Ch 8 OB -Introduction to Maternity and Pediatric Nursing Exam
Oligohydramnios - ANSWER-Lower than normal amount of amniotic fluid
Aminoinfusion - ANSWER--Oligohydramnios
-Umbilical cord compression resulting from lack of amniotic fluid
-Goal of reducing recurrent variable decelerations in the fetal heart rate.
-Goal of diluting meconium-stained amniotic fluid to prevent meconium aspiration syndrome
Why do you do an amnioinfusion? - ANSWER-It replaceds the "cushion" for the umbilical cord and relieves the variable decelerations of the fetal heart rate that may occur during contractions when decreased amniotic fluid is present.
How often should the pads under the mom be changed after the membranes rupture? - ANSWER-Change them as often as needed to keep the mom relatively dry and to reduce the risk of infection of skin breakdown. (like Q20 mins)
What should be documented about the drainage on the underpads after a amnioinfusion? - ANSWER-Should document the color, amount, and any odor of the fluid expelled from the vagina.
What is Induction? - ANSWER-The initiation of labor BEFORE it begins naturally.
What is Augmentation? - ANSWER-The stimulation of contractions AFTER they have begun naturally.
What is the Bishop Scoring System? - ANSWER-- Evaluates the cervical response to induction procedures.
-A higher score (above 6) is predictive of successful labor induction because the cervix has ripened or softened in preparation for labor.
What are indications for labor induction? - ANSWER--Gestational Hypertension
-Ruptured membranes without spontaneous onset of labor
-Infection within the uterus
-Medical problems in the woman that worsen during pregnancy
-Fetal problems such as slowed growth, prolonged pregnancy, or incompatibility between fetal and maternal blood types
-Placental Insufficiency
-Fetal death
What are contraindications to labor induction? - ANSWER--Placenta previa
-Umbilical cord prolapse -Abnormal fetal presentation
-High station of the fetus
-Active herpes infection in the birth canal
-Abnormal size or structure of the mother's pelvis
-Previous classic cesarean incision
Pharmacological Methods to Stimulate Contractions- Cervical Ripening- - ANSWER--
Porstaglandin in a gel or vaginal insert is applied before labor induction to soften the cervix. -Laminaria is an alternative to cervical ripening by swelling inside the cervix
Pharmacological Methods to Stimulate Contractions- Oxytocin induction and the augmentation of labor- - ANSWER--Used to initiate or stimulate contractions
-Most commonly used method
Pharmacological Methods to Stimulate Contractions- Prostaglandin E1: Cytotec (Misoprostol) - ANSWER--Administer PO (buccal/sublingual) or intravaginally
- More effective in achieving vaginal delivery within 24 hours
-Adverse effect: uterine tachysystole (hyperstimulation)
Pharmacological Methods to Stimulate Contractions- Prostaglandin E2: Prepidil or Cervidil - ANSWER--Administer intravaginally, sustained release
Preparing the woman for labor augmentation. - ANSWER-- Explain procedure to woman
-Obtain baseline vital signs and fetal heart rate.
-Ensure IV line is placed (in case emergency)
-Remains in bed for up to 2 hours.
-Oxctocin induction can start 6-12 hours after vaginal insert has been removed.
-Assess for signs of uterine tachysystole (hyperstimulate)
List some way for dilating the cervix. - ANSWER--RU486 (Mifepristone): steroid receptor agonist use for early pregnancy termination (use if fetal demise)
-Stripping amniotic membranes
-Hydroscopic dilators
-Transcervical balloon dilators (16F, 30ml)
-Extra-amniotic saline infusion (puts presure on the cervix like the head would).
What is an Amniotomy? - ANSWER-artificial rupture of membranes (AROM)
Why is a Amniotomy done? - ANSWER--Done to stimulate or enhance contractions.
-Commits the woman to delivery
-Stimulates prostaglandin secretion
What are complications of Amniotomy? - ANSWER--Prolapse of the umbilical cord (RISK)
Oligohydramnios - ANSWER-Lower than normal amount of amniotic fluid
Aminoinfusion - ANSWER--Oligohydramnios
-Umbilical cord compression resulting from lack of amniotic fluid
-Goal of reducing recurrent variable decelerations in the fetal heart rate.
-Goal of diluting meconium-stained amniotic fluid to prevent meconium aspiration syndrome
Why do you do an amnioinfusion? - ANSWER-It replaceds the "cushion" for the umbilical cord and relieves the variable decelerations of the fetal heart rate that may occur during contractions when decreased amniotic fluid is present.
How often should the pads under the mom be changed after the membranes rupture? - ANSWER-Change them as often as needed to keep the mom relatively dry and to reduce the risk of infection of skin breakdown. (like Q20 mins)
What should be documented about the drainage on the underpads after a amnioinfusion? - ANSWER-Should document the color, amount, and any odor of the fluid expelled from the vagina.
What is Induction? - ANSWER-The initiation of labor BEFORE it begins naturally.
What is Augmentation? - ANSWER-The stimulation of contractions AFTER they have begun naturally.
What is the Bishop Scoring System? - ANSWER-- Evaluates the cervical response to induction procedures.
-A higher score (above 6) is predictive of successful labor induction because the cervix has ripened or softened in preparation for labor.
What are indications for labor induction? - ANSWER--Gestational Hypertension
-Ruptured membranes without spontaneous onset of labor
-Infection within the uterus
-Medical problems in the woman that worsen during pregnancy
-Fetal problems such as slowed growth, prolonged pregnancy, or incompatibility between fetal and maternal blood types
-Placental Insufficiency
-Fetal death
What are contraindications to labor induction? - ANSWER--Placenta previa
-Umbilical cord prolapse -Abnormal fetal presentation
-High station of the fetus
-Active herpes infection in the birth canal
-Abnormal size or structure of the mother's pelvis
-Previous classic cesarean incision
Pharmacological Methods to Stimulate Contractions- Cervical Ripening- - ANSWER--
Porstaglandin in a gel or vaginal insert is applied before labor induction to soften the cervix. -Laminaria is an alternative to cervical ripening by swelling inside the cervix
Pharmacological Methods to Stimulate Contractions- Oxytocin induction and the augmentation of labor- - ANSWER--Used to initiate or stimulate contractions
-Most commonly used method
Pharmacological Methods to Stimulate Contractions- Prostaglandin E1: Cytotec (Misoprostol) - ANSWER--Administer PO (buccal/sublingual) or intravaginally
- More effective in achieving vaginal delivery within 24 hours
-Adverse effect: uterine tachysystole (hyperstimulation)
Pharmacological Methods to Stimulate Contractions- Prostaglandin E2: Prepidil or Cervidil - ANSWER--Administer intravaginally, sustained release
Preparing the woman for labor augmentation. - ANSWER-- Explain procedure to woman
-Obtain baseline vital signs and fetal heart rate.
-Ensure IV line is placed (in case emergency)
-Remains in bed for up to 2 hours.
-Oxctocin induction can start 6-12 hours after vaginal insert has been removed.
-Assess for signs of uterine tachysystole (hyperstimulate)
List some way for dilating the cervix. - ANSWER--RU486 (Mifepristone): steroid receptor agonist use for early pregnancy termination (use if fetal demise)
-Stripping amniotic membranes
-Hydroscopic dilators
-Transcervical balloon dilators (16F, 30ml)
-Extra-amniotic saline infusion (puts presure on the cervix like the head would).
What is an Amniotomy? - ANSWER-artificial rupture of membranes (AROM)
Why is a Amniotomy done? - ANSWER--Done to stimulate or enhance contractions.
-Commits the woman to delivery
-Stimulates prostaglandin secretion
What are complications of Amniotomy? - ANSWER--Prolapse of the umbilical cord (RISK)
