Sowela-PN-OB-Labor & Delivery Part 1

Begins w/delivery of baby&ends with delivery of placenta, uterine contractions continue&detach and expel the placenta

Helps patients to know when deciding on whether to be assessed for labor

What are the 5 P’s of labor

If a patient has had a previous c-section with a _______________incision, a VBAC is possible

Nursing actions for late decelerations

1 hour after delivery the fundus should be soft and at the umbilical level

Slowing of FHR after contraction has started to peak and ending AFTER contraction ends

Shoulder Dystocia can cause:

What are the different types of incisions with c-sections?

Controlled surgical enlargement of the vaginal opening during delivery, described in severity by degrees 1st-4th

If your baby has variability then it means your baby is tolerating labor well

Symptoms of preterm labor can be subtle and begin as uterine irritability

What is important to know about Indomethacin?

Methods used to induce labor:

Spontaneous rupture of membranes ONE HOUR prior to the onset of true labor after 37 weeks

Preterm labor is easier if caught early

Prepares expectant mothers for what to expect and reduce anxiety related to labor and delivery

If your patient has had opioids then they can self ambulate

An epidural is contraindicated in clotting disorders

Cervical ripeness is determined by using:

Considered a major abdominal surgery with increased risks for complications and a slower recovery

Indications for a c-section

Fetal presentation: fetal shoulder presenting in the pelvis

The position of the fetus in relation to the ischial spines, fetal head at the level of ischial spines is 0 station

Rapid cervical change occurs with fetal decent, contractions are strong that increase in intensity and length

Many mothers who experience preterm labor go on to deliver at term

Engagement-Decent-Flexion-Internal Rotation-Extension-External Rotation-Expulsion (In this order)

What medication is given as the last resort for preterm labor

__________ are not used prior to 24 weeks and beyond 34 weeks

What medications may be given to delay deliveries in cases of preterm labor?

After an epidural is done the nurse should monitor the patient for:

Indications of fetal distress

The labor and delivery period is also known as:

Local anesthetic administered trans vaginal during the 2nd stage of labor to numb the perineum for episiotomy and repair

Using pharmacological methods to reduce pain and discomfort of labor has no effect on the fetus or placenta

Refers to the first delivery of this type for the mom

What are the different methods for assistive deliveries?

What characteristics of fluid should always be noted after an amniotomy?

Prior to birth the cervix moves to a more posterior position to line up with the birth canal

Nursing actions for fetal distress

Provides traction and rotation of the fetal head; episiotomy is normally performed for this

Reflex to push upon complete dilation of cervix

Delivery of the placenta, ending with maternal stabilization of vital signs.

Laceration: involves vaginal mucosa or perineal skin

May be used orally to initiate contractions prior to oxytocin

Laceration: second degree characteristics, extending to anal sphincters

The thinning and shortening of the cervix, described as a percentage

FHR is below 100/min or above 160/min, FHR shows decreased or no variability, fetal blood pH is less than 7.2

Causes for fetal tachycardia

Indicates healthy fetus and good placental exchange, 120-160 BPM

Used to perform an amniotomy

What are the possible signs of labor?

Laceration: involves vaginal mucosa, perineal skin, and deeper tissues of the perineum

In which position(s) should a patient be placed when getting an epidural?

Contractions are mild, may feel like menstrual cramping with lower back pain, mother is usually pleasant

Fontanels override each other to accommodate for the passage of the head through the birth canal

Nursing care for assistive deliveries

FHR less than 110 for 10 or more minutes

The stimulation of contractions after they have begun naturally, amniotomy is done to augment labor

Terbutaline increases:

Contractions are stronger and closer together, mother may feel irritable, N/V and have urge to push.

Increases vaginal discharge that is thick, mucous like substance with blood tinged streaks

Laceration: extends through the anal sphincter into rectal mucosa

Slowing of FHR with a start of contraction with return to baseline at the end of contraction. NO INTERVENTION NEEDED

Interventions for preterm labor

Uterine contraction and cervical change that occurs between. 20 and 37 weeks gestation

Fetal presentation: fetal buttocks with hips flexed and feet toward the fetal head

Begins with complete dilation&ends with birth, when the fetus reaches +1 station is typically when mother wants to push

Softening of the cervix in preparation for dilation&delivery

Initiation of labor before it begins naturally

Fontanels never completely close

Signs and symptoms of preterm labor

Nursing actions for variable decelerations:

Other types of fetal presentation include:

Causes of a prolapsed cord include:

Fetal presentation: fetal feet are first

Occurs when umbilical cord is displaced, preceding the presenting part of the fetus or protruding through the cervix

Patient with premature rupture of membranes maybe at increased risk for:

A Bishop Score of 6 or higher indicates an unfavorable chance of successful delivery with induction

A patient’s culture does not effect the way that they may tolerate pain

What can cause a decrease or loss of fetal heart rate variability?

Occurs when the fetus is too large; McRoberts Manuever/Suprapubic Pressure is used to get new born out

A c-section baby is at risk for respiratory complications because they don’t get the squeeze

Uncontrolled tear of the tissues, described in severity by degrees 1st-4th degree

The pelvis ability to accommodate or facilitate delivery

Administered in the intrathecal space by an anesthesiologist or CRNA w/placement of a catheter for med administration

Used with olive oil to promote passage of the infant with minimal trauma

Fontanels override each other during the passage through the birth canal

Involuntary uterine contractions that increase in intensity and regularity dilating and thinning the cervix

Preterm premature rupture of membranes (PPROM) is the spontaneous rupture of membranes:

Causes of fetal bradycardia

What do you do in the event of a prolapsed cord?

Analgesia during labor is usually not used until:

Prior to induction, if cervical ripening has not occurred then it must happen naturally

Fetal presentation: vertex/head first

Accelerations of 15 BPM for 15 seconds is an indication of fetal well being

Abrupt slowing of FHR to less than 110, resembles a “v”

Administered IV to stimulate contractions and initiate labor, increasing per protocol until regular strong contractions

FHR greater than 160 for 10 or more minutes