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L&D 5

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juniperk's version from 2017-11-18 19:47

Section

Question Answer
What are the 4 attitudes?Normal, Military, Brow, and Face
What are the 6 subcategories for passenger?Attitude, Lie, Presentation, Position, Engagement, and Station
What are the 4 positions of Lie?Vertex, Breech, Transverse, and Oblique
What are the 4 positions of presentation? What are the positions for breech?Cephalic, face,shoulder, and breech. Breech divided into Frank (bum w/ legs straight up to head), Complete (bum w/ legs crisscrossed) and Footing (foot hanging out)
What are the 3 Passenger Engagements?Floating- presenting part can be easily moved in or out of the inlet, Ballotable- presenting part dips into inlet but can be displaced with upward pressure, and Engaged- presenting part is fixed in pelvic inlet and cannot be displaced.
What is arrested descent?A sign that the baby is not going to fit. Swelling head and no further descent
Which 4 elements can impact how labor is going to progress? Which 2 can cause more pain?Excitement, fear, perceived loss of control, and anxiety. Fear and anxiety can cause more pain.
Oxytocin increases uterine activity which increases the risk of what?Placental abruption and uterine rupture.
Oxytocin can cause contractions to become too strong and what can happen? Reduced placental blood flow can result in non-reassuring fetal heart rate (FHR) patterns such as late decelerations, fetal bradycardia, tachycardia, or minimal variability.
When a patient arrives and birth is imminent, what are the 4 main questions a nurse needs to ask her?1. How many babies are you expecting? 2. What color was the fluid when your water broke? 3. What drugs did you take in the last 24 hours? 4. When is your due date?
What is the immediate nursing intervention if there are persistent late decelerations?1 discontinue uterotonic drugs 2 turn the patient to the left 3. oxygen 8-10L nonrebreather face mask 4. Give prescribed IV bolus of LR or NS 5. notify HCP.
What is the most common fetal malposition and what is the common site of pain?OP (occiput posterior) back pain
If the patient has uterine hyperstimulation (more than 5 contractions in 10 minutes or a resting tone > 20mmHg and is on Oxytocin, what is the protocol if the FHR is still reassuring?The client is placed/maintained in a side-lying position and a bolus of IV fluid is given. If that does not reduce the uterine activity, then the oxytocin is reduced.
Increased circulating insulin in fetus can do what 2 things?growth hormone and interfere with surfactant... chance for RDS
What are the 8 obstetric care for laboring HIV pt?Stat AZT 2mg/kg loading dose over 1 hour. 1mg/kg/ hr maintenance until deliver. start preg assessment ctr. 2. cont' antiretroviral med 3. Confirm delivery plan (confirm viral load <1000... if over then c sect) Tubal ligation. 4. Verify gestational age 5. Minimize intervention (avoid AROM) 6. Avoid internal monitors 7. Avoid operative vag delivery 8 Avoid version, amnicentesis
What is the 5 ob care for C section of HIV pt?1. Verify date (38 weeks... 39 incr risks) 2. Confirm delivery plan. 3. start AZT chemoprophylaxis continue for at least 3 hours prior 4. Antibiotic prophylaxis 30 min prior to incision 5 Tubal ligation
Newborn care for HIV patientsPeds to delivery 2. Weight expedited and called to nursery for AZT dosage 3. Hold vit k injection, eye ointment, and glucose stick until after bath. 4. Stat AZT within 2 h post delivery. 5. Circumcision performed per request
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