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Labor and Delivery 4
Terms in this set (69)
When pt is getting an epidural how long time wise until you need to get heart tones?
What are some ways to increase profusion to the uterus?
*pain control when stressed the mothers uterine arteries constrict
*enhancing maternal relaxation.
What can affect uterine blood flow with regard's to pressure?
Uterine contractions compress
uterine vessels so baby is without during contractions
The placenta functions as?
Placenta focuses on?
The forceful presence of the maternal arterial blood with a mean arterial pressure of 90 encourages
passive fetal return of fetal oxygen-poor blood into the lower pressure of the maternal venous system.
The intervillious space serves as
basically lungs where carbon dioxide and oxygen exchange and waste.
When a placenta is fully functioning the fetus gets?
transfer capacity near 100%the fetus is supplied with approximately twice the resources to meet its needs.
When the transfer exchange from placenta to fetus is 75% the fetus?
does not receive larger molecules and fetal malnutrition can result leading to IUGR.
When then the transfer exchange from the placenta is decreased to 50% what happens?
Oxygen and carbon dioxide exchange is decreased , which can result in fetal compromise.
Maternal hypertension can cause
infarcts to the placenta , causing death to that part of the placenta.
Calcifications of the placenta are caused by?
aging and decrease the surface area of the placenta .
Abruption decreases the ?
amount of surface area of the placenta. The amount of abruption is determined by the remaining placenta attached.
Abnormal placental development such as extrachorial placentation , circummarinate and circumvallate placenta and inadequate lengthening o maternal spiral arteries
will affect the profusion ability of the placenta which will affect the oxygenation and waste removal of the fetus.
Placental problems what will you see on the strip?
*abnormal baseline ranges
What is the substance that covers the cord called?
What changes will you see when a cord is compromised?
*think of a garden hose that is being kinked
Chemoreceptors detect change in ?
gases: oxygen and carbon dioxide, ph
Baroreceptors detect changes in ?
fetal blood pressure
Fetal hypoxemia is occurring who will detect it and what will be the response?
Chemorecptors will detect the change in gases and will send message via CNS to sympathetic nervous system to increase the heart rate.
Hormones that will play a role in the fetal strip?
*catecholamine's:epinephrine and norepinephrine
Think of hormones as messenger to get other system to?
respond or act
What effect will catecholamine's have on the fetus?
norepinephrine and epinephrine will cause vasoconstriction in the fetus and shunt blood flow to vital organs: brain, heart and lungs. This will take away blood from: kidneys, GI.
Vasopressin is an
vasopressor that will increase blood pressure and try to stabilize the hemodynamic system.
Renin -Agiotensin causes
produced by kidneys causes vasoconstriction to maximize blood pressure and the ability to respond to stressors. This is age dependant on the fetus: younger fetus do not have this capability,.
IUGR asymmetric is?
Only the wt is small head size is normal/best kind to have
Organs and the head are small too. Think Zika
How long is acryanosis normal?
normal for 24 hours , passed 48 hours is not normal
Baby is jaundice in the first 12 hours?
This is abnormal and probably a positive coombs. Photo therapy needed and may need to go to NICU
Mottling is cause from?
*cold stress-warm up baby if it still appears call MD
Caput succedaneum think of a ?
cap that you were over your head. This is swelling
Cephal hematoma is what?
blood under the skull from vacuum or forceps or injury.
Does not cross suture line
When a baby has ear tags or something different with the ears contact the MD because?
kidneys could also be damaged, they develop at the same time.
Fontannels on a baby should be
not sunken or bulging. Just flat . Sunken means dehydrated , bulging mean increase ICP.
Retractions, nasal flaring and grunting are signs of?
respiratory distress/get the NICU
Normal heart rate in an infant?
Murmurs can be soft or loud, the loud ones usually means?
Where do we listen for heart sounds?
What causes the sound you hear from a murmur?
turbulent blood flow .
If baby has a two vessel cord we get a
renal ultrasound because it develops around the same time.
What is brick dust?
uric crystals in a baby's diaper which means baby is a little dehydrated.
What is crypochidism
If testes don't descend/after 6 months they do surgery
What is a hydrocele?
testes filled with edema/will illuminate in light.
What kind of injury can occur from a shoulder dystocia?
look for limp floppy arm/most are transient and return in 2 weeks
What is a sign baby hips are not symmetrical?
unequal gluteal folds
What is the tonic reflex?
What is the babinkski reflex?
How long is the postpartum period?
Why do we get meconium sample from baby's who mothers were positive for substance abuse?
meconium-drug stays longer than urine
What is NAS scoring?
What is considered a miscarriage?
*less than 20 weeks and under 500grams
What is a stillbirth or fetal demise?
What is a neonatal death?
within the first 24 hours of life
Approximately how many women miscarry?
What are some of the biggest causes of death in utero?
In utero remember the fetus and blood flow?
*higher infinity for oxygen
Normal range for AFI
AFI of 6 or lower is consider?
AFI of above 18 is considered ?
NST to be reactive must include?
*thirty minute strip
Active labor chart every ?
Pushing in labor , chart every ?
Epidural, how often do we chart on the strip?
5 minutes X 30
With mild preeclampsia , think?
*fetal intolerance to labor
On PIH patients closely monitor?
*protein in urine
*serial ultrasound with BPP
Sinusoidal pattern over 20minutes?
Interuterine resuscitation measures
If no change deliver
What is a category III strip?
Absent variability with decals:lates, variables, or bradycardia. Deliver now
Interuterine resuscitation interventions are?
or any induction agents
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