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Birthing Process

QuestionAnswer
found in cat feces of cats who live outside and hunt birds and mice with parasite toxoplasmosis
how is toxoplasmosis transmitted hand to mouth
you can get toxoplasmosis by eating what raw meat of sheep/cattle
associated with pre-term births hepatitis B
if this if + on culture at time of delivery cannot deliver vaginally Gonorrhea
may be asymptomatic Hep B
how do we treat infants that have been delivered to + gonorrhea on mom treat with erythromycin ointment to prevent blindness
If baby has been treated with the erythromycin ointment and is at further risk what is it treated with also erythromycin syrup
with hep B infants are most commonly infected at birth w/mom secretions but fetuses can also be infected thru what placenta
if mom is on VDRL, RPR or serology what can this cause congenital syphilis
when do we need to treat mom for this and if we don't what can this lead to of the fetus 1st 20 weeks - if not treated can lead to abortion or stillborn
if syphilis is treated after the 1st 20 weeks then this can cause changes in what placenta, liver, spleen, kidney, adrenal glands, bone covering and marrow, CNS, teeth, cornea (congenital cataracts)
if mom was treated and newborn is born how often do we need to ck antibody level every 2 weeks for 3 months
what is the usual tx for syphilis pcn
which infection is usually treated with pyrimethamine (teratogenic) and sulfonamindes (which may cause kernicterus and need for exchange) toxoplasmosis
how is toxoplasmosis usually dx with elevated IgM in cord blood
which infection causes serious perinatal mortality and morbidity; mental retardatin, severs psychomotor problems and visual problems, preterm birth, IUGR, microcephaly, hydrocephaly toxoplasmosis
which infection can cause opthalmia neonatorum, neonatal gonococcal arthritis, septicemia meningitis, vaginitis and scalp abscesses Gonorrhea
for rubella mom should have titer of what value >1:8
if baby is infected with congenital rubella is this usually seen at birth it may not be seen at birth but later on
what is the most common concern with rubella hearing loss-congenital cataracts, CV and IUGR
an intracellular bacterium causes neonatal conjunctivitis and pneumonia chlamydia
what do we tx chlamydia with erythromycin ointment
if the chlamydia is chronic how do we tx with the erythromycin ointment for 2-3 weeks
infants who are at further risk - how are they treated for chlamydia with oral erythromycin syrup
which infection is the common cause of neonatal sepsis and meningitis in the US Group B Strep
how soon before delivery if mom is + on culture for group B strep should we tx want 6hrs tx before delivery
if a baby is infected with HIV at birth do we usually see s/s no usually seen 3-6 months
what may we seen in the 1st year FTT or developmental delays
an infection which is from a virus found in the environment CMV
if CMV is not seen at birth what may be seen later on in infant hearing and learning disabilities
how is CMV transmitted thru breast milk
if mom is HIV + and is treated with meds this can reduce incidence of Nbn developing to what % <3%
is HIV transmitted thru breast milk yes-also thru placenta and maternal blood and secretion (20-35% of transmission)
which infection is transmitted thru placenta or ascends by way of birth canal; direct contamination from personnel, significant other, family etc Herpes simplex virus
when does transmission usually occur from mom to fetus at ROM
if mom is identified early with having herpes and has active lesions when do we need to deliver prior to ROM
what do we treat herpes with antiviral meds
if mom has hepatitis B when should the nbn be treated and with what should be treated with hep B immune globulin (HBIG) asap or w/in 12 hrs
what else is nbn usually treated with hep vaccine
where is the hep vaccine usually given in a different spot than the HBIG
when is a 2nd dose due of the hep vaccine @1 month
when is the 3rd dose due of the hep vaccine @6 months
in 1988 CDC recommended all preg women to be tested for what Hepatitis B
The 4 P's of the birth process Power, Passage, Passenger, and Psyche
Powers uterine contractions, maternal pushing
Passage bony pelvis, soft tissue
Passenger fetus, fetal head
Psyche expectations of birthing process tend to have longer labors if anxious or high anxiety
effacement thinning of cervix %
dilation opening of the cervix in cm
Phases of contractions increment, peak, decrement
Increment period of increasing strength
Peak period of greatest strength
decrement period of decreasing strength
10cm COMPLETE (no longer palpable)
frequency beginning of one contraction, to the beginning of another
Duration beginning of a contraction until the end of the same contraction. <90sec
tetonic contraction >90sec (slowing blood flow to the fetus, baby lacks oxygen and become stressed)
Intensity strenght of contraction
Interval (recovery time) amount of time uterus relaxes between contractions
TRUE LABOR while walking contractions become more intense
maternal pushing only push when fully dilated to prevent problems to the pelvis and the muscle
molding bones overlapping in the head during the birth process
fetal lie determine a vaginal delivery or not. how the baby lays inside the mothers uterus.
longitudinal lie the baby lies up and down-parallel spine
transverse Lie the baby lies crosswise in the uterus-shoulder tries to come out first
Oblique Lie the baby lies diagonal in the uterus (/)
Breech BUTT first
Vertex head fully flexed
military niether flexed or extended
brow partially extended- head partially back
face head is fully extended 9head all the way back)
Frank breech legs extended toward the shoulder
Complete breech butt first with flexion of head and extremities. baby sitting cross legged
footling Breech one foot dangling
Double footling Breech both feet dangling
Attitude normal one of flexion- chin on their chest-well flexed best for birth
Engaged largest diameter of baby is at both the ischial spines
Early deceleration of FHR FHR slows when contraction occurs
Late deceleration of FHR BAD---looks like early deceleration, dip doesn't stop until contraction is over. uterol-plcental diffiency due to baby being stressed.
Variable deceleration of FHR up, down, up, down pattern of FHR, cord compression, shut off oxytocin. C-section if FHR tones go down
Accerlerations of FHR GOOD viable baby
Dilation and effecement onset of contraction, ends with complete cervical dilation
Latent Phase dilation of cervix 0-3cm
Active Phase dilation of the cervix 4-7cm. more intent and INTENSE. too late to stop labor, able to recieve narcotic now
transition dilation of the cervix 8-10cm. sweat on upper lip, very uncomfortable.
Stage 2 10cm (complete) --to-- birth. voluntary contractions, mom is able to push baby out
Stage 3 Birth --to-- Delivery of the placenta (norm 20-30min)
Stage 4 highest risk for hemmorhage. blood loss is usually 250ml-500ml. mom may experience chills
epidural block above the dura-anesthiesiologist cause hypotension. monitor B/P keep bladder empty
Spinal block spinal anesthetic, just below the breasts on down for a C-section, cannot move legs or toes until it wears off, may have decreased sensation to bladder.
Intrathecal block remain in a better ability to push
local infiltration episiotomy--used to stitch up, relieve pain
Pudendal block anesthetic on both sides of the cervix-makes pain and contractions go away, able to push tho
General anesthesia Used for crash c-section, baby's heart tones go down drastically (60's) baby is out immediately. <1min. medicine relaxes uterus, can reach in and pull placenta out
Narcan given to reverse respiatory depression caused from an opiate
Induction stimulation of uterine contractions before they begin spontaneously
Augmentation stimulation of contractions after spontaneously beginning but with unsatisfactory progress (dilation doesn't increase)
Induction via Amniotomy artificial rupture of membranes
Oxytocin (Pitocin) given to induce the labor
prolapsed cord the umbilical cord drops (prolapses) through the open cervix into the vagina ahead of the baby.
Care of the infant Airway Breathing Ciculation warmth
Apgar Score 1.mother's B/P before admin of oxytocic med 2 .fundus firm, midline, below umbilicus 3. maternity/vaginal pads are applied 4. mother and infant allowed to bond
The 4 P's of the birth process Power, Passage, Passenger, and Psyche
Powers uterine contractions, maternal pushing
Passage bony pelvis, soft tissue
Passenger fetus, fetal head
Psyche expectations of birthing process tend to have longer labors if anxious or high anxiety
effacement thinning of cervix %
dilation opening of the cervix in cm
Phases of contractions increment, peak, decrement
Increment period of increasing strength
Peak period of greatest strength
decrement period of decreasing strength
10cm COMPLETE (no longer palpable)
frequency beginning of one contraction, to the beginning of another
Duration beginning of a contraction until the end of the same contraction. <90sec
tetonic contraction >90sec (slowing blood flow to the fetus, baby lacks oxygen and become stressed)
Intensity strenght of contraction
Interval (recovery time) amount of time uterus relaxes between contractions
TRUE LABOR while walking contractions become more intense
maternal pushing only push when fully dilated to prevent problems to the pelvis and the muscle
molding bones overlapping in the head during the birth process
fetal lie determine a vaginal delivery or not. how the baby lays inside the mothers uterus.
longitudinal lie the baby lies up and down-parallel spine
transverse Lie the baby lies crosswise in the uterus-shoulder tries to come out first
Oblique Lie the baby lies diagonal in the uterus (/)
Breech BUTT first
Vertex head fully flexed
military niether flexed or extended
brow partially extended- head partially back
face head is fully extended 9head all the way back)
Frank breech legs extended toward the shoulder
Complete breech butt first with flexion of head and extremities. baby sitting cross legged
footling Breech one foot dangling
Double footling Breech both feet dangling
Attitude normal one of flexion- chin on their chest-well flexed best for birth
Engaged largest diameter of baby is at both the ischial spines
Early deceleration of FHR FHR slows when contraction occurs
Late deceleration of FHR BAD---looks like early deceleration, dip doesn't stop until contraction is over. uterol-plcental diffiency due to baby being stressed.
Variable deceleration of FHR up, down, up, down pattern of FHR, cord compression, shut off oxytocin. C-section if FHR tones go down
Accerlerations of FHR GOOD viable baby
First Stage of Labor
Dilation and effecement onset of contraction, ends with complete cervical dilation
Latent Phase dilation of cervix 0-3cm
Active Phase dilation of the cervix 4-7cm. more intent and INTENSE. too late to stop labor, able to recieve narcotic now
transition dilation of the cervix 8-10cm. sweat on upper lip, very uncomfortable.
Stage 2 10cm (complete) --to-- birth. voluntary contractions, mom is able to push baby out
Stage 3 Birth --to-- Delivery of the placenta (norm 20-30min)
Stage 4 highest risk for hemmorhage. blood loss is usually 250ml-500ml. mom may experience chills
epidural block above the dura-anesthiesiologist cause hypotension. monitor B/P keep bladder empty
Spinal block spinal anesthetic, just below the breasts on down for a C-section, cannot move legs or toes until it wears off, may have decreased sensation to bladder.
Intrathecal block remain in a better ability to push
local infiltration episiotomy--used to stitch up, relieve pain
Pudendal block anesthetic on both sides of the cervix-makes pain and contractions go away, able to push tho
General anesthesia Used for crash c-section, baby's heart tones go down drastically (60's) baby is out immediately. <1min. medicine relaxes uterus, can reach in and pull placenta out
Narcan given to reverse respiatory depression caused from an opiate
Induction stimulation of uterine contractions before they begin spontaneously
Augmentation stimulation of contractions after spontaneously beginning but with unsatisfactory progress (dilation doesn't increase)
Induction via Amniotomy artificial rupture of membranes
Oxytocin (Pitocin) given to induce the labor
prolapsed cord the umbilical cord drops (prolapses) through the open cervix into the vagina ahead of the baby.
Care of the infant Airway Breathing Ciculation warmth
Apgar Score 1.mother's B/P before admin of oxytocic med 2.fundus firm, midline, below umbilicus 3.maternity/vaginal pads are applied 4.mother and infant allowed to bond
Created by: SGT.MOSS