Labor and Birth Flashcards Preview

NUR 359: OB > Labor and Birth > Flashcards

Flashcards in Labor and Birth Deck (95):
1

def labor

progressive cervical changes, in the presence of regular, frequent, painful uterine cxns

2

factors that contribute to the birth passage

- size of pelvis
- type of pelvis
- ability of cervix to dilate
- ability of vaginal canal to distend

3

birth of fetus

- head
- attitude
- lie
- presentation

4

def fetal attitude

-relation of the fetal body parts to one another
-"characteristic posture"
- usually a position of general flexion

5

def fetal lie

-relation of the spine of the fetus in relation to spine of the mom

6

what position do you want the fetal lie to be?

parrallel, vertical

7

def fetal presentation

the part of the fetus that enters the pelvis first

8

what fetal presentation do you want and is most common

cephalic

9

what factors contribute to passage

engagementstationfetal position

10

def engagement

the largest diameter of the presenting part that has passed into the true pelvis

11

true pelvis is considered what station

"0" station

12

when does engagement typically happen

- weeks before labor
-"baby has dropped"

13

what might mom experience with engagement

- urinary freq
-back ache
- easier breathing
-less heart burn and reflux

14

def station

relation of the presenting part of the fetus to the ischeal spine
- determining the rate of descent

15

what station does real labor start

"0" station

16

def fetal position

position of the baby in utero

17

what are the physiologic forces of labor?

-freq of cxns
-effectiveness of pushing

18

def interval of cxns

the period from the end of one cxn to the beginning of the next

19

def acme of cxn

the peak of a cxn

20

do we want the cxns to be regular or irregular?

regular

21

flow of cxns

increment
peak
decrement

22

ROM puts mom at risk for what?

infec

23

if mom is tired of pushing after a few hours, what should we do?

section mom

24

psychosocial considerations r/t labor and birth

- mental and phys preparation
-sociocultural values
- previous experience
-support
-emotional status

25

stages of labor

stage 1-4

26

stage 1 of labor

-from onset to full dilation

27

what happens during stage 1 labor?

- thinning and dilation of the cervix

28

stage 2 of labor

full dilation to delivery of baby

29

stage 3 labor

delivery of the placenta

30

stage 4 labor

recovery from delivery

31

how long does stage 4 labor last

approximately 2 hours

32

what are the 3 phases of labor

latency
active
transition

33

latency phase of labor

-(0-3 cm) dilation
- 4-24 hrs

34

active phase of labor

(4-7 cm) dilation
3-5 hrs

35

transition phase of labor

(8-10 cm) dilation
1/2- 2 hrs

36

when can mom not be given an epidural

during the transition phase

37

why might mom be given an epidural during the latency phase of labor

- to relax mom enough for labor to progress and allow descent of the baby

38

what is done upon admission of mom to the labor suite?

hx
cxns
when they last ate
VS
US
vaginal exam

39

what might we ask mom upon admission to the suite pertaining to the cxns

- when did they start
-what were you doing when they started
- how often are they
-pain scale

40

what in the hx should we ask mom upon admission to the labor suite?

- how was the preg
-GTPAL
-previous births

41

why do we ask mom about when they last ate when they get admitted to the labor suite?

in case they need to be sectioned
for the anesthesia

42

when the mom is admitted to the labor suite, what do we determine with the US

station
gest age
placement

43

what is determined when a vaginal examination is done upon admitting mom to the labor suite

effacement
dilation

44

what do we measure with cxns?

freq
duration
strength

45

how much fluid is expelled when ROM occurs

600-800 cc

46

how do we determine of it is a true membrane rupture

- speculum exam
- pH 7.0-7.5
-(+) ferning

47

what color should the amniotic fluid be?

clear straw color

48

if the amniotic fluid is greenish/black, what could this indicate?

infecmeconium

49

does amniotic fluid normally have an odor?

no

50

what should we suspect if the amniotic fluid has an odor

infec

51

what is used to determine if there is a true ROM

nitrazine paper

52

describe the device used for external fetal monitoring

2 belts

53

what do the 2 belts on the external fetal monitoring do?

- measure cxns
- FHR

54

benefits of external fetal monitoring

see if baby is having decelsmonitor contractions
not invasive

55

drawbacks to external fetal monitoring

-mom cant get up an walk around
- not as accurate as internal

56

what comprises the internal fetal monitoring system?

- fetal scalp electrode
- intrauterine pressure cath

57

what does the fetal scalp electrode do?

-internal FHR monitor

58

what is the avg pressure of the internal fetal monitor

50-80

59

what does the intrauterine pressure cath do?

measures and monitors cxns

60

how does an intrauterine pressure cath work

coil needle is placed on the babys head

61

what is the benefit of using internal fetal monitoring

more accurate than external

62

what is the drawback of the internal fetal monitoring system

invasive

63

what is the normal FHR range in utero?

110-160

64

variability in FHR is ______

good

65

def minimal variability

< 5 bpms

66

def moderate variability

6-25 bpms

67

def marked variability

>25 bpms

68

def accelerations

a 15 bpm incr for greater than 15 secs with return to baseline in less than 2 mins

69

if an accel or decel occurs for longer than 2 mins, it is considered

a change in baseline

70

accelerations are signs of

-fetal awakeness
-well being

71

when do early decels occur

when the cxn starts, the babys HR decr

72

what causes early decels

head compression
vaginal exam

73

when do late decels occur

they begin after the peak of the cxn

74

what do late decels indicate

- fetal hypoxemia

75

are late decels cause for concern?

yes- take action immediately!!!

76

def variable decels

- a visually abrupt decel in FHR below the baseline

77

what characterizes variable decels

- a 15 bpm or more for at least 15 secs

78

when do variable decels occur

can happen at any time

79

what do variable decels indicate?

cord compression

80

placental delivery sequence

cxn
globular uterus
cord lenthens
rush of vaginal blood

81

def globular uterus

uterus becomes very soft

82

what do we do when the cord lengthens?

gently guide it out

83

if the placenta is expelled in fragments, mom is at a very high risk for what?

hemorrhage

84

common analgesics used during labor

stadol
nubain

85

what adverse rxn do analgesics cause and what should we monitor for?

resp depression

86

regional anesthesia techniques

epidural
spinal
pudendal

87

epidural anesthesia

- cath inserted into epidural space
- indwelling
- hooked up to a pump
\-delivers continuous meds

88

spinal anesthesia

-needle is injected, admin med, and removed

89

what is a pudendal used for?

- episiotomy or tear
-pain relief if mom needs stitches

90

what is given before a pudendal

lidocaine

91

what position should mom be in for the admin of regional anesthesia

sitting position nurse bear hugs mom

92

what should we do with mom immediately after the admin of regional analgesics

have mom lie down immediatelyput feet up

93

major side effects of regional anestesia

- hypotension
-bladder distention

94

natural pain mgmt methods

lamaze
dick read
bradley
hypnobirthing
hydrotherapy

95

what is a doula

-a natural birth coach
-not a nurse