-
A pregnancy ending before 20 weeks is termed as a _________
Miscarriage
-
Cervical changes and uterine contractiosn occurring between 20-37 weeks of pregnancy is termed as ______ labor
Preterm
-
A low birth weight baby weighs less than ________
2500g
-
What is more dangerous, preterm or low birth weight?
Preterm
-
Preterm birth is highest among:
Demographic
Social economic status
Age
- Blacks
- Poor
- Under 15y/o or over 45y/o
-
What biochemical marker most accurately predicts preterm labor? How?
Fetal fibronectin
- Their glycoproteins are found in plasma and are produced during fetal life
- **94% accurate
-
How is endocervial length a predicter for preterm birth?
- A shortened cervix less than 3.5cm is a high risk
- **Nurse should avoid checking cervix if mom's in preterm labor
-
What are the signs and symptoms of preterm labor with uterine activity?
- Contractions every 10minutes or less for more than 1 hour
- Painful or painless
-
What are the signs and symptoms of preterm labor with discomfort?
- Lower abdominal cramping or lower back pain
- Nausea/Vomiting/Diarrhea
-
What are the signs and symptoms of preterm labor with vaginal discharge?
- Increasing amounts and odorous
- Rupture of amniotic membranes
-
What is the most important nursing intervention in preventing preterm birth?
Education
-
What are the 3 main diagnostic criteria for preterm labor?
- 1. Gestational age between 20-37weeks
- 2. Uterine activity
- 3. Progressive cervical changes (80% effacement or 2cm dilated)
-
Why are glucocorticoids given as an early intervention?
- To accelerate fetal lung maturity
- Lowers the risk of respiratory distress syndrome
-
What are some lifestyle modifications that should be avoided when feeling the symptoms of preterm labor?
- Sex
- Riding long distances in a vehicle
- Carrying heavy loads
- Standing more than 50% of the time
- Climbing stairs
- Heavy housework
-
What is the point of tocolytic therapy?
Name a few medications
To suppress uterine activty
- Terbutaline
- Magnesium sulfate
- Procardia
-
At what gestational age are tocolytics NOT to be used?
- After 34 weeks.
- **Risks>benefits
-
What are example medications of antenatal glucocorticoids?
How is it given?
- Betamethasone
- Dexamethasone
IM
-
What is the difference between PROM vs PPROM?
PROM - rupture of membranes at least 1 hour before onset of labor during any gestational age
PPROM - rupture of membranes before 37 weeks
-
What is the point of a fern test?
To test vaginal fluid and decipher if it is urine or amniotic fluid
-
How is dystocia defined?
Long, difficult or abnormal labor
-
What is the primary cause for cesarean births?
Dystocia
-
What are the 5 P's the affect labor?
- Powers
- Passageway
- Passenger
- Position
- Psychologica responses
-
What is going on with dysfunctional uterine contractions in primary vs secondary powers?
How do you treat both?
- Primary - HYPERtonic uterine dysfunction
- Painful, frequent contractions cause cervical dilation/effacement to no progress
- Tx: Rest
- Secondary - HYPOtonic uterine dysfunction
- Weaking or cessation of uterine contractions
- Tx: Ambulation or oxytocin
-
What is the difference between pelvic dystocia vs soft-tissue dystocia?
- Pelvic - contractures of pelvic diameters reducing the capacity of the pelvis
- EX: inlet, midpelvis, outlet
- Soft-tissue - obstruction of the passageway by an anatomic abnormality besides the bony pelvis
- EX: placenta, fibroids, cervix
-
What is the most common cause of pelvic dystocia?
Midpelvis contracture
-
What are fetal causes of dystocia?
- Anomalies
- Cephalopelvic disproportion
- Malposition
- Malpresentation
- Multifetal pregnancy
-
What is the most common fetal malposition of pelvic dystocia?
Occipitoposterior
-
What is the most common form of malpresentation?
Breech births
-
What are the types of breech birth
Frank - thighs are flexed on hips, knees extended (piked up)
Complete - thighs and knees are flexed (sitting indian style)
Incomplete - foot or knee extends below the butt
-
What nursing intervention can help move the baby from a breech to a vertex presentation?
Version
-
What are the two most common methods to induce labor?
-
Prolonging the rupture of membranes can lead to ___________
Infection
-
Oxytocin is normally produced by what gland of the body?
What does it do?
Posterior pituitary gland
Stimulates uterine contractions
-
What is augmentation of labor?
Stimulation of uterine contractions after labor has started spontaneously but progress have been poor
-
When should these forceps be used:
Outlet
Low
Mid
Outlet - when baby is crowning
Low - Head is 2+
Mid - Head is at 0
-
What are the different incision types for cesearean births?
Classic - vertical through the skin and uterus
- Low Cervical(a) - horizontal through the skin, vertical through lower part of uterus
- Low Cervical(b) - horizontal through the skin, horizontal through the lower part of the uterus
-
If an opioid is used for pain, what is usually prescribed with it?
Antiemetics
-
What is the main risk for VBAC's?
Uterine rupture
-
What are the 4 requirements to attempt a VBAC?
- Low transverse incision
- Adequate pelvis
- No other uterine scars
- No history of uterine rupture
-
Shoulder dystocia is when the head is born but the should cannot pass through the ________
pubic arch
-
What nursing interventions can be done for shoulder dystocia?
What is contraindicated?
- McRoberts Maneuver
- Suprapubic pressure
NOT Fundal pressure
-
What are the types of prolapsed cords:
Occult
Complete
Frank
Occult - hidden or can't see it
Complete - Visible if membranes are intact or not
Frank - breech birth and cord is out first
-
What is the main risk from a prolapsed cord?
Fetal hypoxia
-
What should the nurse do right away when noting a prolapsed cord?
Sterile glove and hold presenting part off of the umbilical cord
-
What positions are encouraged when coming across a prolapsed cord for the mom?
- Modified Sim's
- Trendelenburg (Knee-Chest)
|
|
