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Flashcards in Sim Lab Deck (28)
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1
Q

What constitutes the First Stage of Labor?

A

Initial Assessment

  • contact (usually phone): health history, prenatal record, birth plan
  • inquire about fetal movement, EDB, bloody show, membrane status, characteristics of contractions, other s/s of labor, GP, previous childbirth experiences
  • determine: True vs False LAbor
  • do they have support
2
Q

what is EDB?

A

estimated date of birth

3
Q

what is gravida? parity?

A

gravida - how many times pregnant

parity - number of greater than 20 weeks (so miscarriages still a part of this)

4
Q

How do you determine between true and false labor?

A
  • examination of cervix
    True: will change cervix
    False: won’t change cervix
5
Q

How do you perform an initial, physical assessment for someone in labor?

A

General Assessment

  • head 2 toe and vitals (pain)
  • Leopold’s maneuver
  • vaginal examination for baseline
  • amniotic membrane status: know when water broke b/c want to have labor at least 24 hours after it breaks
  • uterine contraction
  • FHR and pattern
6
Q

What is Leopold’s maneuver?

A
  • palpation to try and figure out how the baby is positioned in the belly, look up how to do
    butt: more point
    head: round ball

***most babies are head first

7
Q

what is the top of the uterus called?

A

the fundus

8
Q

Describe the vaginal examination for baseline during labor

A

2 fingers with lube through vaginal opening

  • need to assess THICKNESS of cervix and how far DILATED it is (2 most important thing)
  • also assess how far down the fetus has descended
9
Q

What is the range of dilation when doing a vaginal examination during labor?

A

0-10 cm

10
Q

How to rate fetal descent?

A

-3,-2,-1,0,+1,+2,+3 where positive numbers are further down means the labor will be shorter rather than longer

11
Q

how do you check if it’s fluid from amniotic sac and not urine when water breaks?

A

nitrozine test, vaginal fluid pH is acidic where amniotic fluid is alkaline, use pH strip and see if it turns blue

(sometimes use amnisure, special q tip insert in vagina leave in for a minute and when you take it out put it in a solution and lab tests it)

12
Q

What do you need to assess with uterine contractions?

A
  • frequency: measure start of one contraction to start of next contraction
  • intensity: how strong contraction is
  • duration
  • resting tone
13
Q

What is the FHR and what do you need to to know about it?

A
fetal heart rate
- either reassuring or non-reassuring: look at contractions and how baby's reacting to them, good = reassuring
normal HR (measured over 10 min): 110-160
- determine variability (Minimal, moderate, marked): marked variability could mean baby's being pressed, mom has moved etc; there will also be periodic baseline changes (bad is minimal variability with late deceleration baseline changes)
14
Q

Do you have to get the woman’s consent to test for HIV?

A

yes

15
Q

what is a really important genital swab to do on a pregnant woman about to give birth?

A

for strep B

16
Q

What are the non-pharm methods for pain management

A

1) Continuous Labor Support: someone in room for them
(biggest one)
2) Hydrotherapy: relaxation/buoyancy, vasodilation
3) Ambulation and position changes (definitely NOT flat on back)
4) Acupuncture
5) Attention Focusing and Imagery (eye contact’s important)
6) Therapeutic Touch/Massage
7) Breathing Techniques

17
Q

What is Nursing Management during Second Stage of Labor

A

Delivery

  • cleanse perineal area/vulva b/c from here on out always leaking fluid
  • birth assist includes suctioning of newborn, holding legs, umbilical cord clamping
  • immediate care of newborn
18
Q

What entails immediate care of the newborn?

A

1) Drying/Stimulation
2) Apgar score
3) Identification
4) Hugs band: alarm band
5) measure baby/brith statistics

19
Q

What is the third stage of labor

A

Placenta discarded

  • assess for trauma, episiotomy, lacerations
  • usually separates within 10 minutes

Interventions

  • instruct to push
  • admin oxytocin PRN
  • apply ice to perineum if vaginal delivery
20
Q

What’s the Fourth Stage of Labor?

A
  • first 4 hours after delivery

- vital signs, fundus, perineal area, comfort level, lochia, bladder status

21
Q

What is lochia?

A

description of fluid coming from uterus

22
Q

What is bladder status indicative of after labor?

A

recovery status of mother

23
Q

Why should a mother not lay on her side? (or is it her back?)

A
  • supine vena cava syndrome

if have to tilt, better to be on left side

24
Q

For whihc babies are phototherapy lights used for?

A
  • babies with elevated bilirubin
25
Q

If you have a baby that’s high or low birthweight, what’s an important second assessment to do?

A

blood glucose test

26
Q

What’s the respiration rate for the newborn?

A

30-60 breaths/min

27
Q

what is it called when baby’s trunk and face are pink but extremities are blue?

A

acrocyanosis

28
Q

How do you perform a PKU?

A

heel stick, do it on the outer edges