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PM Maternal/Newborn Midterm Review
Terms in this set (30)
Assessing pt in labor -
Support system, make comfortable, reposition. Don't hold hand. She can break it.
Stages of labor
1: 0-10cm latent onset of labor irregular contractions mild to moderate,
1: latent - 0-3cm.
2: active - 4-7cm
3: transition - 8-10cm
2: 10cm to delivery
3: Delivery to placenta
4: Placenta out 1-4 hr into recovery
AVA, Warton's jelly covers the cord.
Painless, bright red blood, soft stomach.
Total covering entire cervix.
Partial coving partial cervix.
Marginal is close to the cervix (touching not covering).
Low lying is close to the cervix but not touching
Dark red blood, painful, hard stomach
Regular and stronger over time, vaginal pressure, contractions start at back move forward, you will feel them no matter what, 5 min apart, lasting 45-60 seconds.
False labor -
Irregular and weak, felt in front of stomach, no pain, contraction will stop when moving, BRAXOTON HICKS
Uterine contractions 20-36 weeks, very preterm is less than 32 weeks, moderate preterm is 32-34 weeks, and late preterm is 34-36 weeks. Hydrate, antibiotics
Neural tube -
Elevated. Take folic acid to prevent AFP
Decreased. Take folic acid to prevent AFP
Remove cord off presenting part. C-section after. Splash and dash. 4 min
Used to stop seizures. Adverse - decrease deep tendon reflexes, decreased urine output, monitor respirations. Antidote - Calcium gluconate. Lab levels 4-7mEq (Normal), 10mEq (decreased DTR), 15mEq (respiratory distress), 25mEq (cardiac arrest).
PID (Pelvic inflammatory disease)
caused by STI, treated with antibiotics.
AFP (alpha fetoprotein)
Elevated = neural tube defect, Decreased = Downs syndrome. Take folic acid to prevent AFP.
ischial spine = 0. Above is negative 1 to 5 (-1 to -5). Below is positive 1 to 5 (+1 to +5)
Temporary drop in fetal heart rate.
Variable: Cord compression, reposition mom.
Early: Do nothing. At all. Perfect.
Late: 5 things
IV bolus fluids
Stop medications - oxytocin/pitocin
Lower head of bed
Ultrasound to see physical response of baby. Nonstress test. Fetal scalp stimulation? Drink really REALLY cold water.
When mother feels the baby move in belly.
Third trimester, baby drops, indication that labor will start, 2-4 weeks prior to delivery
Active labor care of patient
See ATI book pg. 7. Again, do NOT hold her hand. She will break it off and shove it down her husband's throat. You have been warned.
Signs of pregnancy
-perception of fetal movement(quickening: usually felt between 16-18 weeks gestation)
-Goodell's sign-softening of the cervix
-Chadwicks sign-dark blue to purplish red color of the vaginal mucosa
-Hegars sign-softening of the isthmus of the uterus
-Braxton-Hics contractions:painless uterine contractions that occur every 10-20 minutes after the third month of pregnancy and do not represent true labor
-hyperpigmentation of skin
-positive preg test
-palpation of fetal outline
-auscultation of fetal heartbeat
-fetal movements palpated by examiner
-u/s recognition of pregnancy
incision into the amnion (rupture of the fetal membrane to induce labor; a special hook is generally used to make the incision)...
Artificial rupture of membranes. Just like Texas, Hook 'em.
Is withdrawing amniotic fluid
after 20 weeks of pregnancy, positive protein urea (+1), increased BP (140/90), facial, hand and feet edema. Drink lots of water. Nonstress test, biophysical, daily weight, BP meds until baby pops out of mom. BP meds - hydralazine (Apresoline) smooth muscle relaxant, labetolol. Clonus negative smooth foot reaction. Clonus positive foot jerks when pushed.
1+: for one second, 1mm. 2+: 10-15 seconds, 4mm. 3+: 60 seconds, 6mm. 4+: 2-3 min, 8mm
Scenario comfort teaching
Reposition, breathing, support system
add 7 days, subtract 3 months, BOLO year
110 to 160
SEE HANDOUT IN TEXT GROUP
Passageway (birth canal)
Passenger (fetus and placenta)
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