L&D

Question 0

Powers

Answer 0

Primary- effacement, dilation, freguson reflex

Secondary- bearing-down efforts

Question 1

Four P’s

Answer 1

Passenger
Passageway
Powers
Psychologic response

Question 2

Passage

Answer 2

birth canal- bony pelvis, lower uterine segment, cervix, pelvic floor muscle, vagina, introitus

Question 3

Passenger

Answer 3

size of fetal head
fetal presentation
fetal lie
fetal attitude
fetal position

Question 4

Stage 1 of labor process

Answer 4

onset of regular uterine contractions to complete dilation & effacement

Question 5

Stage 2 of labor process

Answer 5

complete dilation to birth of infant

Question 6

Stage 3 of labor process

Answer 6

birth of the infant to delivery of the placenta

Question 7

Stage 4 of labor process

Answer 7

approx. 2 hrs after placenta delivery

Question 8

7 cardinal movements of mechanism of labor

Answer 8

engagment
descent
flexion
internal rotation
extention
external rotation
expulsion

Question 9

latent phase

Answer 9

up to 3 cm

Question 10

active phase

Answer 10

4-7 cm

Question 11

transition phase

Answer 11

8-10 cm

Question 12

BUBBLE HE

Answer 12

Breast
Uterus
Bowel
Bladder
Lochia
Episitomy
Homans- DO NOT DO ANYMORE; look for S&S of clotting
Emotions

Question 13

Rubria

Answer 13

Bright red

day 1

Question 14

Serosa

Answer 14

pink to brown
day 3
can last 22-27 days

Question 15

Alba

Answer 15

white to yellow
day 10
can last 4-6 weeks

Question 16

contractions of muscle fibers
catabolism
regeneration of the uterus epithelium

Answer 16

3 processes of uterine involution

Question 17

REEDA

Answer 17

Redness
Edema
Ecchymosis
Discharge
Approximation

Question 18

Taking-in phase

Answer 18

mother is focused on her own needs

Question 19

letting go phase

Answer 19

parents relinquish fantasies about their infants

Question 20

S&S postpartum hemorrhage

Answer 20

difficult to locate fundus, boggy uterus, fundus above expected level, excessive lochia & clots

Question 21

bacterial infection after childbirth

Answer 21

puerperal infection

Question 22

Normal WBC range after birth

Answer 22

14000-16000 mm3

can reach as high as 30000 mm3

Question 23

fundus descend

Answer 23

after birth midway btwn symphysis pubis & umbilicus
12 hrs later- rise to level of umbilicus
descend 1cm/day
14th day not palpable

Question 24

return of mensus???

Answer 24

Formula- 40-45% in 6-8 wks; 75% in 12 weeks; all within 6 mths Boob- as early as 12 wks or as late as 18 mths

Question 25

anticipatory stage- of role attainment

Answer 25

begins during pregnancy- choosing doc, hospital, classes

Question 26

formal stage- of role attainment

Answer 26

birth of infant to 4-6 weeks this is largely guided by others

Question 27

informal stage- of role attainment

Answer 27

mother learns appropriate responses to their infant's cues & signals

Question 28

personal stage- of role attainment

Answer 28

sense of harmony in role, enjoys infant, sees infant as central person in life & has internalized the parental role

Question 29

drugs used to treat uterine atony

Answer 29

pitocin methergine hemabate dinoprostone (cytotec)

Question 30

major signs of subinvolution

Answer 30

``` prolonged discharge of lochia irregular or excessive uterine bleeding profuse hemorrhage pelvic pain or feelings of pelvic heaviness backache fatigue persistent malaise bimanual examination of the uterus feels larger & softer than normal ```

Question 31

S&S of superficial venous thrombosis

Answer 31

swelling of the involved extremity & redness tenderness & warmth palpate an enlarged, hardened, cordlike vein may have intermitted caudation or no pain @ all

Question 32

S&S endometritis

Answer 32

temp of 38*C or higher within 36 hr of birth chills, malaise, anorexia, ABD pain, cramping, uterine tenderness & purulent, foul smelling lochia, tachycardia & subinvolution

Question 33

Umbilical Vein

Answer 33

within days

Question 34

Ductus Venosus

Answer 34

within days

Question 35

Foramen Ovale

Answer 35

within minutes

Question 36

Ductus arteriosus

Answer 36

within hours

Question 37

Umbilical Artery

Answer 37

within hours

Question 38

changes in the shape of the head that allow it to pass through the birth canal disappears with a few days

Answer 38

molding

Question 39

localized edema in the newborns head, as a result of the pressure against the mothers cervix, crosses suture lines, disappears 12-48 hrs

Answer 39

caput succedaneum

Question 40

bleeding between periosteum & skull, result of pressure during birth, occurs on one or both sides of head, does not cross the suture lines, 2-3 mth to resolve; greater risk of jaundice development

Answer 40

cephalhematoma

Question 41

first voiding occur

Answer 41

NB- 12-24 hrs, few within 48 hrs void 1-2 times during first 2 days @ least 6X/day by the 4th day

Question 42

prophylactic medications given to NB

Answer 42

Vitamin K & erythromycin

Question 43

rich in protein, vitamins, minerals, immunoglobulins | protects GI tract from infection, establishes normal flora, speeds passages of meconium

Answer 43

colostrum milk

Question 44

has less protein & immunoglobulins, but more lactose, fat & calories than colostrums 2-3 days after birth

Answer 44

transitional milk

Question 45

appears less rich than the colostrums/transitional milk | blue color, still supplies all needed nutrients

Answer 45

mature milk