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Maternal > Intrapartum: Process of Labor and Delivery > Flashcards

Intrapartum: Process of Labor and Delivery Flashcards

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1
Q

Preliminary Signs of Labor

A

Lightening
Slight weight loss
Excess energy
Backache
Ripening of the cervix

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2
Q

Signs of TRUE Labor

A

Rupture of membranes
Show
Contractions

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3
Q

True Labor

A
  • Timing of contractions regular
  • Radiating contraction pain
  • Unable to relieve contraction pain with activity
  • Exam changes present
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4
Q

Fake Labor

A
  • Fails to cuase changes to cervix and baby’s position
  • Activity diminishes contractions
  • Keep feeling contractions above belly button (they don’t radiate from back to abdomen)
  • Erratic timing of contractions
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5
Q

5Ps

A
  • Passenger
  • Passage
  • Power
    -Placenta
  • Psyche
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6
Q

PASSENGER

A

a. the size,
b. presentation,
c. position of the fetus
d. fetal attitude,
e. and fetal lie.

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7
Q

With a big baby, you have a ____________ chance of a difficult vaginal delivery. You may also have an increased risk of _______________________________________________

A

greater; preterm birth, perineal tearing, and blood loss

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8
Q

Portion of the body of the fetus that is foremost within the birth canal or in closest proximity to it.

A

Presentation

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9
Q

The most common presentation

A

Cephalic

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10
Q

Types of Cephalic Presentation

A

VERTEX/OCCIPUT
BROW
MILITARY/SINCIPUT
FACE

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11
Q

BUTTOCKS FIRST

A

BREECH

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12
Q

Types of Breech Presentation

A

Frank
Complete
Footling

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13
Q

Fetus is in a _____________________, or the arm, back, abdomen, or side could present.

A

transverse lie

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14
Q

shoulder or acromion is presenting into the pelvic inlet

A

shoulder presentation

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15
Q

bisacromial dimatere (11 cm) presents

A

shoulder presentation

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16
Q

fetal hand or foot prolapses alongside the presenting vertex or breech

A

Compound presentation

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17
Q

relationship of the chosen portion of the fetal presenting part in reference to one of the 4 quadrants or transverse diameter of birth canal

A

Position

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18
Q

the relationship of the fetal body parts to one another

A

attitude

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19
Q

Fetal Position

A

Occiput (cephalic/vertex position)
Mentum or chin (face presentation)
Sacrum (breech presentation)
Acromion or scapula (shoulder presentation)

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20
Q

Feta lspine is parallel to the mother’s spine.

A

longitudinal or vertical

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21
Q

Fetal spine is at a right angle, or perpendicular, to the mother’s spine

A

transverse or horizontal

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22
Q

this position is very rare and occurs in fewer than 5% of pregnancies

A

oblique

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23
Q

PASSENGER ASSESSMENT

A

Leopold’s maneuvers
Vaginal examination

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24
Q

The mother’s rigid bony pelvis and the soft tissues of the cervix, pelvic floor, vagina, and introitus (external opening to the vagina)

A

PASSAGE/ PASSAGEWAY

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25
most common, 55%, inlet transverse diameter is wider than the antero-posterior diameter
Gynaecoid
26
20% of women, heart shaped inlet, funnel-shaped cavity, narrow inlet
Android
27
20% women, oval-shaped inlet, maximam diameter AP with a long and narrow cavity
Anthropoid
28
5% of women, flattened transversely oval, shallow cavity and spacious outlet
Platypoid/Platypelloid
29
Forces of labor acting in concert to expel the fetus and placenta
Power
30
Contractions more than _________________ must be referred
90 seconds
31
usually very painful, can be difficult to talk during one
Contractions (True Labor)
32
have a pattern and contractions will become closer together with time
Contractions (True Labor)
33
associated with dilation of the cervix
Contractions (True Labor)
34
will continue despite changes in your body positioning
Contractions (True Labor)
35
typically, not as painful and you are able to talk
Braxton Hicks (False Labor)
36
no specific pattern, and do not get closer together with time
Braxton Hicks (False Labor)
37
the cervix does not dilate
Braxton Hicks (False Labor)
38
may stop if you shift body positions or go to the bathroom
Braxton Hicks (False Labor)
39
placenta usually forms in the
fundus of the uterus
40
the cervix relaxes, causing it to dilate and thin out
Stage 1
41
uterine contractions increase in strength and the infant is delivered
Stage 2
42
the placenta is expelled
Stage 3
43
recovery stage
Stage 4
44
from the onset of labor until full dilatation of the cervix
CERVICAL DILATION STAGE
45
From full dilation of cervix to birth of baby
EXPULSION STAGE
46
From birth of baby to expulsion of placenta.
PLACENTAL STAGE
47
Time after birth of immediate recovery
RECOVERY STAGE
48
RECOVERY STAGE CRITICAL:
1-2 HOURS
49
LATENT PHASE - ___ cm - ______ hours in multipara - _______ hours in nullipara
- 0-3 cm - 4.5 hours - 6 hours
50
Contractions in Laten Phase
Contraction: Frequency - (every 20 minutes decreasing to every 5 minutes) Intensity – (mild to moderate) Duration – 20– 40 seconds
51
Latent Phase Assessment:
1. Contraction 2. Membranes: intact or ruptured 3. BLOODY SHOW present 4.Time of onset 5. Cervical changes 6. Time of last ingestion of food 7. FHR every 15 minutes, after rupture of membrane 8. Maternal V/S- temperature every 2 hours (rupture membrane), every 4 hours if intact membrane 9. Progress of descent (station) 10. client’s knowledge of labor process is caused by cephalopelvic disproportion 11. Client’s affect: woman is sociable and excited 12. client’s birth plan
52
In Latent Phase, have the client attempt to void every ______________
1-2hours
53
ACTIVE PHASE - ___ cm - ______ hours in multipara - _______ hours in nullipara
4-7cm 3-6hrs in nullipara 2 hrs in multipara
54
Contractions in Latent Phase
Frequency - every 3-5 minutes apart Intensity – moderate to firm Duration – 40 - 60 seconds
55
fetus descends in pelvis and internal rotation begins.
Active Phase
56
more anxious and may feel helpless.
Active Phase
57
complete effacement
Active Phase
58
TRANSITION PHASE _____ cm length:
8-10 cm 30 MINUTES-2HOURS
59
Contractions in Transitional Phase
Frequency: every 2 – 3 minutes. Intensity: firm Duration :60 – 90 seconds
60
irritable or aggressive and loss of control, maybe tiring or unable to cope.
Transitional Phase
61
Breathing pattern may be hyperventilating
Transitional Phase
62
Feeling the urge to push/bear down with contractions.
Transitional Phase
63
Loss of control is common
Transitional Phase
64
Signs of nausea, vomiting, trembling, crying, irritability
Transitional Phase
65
Membrane ruptured, bloody show, cervix fully dilated
Transitional Phase
66
SECOND STAGE OF LABOR Assessment:
a. Signs of imminent delivery. b. Progress of descent. c.Maternal/fetal vital signs. d. Maternal pushing effort (active pushing) e. vaginal distention f. Bulging of the perineum g.Crowning h. Birth of baby
67
Signs of placental separation:
a. Calkin’s sign – earliest sign of placental separation; change in shape of uterus (from discoid uterine shape to globular). a. Sudden gush of vaginal blood. b. Lengthening of the umbilical cord
68
earliest sign of placental separation
Calkin’s sign
69
change in shape of uterus (from discoid uterine shape to globular).
Calkin’s sign
70
placenta separates from the center of the edge
Shultze
71
Clean presentation
Shultze
72
Placenta separates from the edge to the center
Duncan
73
Dirty presentation
Duncan
74

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