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-Monitor for signs and symptoms of intravascular injection.If intravascular injection occurs, the anesthesia care provider should be immediately notified and care includes administering oxygen, fluids, and medication as ordered. Episiotomy and lacerationsoEpisiotomy: surgical incision of the perineum to enlarge the vagina and so facilitate delivery during childbirth. Done prophylactically to prevent soft tissue damageoVaginal lacerations: happen more with instrumental delivery large babies, rapid delivery and op babies-First degree laceration: involves only skin and superficial structures above muscle-Second degree laceration: extends through perineal muscle-Third degree laceration: extends through the anal sphincter muscle-Fourth degree laceration: extends through the anal sphincter into the rectal mucosa
Prework Week 2oVaginal and cervical lacerations: may require general anesthesia and trip to OR for repairNewborn transition and Apgar scoringoApgar score: rapid assessment of 5 physiological status the newborn-HR based on auscultation-RR based on observed movement of chest-Muscle tone based on degree of flexion and movement of extremities-Reflex irritability based on response to tactile stimulation-Color based on observationEach component score 0,1,2. An Apgar score of:0-3: severe distress4-6: moderate difficulty with transition to extrauterine life7-10: stableChapter 9 Pre-work (you may use outline format)Define:EFM: Electronic fetal monitoring is a procedure in which instruments are used to continuously record the heartbeat of the fetus and the contractions of the woman's uterus during laborFSE: Fetal Scalp Electrode is a spiral wire placed directly on the fetal scalp to detects actual beat-to-beat electrical signals of the fetal heartAmnioinfusion: s a method in which isotonic fluid is instilled into the amniotic sac. It is primarily used as a treatment in order to correct fetal heart rate changes caused by umbilical cord compression, indicated by variable decelerations seen oncardiotocography.Tocodynamometry/IUPC: An intrauterine pressure catheter (IUPC) is a device placed into the amniotic space during laborin order to measure the strength of uterine contractions. External tocodynamometers are used to measure tension across the abdominal wall and detect only contraction frequency and duration.Define FHR tracings criteria:Category I: moderate variability, FHR 110-160Category II: Minimal variability, Bradycardia not accompanied by absent variabilityCategory III: absent variability, BradycardiaDefine FHR accelerations: Accelerationsare short-term rises in the heart rate of at least 15 beats per minute, lasting at least 15 seconds.Accelerationsare normal and healthy.Baseline FHR: Thebaseline FHRis the heart rate during a 10-minute segment rounded to the nearest 5 beat per minuteBaseline variability: is defined as fluctuations in the fetal heart rate of more than 2 cycles per minute.