OB_study.txt

• author "me"
• tags "OB final"
• description "OB final study guide"
• fileName "OB study"
• freezingBlueDBID -1.0
• Organ that houses the Fetus?
• Uterus

Fundus

Cervix

Corpus/myometrium

-100g, Spongey layer of decidua sloughed off

• Rubra= red 2-3 days
• Serosa= pink 3-10 days
• White = continues until cervix is closed

Color, fleshy odor, clots (nickel size are fine), amount (240-270 ml) [pad: 1in/h=scant, 4in=light, 6in=moderate, heavy=saturates pad in 1 hour or less], pooling, exertion

Midline between symphasis pubis and umbilicus; 6-12: at umbilicus. Height of fundus Lowers 1 cm each day for 10 days

• Temp 38/100.4 for 24 hours post
• Temp may be increased for 24 hours after milk comes in
• BP rises early and then returns to normal
• Bradycardia occurs during the first 6-10days

• Non pathologic leukocytosis occurs early
• Blood loss average 200-500ml (vaginal) 700-1000 (cesarean)
• Plasma levels rack the pre-pregnant state 4-6weeks postpartum
• Platelet levels return to normal by week 6
• Diuresis
• Cardiac Output Returns to normal Week 6-12

• 10-12 lbs, initially
• diuresis=5 lbs, lost
• Prepregnant weight 6-8 weeks

• infection
• respiratory difficulty
• Constipation
• voiding problems
• circulatory problems

• Breasts
• uterus
• Bowel
• Bladder
• Lochia
• Episiotomy / lacerations
• Homan's/ Hemorrhoids
• Emotions

Size and shape, abnormalities, reddened areas, engorgement, presence of breast fullness due to milk, assess nipples for cracks fissures, soreness, or inversion

• position of fundus related to umbilicus
• position of fundus to midline
• firmness
• Assess incision for bleeding , approximation, and signs of infection

• Homan's sign
• Assess calf for redness and Warmth
• Adequacy of Urinary elimination
• Bladder distention and pain during urination
• intestinal elimination
• Maternal Concerns regarding bowel move­ments

• Motrin (Ibuprofen) PO
• Anaprox DS (Naproxen Sodium)
• Toradol (Ketorolac tromethamine)
• Given PO, IM, IV

• • Cervical softening 7-month to 1 hour before
• •lightening: the fetus descends into maternal pelvis another breathes easier , but waddles primips z-3 weeks before, multips @ initiation
• • Bloody show: Loss of mucous plug
• • increased energy from hormones
• • Braxton Hicks (need to distinguish from Contractions)
• • SROM -1-in 4 women w experience prior to labor

Thinning of cervix

How much cervix is opening

Frequency, duration, intensity

Dilation, station, effacement

Contractions are at regular intervals.

Intervals between contractions gradually shorten

Contractions increase in duration and intensity

Discomfort in back and radiate around to abdomen.

Intensity usually increases with changing activity

Cervical dilation and effacement are progressives

Contractions do not decrease with rest or warm tub bath

Contractions are irregular

Usually no change in intervals between contractions

Usually no change in intensity discomfort is usually in abdomen

Change it activities has no effect on contractions

No change in cervical dilation

Rest and warm tub lesson contractions

A lot of activity from mother. Moms can walk out Baxton Hicks or false contractions

3 the latent phase the active phase and the transition phase

Cervical dilation: 0 to 3 cm

contraction frequency every 10 to 30 minutes

Contraction duration: 30 seconds

Contraction intensity begin as mild and progresses to moderate. 25 to 40 mmHg

Cervical dilation 4 to 7 cm

Contractions every 2 to 5 minutes

Duration of contraction 40 to 60 seconds

Intensity began as moderate and progressed a strong 50 to 70 mmHg

Cervical dilation 8 to 10 cm

Contraction frequency: 90 to 120 seconds

Contraction duration: every 60 to 90 seconds

Intensity strong by population; 70 to 90 mmHg

Mothers pushing baby out

Latent phase: excited relief in control

Active phase need to focus and work, increased anxiety

Transitional phase, they sell loss of control, anxious, Restless, often desirse a break from labor

• 1 passenger, the fetus and placenta
• 2. Passageway, birth canal
• 3. Power, contractions
• 4. Position, position of the mother
• 5. Psychological response

Every 15 to 30 minutes

Void every 2 hours

FHR every 15 to 30 minutes and contractions every 10 to 15 minutes

Every 5 to 30 minutes . Every 5 minutes

delivery of placenta and four hour maternal stabilization

Give vitamin K, eye prophylaxis, observation for the stress, initiate feeding, newborn bath, facilitate parental-infant attachment

Estimates gestational age. Less accurate for neonates less than 28 weeks are greater than 43 weeks

From birth to the 28th day of life

• • Compression of Filth chess quizzes fluid from lungs creating negative pressure, air is sucked into the lungs and thorax recoils
• • where in a quart is clamped pH and carbon dioxide increase and oxygen decrease stimulating baby to take a breath
• •

10 to 15 percent of all pregnancies. Blood loss greater than 500 cc's. Is one of the leading causes of maternal mortality

• Over to standard uterus
• Hematological disorders
• Lacerations to the birth canal
• Infection
• Hematomas

Prolonged labour, anaesthesia, difficult labor, grand multipara, full bladder, incomplete expulsion of the placenta, infection, over distended uterus

Failure of the uterus to return to its pre pregnancy state

Uterine atony, genital tract lacerations, hematomas

Relaxation of the uterine muscles following delivery. Accounts for 80 to 90 percent off early postpartum hemorrhages

• Massage fundus immediately and frequently falling delivery
• • empty bladder a full bladder impedes uterine contraction
• • increase IV fluids
• • may need to add potatoes into IV if not in bag already
• • prepare for IM administration of either methergine (vasoconstrictor) or hemabate (bronchoconstrictor)

• Vaginal bleeding persists even though fundus is firm
• • steady trickle of vaginal bleeding

• No parity: no pregnancies
• Precipitous delivery: less than 3 hours
• Macrosomia LGA
• Forcep or vacuum-assisted delivery
• Epidural anesthesia