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Maternity > Chapters 13, 14: Labor and Birth & Nursing management During Labor > Flashcards

Chapters 13, 14: Labor and Birth & Nursing management During Labor Flashcards

1
Q

Describe Characteristics of false labor:

  1. ) Timing
  2. )Strength
  3. )discomfort
  4. )Activity
  5. ) stay or go
A
  1. ) timing is inconsistent
  2. )generally weak, does not get stronger
  3. )discomfort is in the front
  4. )activity makes it better
  5. ) stay at home
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2
Q

Characteristics of true labor:

  1. ) time
  2. )strength
  3. )discomfort
  4. )activity
  5. )stay or go
A
  1. ) consistent
  2. )gets stronger over time
  3. ) starts from back moves to front
  4. )activity does not make it go away
  5. ) stay home until 5 minutes in between and lasts for 40 to 60 seconds
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3
Q

Premonitory cervical changes

A

change in shape

becomes short and thin

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4
Q

Describe cervical lightening

A

the fetus presenting part begins to descend. ease of breathing and gerd occurs but increase in back and pelvic pressure occur.
can occur 2 weeks before labor in a primapara individual

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5
Q
  1. ) bony prominence through which the feus must travel

2. )Three planes of location?

A
  1. ) pelvis

2. ) inlet, mid pelvis(compresses lungs to expel fluid), outlet

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6
Q

Factors affecting onset of labor

A

estrogen releases, prostaglandin sensitivity, progesterone reuptake

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7
Q

Premonitory signs of labor

A
  • cervical lightening
  • increase in energy
  • bloody show
  • contractions
  • pelvic and back pressure
  • possible membrane rupture
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8
Q
  1. ) the largest and least compresible structure of the fetus
  2. ) what do sutures do?
  3. )what are the intersections of sutures?
  4. ) which is the soft spot
A
  1. ) Skull
  2. ) Allow molding to achieve the smallest diameter
  3. )fontanels
  4. )anterior fontanel
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9
Q

1.)critical factors that affect the process of labour (5 Ps)

A

1.) Passenger, passageway, powers, presentation, psychological response to pregnancy

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10
Q

soft tissue passageway consists of what

A

pelvic floor muscle, cervix, vagina

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11
Q

Describe the pelvic shapes

A
  1. ) Gynecoid - True woman’s pelvis, most appropriate for birth
  2. )anthropoid - found in men and non white women. elongated, longer from anterior to posterior than transverse
  3. )android - funnel heart shaped. considered man’s pelvis. difficult rotation
  4. ) platypeloid - unable to do vaginal birth
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12
Q
  1. ) most favourable fetal attitude
  2. ) relationship between fetal long axis and maternal long axis? what is the most common
  3. ) the other two types?
A
  1. ) flexed position
  2. )fetal lie: longitudinal
  3. )would require cesarean birth if unable to reposition
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13
Q
  1. ) three main fetal presentations
  2. ) variations of cephalic/ vertex
  3. )challenges posed by breech presentation
  4. )buttocks presents first, which presentation is this?
  5. )fetus is cross legged, which presentation is this?
  6. )one or two feet out, which presentation is this?
A
  1. ) vertex, shoulder, breech
  2. ) occiput, soldier, brow, and face
  3. ) head can gat hung up, cord compression, inefficient molding and inefficient dilation
  4. )Frank breech
  5. )complete
  6. )footling
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14
Q
  1. )Primary stimulus powering labor
  2. )what is the purpose of contractions
  3. ) identify and explain the 3 parameters of contractions
A
  1. ) Contractions
  2. )dilation and effacement
  3. ) frequency (start of 1 to start of the next), duration, and intensity
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15
Q

factors that affect a positive birth experience

A 
trust in yourself
trust in care givers
support
pain management
preparedness
information
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16
Q

fetal response to labour

A

can have increase or decrease in HR,
CO2 goes up
breathing, oxygenation goes down

17
Q
  1. )Landmark for vertex
  2. )landmark for face
  3. )landmark for Breech
  4. ) landmark for shoulder
  5. ) occurs when the presenting part reaches the ostation
  6. )refers to when presenting part hasn’t reached ostation
  7. ) when would you expect this on a primagravida?
A
  1. ) Occiput (O)
  2. )Mentum (M)
  3. ) Sacrum (S)
  4. ) Acromion (A)
  5. )fetal engagement
  6. ) floating
  7. ) can occur 2 weeks prior to labor
18
Q

cardinal movements of labor

  1. ) downward movement of presenting part
  2. )when vertex meets resistance from cervix. pelvis wall, and floor?
  3. )first rotation
  4. ) and then?
  5. ) rotation back to original?
  6. ) exit?
A
  1. ) decent
  2. )flexion
  3. ) internal rotation
  4. )extension
  5. )external rotation
  6. ) expulsion
19
Q

what happens in the first stage of labour

A

frequent contractions are achieved: dilation and effacement occur

20
Q

describe latent phase of 1st stage

A
  1. ) dilation ends at 3 cm and effacement ends at 40%
  2. ) contractions are 5-10 min in between lasting from 30 to 45 seconds
  3. ) woman can speak during contraction
21
Q
  1. ) what does it mean if the nurse can indent the fundus during a contraction?
  2. ) describe active phase of first stage of labor
A
  1. ) it is considered a mild contraction
  2. ) dilation from 4 - 7 cm and effacement from 40 - 80 %. Contractions are 2 - 5 min in between lasting 45 to 60 seconds. the woman in more inwardly focused
22
Q

Describe transition phase of the first stage

A

dilation ends at 10 cm and effacment ends at 100%. Contractions are now 1-2 min in between lasting 60 to 90 seconds

23
Q
  1. ) what happens in the 2nd stage of labor
  2. ) what happens in the 3rd stage of labor
  3. ) what is normal blood loss
A
  1. ) start at 10 cm dilation and ends with birth of the fetus
  2. ) starts at birth of the fetus and ends with birth of the placenta
  3. ) 500 ml vaginal birth. 1000 ml cesarean birth
24
Q

describe 4th stage of labor

2.) sings of placental separation?

A

this is when the mother is stabilized

2.) umbilical cord elongation, trickle of dark blood

25
Q
  1. ) Maternal assessment during labor and birth
  2. ) what is the purpose of vaginal exam
  3. ) What is the priority when membranes rupture
  4. ) how would you determine membrane rupture
A
  1. ) assess vital signs and vaginal exam
  2. ) check for dilation, effacement, presenting part
  3. ) check FHR, assess how long the membrane has ruptured ( prolonged membrane rupture increases risk for infection)
  4. ) nitrazine test (blue means rupture)
26
Q
  1. )primary powers of labor

2. ) how is this monitored?

A
  1. ) contraction

2. )external monitoring device, internal monitoring device

27
Q

Method to determine presentation, position, and lie of fetus. explain the process

A

1.) Leopold’s maneuver
2.)Maneuver 1 determines which part is at the fundus
Maneuver 2 determines which side the back is at
maneuver 3 determines which part is the presenting part
Maneuver 4 determines the extent of fetal engagement

28
Q

What do you do when amniotic fluid is stained green

A

prep suction and possible resuscitation

29
Q
  1. ) how to assess Baseline FHR

2. ) what is considered normal FHR

A
  1. ) assess when mum is not contracting and baby is not moving
  2. ) 110 to 160
30
Q

Category I fetal pattern
Category II
Category III

A
  1. ) predictive of normal pattern, no interventions
  2. ) require assessment and monitoring, no interventions
  3. ) interventions are warranted
31
Q

temporary and recurrent baseline changes

A

periodic baseline changes

32
Q

1.) fluctuations of FHR baseline

A

variabilit

33
Q

1 Absent variability

  1. ) minimal variabiltiy
  2. ) normal varibility
  3. )marked varibility
A
  1. ) no change
  2. )<5
  3. ) 6 - 25
  4. ) >25
34
Q

AKA laughing gas

A

nitrous oxide

35
Q

opioids

A
  1. ) nalbuphine
  2. )butorphanol
  3. )meperidine
  4. )fentanyl
36
Q

Provides pain relief without loss of consciousness

  1. ) where in the spinal cord?
  2. ) contraindications for epidurals
  3. ) when is epidural given
  4. ) what is the advantage of combined spinal epidural
A

regional anesthesia

  1. ) below t8 or t10
  2. ) spinal injury or history of surgery, bleeding disorders or anticoagulant therapy
  3. ) 5 cm dilation
  4. ) spinal epidural offers use of legs

Maternity (4 decks)

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