Ch 10
Biophysical Profile - BPP
Name two maternal and neonatal risks that are associated with gestational diabetes mellitus.
Maternal preeclampsia, fetal macrosomia, C/S, develop Type 2 DM later in life, Birth trauma, Electrolyte imbalance for the fetus, Fetal hypoglycemia after birth
Name the factors that affect labor and birth (the 5 Ps).
Passenger -fetus/placenta
Passageway - birth canal
Powers - contractions
Position of mother
Psychologic response
This is the first thing that the nurse should do following rupture of membranes.
Assess fetal heart rate
With an epidural, the nurse is moving the patient side to side and monitoring for this common side effect of an epidural.
Hypotension *may consider urinary retention
This is a simple, non-invasive, inexpensive assessment that can be done by the patient at home to assess fetal well-being.
Daily Fetal Movement Count (DFMC)
Insulin needs in the second and third trimester of pregnancy are considered to be this.
Increased
Cervical change and contractions that do not stop with movement or position change.
True labor
Name the phases of the first stage of labor.
Will accept either:
Traditional - Latent, Active, Transition
Contemporary - Latent & Active
A mother is experiencing maternal exhaustion, and the provider considers the use of these forms of operative vaginal delivery.
Forceps or Vacuum-Assisted Birth
Name at least 3 of the possible risk factors to cause high-risk pregnancies.
Biophysical (genetic disorders or diet), Psychosocial (IPV, Depression, inadequate support), Sociodemographic (income, age, marital status, parity) Environmental (hazards in workplace, substance abuse/use)
In the postpartum period of a woman with cardiovascular disorders, the nurse is monitoring for this worsening condition defined as generalized edema, crackles at the base of the lungs, and some pulse irregularity.
Cardiac decompensation
Repositioning the patient; Giving oxygen 8 - 10 L via non-rebreather mask; Administering IV fluid
Intrauterine resuscitation methods/interventions
This assessment is performed for these reasons: On admission to know baseline, when giving a medication like oxytocin, when noting changes to the FHR strip, when mom feels pressure or urge to bear down, after ROM
Vaginal Examination
Name 2 mechanical/physical methods for cervical ripening.
Balloon catheter, hydroscopic dilater, amniotic sweeping, sexual intercourse, nipple stimulation, walking, amniotomy/AROM (artificial rupture of membranes)
A good result for a nonstress test that has greater than 2 fetal accelerations in 20 mins.
Reactive Nonstress Test
This is the progression of preeclampsia with hemolysis, elevated liver function tests, and low platelet count.
HELLP Syndrome
Changes in heart rate that do not start until after the contraction has started. They are still lower than the baseline after the contraction has completed.
Late deceleration
This stage of labor starts with the birth of baby and ends with the placental separation and expulsion.
Third Stage of Labor
This is performed when the baby's head is delivered and shows the turtle sign. The staff will hyperflex the woman's legs to her abdomen to straighten the sacrum and pull the pelvis and symphysis pubis toward mother's head.
McRoberts Maneuver
One of the best ways to perform ultrasound in early gestation or for patients who are obese.
Transvaginal Ultrasound
Threatened Miscarriage or Threatened Spontaneous abortion
Will take Miscarriage or Spontaneous Abortion
Moderate Variability
(Variability)
Name the primary difference between the labor of primipara and multipara women.
Duration of labor
*Particularly time in First Stage Active Phase & in Second Stage (pushing)
A woman's fetal heart tracing is showing variable decelerations. The nurse is aware that these U, V, or W shapes are caused by this.
Cord compression or prolapsed cord.