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76 Cards in this Set
- Front
- Back
largest part on a infant?
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head
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lie
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relationship between long axis of fetus and long axis of mother (cephalocaudal)
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presentation
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part of fetus that enters pelvis first
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attitude
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1. degree of flexion fetus assumes in utero
2. normally head flexed foward-arms and legs flexed |
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effacement
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thinning out of cervix
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dilation
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external OS enlargement,
10cm-complete ( then push), |
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what to remember with effacement and multipara and primipara?
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occurs before dilation on primipara, at same time as dilation in multipara
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FHR
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normal rate is 120-160 (110 at term)
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abnormal amniotic fluid
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1. blood
2. green fluid- indicates meconium ( affect resp at birth) 3. fluid cloudy or yelow w/odor- indicates infection |
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contractions
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three phases of strength:
1. increment: increasing 2. peak/acme: greatest 3. decrement: decreasing |
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what are the 4 P's
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1. powers
2. passage 3. passenger 4. psyche |
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position
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relationship of presenting part to specific quadrant of the maternal pelvis
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what side is best for a pregnant women?
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left -lateral promotes good maternal fetal circulation
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if a pregnant women is walking through the hall and her water breaks, what do u do?
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if ambulating and ROM occurs, return immediately to be evaluated-assess FHR
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duration
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time from beginning of CTX to end of same CTX
if >90 sec, notify MD |
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frequency
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timed from beginning of one CTX to beginning next CTX
should not be closer than 2 mins. |
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EBL
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normal for VD <500cc
<1000cc for C/S |
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what is a precipitated birth
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1. born in < than 3hrs
2. labor begins abruptly, intensifies quickly 3. may cause uterine rupture, cervicel lacerations or hematoma 4. places fetus at risk for hypoxia 5. may result in birth injuries such as, intracrania hemorrahge, or nerve damage |
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true labor
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1. regluar CTX
2. becomes more intense, freg, last longer 3. intesify w/walking 4. boody show 5. progressive cerivcal changes 6. low back pain (abdomen/thighs) |
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false labor
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1. irregular CTX
2. no cervical changes 3. relieved by walking 4. no bloody show 5. pian (low abdomen/groin) 6. abe to sleep thru contrations |
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when can u use internal modes?
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when membranes have ruptured and cervix is 1-2cm dilated
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what are early decals?
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sign of fetal head compression or dilating of cervix- quickly returns to baseline ( no interventions ness.- good decal)
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what is variable (V,W or U shaped)
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begins/ends abruptly - indicates fetal cord compression, nuchal cord, or inadequate fulid ( may need to respotion pt, or start amnioinfusion)
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what are the variability rates for minimal, moderate, marked
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minimal: <5bpm
modrate 6-25bpm (good O2) marked >25 bpm (good O2) |
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if the fundus is deviated to the right, what do u do?
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ask the pt to void
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how long do u have to do the apgar score
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1-5 mins after birth
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apgar score of 8-10
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no action continued observation
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apgar score 4-7
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may need gentle stimulation
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apgar score 3 or less
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requires aggressive resuscitation
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where is the first temp taken for the infant and why
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rectally, to ensure the anus is open
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what do the nurses apply on the infants eyes to prevent eye infection
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erythromycin
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what do u clean the umbilical cord with and how often
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with alcohol and several times a day
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how may arteries and veins do the umbilical cord has
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(AVA) 2 arteries and 1 vein
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if fundus is higher than umbilicus, soft/boggy what do u do
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massage it
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where is the normal fundus at
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below umbilicus, firm and mid-line-
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how much does the fundus shrink per day
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1 finger width
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why do u give pitocin after labor
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give after delivery of placenta to prevent postpartum hemorrhage
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what is a FSE
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picks up true FHR, IUPC, measures the strength of CTX
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IUPC
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intrauterine pressure catheter
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FSE
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fetal scalp electrode
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why do we want the pt to have an empty bladder during labor
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a full bladder may impede descent of fetus
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what signs to look for when hemorrhage
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abnormal amount of blood loss
elevated HR, decreased BP, narrow pulse pressure is first sign of shock |
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late-non reassuring
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starts at peak of CTX, end well after CTX ends, O2 at 10ml/min ( face mask) , turn off pitocin, administer tocolytics
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when is time of birth noted
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once the feet are out (everything)
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flexion
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fetal head movement that helps it pass through pelvis
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internal rotation
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head enters pelvis diagonally, flexes as it touches pelvic floor and rotates until just below symphonies pubis
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extension
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as head passes under symphysis, it changes from flexion to extension to allow it to fit through pelvis
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external rotation
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when head is born, spontaneously turns to one side as it realigns with shoulders and rotates within pelvis
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lightening
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movement of fetus and uterus down into pelvic cavity-makes breathing easier towards end of pregnancy
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engagement
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entrance of widest diameter of presenting part into true pelvis- often happens before onset of labor in primipara and in multipara may occur until well into labor, zero station
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powers
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contractions- primary power during 1st stage
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maternal pushing
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secondary power
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when does mother push
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when cervix is completely effaced and dilated, mother pushes with each CTX-helps propel fetus through pelvis; should not push before compeletey dialted and effecaed
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passage
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route fetus travels from uterus through cervix and vagina to external perineum
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what pelvic type is most favorable for birth
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gynecoid
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passenger
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consist of fetus with placenta, amniotic fluid, amniotic membranes
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what is the most common : transverse or longitudinal
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longitudinal because fetus parallel to mother's spine
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leopholds maneuver
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method used to palpate fetal position
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occiput
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how head positioned if fetus is in cephalic vertex presentation
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sacrum
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breech presentation
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mentum
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face presentation
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pelvis is divided into 4 quadrants
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R/L anterior
R/ posterior ex: LOA-back of fetal head to left side of mother, occiput ( head) is presenting, and anterior in pelvis; if OP, pt will c/o "back pain" |
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psyche
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birth is described in emotional terms; anxiety causes stress compounds to be released from adrenal glands (catecholamines) that inhibits CTX and direct blood away from placenta
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braxton hicks
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irregular CTX; start early in pregnancy, not true CTX ( no cervical changes) helps position fetus in the uterus
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increased vaginal discharge
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fetal pressure ; should not cause itching or irritation
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bloody show
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pink or dark brown tinged mucus - effacement/dilation slightly (no reason for the hospital);
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energy spurt
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called nesting-small weight loss; before onset of labor
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ruptured membranes
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risk for prolapsed cord and infection; may happen before labor begins
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CTX
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contractions
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ROM
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ruptured membranes
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station
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level of presenting part to ischial spines
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minus station
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head not engaged
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zero station
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head engaged
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plus station
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head is below ischial spines
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dirty Duncan
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mother's side
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shiny Schultz
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fetal side
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