Intrapartum-Zuck
Help!
|
|
||||
|---|---|---|---|---|---|
| Anesthesia | abolition of pain perception (with or without loss of consciousness)
🗑
|
||||
| Analgesia | alleviation of pain sensation or raising of pain
🗑
|
||||
| Pudendal block | anesthesia that eliminates pain in vagina, vulva and perineum, used episiotomy, birth and assisted birth
🗑
|
||||
| Local anethesia | used for perineal anesthesia for performing and repairing episiotomy
🗑
|
||||
| Epidural block | relief of pain from uterine contractions and birth by injection into the dura space
🗑
|
||||
| Spinal block | single dose injection into subarachnoid for pain control during birth, rather than labor
🗑
|
||||
| Narcan | drug that reverses the effects of opiods, prompt onset lasts 1-4hrs, metabolized liver
🗑
|
||||
| Tocolytic | medication used for relaxation of uterine muscles
🗑
|
||||
| Blood Patch | method to repair a tear in dura mater around spinal cord as a result of spinal anethesia
🗑
|
||||
| Glucocorticoid (Dexamethasone, Betamethasone) | medication used to stimulate fetal lung maturity, 24-34 weeks
🗑
|
||||
| Duramorph | addition to thecal anethesia to prolong pain relief, no narcotics for 18 hrs, monitor HR, RR, pulse ox q 30 min-1hr for 24hrs
🗑
|
||||
| Ritodrine (Yutopar) | Beta adrenergic agonist-IV to suppress contractions
🗑
|
||||
| Terbutaline (Brethine) | Beta adrenergic agonist-subq using syringe or pump, SE-tachy, dyspnea, hyperglycemia
🗑
|
||||
| Nifedipine (Procardia) | Ca channel blocker relax smooth muscle-sublingual then oral
🗑
|
||||
| Magnesium Sulfate | CNS depressant preterm labor-IV relax smooth muscle
🗑
|
||||
| Indomethacin | NSAID relaxes smooth muscles by prostaglandin inhibition, rectal or oral
🗑
|
||||
| Prostaglandin | used to ripen cervix or stimulate contractions
🗑
|
||||
| Dinoprostone (Cervidil) | vaginal insert posterior fornix of vagina-prostaglandin
🗑
|
||||
| Dinoprostone (Prepidil) | gel inserted cervix below internal os-prostaglandin
🗑
|
||||
| Oxytocin (Pitocin) | hormone used to stimulate uterine contractions to augment or induce labor
🗑
|
||||
| Laminaria tent | natural cervical dilator made from seaweed
🗑
|
||||
| Misoprostol (Cytotec) | oral tablet or intravaginal ripening agent
🗑
|
||||
| Baseline FHR | 110-160 beats/min during 10 minutes excluding periodic and episodic
🗑
|
||||
| Undetected variability | absence of expected irregular fluctuations in FHR
🗑
|
||||
| Bradycardia | FHR below 110/min longer than 10 min
🗑
|
||||
| Prolonged deceleration | decrease in FHR of 15/min below baseline lasts more than 10 min
🗑
|
||||
| Periodic changes | occur with contractions
🗑
|
||||
| Tachycardia | FHR above 160/min longer than 10 min
🗑
|
||||
| Variability | Exprected irregular fluctuations of baseline (2 or more/min)
🗑
|
||||
| Early deceleration | FHR decrease after onset of contraction-fetal head compression-GOOD
🗑
|
||||
| Late deceleration | FHR decrease after peak of contraction-UPI-Nonreassuring
🗑
|
||||
| Variable deceleration | FHR decrease any time during contraction-umbilical cord compression
🗑
|
||||
| Acceleration | increase FHR 15/min or more, last 15 sec but shorter than 2 min
🗑
|
||||
| Episodic | FHR changes not associated with contractions (movement etc)
🗑
|
||||
| Duration | start to finish of contraction
🗑
|
||||
| Frequency | peak to peak or start to start of contraction
🗑
|
||||
| Resting time | time between contractions
🗑
|
||||
| Acme | peak or intesity of contraction, mmHG, 35=mild, 50=mod, 75=strong
🗑
|
||||
| Normal resting tone | 8-15mmHG
🗑
|
||||
| Amniotomy | artificial rupture of membranes, check FHR, cord compression or prolapse
🗑
|
||||
| External version | External manipulation to turn fetus from unfavorable lie or presenting part, risks-cord compression, injury, placenta bleed, uterine tear/rupture, labor
🗑
|
||||
| Preterm labor | labor begins before 37-38 weeks
🗑
|
||||
| Hypotonic uterine dysfunction | results in less than adequate labor pattern
🗑
|
||||
| Amnioinfusion | intrauterine infusion to increase amount of fluid or flush, correct variable decels, need 30 min to increase fluid, risk of overdistention & increase tone
🗑
|
||||
| Sinusoidal FHR pattern | Related to severe fetal anemia, acidosis, hemorrhage, abruptio or hydrops fetalis, undulating, oscilating, waves, persistent & rounded, no variability
🗑
|
||||
| Cardiac changes with labor | Increase CO & PVR, stage 2 increase intrathoracic pressure & venous pressure, decrease venous return=fetal hypoxia
🗑
|
||||
| GI changes with labor | decrease motility, absorption, emptyingincrease nausea, belching with dilation
🗑
|
||||
| Meds used to treat GI issues during labor | Bicitra, Maalox, Reglan, Zantac
🗑
|
||||
| Urinary changes during labor | decrease tone, capacity, sensation of filling, proteinuria (affects progress & comfort)
🗑
|
||||
| Hemopoietic changes during labor | increase WBC (21-25), fibrinogendecrease coag time, blood sugar
🗑
|
||||
| Respiratory changes during labor | Increase O2 demand (stage 1=40%, stage 2=100%)hyperventilation
🗑
|
||||
| Fetal scalp pH | 7.25 and above=ok7.18 and below=deliver
🗑
|
||||
| Amniotic fluid normals | 1000ml, pale/straw color, no odor, watery, slightly alkaline
🗑
|
||||
| Best evaluation amniotic fluid | Ferning pattern, next nitrazine test
🗑
|
||||
| PURE | Position change q20,urinate q1-2hrs, relaxation, environment & encourage
🗑
|
||||
| Nubain | analgesia, caution with preterm, equal to morphine
🗑
|
||||
| Stadol | analgesia, CHECK RR, must be 10, potent, give begining of contraction
🗑
|
||||
| Stadol/Nubain adverse maternal effects | Resp depression, tachy, hypotension, bladder distention, mental changes, confusion, sedation
🗑
|
||||
| Stadol/Nubain adverse fetal effects | sinusoidal FHR, bradycardia, CNS depression
🗑
|
||||
| Stadol/Nubain adverse neonate effects | resp depression (1-4 hrs), apnea, cyanosis, hypotonia, bradycardia, arrhythmias (Narcan given)
🗑
|
||||
| Narcan adverse effects | increase/decrease BP, increase HR, pain, irritable, crying, pul edema, abstinence syndrome
🗑
|
||||
| Analgesic/anesthesia complications fetus/neonate | CNS depression, hypoxia, lethargy, poor suck/swallow
🗑
|
||||
| Analgesic complications maternal | NV, decrease peristalsis, urine, CNS, BP alter, increase HR, ineffective, allergy, pruritus, delerium
🗑
|
||||
| General anethesia | used cesarean/sterilization, SE=allergy, NV, aspiration, alter BP, uterine atony (hemorrhage), urine retention, hypothermia, surgical comps)
🗑
|
||||
| #1 complication spinal/epidural anesthesia | Hypotension-prevent with bolus 500-1000ml LR
🗑
|
||||
| Medication treatment of hypotension during labor | Ephedrine
🗑
|
||||
| Nerve blocks | "caine" family, local or thecally, preservative to prolong, potentiators with cesarean
🗑
|
||||
| Nursing responsibilities with anesthesia | position of mom, monitor effects, contractions
🗑
|
||||
| Epidural dilation requirement | 3cm min, 4cm with nullipara
🗑
|
||||
| Potential complications spinal/epidural | shiver, NV, hypotension, inhibit bearing, allergy, ineffective, loss sensation, cramps, hypothermia, urine retention, uterine atony, hemmorhage, pruritus
🗑
|
||||
| Specific spinal complications | leakage of CSF, post dural puncture HA (give caffeine)
🗑
|
||||
| Fetal distress manifestations | abnormal FHR, meconium stained fluid with cephalic, hyperactivity
🗑
|
||||
| Short term variability | BTB, monitors compensation by babe with O2 changes, absent or present
🗑
|
||||
| Long term variability | cycles, 3-5/min
🗑
|
||||
| Tachycardia causes | early fetal hypoxia, prematurity, anemia, cardiac arrythmias, HF, mom drug use, anxiety, fever, hyperthyroid, pain mgmt meds
🗑
|
||||
| Tachycardia interventions | reposition, O2 @ 8-10L, increase mainline, antipyretics, calm, persist >1hr=deliver
🗑
|
||||
| Bradycardia causes | late fetal hypoxia, prolonged cord compression, acute fetal asphyxia, heart block, HYPO thermia, tension, glycemia, SE anesthia, positioning, contraction hyperstimulation (Pitocin)
🗑
|
||||
| Recurrent decelerations | occur with 50% contractions in 20min
🗑
|
||||
| Nadir | low point, usually occurs with peak of contraction
🗑
|
||||
| Shoulder humps | quick increase pre and post FHR changes=good
🗑
|
||||
| Intervention for nonreassuring | Intrauterine resuscitation-position, increase mainline, O2 @ 8-10L
🗑
|
||||
| Interventions for variable | check for cord, reposition, O2, amnioinfusion
🗑
|
||||
| Interventions for late | reposition, O2, increase mainline, turn off Pit, Monitor mom-BP:babe-FHR, deliver
🗑
|
||||
| Pseudosinusoidal | saw tooth, mod variability, caused pain meds
🗑
|
||||
| Saltatory | Marked variability >25bpm, unknown cause
🗑
|
||||
| 5 Ps of assessment | Personality, position, passenger, powers, passageway
🗑
|
||||
| Position | change q 20min, supine hypotensive syndrome
🗑
|
||||
| Presentation | cephalic, breech, shoulder, vertex
🗑
|
||||
| Lie | baby spine v. mom spine
🗑
|
||||
| attitude | flexion/extension
🗑
|
||||
| position | presenting part (right or left, part, location)
🗑
|
||||
| Amniotic Fluid Embolism | amniotic fluid into bloodstream (10%maternal mortality, 50% fetal)
🗑
|
||||
| Cord prolapse | emergency, SGA/SFD, premie, breech, transverse, RBOW, anmiotomy w/out engage
🗑
|
||||
| Cord prolapse interventions | position, bladder infusion, delivery
🗑
|
||||
| Nuchal cord (CAN) | cord around neck
🗑
|
||||
| Ferguson reflex | urge to push
🗑
|
||||
| O2 to babe begins decreasing at ____mmHG | 35
🗑
|
||||
| Primary & Secondary powers | primary-contractions, secondary-pushing
🗑
|
||||
| Premature labor | after 20 weeks before 37 weeks
🗑
|
||||
| #1 cause premature labor | UTI- then dehydration, multifetal etc
🗑
|
||||
| Stop premature labor if | cervix <4cm or 50%, BOW intact, viable fetus, no maternal contraindications
🗑
|
||||
| dystocia | long, difficult labor
🗑
|
||||
| dysfunctional | abnormal contractions prevent normal progress
🗑
|
||||
| Hypertonic (Hyperstimulation) | painful but ineffective, increase rest tone >20mmHG, duration >90 sec, intensity >75-80mmHG: decrease rest <30 sec, frequency <2 min, coupling or tripling
🗑
|
||||
| Hypertonic interventions | O2, reposition, shut off Pit, increase mainline, tocolytic, amniotomy, calm
🗑
|
||||
| Hypotonic causes | fetal malposition, overdistention of uterus, pressure not high enough
🗑
|
||||
| Hypotonic interventions | rule out CPD/FPD or pelvic probs, amniotomy, stimulation
🗑
|
||||
| Precipitous labor | <3hrs
🗑
|
||||
| Induction | deliberate initiation of labor
🗑
|
||||
| Augmentation | stimulation or enhancement of contractions
🗑
|
||||
| Contraindications oxytocin | CPD, prolapse cord, transverse lie, nonreassuring status, placenta previa or vasa previa, prior classic uterine incision, active herpes infections
🗑
|
||||
| Indications oxytocin | suspect fetal jeopardy, dystocia, PROM, postterm, chorioamnionitis, maternal med probs, severe preeclampsia, fetal death, multipara w/precep lives far
🗑
|
||||
| Bishops score | cervical readiness, 9 or more more successful (13 total)
🗑
|
||||
| Oxytocin goal of therapy | 3 contractions in 10 minutes or 40-60 sec with good relax and no probs
🗑
|
||||
| Oxytocin Nursing mgmt | 1:1 ratio, dr present on site, EFM, max 20mu/min, start 1-2mu/min and increase q 15-30min, monitor cervix, contractions, VS, babe and h2O intoxication, max fluid 3000ml/24hr
🗑
|
||||
| Oxytocin SE | hyperstimulation, BP alterations, water intoxication, ineffective
🗑
|
||||
| Oxytocin SE fetus | nonreassuring HR or pattern, hypoxia
🗑
|
||||
| Oxytocin SE interventions | reposition, o2, increase mainline, turn of Pit, Notify dr
🗑
|
Review the information in the table. When you are ready to quiz yourself you can hide individual columns or the entire table. Then you can click on the empty cells to reveal the answer. Try to recall what will be displayed before clicking the empty cell.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Created by:
msivola
Popular Nursing sets