Term
what do you use to tx GBS, what if their allergic |
|
Definition
pen G tx, if minor allergy get ceph if major allergy send it to culture and see what it is susceptable to |
|
|
Term
when should mom come to the hospital for labor |
|
Definition
contractions <5 minutes apart sudden gush of fluid bleeding decrease in fetal movement |
|
|
Term
what are the first things you do when mom gets to the hospital to deliver |
|
Definition
review chart and prenatal record (GBS!) ascultation of fetal heart evaluation of contractions (freq/intensity) determine lie (leopold maneuver) determine presentation determine position |
|
|
Term
|
Definition
determine fetal like, presentation and position felt with hand |
|
|
Term
|
Definition
relation of long axis of fetus with maternal long axis |
|
|
Term
what are the 3 types of lie, which is most common |
|
Definition
99% longitudinal transverse oblique |
|
|
Term
|
Definition
portion of fetus lowest in birth canal |
|
|
Term
what are the 2 types of presentation |
|
Definition
|
|
Term
|
Definition
relation of fetal presentation to right or left maternal pelvis |
|
|
Term
what is left occiput posterior |
|
Definition
baby is face up with occiput on left inominate |
|
|
Term
what is left occiput transverse |
|
Definition
baby is sideways with occiput in center of left inominate |
|
|
Term
what is left occiput anterior |
|
Definition
baby is face down with occiput on left pubic area of inominate |
|
|
Term
what are the parts to the vaginal exam |
|
Definition
membranes in tact cervical effacement cervical position (posterior, midpoint, anterionr) cervical dilation station |
|
|
Term
what are the parts of labor management |
|
Definition
lab info NPO: popsicle/ice if no C section expected IV line external monitors or FRH Q15min amniotomu internal monitors bladder emptying maternal temps q4hr BPs, pulses, urine output |
|
|
Term
where can GBS colonize, statistics in mom and body |
|
Definition
cervix, vagina, rectum 30% of mom positive 50% of exposed babies colonized |
|
|
Term
|
Definition
results only intermittently positive |
|
|
Term
|
Definition
usually inconsequential 3/1000 will get infection
early: septicemia, septic shick, pneumonia, meningitis (probablly premature)
late: (up to 4wk post partum) meningitis most common, less common are bone and joint infections |
|
|
Term
how is GBS colonization in mom managed |
|
Definition
culture at 35-37wks for all women
GBS culture positive (or other indications)... IV antimicrobials for >48h during tocolysis intrapartumm antimicrobials at delivery |
|
|
Term
when is intrapartum prophylaxis to GBS indicated |
|
Definition
previous infant with invasive GBS disease GBS bacteriuira during current pregnancy +GBS screening culture during current pregnancy
unknown GBS status if delivery <37 wks, membrane rupture >18h, intrapartum temp >100.4F |
|
|
Term
when is intrapartum prophylaxis not indicated |
|
Definition
previous pregnancy with positive GBS screening culture, without positive this pregnency
planned C section (before membrane rupture)
negative vaginal and rectal GBS screen |
|
|
Term
pain management technuques in childbirth |
|
Definition
prepared childbirth breathing techniques systemic analgesia regional analgesia epidural block analgesia for labor anesthesia for delivery maintain sense of touch and allows movement penedal nerve block paracervical block local block spinal and general |
|
|
Term
what is used for systemic analgesia in labor (3) |
|
Definition
|
|
Term
what is used for regional analgesia in labor, how is it administred |
|
Definition
pain sensation from uterus, cervix, upper vag T10-L1 1st stage
pain sensation from lower vagina and perineum S2-S4 (2nd stage) |
|
|