labor (expulsion) |
| birth of fetus until delivery of placenta | stage 3 of labor |
| stage 4 of labor is... | recovery for mom |
| induction of labor leads to... | LONGER LABOR |
| dilation and labor go faster for... | multiparous women |
| labor of 30 to 35 hours ___________ lead to harmful outcomes. | DOES NOT (should not have time limits, unless fetal health indicators are declining) |
| 1st degree lacerations | skin of perineum and vaginal mucosa |
| 2nd degree lacerations | involves muscles of perineum |
| 3rd degree lacerations | involves anal sphincter |
| 4th degree lacerations | involve lumen of anus (canal) |
| stretch marks indicate | increased likelihood of lacerations (decreased elasticity) |
| hemorrhage above periosteum that can be deadly and extend into neck | subgaleal hematoma |
| hematoma below periosteum that does NOT cross suture and generally heals in weeks (contained by periosteum) | cephalohematoma |
| scalp edema that is resorbed within 12 hours | caput (does CROSS suture) |
| cardinal movements of fetus | DFIRERERE |
| induction can often lead to cascade of... | interventions |
| induction should not be performed before... | 39 weeks unless absolutely necessary |
| back pain sometimes relieved by counter pressure to... | sacral area |
| nubain and stadol are agonist-antagonist narcotics and may... | cause withdrawal in opiate addicts |
| most common side effects of epidurals | BP issues (treat with fluid bolus!), FHR changes, partial paralysis |
| drugs NOT commonly used in labor | morphine sulfate, demerol |
| nursing actions for epidural pump include... | only turning it off (no increasing, decreasing or rebolusing) |
| common drugs for epidurals | nubain, stadol, fentanyl (all can cause withdrawal symptoms for opioid addicted mom) |
Created by:
NurseJoel
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