High-risk Intrapartum
Surgical Incision of the perineum to enlarge the vaginal opening?
Episiotomy
What is the most common pelvis shape?
gynecoid pelvis
Tachysystole
Most common type of incision and most compatible for a VBAC in future pregnancies
Low-transverse
Strengthening uterine contractions when labor has already begun to help progress it.
Discuss how this is done and why it may be done?
Augmentation
occurs when a baby's head or body is too large, or the maternal pelvis is too small/shaped in a way that prevents the fetus from navigating the birth canal
CPD
The stage of labor that begins with full dilation and ends with expulsion of the fetus?
Stage two
What is normal baseline fetal heart rate?
110-160bpm
Least common type of uterine incision used in an emergency and non-compatible with a VBAC in future deliveries
Classical(Vertical)
What do you monitor at the time of ROM and after
Color, amount, odor, fetal heart rate (watch for prolapsed cord)
Temp hourly
Labor lasting less than 3 hours from the onset to delivery. What are risk factors? and monitoring considerations for mother and infant?
Precipitous Labor
Risks: Grand Multip, hx of quick deliveries, SGA, Drugs
Considerations: Monitor for respiratory issues in infant, facial bruising, monitor mother for bleeding, tears
What term describes the relationship of the fetal head to the mothers pelvis and how is it described?
Fetal Station
-3,-2,-1,0,+1,+2,+3
A deceleration in fetal heart rate that is abrupt in onset and return, less than 15 seconds to the nadir. What does this indicate?
Variable Decelerationd
Cord Compression
Discuss the three types of anesthesia that may be used during a cesarean section
Epidural, Spinal, General
Time-released vaginal insert used to initiate or continue cervical ripening (softening and thinning). Usually remains in place for 12 hours and then removed before starting pitocin.
Cervidil
A medical emergency where the infants shoulder becomes lodged behind the maternal pubic bone during delivery?
Discuss risk factors, nursing responsibilities, and interventions
Shoulder Dystocia
Tell me the difference in true labor and false labor
True Labor: regular contractions that get stronger, longer, and closer together, Nothing helps or stops intensity, cervical change occurs
Falso Labor: Irregular contractions, inconsistent, no cervical change, relieved with walking, rest, or warm bath
Deceleration in the fetal heart strip mirrors the contraction. What does this indicate?
Early Deceleration
Head Compression
Discuss how to get your patient ready for the OR when a cesarean section is called
Place orders, make sure consents are on chart, working IV, bolus fluids, administer pre-op meds, notify anesthesia, nursery, and respiratory, SCDS, clip and scrub abdomen, pre-op antibiotics, Labs, Count instruments
the intentional breaking of the amniotic sac by a provider to induce or speed up labor, or to place internal monitors
Amniotomy
A life-threatening condition where widespread clotting uses up clotting factors leading to severe bleeding?
What labs will you see?
DIC
Decreased platelets and Fibrinogen, INcreased PT, aPTT, and D-Dimer
Tell me the five P's that affect labor?
Passage, Passenger, Powers, Position, Psyche
Deceleration in the fetal heart rate that starts after the start of the contraction. What does this indicate?
Late deceleration
Placental Insufficiency
Placenta previa/acretta
CPD, Active HSV, Repeat, Malpresentation, Non-reassuring heart tones, Abruption, Cord Prolaps, Uterine Rupture, Maternal Exhaustion
What should you assess before starting Pitocin on a patient?
Fetal presentation/dilation
Fetal strip
Patient Knowledge and consent