Labor and Birth Flashcards
(95 cards)
1
Q
def labor
A
progressive cervical changes, in the presence of regular, frequent, painful uterine cxns
2
Q
factors that contribute to the birth passage
A
- size of pelvis
- type of pelvis
- ability of cervix to dilate
- ability of vaginal canal to distend
3
Q
birth of fetus
A
- head
- attitude
- lie
- presentation
4
Q
def fetal attitude
A
- relation of the fetal body parts to one another
- “characteristic posture”
- usually a position of general flexion
5
Q
def fetal lie
A
-relation of the spine of the fetus in relation to spine of the mom
6
Q
what position do you want the fetal lie to be?
A
parrallel, vertical
7
Q
def fetal presentation
A
the part of the fetus that enters the pelvis first
8
Q
what fetal presentation do you want and is most common
A
cephalic
9
Q
what factors contribute to passage
A
engagementstationfetal position
10
Q
def engagement
A
the largest diameter of the presenting part that has passed into the true pelvis
11
Q
true pelvis is considered what station
A
“0” station
12
Q
when does engagement typically happen
A
- weeks before labor
- “baby has dropped”
13
Q
what might mom experience with engagement
A
- urinary freq
- back ache
- easier breathing
- less heart burn and reflux
14
Q
def station
A
relation of the presenting part of the fetus to the ischeal spine
- determining the rate of descent
15
Q
what station does real labor start
A
“0” station
16
Q
def fetal position
A
position of the baby in utero
17
Q
what are the physiologic forces of labor?
A
- freq of cxns
- effectiveness of pushing
18
Q
def interval of cxns
A
the period from the end of one cxn to the beginning of the next
19
Q
def acme of cxn
A
the peak of a cxn
20
Q
do we want the cxns to be regular or irregular?
A
regular
21
Q
flow of cxns
A
increment
peak
decrement
22
Q
ROM puts mom at risk for what?
A
infec
23
Q
if mom is tired of pushing after a few hours, what should we do?
A
section mom
24
Q
psychosocial considerations r/t labor and birth
A
- 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
