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Birthing Process
| Question | Answer |
|---|---|
| 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
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