Labor & Delivery

Question 1

What is the definition of labor?

Answer 1

Progressive cervical changes in the face of regular frequent painful uterine contractions

Question 2

Stages of labor

Answer 2

First stage
Second stage
Third Stage
Fourth Stage

Question 3

First stage of labor entails?

Answer 3

Cervical Dilation

Lasts up to 24 hours
Dilation of cervix from 0-10cm
Has 3 PHASES (Names)

Question 4

Second stage of labor entails?

Answer 4

Expulsion - Pushing stage

Lasts under 2 hours
Begins once cervix is fully dilated until delivery of baby

Question 5

Third Stage of labor entails?

Answer 5

Placental delivery

Lasts no more than 1 hour (10min-1hr)
Begins from delivery of baby to placental delivery

Question 6

Fourth stage of labor entails?

Answer 6

Maternal homeostatic stabilization

Begins after delivery of the placenta
Lasts 1-4 hours after delivery of placenta

Question 7

How does one know total amount of time in labor?

Answer 7

Total up all four stages of labor to know total amount of time in labor

Question 8

Phases of labor?

Answer 8

Phases have names**

Latency
Active
Transition

Question 9

Latency phase lasts for how long and how much is dilated during this phase?

Answer 9

Prodromal
Preliminary
Early

4-24 hours
Usually cervix dilates from 0-3cm in this phase

Question 10

Contractions (Freq/Duration) and attitude during latency phase?

Answer 10

Contractions:
Start as severe menstrual cramps, end up being much worse.

Frequency:
Starts: 20 min apart
End: 5 min apart

Duration:
Start: 10 sec each
End: 45 sec each

Attitude:
Good attitude, like she can complete labor fine.

Question 11

Active phase of labor lasts for how long & how much is dilated during this phase?

Answer 11

About 3-5 hours
Cervix dilates about 4-7cm

Question 12

Active Phase: Contractions (Duration/Freq) and attitude during this phase?

Answer 12

Contractions

Frequency:
3-5min apart

Duration:
60 seconds each

Attitude:
Self-absorbed
Interfocused

Question 13

Transition phase of labor lasts how long and how much of the cervix dilated at this point?

Answer 13

Lasts about 1/2 to 2 hours

Cervix dilates about 8-10cm

Question 14

Contractions (Duration/Freq) and attitude during the transition phase of labor?

Answer 14

Contractions:

Frequency:
2-3 min apart

Duration:
60-90 seconds each

Not much of a break in between

Attitude:
Upset
Unhappy
In pain

Question 15

When are pain meds no longer an option? During what phase?

Answer 15

Transitional phase, too close to delivery.

You dont want her to be too numb to push

Question 16

Types of pelvis
Gynecoid

Answer 16

Perfect for delivery
Round
Wide pelvic diameter

Question 17

Anthropoid pelvis

Answer 17

Not ideal but more favorable than android

Long narrow and oval

Fetus usually comes out occiput posterior, sunny side up

Narrow pubic arch

Question 18

Android pelvis

Answer 18

Male pelvis

Heart shape

Narrow diameter

Narrow pubic arch

Question 19

Platypelloid pelvis

Answer 19

Flat wide short and oval

Transverse wide

Wide pubic arch

Question 20

Cervical effacement

Answer 20

Happens in latent phase

Thin out the cervix before dilating

Measured 0%-100%

Occurs during dilation of 0-4cm

Question 21

Which pelvic shapes can have vaginal or c-section deliveries?

Answer 21

Vaginal
Gynecoid - most ideal
Anthropoid

C-Section
Android
Platypelloid

Question 22

Duration of contractions

Answer 22

Length of a single contraction

Ex: Starts at 1:00min ends at 1:01

Start to end of contraction

Question 23

Frequency of contractions

Answer 23

Beginning of the first contraction to the beginning of the next

From start to start

Question 24

How should true labor pains feel?

Answer 24

Should feel the contractions from front to back

The uterus is made of muscles that are horizontal which is why contractions are felt from back to front.

Question 25

Occiput posterior Positioning

Nursing intervention

Answer 25

Most likely cause of back labor pains

Massage with a fist or tennis ball around the coccyx and sacral region, and rotate with pressure.

May try to reposition the patient, place on hands and knees and reposition.See if baby can get flipped around.

Question 26

Fetal Attitude

Answer 26

Position of whole body of fetus

Flexion
Extension

Are they flexed or extended?

Question 27

Fetal Lie

Answer 27

How the baby lies in relation to momma’s spine

Longitudinal - ideal
Lined up with mom’s spine

Transverse - C-Section
Perpendicular to mom

Question 28

Breech

Answer 28

Bottom down head up

Question 29

Types of breech

Answer 29

Frank - feet up against head

Full- flexed attitude, bottom down

Single footing - One leg down the other up

Question 30

What is the biggest issue with breeched babies?

Answer 30

Shoulder are wider
Head may become stuck

Question 31

What two types of breech babies can sometimes be delivered vaginally?

Answer 31

Frank breech

Full breech

Question 32

Vertex presentation

Answer 32

Complete flexion

Ideal for delivery

May feel fontanelles and sutures to know babys position

Question 33

Military presentation

Answer 33

Moderate flexion

Difficult to deliver

Question 34

Brow presentation

Answer 34

Partial flexion (Extension)

Forehead presents first
Cannot do vaginal delivery

Question 35

Face presentation

Answer 35

FULL extension
C-section cannot do vaginal delivery