Maternity Exam 3

sinusoidal pattern

smooth wave pattern 20+ minutes

intrauterine resuscitation

reposition, d/c uterotonics, inc fluid, knee to chest, 10L o2

tachysystole/preterm intervention

tocolytics (-ipine, terbutaline, mag sulfate)

variable decels

v/w shape, cord compression

early decels

head compression (vagina)

late decels

placental insufficiency

visceral pain

originating from organs or nerves; 1st stage

somatic pain

muscles, joints, bones; 2nd stage

catecholamines

inc by anxiety, dec oxytocin, arrest labor

bradley method

focus on deep breathing, for ppl who don’t want interventions

lamaze method

deep breathing, may use meds

effleurage

circular massage on abd, hand, back

water therapy timeframe

37-42wk

opioid agonist antagonist

nalbuphine

pudental nerve block

for episiotomy

contra for epidural

platelets <80k, spins anomalies, cns anomalies, cardiac anomolies, infection, inc icp

vasopressor for epi

ephedrine

closed glottus pushing

counting & instructing, hold breath while bearing down, pull legs

open glottus pushing benefits

dec time, fatigue, pph, inc apgar

third stage of labor

until placenta is out

3 signs of placental separation

surge of blood, cord lengthening, globular fundus

fourth stage nursing interventions

vitals q15m minus temp, fundal check q15m then 30

7 cardinal movements

engagement, descent, neck flexion, internal rotation, extension (crowning), external rotation, expulsion

preterm labor stats

30% resolve spontaneously, 50% hospitalized birth at or near term

risk for preterm birth

trauma, dehydration, cervical insufficiency, history, multiples, low BMI, age, ART

frank breech

hips flexed, knees extended

complete breech

hips & knees flexed

breech risk

history, placenta previa, uterus shape, primi, anomalies

cat II tracing

moderate variability with recurrent late/variable decels; minimal variability with recurrent variable decels; absent variability without decels

meconium staining, grades & treatment

aspiration/hypoxia, grade 1 light & thin, grade 2 green/flecks, grade 3 pea soup; amnioinfusion

meconium staining risks

obesity, htn, smoking, drugs, ogliohydramnos

vacuum extractor

suction head, traction during contractions; not before 34wk

forceps

spoon head to rotate/descend

overt cord prolapse

slips through cervix & compressed by fetus

occult cord prolapse

compressed between cervix and fetus

cord prolapse intervention

expedited birth or CS, trendelenberg, knee-chest, fingers upward into presenting part

uterine rupture risks

CS, oxytocin, misoprostol, polyhydramnos, multiples

uterine rupture presentation

dec variability, late decels, brady, atony, pain; hematoma on u/s

shoulder dystocia CAMPEER

call for help, apply suprapubic pressure, move fetal arm, position hands & knees, episiotomy, elevate legs, rotate

dystocia mcroberts position

thighs to abdomen

cholestasis

poor flow of bile, builds up in blood; itching

betamethasone

corticosteroid that enhances lung maturity/surfactant in preterm, ideally 2 doses in 48 hours