PN-111-3

Accleration

an abrupt increase in FHR above baseline with onset to peak of the acceleration less than < 30 seconds and less than 2 minutes in duration

Acme

the highest or most critical point in growth and development

Amnioinfusion

introduction of a solution into the amniotic sac; an isotonic solution is most commonly used to relieve fetal distress

Amniotomy

Artificial rupture of the amniotic sac

Atony

lack of normal muscle tone

Attitude

a predisposition to respond in a favorable or unfavorable way to objects or persons in one's environment

Braxton Hicks contractions

intermittent painless uterine contractions that occur with increasing frequency as the pregnancy progresses

Deceleration

temporary decreases in the fetal heart rate (FHR) during labor

Decrement

Phase of uterine contractions; decreasing strength

Dilation

expansion of the cervix

Doula

A caregiver who provides continuous physical, emotional, and educational support for the mother before, during, and after childbirth.

Early decelerations

Fetal Head pressed on. This is ok.

Estriol

estrogen of pregnancy

Fetal lie

relationship of the long axis of the fetus to the long axis of the mother

Fetal presentation

the manner in which the fetus appears to the examiner during delivery

Fetal station

Location of the presenting part in relation to the midpelvis or ischial spines; expressed as cm above or below the spines; station 0 is engaged, station -2 is 2 cm above the ischial spines

Increment

Phase of uterine contractions; increasing strength

Intrathecal space

The fluid-filled space surrounding the spinal cord.

Intrauterine pressure catheter

A catheter that can be placed through the cervix into the uterus to measure uterine pressure during labor. Some types of catheters may be inserted for the purpose of infusing warmed saline to add additional intrauterine fluid when oligohydramnios is present.

Later decelerations

Late decelerations occur due to decreased utero-placental insufficiency. The nurse should assist the client into a "lateral position" to improve uterine perfusion and oxygen transfer to the fetus.

Leopold's maneuvers

used to determine the position, presentation, and engagement of the fetus in utero

Lightening

the sensation of the fetus moving from high in the abdomen to low in the birth canal

Meconium

first stool of the newborn

Ophthalmia neonatorum

conjunctivitis of the newborn

Oxytocin

A hormone released by the posterior pituitary that stimulates uterine contractions during childbirth and milk ejection during breastfeeding.

Periodic decelerations

Decelerations of fetal heart rate associated with uterine contractions.

Prostaglandins

Modified fatty acids that are produced by a wide range of cells.

Pudendal block

an anesthetic administered to block sensation around the lower vagina and perineum

Somatic pain

Pain that originates from skeletal muscles, ligaments, or joints.

Spinal anesthesia

regional anesthesia produced by injecting medication into the subarachnoid space

Tocolytic medications

Terbutaline

Used for preterm labor

Delays but does not prevent labor.

Variability

fluctuations in the FHR baseline of 2 cycles per minute or greater, with irregular amplitude and inconstant frequency

Variable decelerations

HR up or down, cord compression = VERY BAD

Prolapsed cord= push head up, change mom position

Visceral pain

a poorly localized, dull, or diffuse pain that arises from the abdominal organs, or viscera

Amniotic band syndrome

group of abnormalities associated with the entrapment of fetal parts in the amnion, often resulting in fetal amputations or clefting

Cephalopelvic disproportion

Inability of the fetus to fit through the pelvis

Chorioamnionitis

Infection of the amniotic sac

External version

a process of manipulating the position of the fetus while in utero, to try to turn the fetus to a cephalic presentation

Fetal demise

death of the fetus

Fetal fibronectin

a protein found in fetal membranes and amniotic fluid

Macrosomia

Large body size

Nuchal cord

Umbilical cord around the fetal neck.

Precipitous delivery

birth of the fetus after less than 3 hours of labor

Premature rupture of membranes

Spontaneous rupture of the amniotic membranes, 1 hr or more prior to the onset of true labor

Preterm premature rupture of membranes

After 20 weeks of gestation and prior to 37 weeks

Retained placenta

Placenta or fragments of the placenta remain in the uterus preventing the uterus from contracting which leads to uterine atony or subinvolution

Shoulder dystocia

delayed or difficult birth of the fetal shoulders after the head is born

Uterine inversion

turning of the uterus inside out after birth of the fetus

Uterine rupture

a tear in the wall of the uterus

Augmentation

Statement of a melody in longer note values, often twice as slow as the original.

Bishop's score

pre-labor scoring system to assist in predicting whether induction of labor will be required

External cephalic version

Turning a breech baby to cephalic presentation through the maternal abdominal wall

Labor induction

the process of initiating labor by artificial means

Pfannenstiel's incision

transverse skin incision, two finger-breadths above the symphysis pubis

Trial of labor after cesarean

TOLAC

Vacuum extraction

technique that uses suction to help the doctor move the baby down the birth canal as the mother pushes

Vaginal birth after cesarean

VBAC

Dystocia

difficult labor

Polyhydramnios

excessive amniotic fluid

1. Immediately prior to an amniotomy, the external fetal heart monitor tracing shows 145 bpm with early decelerations. Immediately following the procedure, an internal trancing shows a fetal heart rate of 120 with variable decelerations. A moderate amount of clear, amniotic fluid is seen on the bed linens. The nurse concludes that which of the following has occurred?

Succenturiate placenta

The first nursing action if a visible prolapsed umbilical cord occurs is to

relieve pressure on the cord

A client just spontaneously ruptured membranes. Which of the following factors makes her especially at high risk for having a prolapsed cord?

\-Breach presentation

\-Transverse lie

labor augmentation

the process of accelerating the quality of labor by artificial means

1. Of the following options for cesarean birth, the most important nursing care during post anesthesia recovery is to:

Assess the fundus

When educating a patient regarding warning signs of preterm labor what data would you include

\-Contractions with or without discomfort

\-Pain or discomfort in the vulva and thighs

Measures to halt preterm labor

◦Progesterone

◦Treat infections

◦IV hydration

◦Bedrest

◦Tocolytic drugs: used for short time while waiting for lungs to mature

◦-Magnesium sulfate, indomethacin, nifedipine

◦Corticosteroids- betamethasone (for lung development)

How does a nurse recognize fetal distress

FHR is less than 120 or greater than 160

Prolapsed cord

When cord slips down below fetal head and pelvis, compressed and interrupts blood supply

Version

Method of changing fetal presentation usually breech to cephalic

vaccum extraction

Use of suction applied to the fetal head to assist the mother's expulsive efforts

Forceps delivery

Assistance at birth with instrument that has curved blade that fits around the fetal head

episiotomy

Surgical enlargement of vagina

Cesarian Birth

Surgical delivery of fetus through incision in abdomen

A woman, 40 weeks' gestation, calls the labor unit to see whether she should go to the hospital to be evaluated. Which of the following symptoms woman indicates that she is probably in true labor and should proceed to the hospital?

\-Braxton hicks contractions become regular and uncomfortable

\-Presence of bloody show

\-Energy spurt

\-Contractions increase with walking

A 39 weeks' gestation primigravida presents to the OB unit claiming that she believes she is leaking amniotic fluid. To assess for the presence of amniotic fluid the nurse may perform which of the following tests.

\-Fern test

\-Amnisure

\-Nitrazine test

A nurse is caring for a laboring woman who is in transition. Which of the following signs/symptoms would indicate that the woman is progressing into the second stage of labor?

\-Uncontrollable urge to push

\-Inability to breathe through contractions

In addition to breathing with contractions, which of the following actions can help a woman in the first stage of labor to work with her pain?

Performing effleurage

Two powers of labor

Uterine contractions and maternal pushing efforts

Cervical effacement is expressed as

percentage of the original cervical length

The amount of cervical dilation is expressed in

Cm

The nurse should promptly report contraction durations longer than \_______________ seconds or intervals shorter than \_______________ seconds and frequency closer than every \_______________ minutes

60, 5, 2

Choose the best method during the admission process to help relieve general anxiety for a woman who has not attended prepared childbirth classes and who is having her first baby?

Give simple explanations about her environment and what to expect during labor

When a portion of the fetal head is visible during a contraction.

Crowning

Approximate strength of the contraction. In most cases it is described in words such as "mild", "moderate", or "strong"

Intensity of contraction

Refers to how a reference point on the fetal presenting part is oriented within the mother's pelvis. ROA, LOP etc.

Presentation

Describes the level of the presenting part in the pelvis.

Station

Time elapsed time from the beginning of one contraction until the beginning of the next contraction. Described in minutes

Duration of contraction

The amount of time the uterus relaxes between contractions

Interval of contraction

Describes how the fetus is oriented to the mother's spine

Lie

When the physician artificially ruptures the membranes

Amniotomy

Occurs when the presenting part reaches the level of the ischial spines

Engagement

Irregular contractions that begin during early pregnancy and intensify as full term approaches

Braxton hicks contractions

The elapsed time from the beginning of one contraction until the end of the same contraction. Described as average number of seconds for which contractions last

Frequency of contraction

Refers to the fetal part that enters the pelvis first.

Position

Which of the abbreviations would mean that the fetus is in breech position?

RSA

Which of the abbreviations is the most common fetal presentation?

ROA

Which of the fetal presentation abbreviations would most likely cause back labor?

LOP

While caring for a client in transition phase of labor, the nurse notes that the fetal monitor tracing shows average short-term and long-term variability with a baseline of 142 bpm. What should the nurse do?

Provide caring labor support

Describe three (3) characteristics of abnormal amniotic fluid

\-Green

\-Odor

\-Cloudy

A Baseline fetal heart rate of 125 bpm during labor should be interpreted as:

Normal for a full term fetus