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Nursing of Childbearing Family > Chapter 16: Giving Birth > Flashcards

Chapter 16: Giving Birth Flashcards

1
Q

The ____________ provides oxygen reserve for the fetus while the uterus is contracting.

A

placenta

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2
Q

Contraction cycle: term for period of rising activity

A

increment

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3
Q

Contraction cycle: two terms to describe the strongest point of the contraction

A

peak, acme

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4
Q

Contraction cycle: term for period of decreasing activity

A

decrement

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5
Q

Contraction cycle: term for the length of the contraction from beginning to end

A

duration

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6
Q

Contraction cycle: term for strength of contractions described by mild, moderate, or strong

A

intensity

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7
Q

Contraction cycle: term for the period between the end of one contraction and the beginning of the next

A

interval (resting tone)

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8
Q

Contraction cycle: term for the period from the beginning of one contraction to the beginning of the next

A

frequency

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9
Q

Assessment method for palpating a contraction

A

Place fingertips of one hand at the fundal portion

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10
Q

Palpated mild contractions feel like this body part

A

tip of nose

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11
Q

Palpated moderate contractions feel like this body part

A

chin

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12
Q

Palpated strong contractions feel like this body part

A

forehead

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13
Q

Palpated resting tone in between contractions feels like this

A

soft

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14
Q

Goal interval time period in seconds

A

60 seconds

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15
Q

Purpose of contractions

A

propel baby forward and through birth canal

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16
Q

This portion of the uterine body contracts actively

A

upper two thirds (upper uterus)

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17
Q

These portions of the uterus are passive during contractions

A

lower third (lower uterus), cervix

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18
Q

The upper portion of the uterus becomes (thicker, thinner) with contractions

A

thicker

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19
Q

The lower portion/cervix becomes (thicker, thinner) with contractions

A

thinner

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20
Q

Term for thinning and shortening of the cervix

A

effacement

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21
Q

Term for opening of the cervix

A

dilation

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22
Q

The cervix of the primigravida thins (before, while) it dilates

A

before

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23
Q

The cervix of the multigravida thins (before, while) it dilates

A

while

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24
Q

During a contraction, placenta blood flow is ____________, BP slightly ___________, and pulse _____________.

A

decreased, increases, decreases

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25
Q

During labor, the depth and rate of respirations ______________, increasing the risk for __________________.

A

increases, hyperventilation (ultimately respiratory alkalosis)

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26
Q

During labor, gastric motility is ____________. The woman in labor should avoid large amounts of __________.

A

decreased, sugar

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27
Q

During labor, the sensation of a full bladder is ____________, and the bladder fills ___________.

A

reduced, rapidly

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28
Q

Average blood loss during a vaginal birth is _________ mL

A

500

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29
Q

During pregnancy, labor, and after delivery, the woman has ____________ levels of clotting factors (fibrinogen)

A

elevated

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30
Q

Three protective mechanisms the fetus has to tolerate interruption of blood flow during contractions

A

fetal hemoglobin, fetal hematocrit, high cardiac output

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31
Q

During labor, fetal lung fluid _____________ to facilitate breathing after birth, which is aided by thoracic compression.

A

decreases

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32
Q

The Power of labor that is active during the FIRST phase of labor to move the fetus through the maternal pelvis

A

uterine contractions

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33
Q

The Power of labor that is active during the SECOND stage of labor to move the fetus through the pelvis

A

maternal pushing efforts

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34
Q

Before the mother starts pushing, she must be _____ dilated and ____ station

A

10 cm (fully), +2

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35
Q

The Passage for the birth of the fetus consists of the ______________ and its _______________.

A

maternal pelvis, soft tissues

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36
Q

_______ and __________ do not readily yield to the forces of labor, which makes the ______________ more important to the outcome of labor.

A

bones, joints, bony pelvis

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37
Q

This hormone increases and softens the cartilage that links the pelvic bones

A

relaxin

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38
Q

The Passenger contains these three things

A

fetus, membranes, placenta

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39
Q

Term for the fetal head changing shape (from movable bones due to sutures and fontanels) allowing its adaptation to the size and shape of the pelvis

A

molding

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40
Q

Term for the orientation of the long axis of the fetus to the long axis of the woman

A

fetal lie

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41
Q

Type of fetal lie in which the head or buttocks of the fetus enters the pelvis first

A

longitudinal lie

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42
Q

Type of fetal lie in which the long axis of the fetus is at right angles to the woman’s long axis

A

transverse lie

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43
Q

Type of fetal lie in which the fetus is at an angle between longitudinal and transverse lies

A

oblique lie

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44
Q

Term for the relation of fetal body parts to each other (degree of flexion or extension)

A

attitude

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45
Q

Term for the fetal part that enters the pelvis first

A

presentation (presenting part)

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46
Q

____________ cephalic presentation occurs when the fetal head is completely flexed; this is the most favorable because the smallest part of the head is pointing down

A

Vertex

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47
Q

___________ cephalic presentation occurs when the head is in a neutral position (neither flexed nor extended), is usually a temporary position

A

Military

48
Q

__________ cephalic presentation occurs when the fetal head is partly extended with the longest head diameter is presenting.

A

Brow

49
Q

__________ cephalic presentation occurs when the head is fully extended and the fetal occiput (head) is near the fetal spine.

A

Face

50
Q

___________ breech presentation occurs when the hips are fully flexed and the fetal legs are extended across the abdomen toward the shoulders.

A

Frank

51
Q

___________ breech presentation occurs when the head, knees, and hips are flexed with the buttocks presenting (also known as reversal cephalic presentation)

A

Full (complete)

52
Q

_____________ breech presentation occurs when one or both feet are presenting.

A

Footling

53
Q

Breech presentation of a fetus increases the risk of developmental _________________

A

hip dysplasia

54
Q

Term for the location of a fixed reference point on the presenting part in relation to the four quadrants of the maternal pelvis

A

position

55
Q

First letter (2) of the fetal position that describes which side of the mother’s pelvis the fetal reference point is

A

R (right) or L (left) (may be omitted if neither to the right nor left)

56
Q

Second letter (3) of the fetal position that refers to the fixed fetal reference point

A

O (occiput or back of head), M (mentum or chin), S (sacrum or buttocks in breech presentations

57
Q

Third letter (3) of the fetal position which describes front or back

A

A (anterior), P (posterior), T (transverse, neither anterior nor posterior but along middle)

58
Q

In a posterior fetal position, the fetal reference point points toward the maternal ____________.

A

sacrum

59
Q

In an anterior fetal position, the fetal presenting part points toward the maternal ____________.

A

symphysis

60
Q

In a right or left occipital transverse position, the occiput is facing the ____________

A

ischial spine (right or left)

61
Q

The Psyche of labor may be characterized by these three things that can decrease ability to cope with labor pain

A

anxiety, fear, fatigue

62
Q

These molecules are secreted in response to anxiety or fear during labor and inhibit uterine contractility and placental blood flow

A

maternal catecholamines

63
Q

______________ augments the natural process of labor.

A

Relaxation

64
Q

When preparing for labor, the ratio of estrogen and progesterone changes. Which increases?

A

estrogen

65
Q

To prepare for labor, the decidua produces ______________

A

prostaglandins

66
Q

Term for the energy spurt that is a premonitory sign of labor

A

nesting

67
Q

The conclusive difference that distinguishes true labor* (from false labor) is this

A

progressive effacement and dilation of the cervix

68
Q

True or false labor: Contractions are inconsistent in frequency, duration, and intensity.

A

false

69
Q

True or false labor: A change in activity, such as walking, does not alter contractions, or activity may decrease them.

A

false

70
Q

True or false labor: Contractions have a consistent pattern of increasing frequency, duration, and intensity that usually develops.

A

true

71
Q

True or false labor: Walking tends to increase frequency and strength of contractions

A

true

72
Q

True or false labor: Discomfort felt in the abdomen and groin

A

false

73
Q

True or false labor: Discomfort may be more annoying than truly painful.

A

false

74
Q

True or false labor: Discomfort begins in lower back and gradually sweeps around to the lower abdomen like a girdle.

A

true

75
Q

True or false labor: Back pain may persist in some women. Often feels like menstrual cramps.

A

true

76
Q

True or false labor: No significant change in effacement or dilation of the cervix after an observation period of 1-2 hours.

A

false

77
Q

True or false labor: Effacement and/or dilation of cervix occurs. Progressive effacement and dilation of cervix are most important characteristics

A

true

78
Q

Term for the mechanism of labor in which the presenting part goes down through pelvis; described by station

A

descent

79
Q

Term for the mechanism of labor that occurs when the largest diameter of the fetal presenting part has passed the pelvic inlet and entered the pelvic cavity (station is 0 or lower [+])

A

engagement

80
Q

As the fetus descends, the fetal head is ___________ farther as it meets resistance from the soft tissues of the pelvis.

A

flexed (mechanism of labor termed flexion of the fetal head)

81
Q

Term for the mechanism of labor in which the head gradually turns to an OA position

A

internal rotation

82
Q

Term for the mechanism of labor in which the fetal head changes position to negotiate the curve of the pelvis (fetal head pivots and is born like this)

A

extension of the fetal head

83
Q

Term for the mechanism of labor in which the born head turns to the side it was in utero while the shoulders internally rotate

A

external rotation

84
Q

Term for the mechanism of labor in which the anterior and posterior shoulders pass and the rest of the body follows

A

expulsion

85
Q

Put the following mechanisms of labor in order:

  1. Flexion of the fetal head
  2. Internal rotation
  3. Descent
  4. Expulsion of the fetal shoulders and body
  5. Engagement of the presenting part
  6. Extension of the fetal head
  7. External rotation
A

3, 5, 1, 2, 6, 7, 4

86
Q

Term for the spontaneous turn of the fetal head to the same side as it was in utero to realign with shoulders and back

A

restitution

87
Q

When charting on a Freedman’s curve, it is expected to see a change every ________.

A

2 hours

88
Q

When the placenta has separated, the uterus has a(n) ___________ shape

A

spherical

89
Q

When the placenta has separated, the uterus _______________ in the abdomen as the placenta descends into the vagina and pushes the fundus ________.

A

rises upward, upward

90
Q

When the placenta has separated, the cord ____________________ from the vagina.

A

descends further

91
Q

When the placenta has separated, this appears

A

gush of blood

92
Q

Term for the mechanism by which the placenta is expelled with the shiny, fetal side first

A

Schultze mechanism

93
Q

Term for the mechanism in which the placenta is expelled with the rough maternal side first

A

Duncan mechanism (less common)

94
Q

Lochia rubra should be a(n) _____________ color with _______ clots.

A

dark red, small

95
Q

During the postpartum period, the nurse and mother are ____________. Vital signs and fundal checks are done every ____ minutes during the first hour and every ____ minutes during the second hour.

A

One on one, 15, 30

96
Q

During the postpartum period, the uterus should feel _____ like a(n) __________. Massage it if it is _______.

A

firm, grapefruit, soft (boggy)

97
Q

To relieve suture pain, swelling, and limit hematoma formation to the perineum, apply ___________.

A

ice/cold packs

98
Q

To shorten the chill common after birth, apply a(n) _________________.

A

warm blanket

99
Q

The purpose of the first Leopold maneuver is to distinguish between these two things

A

cephalic and breech presentation

100
Q

The purpose of the second Leopold maneuver is to determine the sides that these two things are on

A

fetal back, fetal arms/legs

101
Q

The purpose of the third Leopold maneuver is to confirm the ______________ and whether it is ___________.

A

presentation, engaged

102
Q

Four lab tests done during labor and delivery

A

CBC
T&S (type and screen)
RPR (syphilis)
HIV

103
Q

FHR must be out of normal range (tachycardia, bradycardia) for ___________ before performing interventions and notifying the provider

A

10-20 minutes

104
Q

After amniotic fluid rupture, assess the FHR for at least ____________

A

one minute

105
Q

Passage of meconium into amniotic fluid before birth may be a result of ________________

A

transient hypoxia

106
Q

A cloudy, yellowish, or foul odor to the amniotic fluid indicates __________.

A

infection

107
Q

The interval between contractions should last at least _______________. If contractions are shorter than that, the uterus relaxation is _____________.

A

60 seconds, incomplete

108
Q

Persistent contractions (without a long enough interval in between) may decrease placental ___________ and fetal __________, _____________, and _________ exchange.

A

blood flow, oxygen, nutrient, waste

109
Q

Signs of impending birth: The mother says this

A

“The baby’s coming”

110
Q

Signs of impending birth: mother makes these sounds and/or bears down

A

grunting sounds

111
Q

Signs of impending birth: checking this area

A

perineum

112
Q

Apgar Score: heart rate (0, 1, 2)

A

0: absent
1: <100/min
2: 100/min or greater

113
Q

Apgar Score: respiratory effort (0, 1, 2)

A

0: no spontaneous respirations
1: slow respirations or weak cry
2: spontaneous respirations with a strong, lusty cry

114
Q

Apgar Score: muscle tone (0, 1, 2)

A

0: limp
1: minimal flexion of extremities; sluggish movement
2: flexed body posture; spontaneous and vigorous movement

115
Q

Apgar Score: reflex response (0, 1, 2)

A

0: no response to suction or gentle slap on soles
1: minimal response (grimace) to suction or gentle slap on soles
2: responds promptly to suction or a gentle slap to the sole with cry or active movement

116
Q

Apgar Score: (skin) color (0, 1, 2)

A

0: pallor or cyanosis
1: bluish hands and feet only
2: pink (light skinned) or absence of cyanosis (dark skinned), pink mucous membranes

Nursing of Childbearing Family (15 decks)

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