L&D I

Question 1

What are the Four P’s?

Answer 1

Powers, passage, passenger, psyche

Question 2

_____________________________ favor efficient passage of the fetus through the mother’s pelvis

Answer 2

Natural mechanisms of labor

Question 3

_________________________ further describe the relation of the fetus (passenger) to the maternal pelvis

Answer 3

Presentation and position

Question 4

Labor contractions are ____________ to give baby a rest, bp increases bc blood is shunted away from uterus

Answer 4

intermittent

Question 5

how often should moms go to the bathroom to urinate during labor? if she is not progressing –check to see if she went to the bathroom,

Answer 5

every 2 hours at least

Question 6

What is normal blood loss during pregnancy?

Answer 6

500-1000 mL

Question 7

during pregnancy, blood volume increases ________, as long as they have a hemoglobin of ____ and hematocrit of ___ we are happy. most pregnant people are anemic. levels of fibrinogen are elevated

Answer 7

40-45%, 11, 30

Question 8

Maternal Physiologic effect of birth process: Supine hypotension
causes hypotension, _______

Answer 8

tilt hips with pillow

Question 9

Maternal Physiologic effect of birth process: Hyperventilation -pain, anxiety, help them ____ calmly, she may feel dizzy. try to get her to ____.

Answer 9

breathe, focus

Question 10

Maternal Physiologic effect of birth process: Reduced gastric motility
typically moms will be on ______, bc of reduced gastric motility –possible c section

Answer 10

clear liquids

Question 11

t/f: . most pregnant people are anemic. levels of fibrinogen are elevated

Answer 11

true

Question 12

Fetal Physiologic Effects of the Birth Process: Placenta circulation -__________ can impair placental circulation, ______ –can make babies not tolerate labor well

Answer 12

diabetes and hypertension, fetal anemia

Question 13

Fetal Physiologic Effects of the Birth Process: Cardiovascular system
reacts quickly, we care about decels, how we can tell if baby is doing well, Normal FHR in utero is ______.

Answer 13

110-160

Question 14

Fetal Physiologic Effects of the Birth Process: Pulmonary system
babies breath in utero, the process of labor helps ______ out of lungs, approximately 35% of maximum amount of fluid is in lungs (some is absorbed in the circulatory or lymph system) –vaginal birth helps squeze fluid out. __________ are at a higher risk for respiratory distress (be prepared to reseccitate), crackles can be heard on an infant

Answer 14

squeeze fluid, C –section babies

Question 15

Powers: During the first phase of labor (onset through dilation) ______________ are the primary force moving the fetus through thematernal pelvis.

Answer 15

uterinecontractions

Question 16

Powers:
During the second stage of labor (dilation through birth) the ____________________ to add power to the contraction and push the fetus through the pelvis.

Answer 16

woman uses her voluntary pushing efforts

Question 17

contractions push baby down and cause ________________

effacement happens first with ______________ and takes longer than with ________________.

______ –is not completed a pregnancy past 20 weeks gestation.

Answer 17

dilation and effacement. , primigravida, a multigravida, nolipara

Question 18

What are the two determinants of Passage? Which is more important?

Answer 18

maternal pelvis and soft tissues. Maternal pelvis (if it doesnt give -possible c section)

Question 19

______ is the normal pelvic shape and sets us up for a good delivery.

Answer 19

gynecoid pelvis

Question 20

_______ can deliver vaginally but might be OP (will be opposite posterior).

_______________ cannot deliver vaginally (well they can but its hard).

Answer 20

anthropoid, android and platypelloid

Question 21

what is the best positionn to labor?

Answer 21

OA. can be LOA, OA, or ROA

Question 22

What happens with OP?

Answer 22

will take longer and moms will have back pain.

Question 23

after fetal head, ______ are next

typically if we can get the _____ out, we can get the shoulders out as well.

Answer 23

shoulders, (shoulder dystocia),

head

Question 24

lie is either longitudinal or transverse

we want ______.

if baby is transverse she will probably have a ________.

__________–where they attempt to move the baby into the right position. ___________ is a huge risk with this. 95% of the time youre going to prepare for a c section.

Answer 24

longitudinal, c section, external version, placental abruption

Question 25

attitude is ____________________

__________ is what we want.

_________ is not ideal –we could deliver baby vaginally.

Answer 25

extension or flexion., flexion, extension,

Question 26

WHat are the different types of cephalic presentation?

Answer 26

VMBF -vertex military, brow, face

Question 27

What is the most common breech position? What is going to happen with this presentation?

Answer 27

frank breech is most common –we are never going to deliver this via a c section.

Question 28

What makes the breech position more likely?

Answer 28

placenta previa, multiple gestations, hydrocephaly

Question 29

What letter abbreviates breech position?

Answer 29

S -sacrum

Question 30

________________________will help baby get into OA position

Answer 30

different position changes (move the mom around)

Question 31

physiologically things happen with ____ that do not allow her to actually progress in labor.

Answer 31

fear

Question 32

What helps decrease anxiety and fear?

Answer 32

prenatal class, hospital tour, classes, what epidural looks like.

Question 33

What is our goal considering culture?

Answer 33

do everything we can to get them the labor they desire while still staying safe is our goal.

Question 34

Premonitory Signs of Labor:

______________________
______________________
______________________
“Bloody show”
Energy spurt (nesting)
Small weight loss

Answer 34

Braxton Hicks contractions
Lightening
Increase in clear and nonirritating
vaginal secretions

Question 35

Premonitory Signs of Labor:

Braxton Hicks contractions
Lightening
Increase in clear and nonirritating vaginal secretions
______________________
______________________
______________________

Answer 35

“Bloody show” (from mucus plug)
Energy spurt (nesting)
Small weight loss (1-3 pounds)

Question 36

The patient should enter the birth center for evaluation if she is uncertain or has concerns during which we will?

Answer 36

will keep moms for 1 hour to look at cervical change. put on monitor, do SVE, wait an hour, do another SVE

Question 37

Felt in the abdomen and groin.

Answer 37

false labor contractions

Question 38

Begins in lower back and gradually sweeps around to the lower abdomen like a girdle.

Answer 38

true labor contractions

Question 39

What does latent labor begin and end with?

Answer 39

onset of regular contractions
until the active phase in which cervical dilation accelerates, which usually occurs at 5 cm dilation.

Question 40

What is the longest phase with primagravas ? and it is also the longest regardless of previous children as well

Answer 40

latent phase

Question 41

When does the active first stage of labor begin and end?

Answer 41

6cm to 9 cm

Question 42

What are signs that active phase of stage one are over?

Answer 42

irritability, inability to cope, shakiness, increased perspiration and bloody show

Question 43

what stage does a gush of blood occur?

Answer 43

third stage after the placenta delivers

Question 44

List the cardinal movements

Answer 44

descent of presenting part through true pelvis

engagement of part reaching the ischial spines in the pelvis (0 station)

flexion of head

internal rotation

extension of head

external rotation

expulsion of fetal shoulders and fetal body

Question 45

What stage is best for education?

Answer 45

latent first stage

Question 46

What stage are they most at risk for hemorrhaging?

Answer 46

fourth stage