1Pitocin Intended Response
To stimulate contractions
2What is Mg Sulfate
muscle relaxant
3Ms Sulfate treats what conditions
preeclamsia, preterm labor, and eclampsia by slowing contractions
4Cytotec uses
Stops PPH and ripens cervix during induction
5Cytotec administration
oral, rectal, vaginal
7Methergine intended response
stimulate contractions
8betamethasone uses
A corticosteroid used to mature fetal lungs in preterm birth;
9betamethasone admin
Administered IM to mom
10What is betamethasone
corticosteroid
11interventions for prolapsed cord
Priority: take pressure off of cord (hold it/position)
Position:trendelenburg or knee to head/mcroberts
12Spinal headache treatment
blood patch
13Blood patch admin
draw moms’ blood, and inject it through the same hole that the epidural needle and creates a scab, it is instant relief.
14spinal headache cause
epidural insertion site causes leaking of spinal fluid
15Late decelration position
left lateral/side lying
16LION for late decel
Lateral side lying
IV bolus
Oxygen
Notify dr
17Chorioamnionitis is what
infection of chorion (placenta/amniotic fluid)
18S/S of chorioamnionitis
maternal: fever and long ROM
fetal:tachycardia or altered variability
19Shoulder dystocia Risk factor
Macrosomia/LGA
maternal exhaustion/prolonged labor
GDM
prior hx
abnormal presentation
overweight mom
gestational age > 41 wk
20Is boggy uterus 30 min PP...
21Normal or abnormal...increased WBC PP
normal
22normal or abnormal... straw colored fluid
normal
23normal or abnormal...temp of 99.9 PP
normal
24normal or abnormal..globular uterine shape PP
normal
25Infection monitoring
time of ROM, WBC, fever, chills
26definition of effacement
thinning, shortening, and softening of cervix to open vaginal canal in birth
27definition of molding
pressure of vaginal canal causes irregular shape of ehad
28Pudendal nerve block administration
injection into pudendal nerve in pelvis at vaginal wall
29pudendal nerve block use
relieve pain in labor from vagina to anus
30lightening def
feeling of baby dropping into true pelvis
31Pros of breast feeding
Prevention of hemorrhage, bonding, immunity, weight loss in mom, decreased cancer risk in mom, higher IQ in baby, decreased obesity/asthma, decreased NIC
32S/S of mastitis
flu like symptoms, shiny/hard/tender/swollen breast, red streak/spot
33Mastitis tx
antibiotics, heat/cold
34How to suppress milk production
- tight fitting bra
- cold compress
- hot compress
- cabbage leaves on breast
35tachysystole def
too frequent contractions
36How often should contractions be
- 30-50 sec duration
- 30-70 sec duration
- 2-3min apart
- 1-2min apart
37Sinusoidal FHT on chart
looks like big uniform mountains
38Sinusoidal prognosis/interventions
prep for emergency C-section, expect resuscitation of baby one delivered
39Signs of placental seperation (stage 3)
- gush of blood
- N/V
- uterus firms up
- globular fundus
- umbilical cord lengthens
40When should the fundus be at umbilicus
- immediatley after birth
- 12 hrs after
- 24 hrs after
- day 2
- day 3
41When should fundus be 1 finger above umbilicus (1/U)
12 hours after birth
42When should fundus be 1 finger below umbilicus
24 hr after birth
43Bleeding PP
scant- 1 in
light- 4 in
moderate- 6in
heavy/excessive- fully saturated pad within 1 hr
44Hemorrhage interventions
#1 is FUNDAL MASSAGE
-Call for help
-Foley, 2nd IV
-MED: Pitocin, methergine, hemabate, cytotec, analgesic
-interventions: Manual extraction, DnC, hysterectomy
-weigh pads 1g=1mL
45How much blood is considered a hemorrhage
Vaginal >500mL
Csection >1000mL
46Stages of Labor
1: Latent, Active, Transition to complete dilation
2: complete dilation to delivery of fetus (pushing)
3: delivery of placenta
4: homeostasis and stabilization of mom (recovery)
47Hemorrhage RF
TONE, TISSUE, TRAUMA, THROMBUS
48First Stage of Labor
from onset of regular contractions to full effacement/dilation
49First Stage of Labor position
upright
50frank breech
buttocks first with extended legs
51full/complete breech
criss cross above pelvis
52footling/incomplete breech
one or both legs presenting
53physical maternal changes in labor
TACHYCARDIA, HTN (during contractions), TACHYPNEA, HIGH WBC, LOW GASTRIC MOTILITY, LOW BGL
54Latent phase dilation
0-3cm
55latent phase effacement
0-40
56latent phase contractions
q5-10 min and mild, like menstrual cramps
57active phase dilation
4-7cm
58active phase effacement transition phase
40-80
59active phase contractions
q 2-5 min and longer plus more strong and painful
60transition phase dilation
8-10cm
61transition phase effacement
80-100
62transition phase contractions
q 2-3 min and strong/long, cause n/v, shakiness, back ache, diaphoresis
63which stage of labor is longest
first stage
64how long does stage 3 of labor last
up to 30 min to deliver placenta
65how long does stage 2 last
up to three hours
66what are the phases of stage 2
pelvic and perineal phases
67What happens during the pelvic phase of stage 2
fetal descent
68what happens during the perineal phase of stage 2
pushing
69How long is stage 4
1-4hr
70What takes place during stage 4
breast feeding, skin to skin, fundal massage, perineal care