Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
MCN
maternity
| Question | Answer |
|---|---|
| 5 P's | pelvis, passenger, pelvis/presenting part, power, psyche |
| Types of pelvis | gynecoid, android, anthropoid, platypelloid |
| gynecoid | favorable, rounded, nl female caucasian |
| android | not favorable, heart shaped, male, narrow |
| anthropoid | favorable, oval, non-caucasian, born OP |
| platypelloid | favorable, oval, born OT |
| fetal head | sutures, mentum, sinciput, occiput, fontanelles, |
| sutures | frontal, saggital, coronal, lamboidal |
| fontanelles | anterior(larger,daimond shape,front, closes 12-18months), posterior(smaller, harder to find, triangle, closes 8-12weeks) |
| mentum | chin |
| sinciput | brow |
| occiput/vertex | go together, area between fontanelles |
| bregma | also area of anterior fontanelle, where coronal and saggital sutures meet |
| fetal attitude | flexion |
| fetal lie | relationship of baby and mothers spine...longitudinal=parallel.. transverse=perpendicular(c-section) |
| fetal presentation | body part of fetus at pelvic passage |
| vertex presentation (subocciptobregmatic) | head flexed on chest, presenting part occiput |
| military presentation (occiptofrontal) | no flexion or extension, presenting part top of head |
| brow presentation (submentobregmatic) | partial extension, presenting part sinciput (brow) |
| face presentation (occipitomental) | head hyperextended, presenting part face |
| breece | but of feet presenting first (complete, frank, or footling) |
| transverse lie | shoulder presentation (C section) |
| engagement | when baby reaches station 0, 2-several weeks before onset of labor or during labor. |
| station | relation of presenting part with ischial spine. -5 to +5..fully dilated at +2 or 3 |
| fetal position | R or L of maternal pelvis, presenting part (O,M,S,A), anterior, posterior, or transverse (A,P,T)..OA most common |
| Powers-contractions | primary and secondary work together, 3 phases (increment,acme,decrement), |
| primary force | uterine contractions=effacement & dilation, rhythmic but intermittent, between contractions relaxation |
| secondary force | use of ab muscles to push during 2nd stage of labor, adds to primary force after full dilation |
| psyche | accomplish task of pregnancy, coping mechanism, previous experience, support, preparation, cultural influences |
| physiology of labor | usually occurs 38th-42nd wk., exact cause not understood. progesterone w/draw hypothesis, prostaglandin hypothesis, CRH |
| progesterone withdrawal hypothesis | decrease progesterone allows estrogen to stimulate contractions. progesterone is administered to prevent preterm birth. increases 10x during pregnancy then drops |
| prostaglandin hypothesis | used to induce labor, inhibitor of prostaglandin in used to stop preterm birth (PGE) |
| corticotropin-releaseing hormone (CRH) | increase throughout pregnancy with sharp increase at term. known to stimulate prostaglandin F & E by amnion cells |
| effacement | thinning of cervix 0-100%. drawing up of the internal os and the cervical canal into side walls of uterus. long & think to short &thin |
| myometrial activity | effacement leading to cervical dilation |
| signs of labor | lightening, braxton-hicks, cervical changes, bloody show, ROM, energy burst, wt loss, N/V/D, indigestion |
| cervical changes in labor | goes from rigid and firm to weak and soft. collagen fibers decrease and water increases. softening of cervix=ripening |
| braxton-hicks contractions | irregular, intermittent, occurs throughout labor, uncomfortable, pain in ab and groin, false labor |
| lightening | baby drops making easier to breath but sitting on bladder and frequent urinating |
| bloody show | mucous plug expelled, labor normally begin 24-48 hours |
| SROM | 80% of people with go into labor within 24 hours |
| AROM | augment labor, induce labor |
| burst of energy | 24-48 hours before labor, do not overexert to waste energy needed for labor. |
| true labor | regular contractions, interval between shortens, increase in I,D,F, discomfort in back-ab, intensity increase w walking, dilation and effacement progress |
| false labor | contractions irregular, pain in ab, no change in I,F,D,dilation or effacement |
| client education of true/false labor | feel free to come in for exam only way to tell is by vaginal exam, hard to distinguish the difference |
| stages of labor | 1st stage-true labor to 10cm 2nd stage-pushing 3rd stage-placenta delivery 4th stage-1-4 hrs post birth |
| first stage | true labor until 10cm dilation. SROM/AROM occurs. 3 phases: latent/early phase, active phase, transition phase |
| latent/early phase | 0-3cm, beginning of regular contractions, talking and smiling, increase in I,F,D |
| active phase | 4-7cm, nl ask for epidural, fetal descent progressive, insrease anxiety and pain, decrease coping |
| transition phase | 8-10cm, increase in I,F,D, fear of being left alone, restless, changing positions, needs support, fetal descent dramatically, contractions q11/2-2 min for 60-90s |
| second stage | pushing stage, begins with complete dilation and ends with infant birth, 15m-3hours. feel pressure & urge to push. burning from stretching tissue |
| cardinal movement of labor | DIDRED, descent thru pelvis, internal rotation, delivery and extension of head, restitution (baby stops), external rotation, delivery of shoulders. |
| third stage | delivery of placenta. 5 to no more than 30min. bleeding-lengthening of cord-placenta. |
| types of placent | shiny-shultze=baby side dirty-duncan=mom side |
| fourth stage | 1-4hours after birth, readjustment begins, blood loss range 250-500ml, decrease in BP, increase pulse pressure, moderate tachycardia. |
| uterus 1-4hours post partum | remains contracted in midline of ab, fundus midway between symphysis pubis&umbilicus, N/V cease, thirsy&hungry, shaking chills |
| maternal systemic response to labor | labor and birth effect almost all maternal physiological systems |
| mom cardiovascular changes | CO&BP increase w contractions, fear, and pain. position affects CO. supine CO,SV,BP decrease and HR increase |
| mom fluid and electrolyte changes | sweating, IV fluids or oral fluids needed |
| mom respiratory changes | O2 demand&consumption increase w contractions, hyperventilation= Low PaCO2=rep. alkalosis=metabolic acidosis compensated. quickly reversed in 4th stage w change in RR |
| mom renal system changes | increase maternal renin, plasma renin, angiotensinogen, polyuria |
| mom GI system changes | gastric motility, absorption, and emptying time decreased while stomach volume remain increased. |
| mom immune system and blood values changes | WBC increase to 25-30,000mm3 due to neutrophils from stress, difficult to ID infection. Blood glucose decrease from energy burned=need less insulin |
| reasons for pain in labor | complexity of physical causes. dilation, hypoxia of uterine muscles, pressure, uterine stretching, distention of vagina |
| factors affecting response to pain | prep classes, culture, fatigue, experiences, anxiety, less energy, lose ability to cope, anticipate discomfort |
| fetal HR changes | decelerations can occur with increased intra cranial pressure |
| fetal acid base status in labor | blood flow decrease=decrease pH, in 2nd stage labor w increased contractions pH decrease more rapid, fetal O2 sat drops 10% |
| fetal hemodynamic changes | fetal reserve is enough to see the fetus through anoxic periods unharmed |
| fetal behavioral states | sleep state should be no longer than 40 min |
| fetal sensation | @37-38 weeks fetus can experience light, sound, and touch. fetus experiences labor as women labors |
| intrapartal maternal assessment | name, age, hx, LMP, EDB, physician, blood type, HPI, problem in prenatal, pregnancy data, feed method, ed, NST, BPP, |
| intrapartal risk screening | abnormal presentation, multiple gestations, hydraminos, smoking, SA, ethol, culture, prenatal care, PTSD, DM, AIDS |
| assessment of labor progress | assess contractions, dilation, effacement |
| contraction assessment | palpate, continuous electrical monitoring, note I,F,D,relaxation, pain |
| cervical assessment | dilation&effacement evaluated, vaginal exam can also provide info about membrane status, amniotic fluid, fetal position and station |
| determination of fetal position and presentation | inspecting&palpating ab, perform vaginal exam, auscultate FHR. ultrasound may also be used |
| auscultating fetal heart rate | handheld doppler ultrasound or fetoscope used, most clearly heard at fetal back |
| leopolds maneuver | systemic way to evaluate maternal ab by palpating and finding position of fetus, empty bladder before, lie supine with legs bent, hard with obese and high amniotic fluid |
| EFM | electronic fetal monitoring, continuous tracing of FHR, done if 1 or more problems present. -previous stillborn, complications, induction of labor, preterm labor, labor after csection, low FHR, nonreassuring status, meconium staining of fluid |
| FHR baseline rate | average FHR |
| FHR baseline variability | interplay between sympathetic and parasypathetic over 10min period. absent, minimal, moderate, marked |
| FHR accelerations | increase in FHR normally cause by fetal movement |
| FHR decelerations | decrease FHR from decreased blood flow, compression of fetal head |
| types of FHR decelerations | early, late, variable, sinusoidal, episodic, intermittent, prolonged |
| early FHR decelerations | occur before contractions |
| late FHR decelerations | decreased blood flow and O2 to fetus |
| variable FHR decelerations | compressed cord, hypertension |
| sinusoidal FHR decelerations | waveform, anemia, hypoxia |
| episodic FHR decelerations | result from vaginal exams |
| intermittent FHR decelerations | occur with less than 50% contractions |
| prolonged FHR decelerations | leave baseline for 2 min but no more than 10 min. |
| BUBBLE H2E | breast, uterus, bladder, bowel, lochia, episiotomy, homans sign, hemorrhoids, emotional status |
| nl FHR | 120-160 bpm |
| nl fetal RR | 30-60 |
| nl fetal temp | 36.4-37.2-rectal 36.6-37.2-auxillary |
| electronic monitoring | provides an objective continuous record of the uterine activity and the FHR, internal or external, indications for use vary. |
| electronic monitoring of uterine activity/contraction pattern | assesses contraction pattern, continuous tracing of contraction pattern, allows for evaluation of effectiveness of labor. |
| uterine external and internal monitors | external=tocodynamometer (toco) internal=intrauterine pressure catheter (IUPC) |
| Purpose of fetal monitoring | visual assessment of FHR, continuous tracing of FHR, evaluate fetal well being |
| fetal external and internal monitors | external=ultrasound internal=fetal scalp electrode |
| external monitoring advantages | non-invasive, can be done at any time, does not require ROM, can monitor multiples |
| external monitoring disadvantages | belts may be cumbersome, tracing may be affected by artifact/movement, only shows F&D for uterus, only show LTV for fetus |
| internal monitoring advantages | shows LTV and STV, direct measure of FHR, no gaps in tracing, more comfortable, can measure intensity |
| internal monitoring disadvantages | requires ROM, requires cervix 2-3cm, invasive, risk of infection, risk of uterine rupture |
| BPP-all done by ultrasound except FHR done NST | comprehensive assessment of fetal breathing movement, movement of body or limbs, fetal tone, amniotic fluid volume, and FHR 0-2 for each score of 8-10/10 nl |
| BPP is indicated when.. | risk of placental insufficiency or fetal compromise because: IUGR, DM, HD, HTN, preclampsia, sickle cell, hx stillbirth... |
| NST | evaluate fetal status, should show at least 2 accelerations of FHR with fetal movement on 15bmp lasting 15s or more over 20min |
| AFI | the vertical diameter of the largest amniotic pocket in each of the 4 quadrants is measured...over 8cm=hydramnios, less than 5cm olgiohydramnios |
| fetal scalp blood sampeling | done while mom in laborby checking pH to see if there is enough oxygen going to the brain, also done to check platelet counts |
| scalp stimulation test | examiner applies pressure to fetal scalp while doing vaginal exam, fetus who is not in stress or distress responds with an acceleration of the FHR |
| cord blood analysis | done to determine if acidosis is present, recommended when apgar score is less than 7 at 5min of age, nl blood pH should be 7.25 |
Created by:
gudknecht
Popular Nursing sets