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201 Exam 3: Birth, OB, etc. > Healthy Pregnancy and Labor > Flashcards

Healthy Pregnancy and Labor Flashcards

1
Q

What are some preliminary signs of labor?

A

Lightening
increase in activity
slight loss in weight
backache
Braxton hicks
ripening of cervix

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2
Q

What are some true signs of labor?

A
  • uterine contractions- regular, rhythmic, increase in intensity
  • bloody show
  • rupture of membranes
  • cervical dilation
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3
Q

You dont want membranes ruptured for more than __ hours without the baby born because this can cause infection

A

no more than 24 hours

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4
Q

What are the 4P components of labor?

A

Passageway
Passenger
Powers
Psyche

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5
Q

Maternal bony pelvis and vagina as well as cervical tissues. Route that the fetus must travel to deliver.

A

Passageway

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6
Q

The fetus

A

Passenger

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7
Q

primary and secondary forces of labor (contractions as well as pushing)

A

Powers

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8
Q

Psychological components of mother; goal is for the parents to have a positive experience

lots of time is spent here

A

Psyche

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9
Q

what must be of adequate size in order to vaginally deliver a baby?

A

pelvis

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10
Q

safe labor and delivery depends on (2)

A

the structure of the fetal head

alignment w the pelvis

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11
Q

4 methods to determine fetal position, presentation and lie

A
  1. abdominal inspection and palpation (Leopolds)
  2. vaginal exam
  3. auscultation of FHT
  4. ultrasounds
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12
Q

what 5 bones of the fetus’s head is most important?

A

2 frontal, 2 parietal, occipital

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13
Q

what suture of the fetus’s head is most important?

A

sagittal suture

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14
Q

membranous tissue between bones of the skull

A

sutures

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15
Q

what occurs when sutures overlap during labor

occurs because of the pressure of the cervix

A

molding

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16
Q

how long does molding usually occur?

A

1-2 days

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17
Q

____ are junctions of the main suture lines

A

fontanelles

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18
Q

what shape is the anterior fontanelle

A

large and diamond shaped

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19
Q

what shape is the posterior fontanelle

A

small and triangular shaped

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20
Q

when doing a cervical check on a mom, what fontanelle do we want to feel?

A

Anterior fontanelle (diamond shaped)

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21
Q

what is the goal of the fetal presenting part?

A

present the smallest part of the skull to the smallest part of the pelvis

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22
Q

what occurs when an inappropriate presentation of the fetal head occurs?

A

It can stall, prolong, or stop labor. Won’t allow for engagement

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23
Q

Relationship of the long axis of the fetal body to long axis of the mothers body

A

Fetal Lie

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24
Q

If a fetus is lying in a mothers abdomen in a horizontal manner, what lie position is this called?

A

Transverse

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25
Q

Fetal body part that will first contact the cervix or be born first and determined by the combination of fetal lie and degree of fetal flexion (Attitude)

A

Fetal presentation

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26
Q

What are three fetal presentations that can occur

A

Cephalic (Occiput)
Breech (Sacrum present)
Shoulder (scapula or acromion process)

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27
Q

if the fetal presentation is the fetus’s shoulder, what are some things we know right away?

A

fetus is in a transverse lie
can be caused by placenta previa

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28
Q

The relationship of the presenting part to the specific quadrant and size of the pregnant mom’s pelvis

A

Fetal position

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29
Q

position of presenting part toward one of the 4 quadrants of mom’s pelvis

right anterior
left anterior
right posterior
left posterior

A

maternal landmarks

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30
Q

If the fetal presenting part is the occiput, what is the letter abbreviation?

A

O

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31
Q

If the fetal presenting part is the chin, what is the letter abbreviation?

A

M
(Mentum)

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32
Q

If the fetal presenting part is the sacrum, what is the letter abbreviation?

A

Sa

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33
Q

If the fetal presenting part is the shoulder(scapula or acromion process) , what is the letter abbreviation?

A

A

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34
Q

what is the first letter in a fetal position abbreviation meaning?

A

part of the maternal pelvis the presenting part is toward (R= right, L= Left)

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35
Q

what is the second letter in a fetal position abbreviation meaning?

A

landmark of the fetal presenting part
(O,Sa, M, F, A)

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36
Q

what is the third letter in a fetal position abbreviation meaning?

A

location of the presenting part
a= anterior
p= posterior
t= transverse

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37
Q

what are the 2 best fetal positions?

A

LOA or ROA

38
Q

settling of fetal presenting part into the pelvis

A

engagement

39
Q

if a fetus is not engaged, what is it considered and what is the station score?

A

Considered “Floating” and a score of -4

40
Q

relationship of presenting part to the ischial spines

A

Station

41
Q

describe the station scores of -4, 0, and +4

A

-4 floating
0 engaged
+4 at outlet (Crowning)

42
Q

to present the smallest diameter of fetal head to the smallest part of the birth canal

A

cardinal movements

43
Q

movement of the fetal head in the pelvic inlet and beyond the dilated cervix: pressure from the head on sacral nerve causes need to push

A

decent

44
Q

as head reaches the pelvic floor flexes forward

A

flexion

45
Q

head enters pelvis during decent in diagonal
position. The head then rotates until the occiput is anterior –
shoulders are now in correct position

A

internal rotation

46
Q

as occiput is born the neck stops beneath the pubic
arch – acts as a pivot

A

extension

47
Q

immediately after head is born, head rotates
back to diagonal – aligns shoulders with outlet

A

external rotation

48
Q

if baby is face ___ during delivery birth may be more painful and traumatic

A

face up

49
Q

It is typical for a woman to complain of back labor when the
fetus is in the ____ position

A

posterior

50
Q

in order for uterine contractions to be effective, what do they need to be?

A

increase in length and intensity as well as they should be rhythmic

51
Q

what is a primary power?

A

uterine contractions

52
Q

what is a secondary power?

A

maternal pushing efforts

53
Q

at what point can a laboring woman bear down?

A

when cervix is fully dilated

54
Q

if a laboring woman bears down before she is fully dilated what can occur?

A

fetal and cervical damage

55
Q

what are false contractions called

A

braxton hicks

56
Q

looking at a uterine contraction strip:

length of contraction

A

duration

57
Q

looking at a uterine contraction strip:

from onset of one contraction to onset of the next

A

frequency

58
Q

looking at a uterine contraction strip:

strength of contraction

A

intensity

59
Q

shortening and thinning of cervical canal (0-100%)

A

effacement

60
Q

how does effacement occur?

A

contractions

61
Q

_____: enlargement or widening of the cervical canal (0-
10 cm)

  • ____ occurs due to contractions and pressure on the cervix
A

dilation

62
Q

psychological state or feeling tat women bring to labor

  • emotional status
  • expectations
    -complications of pregnancy
    -previous childbirth experience
    -support?
A

psyche

63
Q

first stage of labor has how many stages?

A

3

64
Q

first stage of labor: when cervical dilation is 0-5cm

A

latent phase

65
Q

first stage of labor: when cervical dilation is 6-7cm

A

active phase

66
Q

first stage of labor: when cervical dilation is 8-10cm

A

Transition Phase

67
Q

this stage of labor begins w complete cervical dilation and ends w birth of infant

A

second stage of labor

68
Q

stage of labor begins with birth of infant and ends with
expulsion of placenta

A

third stage of labor

69
Q

stage of labor is the first 1-4 hours after birth of the
placenta

A

fourth stage of labor

70
Q

approximately how long does stage 1 of labor last?

A

around 12 hours

71
Q

pain control used in the first stage of labor

A

distraction
aromatherapy (essential oils)
acupressure
walking

72
Q

during the active phase of labor how often should they dilate and by how many cm?

A

1 cm per hour

73
Q

approximately how long is the active phase of labor in stage one?

A

2-3 hours

74
Q

what what stage and phase are contractions at peak intensity occurring every 2-3 minutes and lasting 60-70 seconds

A

first stage, transitional phase

75
Q

at the end of transitional phase what urge occurs?

A

urge to push

76
Q

what is it called with the fetus descends into the birth canal?

A

crowning

77
Q

what phase is it when the laboring woman starts to push

A

second stage

78
Q

the placental stage is what stage of labor?

A

Third stage

79
Q

approximately how many ml of blood is typically lost w childbirth?

A

300 - 500 ml of blood

80
Q

what are some danger signs of labor for the mother?

A
  • high or low BP
  • abnormal pulse
  • prolonged or inadequate contractions
  • abnormal appearance of abdomen
81
Q

danger signs in labor for fetus examples

A
  • high or low FHR
  • meconium staining (Distress)
    -hyperactivity
    -low O2 saturation
82
Q

what are 4 ways to determine fetal positioning and lie?

A

fetal heart tones
Leopold maneuver
vaginal exam
sonography, if needed

83
Q

ELECTRONIC MONITORING OF FETAL HEART
RATE

No amplitude range detected: indicates the natural pacemaker activity of the fetal heart (sympathetic
and parasympathetic) may be affected. Narcotics and magnesium may cause.

A

absent

84
Q

ELECTRONIC MONITORING OF FETAL HEART RATE

Amplitude range is detectable but is 5 beats per minute or fewer

A

minimal

85
Q

ELECTRONIC MONITORING OF FETAL HEART RATE

Amplitude range is 6-25 beats per minute (normal)

A

moderate

86
Q

ELECTRONIC MONITORING OF FETAL HEART RATE

Amplitude range is greater than 25 beats per minute-may represent an increased sympathetic
response in the neonate due to a stressful intrapartum event

A

marked

87
Q

normal fetal heart rate

A

110 - 160 bpm

88
Q
  • The difference between the highest and lowest heart rate
  • Most reliable indicators of fetal well-being
A

variability

89
Q

4 types of decelerations

A

Early Decelerations
* Late Decelerations
* Prolonged Deceleration
* Variable Decelerations

90
Q

Increase in fetal heart rate by 15 beats and last 15 seconds above the baseline

A

accelerations

91
Q

Decrease in fetal heart rate

A

Decelerations

201 Exam 3: Birth, OB, etc. (3 decks)

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