THE PERSON Flashcards

1
Q

FACTORS affecting labor

A

 Perception & meaning of childbirth
 Readiness & preparation for childbirth
 Coping skills
 Past experiences
 Cultural & social background
 Presence of significant others and support system

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2
Q

SIGNS OF LABOR

A

(WRISLIR)
* Weight Loss
* Ripening of the Cervix
* Increased Braxton Hicks
* Show –
* Lightening
* Increased Level of Activity
* Rupture of Membranes

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3
Q

 Contraction disappears with ambulation

A

FALSE LABOR

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4
Q

 Absence of cervical dilation

A

FALSE LABOR

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5
Q

 No ↑ DIF (duration, intensity, frequency)

A

FALSE LABOR

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6
Q

 Discomfort @ abdomen

A

FALSE LABOR

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7
Q

 Absence of show

A

FALSE LABOR

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8
Q

 Contraction stops when sedated

A

FALSE LABOR

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9
Q

 Contraction persists when sedated

A

TRUE LABOR

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10
Q

 Uterine contraction ↑ DIF (duration, intensity, frequency)

A

TRUE LABOR

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11
Q

 Progressive cervical dilation

A

TRUE LABOR

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12
Q

 Presence of show

A

TRUE LABOR

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13
Q

 Ambulation increases contractions

A

TRUE LABOR

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14
Q

 Discomfort radiates to lumbosacral area

A

TRUE LABOR

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15
Q

Length of Labor 1st stage:

A

PRIMI MULTI
10 – 12 HOURS 6 – 8 HOURS

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16
Q

Length of Labor 2nd stage:

A

Primi: 30 MINS – 2 HOURS
Ave: 50 mins

Multi: 20 – 90 MINS
Ave: 20 mins

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17
Q

Length of labor 3rd stage:

A

Primi: 5 – 20 MINS

Multi: 5 – 20 MINS

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18
Q

Length of labor 4th stage:

A

PRIMI: 2 – 4 HOURS

MULTI: 2 – 4 HOURS

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19
Q

 STAGE 1 or the

A

DILATATION STAGE

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20
Q

 Starts from first true uterine contraction until the cervix is completely effaced and dilated.

A

 STAGE 1 – DILATATION STAGE

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21
Q

Stage 1 : ○ Dilatation – widening of cervical os to

A

10cm

22
Q

Stage 1: ○ Effacement – thinning to

A

1-2cm

23
Q

Stage 1:
Causes

A
  1. Ferguson Reflex
  2. Fetal head and intact BOW serves as a wedge to dilate the cervix
24
Q

Stage 1:
 Maternal Assessment During Labor

A

 Check V/S q 4hrs during the first stage

  • temp q hour if membranes are already ruptured (risk of infection)
  • BP b/n contractions, in left lateral pos, q 15 – 20 mins after giving anesthesia
  • a rapid pulse indicates hemorrhage & dehydration
25
Q

Stage 1:
Show

A

slightly blood-tinged mucus discharge

26
Q

Stage 1 :
 Internal Examination

A

to assess status of amniotic fluid, consistency of cervix, effacement/dilatation, presentation, station, and pelvic measurement.
- do it during relaxation
- less IE done once membrane have ruptured
- start with middle finger then index finger

27
Q

 Status of Amniotic Fluid (if ruptured)

A

 Danger of cord prolapse if fetal head is not yet engaged.
 Danger of serious intrauterine infection if delivery does not occur in 24 hours

28
Q
  • used to assess whether membrane ruptured or not.
A

NITRAZINE PAPER TEST

29
Q

NITRAZINE PAPER TEST Procedure

A

: “Insert and Touch”

30
Q

NITRAZINE PAPER TEST
Color Yellow

A

intact BOW

31
Q

NITRAZINE PAPER TEST
Color blue

A

ruptured

32
Q

 Normal Color of Amniotic fluid

A

clear, colorless to straw colored

33
Q

meconium stain (fetal distress in non – breech presentation)

A

 Green tinged

34
Q

hemolytic disease

A

 Yellow/Gold

35
Q

What color means infection

A

 Gray/Cloudy

36
Q

what color means bleeding

A

 Pinkish/Red stained

37
Q

Color means fetal death

A

 Brownish/Tea Colored/Coffee Colored

38
Q

OTHER TEST TO DETERMINE STATUS OF AMNIOTIC FLUID

A

 Ferning pattern of cervical mucus
(“swab – dry – view”)
 Nile blue sulfate staining of fetal squamous cells

39
Q

FETAL ASSESSMENT DURING LABOR
FHT Monitoring
 Latent Phase

A

every hour

40
Q

FETAL ASSESSMENT DURING LABOR
FHT Monitoring
Active Phase

A

every 30 minutes

41
Q

FETAL ASSESSMENT DURING LABOR
FHT Monitoring
 Second Stage of Labor

A

every 15 minutes

42
Q

FETAL ASSESSMENT DURING LABOR
FHT Monitoring
 FHT is taken more frequently in high

A

risk cases

43
Q

 Normal FHT Pattern
Baseline rate:
Early Deceleration :
Acceleration:

A

120 – 160 bpm

FHT @ contraction, Normal @ end of contraction (head compression)

FHT when fetus moves

44
Q

 Abnormal FHT Pattern
 Bradycardia:
* Tachycardia:

A

Brady: –
100 – 119 bpm – moderate
below 100 bpm – marked

Tachy:
161 – 180 bpm – moderate
above 180 bpm – marked

45
Q

 Abnormal FHT Pattern
 Bradycardia
Causes:

A
  1. fetal hypoxia (analgesia & anesthesia)
  2. maternal hypotension
  3. prolonged cord compression
46
Q

Abnormal FHT Pattern
Tachycardia
Causes:

A
  1. maternal fever, dehydration
  2. drugs (atropine, terbutaline, ritodrine, etc.)
47
Q

MGT:
Brady
TAchy

A
  1. place mother on left side
  2. assess for cord prolapse
  3. administer oxygen
  4. D/C oxytocin, position on LLP
  5. give 02 at 8 – 10 lpm
  6. prepare for birth if no improvement
48
Q

 Abnormal FHT Pattern

A
  1. Bradycardia
  2. tachycardia
  3. Variable pattern
  4. sinusoidal pattern
49
Q

deceleration at unpredictable times of uterine contraction

A

Variable pattern

50
Q

no variability in FHT

A

 Sinusoidal Pattern

51
Q

Causes and MGT of Variable Pattern

A

CAUSE: sign of cord compression
MGT: release pressure on the cord

52
Q

Causes of  Sinusoidal Pattern

A

CAUSE: hypoxia, fetal anemia & prematurity