what does veal chop stand for ? - ANSWER variable deceleration -> cord compression
(turn patient)
early decels -> head compression (check patient)
accelerations -> okay! (no intervention)
late decels -> placental insufficiency (intrauterine resucitation)
what should happen for intrauterine resuscitation ? - ANSWER change position and/or
elevate legs, bolus IV fluids, turn off pitocin if infusing, administer O2 at 8-10L/min, notify
MD/midwife, delivery
what is the single best indicator of fetal well being? - ANSWER fetal heart rate variability
what are the stages of labor? - ANSWER 1. labor (phase 1 - early 0-5cm, phase 2 - active
6-10cm)
2. delivery of infant
3. placenta delivery
4. recovery, greatest risk for hemorrhage here
name the four signs the placenta is ready to be delivered? - ANS globular uterus, gush
of blood, lengthening of cord, hard contractions
what do platelets have to be above to get an epidural? - ANS have to be above 100,000
name two contraindications to spinal anesthesia? - ANS low platelets, large body
habitus
, Meconium aspiration syndrome This condition may be very harmful since the meconium
was aspirated by the fetus within the uterus and may lead to hypoxic encephalopathy.
what is shoulder dystocia? -ANSWER condition in which baby's head is born but
shoulder cannot pass under pelvic arch, can be a result of fetal macrosomia related to
gestational diabetes or cephalopelvic disproportion; main symptom is the turtle sign;
can lead to breaking of the baby's collarbones, hypoxia, a brachial plexus injury; treat
with suprapubic pressure, McRobert's or Gaskin maneuvers
What is a cord prolapse? -ANSWER cord lies below the presenting part of the fetus; S&S
of recurrent deep variable decels and cord within the vagina, can lead to fetal death
from hypoxia; treat by holding presenting part off the cord, place in Trendelenburg, run
to the OR for emergency C section
what is placenta previa? -ANWER when the placenta implants over the cervical os, S&S
of minimal bright red painless bleeding*, NO vaginal exams! (and no sexual intercourse)
what is placental abruption? -ANWER premature separation of the placenta from the
uterine wall, S&S of minimal to moderate dark red often painful bleeding, but can be
concealed where there is no bleeding but the abdomen is boardlike
What is pre-eclampsia? - ANSWER pregnancy induced hypertension with proteinuria,
can advance to eclampsia, treat with magnesium sulfate, cured with delivery
What is eclampsia? - ANSWER pregnancy induced hypertension with proteinuria and
seizures, cured with delivery of fetus, treat with magnesium sulfate and induce a
delivery
HELLP- what is it? -ANSWER Preeclampsia with thrombotic microangiopathy involving
the liver characterized by Hemolysis, Elevated Liver enzymes, and Low Platelets; may
need a c-section for this
what is the difference between breast engorgement and mastitis? -ANSWER mastitis
-one breast, fever, tender, can prevent with a good latch
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