Term
| dysfunctional labor that does not result in dilation, effacement or fetal descent is called |
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Definition
|
|
Term
| name 4 possible problems of labor |
|
Definition
| power, passenger, passage, psyche |
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|
Term
| two problems of powers include |
|
Definition
| ineffective contractions, ineffective maternal pushing |
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|
Term
| these contractions are coordinated but too weak |
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Definition
|
|
Term
| at what phase does hypotonic dysfunction normally occur |
|
Definition
|
|
Term
| a major cause of hypotonic contractions is |
|
Definition
| uterine overdistension (macrosomia, multiple fetuses, polyhydramnios) |
|
|
Term
| name some nursing measures that can be done to help hypotonic labor |
|
Definition
| hydrate, change maternal position (upright position), pain management, reduce anxiety, amniotomy or augmentation |
|
|
Term
| the major risks of amniotomy is what |
|
Definition
| prolapsed cord, infection, abruptio placentae |
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|
Term
| when contractions are uncoordinated and erratic they are |
|
Definition
|
|
Term
| hypertonic contractions usually happen to whom |
|
Definition
| women in early labor with their first baby |
|
|
Term
| during what phase of labor do hypertonic contractions occur |
|
Definition
|
|
Term
| what is the major problemw ith hypertonic contractions |
|
Definition
| pain and decreased uterine blood flow |
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|
Term
| the pain and high resting tone of the uterus in hypertonic contractions presents similiar to what other complication |
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Definition
|
|
Term
| the primary intervention to promote a normal labor pattern with hypertonic contractions is what |
|
Definition
|
|
Term
| what two types of drugs may be given for a hypertonic uterus |
|
Definition
| ocytocin (to reset) and tocolytics |
|
|
Term
| how long is the second stage of labor usually allowed to progress |
|
Definition
|
|
Term
| 4 possible problems with the passenger include what |
|
Definition
| fetal size, presentation or position, mutifetal pregnancy, anomilies |
|
|
Term
| macrosomia is defined as what |
|
Definition
| fetus larger than 4000g or 8lb 13oz |
|
|
Term
| what are the two problems with the progress of labor that occur with a macrosomic baby |
|
Definition
| does not fit through the pelvis, hypotonic contractions |
|
|
Term
| the greatest fetal complication with macrosomia is |
|
Definition
|
|
Term
| shoulder dystocia is dangerous because |
|
Definition
| the umbilibcal cord may get stuck |
|
|
Term
| name two things that can be done to help with shoulder dystocia |
|
Definition
| suprapubic pressure and mcrobert's maneuver |
|
|
Term
| rotation abnormalities can occur with what two fetal positions |
|
Definition
|
|
Term
| what type of pain occurs with OT OP positiion |
|
Definition
|
|
Term
| name 5 techniques a woman can use to promote fetal head rotation to OA |
|
Definition
| hands and knees, lunge, squat, leaning forward |
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|
Term
| if position changes do not work, what can be done to assist the head to come out |
|
Definition
|
|
Term
| the umbilical cord is most likely to be compressed in what position |
|
Definition
|
|
Term
| with a footling presentation, what is done |
|
Definition
| OR immediately for C section birth |
|
|
Term
| before labor, w can be doen to correct a breech birth |
|
Definition
|
|
Term
| the mother with a multifetal pregnancy is at an increased risk of what |
|
Definition
| fetal hypoxia, hypotonic laborpostpartum hemorrhage |
|
|
Term
| when in bed, how should a woman with multiple fetuses remain |
|
Definition
|
|
Term
| give two example of fetal anomilies that can impede labor |
|
Definition
|
|
Term
| problems of passage can be a result of what two |
|
Definition
| the pelvis or soft tissue obstruction |
|
|
Term
| name the two variations of abnormal labor duration |
|
Definition
| prolonged and precipitate labor |
|
|
Term
| in the active phase, a woman should be dilating how fast |
|
Definition
|
|
Term
| name 4 causes of prolonged labor |
|
Definition
| maternal infection, fetal infection, maternal exhaustion, anxiety |
|
|
Term
| how should a nurse manage prolonged labor |
|
Definition
| comfort,conserve energy, position changes, assess for infection |
|
|
Term
| precipitate labor is one in which birth occurs in how long |
|
Definition
|
|
Term
| precipitate birth is one that occurs without |
|
Definition
| a trained attendent (if the nurse catches it is a precipitate birth) |
|
|
Term
| nursing management of precipitate labor includes |
|
Definition
| side lying, O2, IV fluids, stop oxytocin, admin a tocolytic |
|
|
Term
| signs of intrauterine infection include what |
|
Definition
| fetal tachycardia, maternal tachycardia, tachypnea, temp (100.4), amniotic fluid that is yellow, cloudy or has a strong odor |
|
|
Term
| PROM is rupture of the amniotic sac before what |
|
Definition
| true labor has begun (cervical change) |
|
|
Term
|
Definition
|
|
Term
| pssoble causes of PROM include what |
|
Definition
| infection, weak amniotic sac, previous preterm birth, fetal abnormalitity, incompetent cervix, overdistension, hormone changes, sex, stress or low SES, nutritional deficiencies |
|
|
Term
| the greatest risks of prom are |
|
Definition
| infection and umbilical cord prolapse |
|
|
Term
| two major aspects of therapeutic mgmt of PROM is |
|
Definition
| determine true rupture, maternal antibiotics |
|
|
Term
| fluid is collected through a speculum exam and can be identified as amnitoic via what 2 ways |
|
Definition
| Ph test (blue is +) or fern test |
|
|
Term
| if membranes truely are ruptured, what is checked next |
|
Definition
| lung maturity and gestational age |
|
|
Term
| with PROM with a gestation near term, what is done |
|
Definition
| induction if cervix is favorable |
|
|
Term
| with PROM preterm gestation, what is usually done |
|
Definition
| may be observed in the hospital with nonstress tests performed daily, steroids and abx may be given |
|
|
Term
| what should you teach the pt who goes home with PPROM |
|
Definition
| avoid sex, avoid breast stimulation, take your temperature at least 4 times a day, note and report uterine contractions or a foul odor |
|
|
Term
|
Definition
|
|
Term
| some possible associated factors to preterm labor are what |
|
Definition
| infection, assisted reproductive technology, previous preterm birth, short cervical length |
|
|
Term
| what are the signs of preterm labor |
|
Definition
| back ache, constant soreness, mild cramps, menstrual cramps, feel the baby is balling up |
|
|
Term
| what can be given to prevent preterm birth to women who had previous preterm birth or are at high risk |
|
Definition
|
|
Term
| home care guidelines include what |
|
Definition
| drink water, empty bladder, side lying position, palpate contractions for an hour |
|
|
Term
| name three ways to Predict preterm birth |
|
Definition
| short cervical length, hx of preterm birth, or positive fFN after 22 weeks |
|
|
Term
| at what point can preterm labor NOT be stopped |
|
Definition
|
|
Term
| in what situations would you NOT stop preterm labor |
|
Definition
| preeclampsia, prolonged maternal alteration, serious infection, nonreassuring FHR that cannot be corrected |
|
|
Term
| if hydramnios is causing the preterm labor, what can be done |
|
Definition
| amniocentesis to remove fluid |
|
|
Term
| although it can cause many problems for the mother, you advise her to do what to stop preterm labor |
|
Definition
|
|
Term
| tocolytics are most likely to be effective at what point |
|
Definition
|
|
Term
| what is the first line drug for preterm labor, second line? |
|
Definition
| nifedipine, and terbuteline |
|
|
Term
| what are three criteria to continue mag therapy |
|
Definition
| respirations 12, present DTR's, urine output of 30ml |
|
|
Term
| what other 2 should be checked on mag therapy |
|
Definition
| fluid overload and bowel sounds |
|
|
Term
| what can reverse magnesium toxicity |
|
Definition
|
|
Term
| common side effects of nifedipine include what |
|
Definition
| HA, dizziness, nausea, hypotension, tahcycardia, |
|
|
Term
| the side effects of the beta agonist terbutaline include what |
|
Definition
| nervousness, jittery, tachycardia |
|
|
Term
| the major complication of indomethacin is |
|
Definition
| bleeding (closure of PDA) |
|
|
Term
| the two ways to accelerate fetal lung maturity includes what |
|
Definition
Betamethasone
12 mg IM X2 doses, 24hours apart
Dexamethasone – if they are going faster
6mg, X4 doses IM, 12 hours apart |
|
|
Term
| side effect of corticosteroids include what |
|
Definition
| pulmonary edma, nervousness, glucose intolerance, infections (UTI) |
|
|
Term
| a prolonged pregnancy is how long |
|
Definition
|
|
Term
| an abnormally adherent placenta is called what |
|
Definition
|
|
Term
| the next two above placental accreta are what |
|
Definition
| placenta increta and percreta |
|
|
Term
| prolapsed cord occur after what event |
|
Definition
|
|
Term
| what r/t amniotic fluid could lead to a prolapsed cord |
|
Definition
|
|
Term
| name some nursing interventions for a prolapsed cord |
|
Definition
| hips higher than head, elevate presenting part, avoid touching the cord, 8-10ml of O2 by face mask, tocolytic drug |
|
|
Term
| a tear in the wall of the uterus is what |
|
Definition
|
|
Term
| risks for uterine rupture include what |
|
Definition
| previous uterine surgery, high parity, abdominal trauma, fetopelvic disporportion, hypertonic contraction |
|
|
Term
| what are the signs that uterine rupture has occurred |
|
Definition
| SHOCK, labor stops, abdominal pain and tenderness, scalp pain, chest pain, nonreassuring fetal reactions, absent fetal heart sounds, |
|
|
Term
| if uterine rupture occurs, what 2 may be needed |
|
Definition
| C section and hysterectomy |
|
|
Term
| 2 signs of abruptio placenta |
|
Definition
|
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