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NR327 Intrapartum test with complete verified solutions
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NR327 Intrapartum test with complete verified solutions
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NR327 Intrapartum test withcomplete verified solutions
Induction
Pt needs labor artificially started
-Mom never had contractions, water never broke, no signs of labor.
Starting labor for a medical purpose
Augmentation of labor
-Helping labor move along
-Mechanical / chemical stimulation/restimulation of labor
contractions
Augmentation Vs. Indcution
Augmentation: helping the labor along
Induction: artificially starting the labor
Reasons to induce
-Preeclampsia
-Post dates (more than 42 wks)
-Diabetes
-IUFD (fetal demise)
-IUGR (growth restriction)
-Low Amniotic Fluid Index (AFI) / oligohydramnios
-Elective induction (for non-medical indications; not possible b4 39
wks)
Reasons to augment labor
-Prolonged ROM
-Labor Dystocia (was in labor, but it stops/slowed down)
What is Bishop score used for?
To determine if the woman is ready for a vaginal delivery, and will it
be possible for her to deliver baby vaginally
-The readiness for labor induction in a woman who had previous
delivery should be a score of 8 or more, for the 1st time mom it
should be 10 or more
,Describe Bishop score
Evaluation tool used to determine if mom is ready for labor (vaginal
deliveries only)
-checks if cervix is ready for labor
What are the categories of the Bishop Score?
-Position
-Consistency
-Effacement
-Dilation
-Station
Bishop score think ______
Cervix
What bishop score is favorable for induction?
8 or more for moms that had babies already
10 or more for new moms
Types of induction
-Cervical Ripening
-Induction: Mechanical / Chemical
Describe Cervical Ripening
-use chemical Agent (Prostaglandins) to make cervix shorter
(effacement) and softer
-Misoprostol (Cytotec)
-Dinoprostone (Cervidil)
Commonly used meds for Cervical Ripening
-Misoprostol (Cytotec)
-Dinoprostone (Cervidil)
must obtain consent before administering these to Pt
, How do Cytotec and Cervidil work for cervical ripening?
misoprostol (Cytotec): PO, it makes cervix thinner and softer
dinoprostone (Cervidil): Administered thru cervix, softens cervix.
Bedrest for 2 hr after administration
both make cervix softer and thinner
Types of mechanical induction
-Nipple stimulation
-Balloon catheter
-Hydroscopic dilators
-Membrane stripping
-AROM or amniotomy
Describe nipple stimulation
Most non-invasive mechanical induction
-performed by mom
-Stroke nipple couple times /min to a pattern of 3 contractions in 10
min.
Describe Balloon Catheter
-Like a foley, but w/ 2 balloons
-Dr administers
-Insert into vagina to cervix. Need cervix to be 1cm open
-Once both balloon filled, pressure from both balloons on either side
of cervix makes the cervix thin and dilate - balloon falls out at 5-6cm
Describe Hydroscopic dilators
(like a big tampon)
-Is inserted into cervix
-Once inserted it absorbs fluid inside of cervix and vagina and
expands
-By expanding, it puts pressure on cervix and it dilates
-Falls out on its own (3-4cm)
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