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107 Ch. 19 & 23
Labor and Birth at Risk
| Question | Answer |
|---|---|
| what is preterm labor | preterm labor: 20-37wks preterm birth: up to 37 wks, length of gestation, not wt term: 38-42 postterm: past 42 |
| what is considered low birth wt | <2500g or less |
| What are two main predictors for preterm birth | Fetal fibronectins - b/n 24-34wks salivary estriol Endocervical length |
| Causes of preterm labor | infections (oral hygiene), turning(version), demographic factors |
| what is most important nursing prevention for preterm birth | education about early symptoms |
| what are main early signs for preterm labor | gestational age b/n 20-37wks uterine activity cervical changes: 80%/>2cm dilation |
| what are tocolytics used for and examples of common ones | stop contractions Terbutaline(Brethine) Mg Sulfate(most common) |
| what do you give to mature young preterm lungs in preterm labor | glucorticoids, not good for cord prolapse, chorioamnionitis, abruptio placentae |
| what is difference b/n PROM and PPROM | PROM: premature rupture of membranes before 1 hr of labor PPROM: before 37 wks, can be inf. |
| what is dystocia | long difficult, abnormal labor from dilation, effacement, descent |
| what is dysfunctional labor | abnormal uterine contracitons prevent progress. Those at incr risk: body build,malposition (op), malpresentation(breech), CPD(diabetic), over on oxytocin, mom tired, epidural b4 time, hyper/hypotonic uterine tone |
| what is precipitous labor | lasts less than 3 hrs from onset |
| what is version | turn baby in utero to head down. Risks: labor, abrupt placentae(have C-section ready) |
| what is a prostaglandin do | ripens cervix, Cytotec |
| what is an amniotomy | artificial breaking of H2O |
| How should pitocin be given or never given | always on pump, PB, never primary adn always with NS or LR |
| what are prerequisites for vacuum assisted birth | vertex presentation, ruptured membranes, absence of CPD(diabetic big baby) |
| Which incision for c-section can't do a VBAC | vertical thru uterus - classical |
| what are risks for postterm birth | dysfx labor, birth canal trauma, more interventions, lg infant(macrosomia), shoulder dystocia, aging placenta |
| what is normal blood loss for vag/C-section? If more, what is that called | vag: 500ml C-section: 1000ml PPH: postpartem hemorrhage: leading cause of mom death, VS q15min, fundal massage |
| what is the McRobert's maneuver | open pelvis for shoulder dystocia |
| what are two kinds of prolapse cord | occult(hidden): compressed up high, complete Cause variable compressions TX: Trendelenberg/knee-chest pos |
| Some OB emergencies | Amniotic fluid embolism, rupture of uterus |
| Risk Factors for hemorrhage | uterine atony: boggy soft uterus, hypotenia lacerations of genital, hematomas, retained placenta, inversion/subinvolution of uterus |
| What drug helps uterus to contract if oxytocin doesn't | Methergine by IM only, not for HTN |
| what is tx for hemorrhaging | replace fluids S/S: not show til 30-40% loss of blood, tachy then brady, clammy |
| What is idiopathic thrombocytopenic purpura | low platelets, leads to DIC (disseminated intravascular coagulation) clotting then bleed out |
| what is puerperal sepsis and other infections postpartum | infection in canal in 28 days of abortion or birth, endometritis, wound inf, UTI, mastitis |
| What are things that happen after childbirth | incontinence cystocele: bladder goes into vag rectocele: rectum goes into vag wall..Tx: Pessary Fistulas: vesicovag, urethrovag, rectovag |
| Psychological postpartum complications | baby blues, depression, psychosis(emergency) |
Created by:
palmerag
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