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Intrapartum
OB Exam 2
| Question | Answer |
|---|---|
| contractions that occur regularly and increase in frequency, duration and intensity AND cause changes to cervical dilation and effacement is known as ____ | true labor |
| irregular contractions without cervical change is known as ___ | false labor |
| the three important assessments obtained during a SVE are ____ | dilation, effacement, station |
| there are ___ stages of labor | 4 |
| the transition phase occurs at ____ | 8-10 cm dilated |
| the 5 P's of labor are ___ | powers passage position passenger psyche |
| a non-invasive obstetric technique that uses a device on the maternal abdomen to produce sound/vibration, inducing a fetal startle reflex or heart rate acceleration is known as ____ | acoustic stimulation |
| speeding up the process after labor starts on its own is known as ____ | augmentation |
| inducing labor is known as ___ | induction |
| a woman who has had more than one pregnancy resulting in viable offspring is considered ___ | multipara |
| a woman who has never given birth to a live infant or a viable child, including cases of miscarriage or stillbirth is considered ___ | nullipara |
| a safe, non-invasive prenatal test used after 28 weeks gestation to check a baby's heart rate in response to their movement | non-stress test (NST) |
| a critical fibromuscular anchor point between the vagina/vulva and anus is known as the ___ | perineum |
| a woman who is giving birth for the first time is considered ____ | primipara |
| ___ is an increase in core body temperature | pyrexia |
| a condition where the enlarged pregnant uterus compresses the inferior vena cava and aorta while the patient is supine is known as ____ | vena cava syndrome |
| ___ is when the fetus presents head first with one arm up | compounding |
| ___ is when the fetus presents feet first | breech |
| __ is when the fetus is in a regular breech position | complete breech |
| ___ is when the fetus is crunched criss cross applesauce | frank breech |
| ___ is when the fetus has one leg protruding | single foot breech |
| an immediate need to deliver fetus (usually within 30 minutes) is known as an ____ c/s delivery | emergent |
| the need for rapid delivery of fetus, but patient and fetus are stable (within an hour to couple of hours) is known as a ___ c/s delivery | urgent |
| the need for delivery related to complications during labor (that shift or that day) is known as a ___ c/s delivery | non-urgent |
| TOLAC/VBAC | trial of labor after cesarean, vaginal labor after cesarean |
| analgesics are administered once ___ | cervical change has occurred |
| if an analgesic is given too early it can ___ | prolong labor |
| ___ can be used to reverse the side effects of respiratory depression in a newborn | narcan |
| ___ also known as "laughing gas", is inhaled into the bloodstream but does NOT affect the baby | nitrous oxide |
| ___ is injected into the perineum (usually lidocaine) to treat pain after a laceration/episiotomy | local anesthesia |
| ___ is injected into the pudendal nerve to numb the perineum usually used in the second stage of labor before delivery | pudendal block |
| ___ is injected into the epidural space used commonly for vaginal deliveries | epidural anesthesia |
| ___ is injected into the subarachnoid space, commonly used for c-sections | spinal anesthesia |
| ___ is an IV injection or inhalation that renders unconsciousness used mainly for emergency c-sections | general anesthesia |
| auscultation with a doppler, should be done every ___ minutes in the active first stage and every ___ minutes during the second stage | 30, 15 |
| normal FHR baseline is ___ | 110-160 |
| a ___ FHR pattern could be a sign of severe fetal anemia/RH immunization, placental abruption, fetal-maternal hemorrhage, fetal acidosis | sinusoidal |
| a ___ FHR pattern is BAD but could be due to thumb sucking, narcotic administration, and usually lasts less than 20 min | pseudosinusoidal |
| ___ are fluctuations within baseline based on oxygenation and CNS function | variability |
| ___ can be done to correct poor variability | O2 administration |
| ___ are abrupt to peak rise in less than 30 second intervals, lasting at least 15 seconds long | accelerations |
| accelerations indicate ___ | a well-oxygenated fetus |
| __ are abrupt decrease of less than 30 seconds to nadir | variables |
| variables indicate ___ | umbilical cord compression |
| ___ are a gradual decrease that mirrors the contraction peak | early decels |
| early decelerations indicate ___ | fetal head compression |
| a gradual decrease that occurs after the peak of the contraction and doesn't end until the start of the next contraction is known as ___ | late decels |
| late decelerations indicate ___ | uteroplacental insufficency |
| late decels are treated with ____ | POISON |
| is it essential to notify the ____ when FHR shows late decels | HCP, also document findings |
| the time from the beginning of one contraction to the beginning of the next contraction is known as the ____ | frequency |
| the time from the beginning of the contraction until relaxation is known as ____ | duration |
| the ____ is the strength of contractions (cannot be measured externally) | intensity |
| ___ is an external monitor used to measure the frequency and duration of contractions | toco |
| an external monitor used to measure FHR but is likely to pick up other sounds is known as a ___ | ultrasound transducer |
| ___ an internal monitor that can be used after ROM to measure the strength of contractions and add amnioinfusion PRN | IUPC |
| ___ an internal monitor that can accurately pick up FHR without artifact | fetal scalp electrode (FSE) |
| the acronym POISON stands for ___ | position changes oxygen delivery IVF bolus SVE oxytocin off notify HCP |
| a patient can be ___ if she is post-term gestation or if there are maternal/fetal comorbidities or concerns present | induced |
| a patient might be___ if there is insufficient uterine activity/dysfunction or prolonged ROM | augmented |
| foley bulbs, cook catheter, and dilapan are____ | mechanical devices used to promote cervical ripening |
| pharmacological medications that can be used to enhance cervical ripening are ____ and should not be used for ___ patients | cervidil and cytotec, TOLAC/VBAC |
| digital separation of the chorionic membrane from the wall of the cervix and lower uterine segment during an SVE to stimulate labor is known as ___ | sweeping/stripping of membranes |
| ___ is a way to artificially ROM using an amnihook and should only be done by HCP | amniotomy |
| ____ involves using warm sterile saline or LR solution into the uterus through an IUPC that is used to relieve cord compression and thin meconium in fluid | amnioinfusion |
| ____ the most common induction agent that is considered a high risk medication when used during IP because it can cause tachysystole and lead to fetal distress | pitocin |
| rapid labor or birth that lasts less than 3 hours from onset is known as a ____ | precipitous labor |
| more than 20 hours for first time pregnancy or more than 14 after previous pregnancy is known as a ___ | prolonged labor |
| ____ is when the pelvis is small or abnormal causing delayed descent of the fetal head | cephalopelvic disproportion (CPD) |
| a ___ is done by the HCP to turn the fetus using external manipulation | external cephalic version (ECV) |
| a ____ can be done if the fetus is breech/shoulder/transverse presentation 36 weeks of gestation or greater NST reactive breech is not engaged | ECV |
| a ____ delivery is when a vacuum cup is applied to the fetal head with negative pressure and should only be attempted 3 times before going or the OR for a c-section | vacuum assisted |
| a fetus has to be at least ___ weeks gestation in order to perform and operative vaginal delivery | 34 |
| a ___ delivery is when forceps blades are placed over the parietal lobes of the newborn | forceps assisted |
| greater than 42 weeks of gestation is known as a ____ | post-term pregnancy |
| if a stillborn is less than 28 weeks gestation, labor should be induced using ____ | misoprostol |
| ___ is an intraamniotic infection | chorio |
| ___ is an emergency due to the difficulty in delivering the shoulders secondary to the anterior shoulder becoming impacted on the pelvic rim | shoulder dystocia |
| immediate retraction of the fetal head against the perineum after extension, known as the ____ | "turtle sign" |
| during a shoulder dystocia, the HCP has ___ minutes to deliver the newborn before going to the OR for an emergency c-section | 5 minutes |
| episiotomy woods screw maneuver deliver posterior arm break anterior clavicle zavanelli are all ways for the ___ to fix a shoulder dystocia | HCP |
| mcroberts position gaskins position straight cath suprapubic pressure are all ways for the ___ to fix a shoulder dystocia | nurse |
| an emergency when the umbilical cord lies between or bedside the presenting part which compresses blood flow to the infant is known as an ____ | umbilical cord prolapse |
| an emergency where abnormal fetal blood vessels run through the fetal membranes over or near the cervical opening is known as ____ | vasa previa |
| an emergency due to the laceration of the uterine walls tearing and extending to uterine vessels leading to hemorrhage | uterine rupture |
| direct opening from uterine cavity to peritoneal cavity is known as___ | complete uterine rupture |
| rupture to peritoneum lining, but not through the uterus is known as ____ | incomplete uterine rupture |
| partial separation of an old uterine scar is known as ____ | dehiscience |
| a very rare emergency where a small tear in amnion or chorion causes a small amount of amniotic fluid to leak into the chorionic plate and enter the circulatory system is known as an ____ | amniotic fluid embolism (AFE) |
| regular contractions to full dilation (10cm) is considered the ___ stage of labor | 1st |
| full dilation to the delivery of the infant occurs during the ___ stage of labor | 2nd |
| delivery of the placenta occurs during the ___ stage of labor | 3rd |
| postpartum (1-4 hours after delivery) is considered the ___ stage of labor | 4th |
| APGAR scores are tested at ___ and ___ | 1, 5 minutes, again at 10 minutes if abnormal |
| a 7+ APGAR score is ____ | reassuring |
| a 4-6 APGAR score requires ____ | reassessment |
| a 3 or less APGAR score likely requires ____ | resuscitation measures |
| ___ is an opioid used for moderate-to-severe pain management | nubain |
| ___ a narcotic analgesic used for short-term relief of moderate-to-severe pain | stadol |
| is ___ an opioid analgesic sometimes used for pain management during labor | demerol |
| fetal tachycardia is commonly due to ___ | maternal fever |
| a women that is 0-5 cm dilated effacement < 80% contractions that become strong and more regular over time patient is receptive to education, praise, and support remains mobile and talks between contractions is in the ___ stage of labor | 1st latent |
| a women who is 6-10 cm dilated regular contractions every 2-5 min effacement > 80% experiencing nausea/vomiting tremble diaphoretic have a strong urge to bear down/push is in the ___ stage of labor | 1st active |
| full dilation (10cm) to delivery of the infant is known as the ___ stage of labor | 2nd |
| when a women is fully dilated but not yet pushing she is in the ___ stage of labor | 2nd latent |
| when a women is fully dilated and actively pushing, she is in the ___ stage of labor | 2nd active |
| delivery of the infant to delivery of the placenta is known as the ___ stage of labor | 3rd |
| the placenta should be delivered within ____ minutes or less | 30 |
| the placenta is a ___ vessel cord | 3 (2 arteries, 1 vein) |
| delivery of the placenta to 1-4 hours after delivery is known as the ___ stage of labor | 4th |
| maternal or fetal health conditions malpresentation of the fetus maternal request could all warrant a ___ delivery | c/s |
| an umbilical cord prolapse uterine rupture vasa previa rupture category III FHR would all warrant an ___ c/s delivery | emergent |
| TOLAC/VBAC patients are at risk for ____ | uterine rupture |
| if an analgesic is given too late it can cause ___ | respiratory depression to the newborn |
| these drugs can cause drowsiness dizziness fainting hypotension nausea/vomiting urinary retention respiratoy depression | narcotics |
| the most common side effect of epidural and spinal anesthesia is ___ | hypotension |
| the best way to prevent hypotension from epidural anesthesia is to ___ | preload with IV fluids |
| ____ anesthesia puts patients at risk for fetal depression, uterine relaxation, and maternal vomiting/aspiration | general |
| ____ detects changes in FHR/status during labor and prompts treatment for underlying issues` | FHR monitor |
| for patients with risk factors, auscultation with a doppler, should be done every ___ minutes in the active first stage and every ____ minutes during the second | 15, 5 |
| internal monitors can be used once ___ has occurred | ROM |
| ___ changes are associated with uterine contractions | periodic |
| ___ changes are NOT associated with uterine contractions | episodic |
| variables are treated with ____ | position changes or amnioinfusion |
| the mnemonic VEAL CHOP stands for ___ | V: variables C: cord compression E: early decels H: head compression A: accelerations O: oxygenation L: late decels P: placental insufficiency |
| FHR 110-160 moderate variability absence of variables or late decels accels present or absent early decels present or absent would indicate a category ___ FHR and is ____ | 1, reassuring |
| bradycardia, tachycardia minimal or absent variability without decels lack of acels with stimuli episodic decels lasting greater than 2 min recurrent lates moderate variability variable decels would indicate a category ___ FHR and should be ____ | 2, monitored |
| absent variability with late decels variable decels bradycardia sinusoidal pattern would indicate a category ___ FHR and should be ___ | III, fixed or deliver within 30 min |
| ___ are measured with palpation and electronic monitoring | contractions |
| lacerations PPH bladder trauma cephalohematoma are risk during a ____ assisted delivery | vacuum |
| vaginal/cervical lacerations PPH perineal hematoma bladder trauma facial bruising/lacerations nerve palsy ocular trauma are risk during a ___ assisted delivery | forceps |
| a fetus that is greater than 42 weeks gestation is at an increased risk for ___ because the placenta starts to ____ | stillbirth, calcify |
| ____ increases the risk for complications, including preterm birth, preeclampsia, and PPH | multiple gestations |
| fetal tachycardia maternal WBC > 15,000 purulent fluid from the cervical opening cloudy, yellow, thick discharge from the cervical opening positive for bacteria in amniotic fluid are signs of ___ | chorio |
| an emergency when the umbilical cord lies between or bedside the presenting part which compresses blood flow to the infant | umbilical cord prolapse |
| mom reports that something "gives way" sharp pain in the lower abdomen contractions cease, mom becomes anxious tachycardia shakiness blood loss FHR bradycardia or absent fetal parts can be felt on palpation are signs of ____ | uterine rupture |
| dyspnea hypotention cyanosis cardiac arrest hemorrhagic shock impending sense of doom are signs of ___ | amniotic fluid embolism (AFE) |
Created by:
gnitti
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