INTRAPARTUM Flashcards

(66 cards)

1
Q

Period extends from the beginning of contractions that cause cervical dilatation to the first 1 to 4 hours after delivery of the newborn and placenta.

A

INTRAPARTUM

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2
Q

FACTORS INFLUENCING A WOMAN’S RESPONSE TO PREGNANCY:

A

✓ Memories of her own childhood
✓ Cultural background
✓ Existing support systems
✓ Socio-economic conditions
✓ Perceptions of maternal role
✓ Coping mechanisms
✓ Knowledge of pregnancy changes

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3
Q

Initial ambivalence about pregnancy; pregnant woman places main focus upon self.

A

FIRST TRIMESTER

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4
Q

Acceptance of reality of pregnancy; increased awareness and interesting fetus; introversion and feeling of well-being.

A

SECOND TRIMESTER:

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5
Q

Anticipation of labor and delivery and assuming mothering role, viewing infant as reality vs. fantasy; fears, fantasies and dreams about labor are common, “nesting” behaviors like preparing layette.

A

THIRD TRIMESTER:

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6
Q

✓ Acceptance of pregnancy as a realityand incorporation of the fetus into body image.
✓ Preparation for physical separationfrom the fetus.
✓ Attainment of maternal role.

A

III. PSYCHOLOGICAL TASKS OF
PREGNANCY

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7
Q

✓ Accept the biological fact of pregnancy . . . . “I am pregnant”
✓ Accept the growing fetus as distinct from self and as a person to care for . . . . . “I am going to have a baby”.
✓ Prepare realistically for the birth and parenting of the child. . . . . . .
“I am going to be a mother”.

A

DEVELOPMENTAL TASKS OF PREGNANCY

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8
Q

Ambivalence and anxiety about role change; concern or identification with mother’s discomforts (couvade).

A

FIRST TRIMESTER:

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9
Q

Increased confidence and
interest in mother’s care; difficulty relating to fetus: “jealousy”

A

SECOND TRIMESTER

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10
Q

Changing self-concept; concern about body changes; active involvement common fears about delivery, mutilation or death of partner or fetus.

A

THIRD TRIMESTER:

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11
Q

✓ Normal rivalry depends on thedevelopmental stage.
✓ May need increased affection andattention.
✓ Regression in behavior (may appearin bedwetting and thumb sucking); rejection.

A

SIBLING REACTIONS TO
PREGNANCY

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12
Q

Subtle signs that can signal the onset of labor.

A

PRELIMINARY SIGNS

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13
Q

descent of the fetal presenting part into the pelvis.

A

LIGHTENING

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14
Q

approximately 10 to 14 days before labor begins due to tight abdominal muscles.

A

Primiparas

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15
Q

✓ usually on the day of labor or even after labor has begun.
✓ Changes the abdominal contour as the uterus become lower & more anterior.
✓ Gives relief from the diaphragmatic pressure & shortness of breath.

A

Multiparas

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16
Q

LIGHTENING RESULT IN:

A
  1. Gives relief from the diaphragmatic pressure & shortness of breath.
  2. relief of respiratory discomfort because of the release of pressure on maternal diaphragm
  3. increased frequency of urination because fetal head presses against the bladder
  4. leg pains caused by compression of the sciatic nerve
  5. muscles spasms
  6. increased vaginal discharge
  7. decreased fundal height because of descent of fetal head to pelvic brim.
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17
Q

Irregular painless contractions of pregnancy become stronger, longer, more frequent, enough to cause discomfort and alarm the mother.

A

INCREASED BRAXTON HICKS CONTRACTIONS

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18
Q

Consistency of cervix becomes butter soft when is near at hand.

A

RIPENING OF THE CERVIX

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19
Q

✓ Due to high level of adrenalin, woman become highly energetic and active.
✓ Advice mother not to use this energy for doing household chores but to save it for labor & delivery.

A

INCREASE LEVEL OF ACTIVITY

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20
Q

due to the decline in progesterone level.

A

WEIGHT LOSS

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21
Q

When the cervix dilates, this blood tinged mucus is released together with the operculum (mucus plug).

A

SHOW

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22
Q

Signified by a gush or steady trickle of clear fluid from the vagina.

A

RUPTURE OF MEMBRANES (bag of water)

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23
Q

The cervix feels softer than the normal, like the consistency of an earlobe during pregnancy, but at term, the cervix becomes “butter soft” & tips forward.

A

GOODELL’S SIGN

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24
Q

Uterine contractions

A

POWER

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25
Begins at the onset of regularly perceived uterine contractions & ends when rapid cervical dilation begins.
LATENT PHASE OR PREPARATORY PHASE
26
usually complete effacement in primigravida
CERVIX 1-4 cm dilatation;
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CONTRACTIONS
Mild
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DURATION
30sec, average
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FREQUENCY
over 10 mins (can be 5 to 8 min)
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MATERNAL DISCOMFORT
backache, abdominal cramps
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NURSING INTERVENTIONS: PROPER POSITIONING
side; backrub; support system can include husband stay with client to provide support.
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ASSESS MEMBRANES
intact or ruptured, color of fluid
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ASSESS BLOODY SHOW:
amount
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FETAL HEART RATE
Count immediately after rupture of membranes
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NORMAL
120-160 beats/minute
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CERVIX 4 to 8 cm; complete effacement
ACTIVE PHASE
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CONTRACTIONS
moderate
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DURATION
45 to 60 sec
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FREQUENCY
every 3 to 5 min
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less talkative, more anxious, fears losing control; restless; increasing in anxiety with malar flush (skin warm & flushed)
MATERNAL BEHAVIOR:
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TRANSITION PHASE
● CERVIX: 8 to 10cm ● CONTRACTIONS: strong ● DURATION: 60 to 90 sec ● FREQUENCY: every 2 to 3 min
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PREVENT SINUS HYPOTENSION
position client in LEFT LATERAL RECUMBENT
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2nd stage
CROWNING
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From delivery of the baby to the expulsion of placenta
THIRD STAGE / PLACENTAL STAGE
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when uterus changes in shape (discoid to globular) & consistency (soft to firm)
CALKIN’S SIGN
46
NORMAL BLOOD LOSS
300 to 500 ml.
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more common; present in 80% of cases
SCHULTZE MECHANISM:
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less common; present in 20% of cases.
DUNCAN MECHANISM:
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From delivery of the placenta until the condition of the woman has stabilized.
FOURTH STAGE / IMMEDIATE POSTPARTUM
50
Also known as postpartum bleeding Is a normal part of healing after giving birth in which blood and mucus are discharged vaginally
LOCHIA
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THE PASSAGE
WOMAN’S PELVIS.
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THE PASSENGER
THE FETUS
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Refers to the route the a fetus must travel from the uterus through the cervix and vagina to the external perineum.
PASSAGEWAY - PELVIS
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The widest body part is the head.
PASSENGER - THE FETUS
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uppermost portion of the skull with 8 bones.
Cranium
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area referred to as the sinciput
FRONTAL
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area referred to as the occiput.
OCCIPITAL
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Lies at the junction of the coronal & sagittal sutures.
anterior fontanelle – bregma.
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frontal bones are 2 fused bones & 2 parietal bones.
Diamond shaped
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Lies at the junction of the lambdoidal & sagittal sutures.
Posterior fontanelle
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MATERNAL PSYCHOLOGICAL ADJUSTMENT (REVA RUBIN)
✓ Taking-In Phase (Dependent and Passive) ✓ Taking – hold Phase (Striving for Independence) ✓ Letting – go Phase (Independent)
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important communication with the baby
Touch
63
forms a trusting relationship
Eye to Eye contact
64
babies respond to higher pitched voice that parents use in talking to the baby
Voice
65
baby quickly identify their own mother’s breast milk
Odor
66
baby moves in rhythm to pattern of adult speech.
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