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Maternity & Women's Health > Intrapartum Nursing Care > Flashcards

Intrapartum Nursing Care Flashcards

(51 cards)

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1
Q

What are the original 3 P’s of Labor?

A

Powers (contractions), passenger (fetus), passageway (pelvis)

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2
Q

Expanded P’s of labor

A
  • Powers
  • Passenger
  • Passageway
  • Physiology
  • Psychology
  • Preparation
  • Position: Choice
  • Professional providers
  • Place of birth
  • Procedures
  • People: Nonprofessionals
  • Policies (Social context)
  • Pressure interface
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3
Q

What is engagement during labor?

A

When the largest diameter of fetal presenting part passes the pelvic inlet

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4
Q

Lightening during labor is associated with?

A
  • Reduced dyspnea
  • Leg cramps
  • Pelvic pressure/pain
  • Edema
  • Urinary frequency
  • Vaginal secretions
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5
Q

Components of the Feto-Pelvic Relationship?

A

Lie, Attitude, Presentation, Position

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6
Q

Where is the largest diameter of the fetal head and what is the avg diameter at term?

A

biparietal diamater, avg is 9.5 cm

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7
Q

What is the relationship of the long axis of the fetus to the maternal long axis (fetal spine to maternal spine)?

A

Fetal Lie

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8
Q

What is the preferred fetal lie?

A

longitudinal vertex

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9
Q

What type of presentations can occur with a longitudinal lie?

A

vertex or breech

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10
Q

Types of fetal lie?

A

longitudinal, transverse, oblique

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11
Q

What type of presentations can occur with a transverse lie?

A

the shoulder

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12
Q

What type of presentations can occur with an oblique lie?

A

variable, unstable lie

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13
Q

Relationship of fetal parts to each other

A

Fetal attitude

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14
Q

What are the types of fetal attitude?

A
  • flexion (“vertex”)
  • military
  • partial extension (“brow”)
  • complete extension
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15
Q

Types of fetal presentations?

A

cephalic, breech, shoulder

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16
Q

Types of Breech?

A

complete (flexed), frank (extended), footling

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17
Q

What is the most common type of breech?

A

Frank or Extended breech

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18
Q

What is the shape of the (1) anterior and (2) posterior fontanel?

A

1) diamond

2) triangle

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19
Q

Describe a complete or flexed breech?

A
  • hips and knees are both flexed

- knees to chest

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20
Q

When does engagement usually occur in a primagravida?

A

2 weeks from onset of labor

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21
Q

Describe a frank or extended breech?

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A

legs are extended along the torso (touch toes position)

22
Q

What is occiput?

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A

back of the head

23
Q

Fetal Position (TPAO)

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A

Transverse, Posterior, Anterior, Occiput

24
Q

S/S of fetus in Occiput Posterior position?

Study These Flashcards
A
  • severe back pain or “back labor”
  • irregular contractions
  • slow labor progress
25
Nursing interventions for Occiput Posterior?
- turn mother toward side opposite of fetal back | - counter pressure on sacrum
26
Leopold's 4 maneuvers?
1) determines presentation by palpating the fundus 2) determines fetal lie & position of back 3) confirms #2 4) determines position of occiput
27
When performing Leopold's maneuver, you palpate a hard (1), soft (2) surface and nothing (3). What is being felt?
1) head 2) butt 3) fetus is in the transverse or oblique fetal lie
28
What separates the false from the true pelvis?
linea terminalis
29
4 Pelvic bone types?
gynecoid (oval), android (heart) anthropoid (oval), platypelloid (flattened, transverse oval)
30
What is the most common pelvic bone type?
gynecoid (oval)
31
What is the definition of ballotable?
when the presenting part of the fetus has not engaged and is movable
32
When the presenting part is at the level of the ischial spines, the baby is at what station?
0 station
33
What are the cardinal movements of delivery?
Engagement, descent, flexion, internal rotation, extension, restitution, external rotation, expulsion
34
What is the purpose of the flexion cardinal movement of delivery?
so the head can be at the smallest diameter to fit the pelvis
35
At which cardinal movement can the head be felt?
extension
36
Methods of maintaining perineal integrity during childbirth?
- spontaneous bearing down - warm compresses - perineal support ( hand on perineal) - position changes/alternative lithotomy
37
Physiological effects of uterine contractions?
- decreased uterine blood flow - dilates and effaces cervix in first stage of labor - increases maternal BP (vasoconstriction) -
38
Stages of labor?
1) 0-10 cm 2) 10 cm to delivery 3) delivery of the placenta 4) 1st hr PP
39
What are the 3 phases of the 1st stage of labor?
1) early/latent = 0-3 cm 2) Active = 4-7 cm 3) Transition = 8-10 cm
40
1st stage of labor?
begins with regular contractions and ends with dilation of the cervix to 10 cm (complete dilation)
41
When does the "bloody show" appear during pregnancy?
24-48 hrs prior to labor, but can occur up to 4 wks prior to labor
42
Signs of the "Bloody Show" during pregnancy?
- loss of mucus plug - pink tinged secretions. thick consistency - not an immediate sign of labor
43
Signs of impending Labor?
``` Lightening (primigravida) Return of urinary frequency Backache Stronger Braxton-Hicks contractions Weight loss 1-2 lbs Surge of energy (24-48 hours pre-labor) Increased vaginal discharge, bloody show Cervical ripening Possible rupture of membranes ```
44
What does PROM stand for?
- Premature Rupture of Membranes | - > 37 wks with no contractions
45
Membrane ruptures > 24 hrs prior to hospital visit?
Preterm Premature Rupture of Membranes (PPROM)
46
Signs of true labor?
- contractions increase in intensity - some consistency - PROGRESSIVE cervical change
47
Signs of false labor?
- Braxton Hicks - contractions stay in front - are inconsistent - NO cervical change
48
When to go to the hospital or birth center?
- Regular contractions - Rupture of membranes - Vaginal bleeding - Fetal movement
49
Average labor duration considerations: 1) Primigravidas 2) Multigravidas
- 9 hrs +/- 4 hrs | - 6 hrs +/- 3 hrs
50
of contractions needed before going to the hospital: 1) nullipara 2) multipara
1) q 5 or less, lasting 60 sec. x 1-2 hours | 2) q 5 or less, lasting 60 sec. x 1 hour
51
Signs of Placental Separation?
- Elongation of cord - Trickle of blood - Change in shape of uterus of discoid to globular - Uterus rises in abdomen

Maternity & Women's Health (18 decks)

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