The Five P's
what is the purpose of Powers (contractions) in the first stage of labor?
dilate the cervix
what is a normal baseline for FHR?
110-160 bpm
preterm birth is birth before ___ weeks
preterm labor is contraction and cervical change before __ weeks
37 (for both)
T or F: for a full term baby, a vacuum extraction is safer then using forceps to deliver the baby
true
T or F retained placental tissue is the most common cause of late/delayed PPH
True
which of the following are indicative of true labor? (choose all that apply)
a. regular contractions
b. sedation diminishes contraction pattern
c. discomfort in lower abdomen and groin
d. bloody show
e. contractions continue with change of position
a, d, e
____ is the most common fetal attitude, the fetus occupies the smallest space
complete flexion
T or F: a category 3 fetal heart tracing requires evaluation and continued monitoring
False - it requires prompt evaluation and interventions!
which if the followign are risk factors for preterm labor? (select all that apply)
a. smoking
b. previous pre-term birth
c. long interval between pregnancies
d. UTI
e. woman who is under 5 feet
f. shortened cervix
a, b, d, e, f
tachysystole is defined as more than __ contractions in ___ minutes, averaged over 30 min, with. less than ___ seconds of relaxation
5, 10, 60
which factors increase risk of developing mastitis?
a. poor infant suck
b. excessive breast pumping
c. improper breast hygiene
d. underwire bra
e. engorgement
a, c, d, e
what is the major risk of an epidural?
bonus: is it an anesthetic or analgesic?
decreases in blood pressure (hypotension)
why does the fetus go through the cardinal movement's while traveling through the "passageway"?
to obtain best fit of fetal head depending on where it is in the birth canal
What does VEAL CHOP stand for?
Cord, Head compression, Oxygenated, Placental abnormalities
T or F: magnesium sulfate is a drug currently used to stop contractions
no longer used for this, is neuroprotective
an intervention that may cause further impaction of the fetal shoulder in a a delivery with shoulder dystocia is
a. supra-publc pressure
b. McRoberts maneuver
c. McDonald's maneuver
d. fundal pressure
d.fundal pressure
what four T's associated with PPH?
Bonus: How much blood is lost in a PPH
tone (uterine atony), tissue (retained placenta), trauma (lacerations, uterine rupture), Thrombin/ CloTTing (coagulopathy)
active management of the third stage of labor is important to prevent ______
too much blood loss
the most common and best fetal position for delivery is __ __ __ (3 letters). What does each of these letters stand for.
LOA
left (mom's left), occiput (head flexed), A (anterior)
in the occurence of late decels the nurse should change the mom to the _____ position, _____ Pitocin, and promote perfusion to the fetus by ____
left lateral lying; stop; starting an IV
what is the main goal of tocolytic therapy?
stop labor long enough to get corticosteroids on board to promote fetal lung maturity
an amniotic fluid embolism is an escape of amniotic fluid into _____. and is usually fatal to the mom because amniotic fluid can contain (list 2 things)
maternal circulation
debris, lanugo, vernix, meconium
the incidence of thrombosis has decreased due to ______.
early ambulation
it is important to promote relaxation during labor because _____ can inhibit uterine contraction and placental ______
catecholamines (hormones released in response to stress), perfusion
Where and what are you palpating for in the second Leopold maneuver?
each side of uterus, fetal back
what is the difference for early decels and variable decels? What is a nursing intervention for each?
early decels are a mirror image of the contraction and are due the head compression of the fetus. No nursing interventions required
variable decels are abrupt and do not have to coincide with contractions, they indicate cord compression. Nursing interventions include: stop Pitocin, assist with amnioinfusion, change position of mother, use hand to relieve pressure on prolapsed cord
which tocolytic drug has adverse effects of maternal and fetal tachycardia, myocardial ischemia, hyperglycemia, pulmonary edema, and maternal death?
Terbutaline (brethine) - its a beta agonist
the four major risk factors for cord prolapse are:
high station, small fetus, transverse lie, hydraminos
sudden onset dyspnea, pallor, sweating, confusion, and chest pain are all signs of what complication?
what are two actions taken to treat this?
pulmonary embolism
elevate head of bed, give oxygen (8-10L), narcotics, "clot busters"
name whether the following increase, decrease or remain the same in initiation of labor
progesterone
estrogen
prostaglandins
cortisol
oxytocin
progesterone -decrease
estrogen - increase
prostaglandins - increase
cortisol - increase
oxytocin - increase