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What is fetal attitude It is the relationship of the various parts of the fetal body to one another in utero
What is the chararacteristic uterine posture? It is one of uterine flexion
What is fetal lie? It is the relationship of the fetal axis to the maternal site
What is longitudinal lie? The long axis of the fetal body is parallel to the long axis of the maternal body
What is transverse lie? The long axis of the fetal body is parallel to the long axis of the maternal body
What are assessments of fetal position? Station and engagement
What is engagement? The presenting part has descended into the maternal pelvis to the level where its widest,the largest diameter has reached or passed through the pelvic inlet. The presenting part has reach the level of the ischial spines--0 station
What is station? This refers to the relationhip of the presenting part to an imaginary line drawn between the ischial spines of the maternal pelvis
What is position? This is the relationship of the landmark on the presenting part to a specific part of the maternal pelvis
What is floating? This is when the presenting part of the body is freely moveable above the pelvic inlet
What are the two most important signs of true labor? They are cervical dilatation and effacement?
What is effacement? It is the thinning and shortening of the cervix. It is measured in percentages
What is dilation ? It is the opening of the cervix. Full dilation is expressed in cm --10cms is fully dilated
The presenting part can appear in three categories . What are these categories They are cephalic, breech, and shoulder
How to assess the duration of contractions? From the begining of to the end of each contraction
When is the best time to assess Vital signs when a patient is in labor? Between contractions. Because during a contraction maternal cirulating blood volume increases
What do cervical ripening agents do? Ripening refers to the softening of the cervix - a process that involves the cervix progressing from a firm and closed opening to a softened, effaced (thinned) and often dilated opening.
Name several ripening agents? Prostaglandin E2, Cytotec, Laminaria tents
How does the Bishop score work? Evaluates the cervix in relationship to successful induction. This scoring system attempts to predict success of induction by assessing five factors: position of the cervix in relation to the vagina, cervical consistency, dilation, effacement, station
Which pelvis is has round adequate diameters andwith long and transverse A/P Diameters? Gynecoid
Android pelvis has short A/P diameter and and a heart shape inlet. What are the implications for birth? There is slow descent and possible arrest of labor. May need operative birth
What is the goal in teaching childbirth education classess? To help clients to know what to expect in labor
What is cephalopelvic disproportion? The pelvic size is too small to allow the descent and passage of the fetal head
What is dystocia? This is difficult labor caused by factors of the pelvis,fetus,or abnormal or uncoordinated uterine contractions
What is malposiiton? Abnormal position of the presenting part of the fetus in relationship to the maternal pelvis, (it is a position other than flexed fetal head in AOP )
What does Leopold Maneuvers involve? External palpation of the client's uterus to determine the number of fetuses, presenting part,lie, and attitude and amount of descent and to ausculte FHR
What are early signs of Magnesium Toxcity? Hot all over , flushing , thirsty, sweaty, depression of relfexes, hyotension, flaccidity
At what levels of Magnesium does absence or decrease in the patellar reflexes occur? 7mg/liter -10 mg/liter
Are fibrin split products present in HELLP? Yes
what is molding? This occurs when the fetus adapts to the size and shape of the pelvis during labor
What are the classic symptoms of PIH? Hypertension,edema,and proteinuria
In what stage of labor should the client use the "pant-blow" method of breathing? The active Phase
What is station? It is the relationsip of the presenting part to an imaginary line drawn between the ischial spines of the maternal pelvis
The two most importaqnt signs of true labor are? Cervical dilation and effacement
What is the normal biophysical score range? The normal biophysical range is 8 to 10 if the amniotic fluid volume is adequate
what is the primary reason for evaluating afp levels in pregnancy? Neural tube defect. An open neural tube allows a high level of AFP to seep into amniotic fluid
what nursing instruction should the client having an ultrasound in the second trimester receive? Need to drink 1 to 2 quarts of water so as to have a full bladder
Why would an amniocentesis be done on a third trimester pregnant client? to determine fetal lung maturity
what should nursing care include after an amniocentesis? Monitor uterine activity - Risk with amniocentesis is the onset of spontaneous contractions
why would one iniitate contractions in a contraction stress test? The CST involves recording the response of the fetal heart rate to stress induced by uterine contractions
Can anxiety affect pain during labor? Yes. Anxiety affects a women's perception of pain . Tension during labor causes tightening of abdominal muscles,impeding contractions and increasing pain by stimulating nerve fibers.
What is the value of a birth plan? The birth plan helps the woman and her partner look at available options and to plan the birth experience to meet their needs
How can a woman decrease the amount of pain during labor? By trying to relax. Relaxation will help the contractions to be more effective and the labor less painful
What is neuromuscular dissociation? Neuormuscular dissociation helps the woman learn to relax her body even when one group of muscles is strongly contracted
Why is Magnesium sulfate an anticonvulsant? It acts by blocking neuromuscular transmission and depresses the CNS to control seizure activity
What assessment should be avoided if you are caring for a woman with HELLP? Abdominal palpation could resuilt in a sudden increase in intraabdominal pressure leading to the rupture of the subcapsular hematoma
What happens to the insulin requirements for an insulin dependenet diabetic who has just given birth? Drops signficantly
Which test gives the best idea of the control of diabetes during pregnancy? Glycosated hemoglobin
What is macrosomia? Excessively large body of infants of diabetic mothers (usually experience high levels of glucose in utero)
These movements represent the normal adaptation of the fetus to the maternal pelvis and facilitate vaginal birth. The cardinal movements of labor
What are the cardinal movements of labor They are engagement,descent,flexion,internal rotation,extension,restitution,external rotation and expulsion
A client with an android pelvis is at increase risk for? Prolonged labor
Why are we concenrned when a client with PIH has a svere headache and visual changes? Indicates a worsening of PIH and impending convulsions
What is the frequency of contractions? From the begining of one contraction to the begining of the next
What is the duration of contractions? The length of each contraction from beginning to end
When does engagement occur When the presenting part enters the pelvic inlet
Multiparous women have shorter labor than do nulliparous women . True or False true
Why is continous fetal monitoring used when oxytocin is administered The uterus may contract more firmly and the resting tone may be increased with oxytocin . This may compromised uteroplacental exchange
How should a woman with pih be monitored ? With continous fetal monitoring because maternal hypertension may reduce placental blood flow through vasospasm of the spiral arteries
When can apply internal monitoring devices? When the membranes are ruptured. Cervical dilation of 4 cm would permit the insertion of fetal scalp electrodes and the intrauterine catheter
What is a late deceleration? Begins near the acme of the contraction and continues well beyond the end of the contraction. It indicates uteroplacental insufficiency
What causes variable deceleration? cord compression
This is a slowing of the FHR early in the contraction. It mirrors contractions and indicates head compression. It an early decelerations
What is the normal fetal heart rate range ? 120 to 160 beats per minute
What causes a transient decrease in FHR before ,during,and after a contraction Variabe deceleration
The fetal positon is described by a series of letters. The first letter in the series denotes which of the following? The side of the maternal pelvis
What is characteristic of true Labor? Contractions occur at regular intervals and are not intensified by walking
What can measure actual uterine pressure? An intrauterine pressure catheter
What is the nurse's responsibility in fetal monitoring? Teach the woman and her support person about the monitoring equipment and to discuss any questions that they may have
How can a client decrease complications when diabetes impacts the pregnancy? By maintaining normal blood glucose control before and during the pregnancy
What can a pregnant woman eat when expewreincing hypoglycemia? Have crackers and milk
The neonate of a diabetic mother is at risk for _________after birth Hypoglycemia
What is the best position for the client post epidural or spinal anesthesia? Semi-Fowler's
What type of precautions are used in the delivery room? Blood and body fluids
What is an important intervention in the latent phase of labor? Encourage her to get out of bed and walk . Gravity will aid in descent
What is the first sign of Magnesium toxicity in apregnant women? Decreased DTRs
What is clonus? It is fasciculations after dorsiflexion
What is the priority if a pregnant woman has a seizure? Turn to left side --it will help oxygenate the baby and keep the mother's airway patent
The lecithin -sphingomyelin ratio is ? It indicates the lungs have the correct glycoproteins to produce surfactants
The placental hormones that cause insulin resistance are_________ and____________ Human placental lactogen and somatotropin
HbA1C is an average measurement of glucose over the past_________days 120 days
This is _________the artficial rupture of membranes? Amniotomy
What is an episiotomy? This is an incision through the perineal body to facilitate delivery by enlarging the vaginal orifice
During this pahse contractions are strong 2 to 3 minutes apart and the cervix is 8 to 10cms Transition
This gives perineal anesthesia of short duration. Does not cause CNS depression in the fetus. Pudenal block
This anesthesia is given in the first and second stage of labor and can be administered at dilation of 4 to 6 cms Epidural
What chapters are for the test 10,11,12,14,15,16 and parts of 25 and 26
If the ischial spine are o station then the crowning is +3
What are the instulin needs during the pregnancy of a diabetic mother? Insulin needs vary according to stage of gestation.. Insulin needs decrease during the first trimester ,when nausea ,vomiting ,and anorexia are a factor. They increase during the second and rthird trimesters, when pregnancy hormones create insulin resista
Would should be included in the plan of care for the woman with heart disease who is in labor? She will need continuous monitoring of cardiac rhythm
Should a woman with a history of drug abuse be screened again for hepattis B? Yes during the third trimester
What happens if a woman has excessive paind uring labor? Excessive pain activates the stres sresponse and may result in decrease placental perfusion
Why should a narctoic be given to a laboring woman at the begining of a contraction ? Less medication will be transferred to the fetus
How can yo improve placental blood flow immediately after a Painmedication injection during labor? Place awedge under the woman's righ hip
What are the 4 "p"s during labor ???? Powers, passge ,passenger, psyche
What factors influence a woman's experience of pain? Culture ,anxiety and fear, previous experience with pain, prepartion for child birth and support systems
What assessment indicate hemorrhage in th eearly postpartum patients? An elevated pulse rate
Multiparous women have shorter labors than do nulliparous women. True or False True
How frequently should the FHR be check in the active phase of labor? Every 30 minutes 15 minutes if the fetus was high risk
What is apgar score?? ???
This is similar to an early deceleration. It causes urteroplacental insufficiency but begins near the acme of the contraction? What is late decleration
What are evidence of norma infant attachment after delivery? The motyher touches the infant and talks softly to the infant
LAD coronary artery innervates? L Anterial wall of L Ventricle
Circumflex coronary artery innervateS? Blood to Lateral Left Ventricle
When does the heart feed itself? DIASTOLE
Right coronary artery innervates? R Ventricle and inferior L Ventricle
Where are Coronary Arteries? From the Base of Aorta, epicardial surface, dive into myocardium
Phase 4 (transmembrane potential -90) heart at rest (negative charge)
Phase 0 QRS Na+ moves into, K+ moves out of cell, (depolarization)
Phase 1 & 2-(early repolarization, Plateau) ST segment Ca+ ventricular contraction
Phase 3 (rapid repolarization) T wave Na+ out, K+ pump in (repolarization)
Created by: bdragich1