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OB
Review of intrapartum
| Question | Answer |
|---|---|
| Five signs of labor | Lightening, Braxton hicks contractions, Increased bloody show, Burst of energy |
| True labor vs False labor | True labor- regular rhythmic contractions that intensify with ambulation, pain in the abdomen sweeping around from the back and cervical changes False labor-irregular rhythm, abdominal pain that decreases with ambulation |
| What results from hyperventilation in labor? | Respiratory alkalosis instruct pt to breath into a paper bag or cupped hand |
| Maternal changes in the transition phase of labor | Irritability and unwillingness to be touched but dont want to be left alone, n/v, and hiccupping |
| When should a laboring client be examined vaginally | Prior to analgesia and anesthesia to rule out cord prolaps,e to determine labor progress and to determine when pushing can begin |
| Define cervical effacement | Shortening of cervix expressed in percentages (0-100%) |
| Where is the FHR best heard | Fetal back in vertex, OA postions |
| Normal FHR during labor | 110-160 bpm |
| Normal maternal BP, pulse and temp during labor | <140/90 <100 bpm <100.4 |
| Four nursing actions for second stage of labor | Ensure cervix is completely dilated before pushing is allowed Assess FHR with each contraction Teach woman to hold breath for no longer than 10 sec Teach pushing techniques |
| Three signs of placental separation | Gush of blood Lengthening of cord Globular shape of uterus |
| When should the postpartum dosage of Pitocin be admin? Why? | Immediately after placenta is delivered to prevent post partum hemorrhage and atony. |
| Contraindication to use of Methergine | Hypertension |
| Five symptoms of resp distress in the new born | Tachypnea, dusky color, flaring nares, retractions and grunting |
| If meconium was passed in utero what nursing action must be taken? | Arrange of immediate ET tube observation to determine te presence of meconium below the vocal cords |
| Good apgar score | 7-10 |
| Major cause of maternal death when gen. anesthesia is admin | Aspiration of gastric contents |
| What is the first sign to observe for hypotension in a laboring patient after she receives epidural? | Hypotension resulting from vasodilation below the block, which pools blood in the periphery, reducing venous return |
| Three actions to take if hypotension occurs in a laboring client | Turn client to left side Admin O2 by mask at 10L/min Increase speed of IV infusion |
| Define fourth stage of labor | 1-4 hrs after delivery of placenta |
| Actions to prevent post partum hemorrhage | Massage the fundus gently and keep the bladder emptied |
| Nursing actions when a soft boggy uterus is palpated | Perform fundal massage |
| Symptoms of hypovolemic shock | Pallor, clammy skin, tachycardia, lightheadedness and hypotension |
| How often should the nurse check the fundus during the fourth stage of labor? | Q 15 mins x 1 hr Q 30 mins x 2 hr if normal delivery. |
| Latent phase of labor | From beginning of true labor to 3-4cm dilation. Client will be mildly anxious, mild contractions, initially 10-20 mins apart 15-20 sec duration |
| Active phase of labor | 4-7 cm dilation; Client will have increased anxiety, discomfort, unwillingness to be left alone, moderate to severe contractions ( 2-3 mins apart 30-60sec duration) |
| Transition phase of labor | 8-10 cm dilation; Client will experience sudden nausea, hiccups, extreme irritability and unwillingness to be touched, severe contractions (1 1/2 mins apart, 60- 90 sec duration) |
Created by:
roseiv2014
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