NR 465 OB Exam 1
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What is Nagele’ Rule?
- First day of period LMP
- Minus 3 months
- Plus 7 days
What is the McDonald's Rule?
It is measuring the size of the uterus. From the top of the fundus to the top of the mother's pubic bone. The number of cm should match the number of weeks
How many vessels are in the umbilical cord?
Two arteries one vein
What is the first stage of labor?
- First stage-lasts from beginning of dilation to when cervix is fully dilated
- 3 phases:
When is the second stage of labor?
lasts from full dilation to birth of infant
When is the third stage of labor?
- lasts from infant’s birth to expulsion of
When is the fourth stage of labor?
first two hours after birth
What are characteristics of the latent stage of labor?
- Beginning cervical dilatation and effacement
- More progress in the effacement of the cervix (0-3cm)
- No evident fetal descent
- Uterine contractions increase in frequency, duration, and intensity
- Contractions are usually mild
- Can usually stay comfortable during this period without meds
- Feels able to cope with the discomfort
- May be relieved that labor has finally started
- Is able to recognize and express feelings of anxiety
When is the active phase of labor?
- Cervical dilatation from 4 to 7 cm
- Progressive fetal descent
- Contractions increase in strength, frequency, duration
- Is usually a more painful period
- Anxiety increases
- Fears loss of control
- May have decreased ability to cope
What takes place during the transition phase of labor?
- Cervical dilatation from 7 to 10 cm
- Progressive fetal descent
- Contractions more frequent and intense
- Withdraws into herself
- Doubts ability to cope
- Apprehensive and irritable
- Terrified of being alone
- Does not want anyone to talk to her or touch her
What are the 5 P's of labor?
- Passageway (birth canal)
- Passenger (fetus and placenta)
- Powers (contractions)
- Position (maternal)
- Psychological response
What is supine hypotension?
- Weight of the uterus compresses the vena cava, reducing the amount of blood returned to her heart
What are the danger signs of pregnancy to watch out for?
- -Gush of fluid from vagina
- Vaginal bleeding
- Abdominal pain
- Fever and chills
- Dizziness, blurred vision, spots before eyes
- Persistent vomiting
What is the function of the placenta?
It is the means of metabolic and nutrient exchange between the embryonic and maternal circulations.
What are the main functions of amniotic fluid?
- Act as a cushion to protect the embryo against mechanical injury
- Control temp
- Allow umbilical cord to be relatively free of compression
What type of decelerations are there?
What do variable decelerations imply?
Typically cord compression
What do early decelerations typically imply?
Fetal head compression
What do late decelerations often indicate?
What does BUBBLEHE stand for?
- Head to toe assessment:
What are the different stages of lochia?
What are the characteristics of lochia rubra?
Dark red discharge that is present for the first 2 to 3 days after birth
What are the characteristics of locia serosa
Pink in color follows from the 3rd to 10th day
What are the characteristics of lochia alba?
White, primarily composed of leukocytes, day 10 to 6 weeks
What type of pain medication do you give to a mother after birth?
- NSAIDS – GI upset
- Oxycodone/acetaminophen (Percocet) – dizziness, sleepiness
- PCA – Morphine for C/S – respiratory distress
What is the order of meds to give during a postpartum hemorrhage?
- 1. Oxytocin
- 2. Methergine (except with cases of HTN)
- 3.Hemabate (except with cases of asthma)
- 4. Cytotec
What are the 4 T's of postpartum hemorrhage?
Tone, Trauma, Tissue and Thrombin
What are the 4 ways to loose heat?
When does the anterior fontanel close?
18 months after birth
When does the posterior fontanel close?
6-8 weeks after birth
What is the difference between pathological and physiologic jaundice?
- Pathological is harmful
- Physiologic poses no harm to the infant
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