5 P's
Contractions/uterine activity/maternal pishing
What is Powers?
"My water broke"
What is Spontaneous Rupture of Membranes?
SROM
A pulsating mass is palpated during a vaginal exam
What is Prolapsed Cord.
Fetal monitor strip shows baseline of 130 with abrupt, sharp drops to 80 that last for 30-50 seconds before abruptly returning to the baseline. Nursing interventions are ineffective. Who do you call and why?
Who is the health care provider for an amnioinfusion?
Gradual drop from the baseline that starts at the beginning of the contraction and returns to the baseline before the contraction ends.
What is Early Deceleration?
Medication titrated to establish an adequate labor patterm
What is Oxytocin?
Fetal- head, weight, presentation, attitude, lie
Pasenger
My water broke two hours ago but I am not having contractions.
What is Premature Rupture of Membranes?
PROM
Patient is suddenly very anxious, short of breath, coughing, and cyanotic. Nurse observes fetal bradycardia, maternal hypotension, and petechiae to chest and upper arms.
What is Amniotic Fluid Embolism? AFE
New terminology: Anaphylactoid Syndrome
Shortly after receiving an epidural, the FHT are 130 with moderate variability, gradual drops to 100 that start after the contraction begins and gradually return to the baseline after the contraction ends. Nursing interventions are ineffective. What do you do now and why?
What is call anesthesia to administer ephedrine?
Increase from the baseline that increases at least 15 beats and lasts at least 15 seconds.
What is acceleration?
If your patient scores less than this on the Bishop's score, you should call the provider and request cervical ripening instead of starting the oxytocin.
What is 7?
Pelvis-shape and size of inlet & outlet, cervix, and birth canal
What is Passage?
The patient's cervix is unchanged after 2 hours, so the doctor grabs a hook.
What is Artificial Rupture of Membranes?
AROM
Patient c/o tearing sensation. Nurse notes contractions absent, fetal bradycardia or absence, increase in abdominal tenderness and loss of fetal station
What is Uterine rupture?
Other possible findings: Uterine tachysystole, absent variability, fetal parts palpable through abdominal wall.
example loss of station: Prior SVE was 3/80/0, current SVE 5/100/-3
Amniotic fluid is green. Who do you call and why?
Who is the neonatal team in case resuscitation is needed at delivery.
Abrupt sharp drop from baseline, reaches the nadir within 30 seconds, with rapid return to baseline
What is a variable decel?
Two prostaglandins used for cervical ripening
What are misoprostol and dinoprostone?
Previous experiences, support system, culture
What is Psyche?
My water broke and I am only 28 weeks gestation. Luckily, I am not having contractions.
What is Preterm Premature Rupture of Membranes?
PPROM
Fetal heart tones (FHT) baseline 140, moderate variability, with increases to 165 that last 20-30 seconds. FHT sudden drop to 70 that has remained down for the past 6 minutes despite nursing interventions
What is a prolonged deceleration?
Gradual drop from the baseline that starts after the contraction and returns to the baseline after the contraction ends.
What is a late?
Patient asks why induction is needed after they have reached 39 or more weeks
What is risk to fetus due to placental aging?
Encourage mom to move frequently, how is the fetus situated?
What is Position?
I must be verified prior to AROM.
What is fetal engagement?
Should be 0 or + station
Baby's head deliver's then turtle's.
What is shoulder dystocia?
Drop in fetal heart rate that lasts more than 2 minutes but less than 10 minutes
What is a prolonged decel?
Verify these three things before starting oxytocin
What is: Gestational age, bishop's score, fetal status (NST)?