Labor & Delivery - Unit 2 (Class) Flashcards by Andrew Working

Contractions - coordinated (def)

contracts all at once.

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Contractions - involuntary (def)

we can’t make it do it - we can’y say contract now, mother fucker!

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How do we measure frequency of contractions?

You start from the beginning of one contraction to the beginning of the second contraction.

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Contractions - measured in hours. T/F?

FALSE - minutes minutes minutes minutes MINUTES!

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Duration - how do we measure duration of contractions?

From start to finish. IN SECONDS

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Contraction cycle - Increment - Top - Decrement - Interval -

Increment - going up! Top - peak (aka acme) Decrement - going down! Interval - space between contractions.

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Intensity - what do mild, moderate, and strong feel like?

Mild = soft like nose. Moderate = chin. Strong = forehead.

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Contractions - can tell intensity from monitor. T/F?

FALSE, UNLESS there is an internal monitor.

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Cervix is usually as thick as pinky is long. T/F?

True

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Effacement = what?

Thinning - the cervix becomes very thin, like paper - it almost disappears. You can feel the babies head when it’s 100%

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Dilation = what?

The cervix becomes open. It is in cm. Complete = 10. A cheerio = finger tip cervix.

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What happens to the cardiovascular system during labor?

Increased BP with contractions, increased blood volume, decreased pulse during contraction.

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What happens to the respiratory system during labor?

Increased RR, increased O2 demand, watch for hyperventilation.

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What happens to the GI system during labor?

Slows down! just tell the pt to act like they are having a big shit…that’ll help!

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What happens to the urinary system during labor?

You lose bladder sensation - it’s easy for the mom to get a full bladder/distended bladder and she might not even realize she has to pee!

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Full bladder won’t allow for baby to descend. T/F?

True

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If the mom has to pee, check the dilation/cervix/ first. T/F?

TRUE - or you could have a baby on your hands.

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What happens to the blood during labor?

BV increased about 1.5 liters from the start of pregnancy. Total loss = 500 m. late stage = a hypercoaguable state, meaning we are aware of risk for DVT. Clotting factors are increased.

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When uterus clamps down, circulation is decreased to little one. T/F?

True

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Can babies go a minute/minute and a half without oxygen when the cord is clamped during a contraction?

Yes

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Cord is cut - what happens with the ductus arteriosus, foramen ovale, and ductous venosus?

They close!

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What are 4 components of the birth process?

Powers (making it happen!), Passage (pelvis), Passenger (bambino!) and Psyche (mental part of it!)

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Passage - what is the difference between the false pelvic and true pelvis?

False = top of pelvis and has nothing to do with birth process. True = lower porition, including inlet (upper pelvic opening, midpelvis (pelvic cavity) and outlet (lower pelvic opening).

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Cartilage in pelvis will start to relax due to the hormone relaxin. T/F?

True

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Babies head bones aren't fused. T?F?

True - makes it easy for them to be pushed through.

Flexion - moderate poor full

Mod (Military) = kind of flexed but not really. Poor (Brow) - almost how we look. Full extension (Face)- you'll feel the face!

What's the vertex presentation?

Complete flexion - chin to chest.

Cephalic down position = the worst. T/F?

FALSE - it's the best.

Transverse = what angle?

90 degree

Look at babies head and where it touches- that determines position. T/F?

True

We want the baby to be born OA = what does that mean?

Occipital anterio.

What's OP?

Occipital posterior - like ellie was born!

Right or left = babies right or left. T/F?

FALSE - it's mom's.

Posterior - risk for back labor/pain. T/F?

True

Name the positions!

Just look at the other!

Psyche - what does it include?

Aniety, fear - they can stall labor. Help patient & talk to them. Get up in that pudenda!

Braxton Hicks - has a pattern. T/F?

FALSE - it does not.

In order to be in labor, you have to have contractions, discomfort, and cervical dilation. T/F?

True

What is descent?

Going down (baby) - pretty much the same as lightening.

What is Engagment?

In pelvis.

What is internal rotation?

Coming down and rotating (baby)

Extension - as babies head comes out, it's going to look up and be like "hey bitches!" T/F?

True (just minus the words)

External rotation - as the baby moves out, what happens with shoulders?

They move out, shoulders come one at a time.

Babies are nose breathers, so clean their mouth out first. T/F?

True - that way it won't go back down in their throat.

What are the 3 parts of the first stage of labor?

Latent, active, transition

What happens during the latent stage?

From close to 3cm. It can be quite long. Mom may not know she's in labor. Longer for 1st time mom. Contractions gradually increase. Contractions are 20-40 seconds long and are 5 minutes apart.

What are moms like during the latent stage?

Sociable, happy, yay!

What occurs during active?

4-7 cm. Completely effaced, Fetus descends in pelvis, rotates, etc.

What are contractions like during the active stage?

2-5 minutes apart, 30-60 seconds in length. More uncomfortable.

What's the mom like during the active stage?

Anxious, uncomfortable - "oh boy, we are having a baby. This is real!"

Transition - length? Info?

SHORT and INTENSE. COntractions and everything are moving right along 1-1.5 minutes apart, 60-90 seconds in length. Not much rest in between.

What is mom like during transition phase?

CRAZY. MIGHT LOSE CONTROL. N/V, shaking, etc. Vomiting can cause baby to come out.

What occurs during the second stage of labor?

You're 100% effaced, and contractions can subside for a bit. Best thing for mom is to "labor down" - baby is coming so let mom have a few. She might say "i feel better, have a new sense of purpose, I've come this far!"

What happens with the third stage?

Starts with birth of baby and goes until the placenta comes out. Once baby comes out, the cavity gets smaller and the placenta seperates away.

It's okay to pull on the cord to get the placenta out. T/F?

FALSE - never ever ever ever do that.

When is the 4th stage?

1-4 hours after. 2 hour checks common. Check for bleeding, fundal height, vital signs, etc.

Fundal check - it should feel hard after birth. T/F?

True

If the fundus is too soft, what do we do?

Massage it - hold on to the ligaments (so it doesn't fall out and massage!)

What is lochia?

The bleeding post partum. A little bit is okay, but nothign crazy!

Should we ask questions about home meds and such?

YES. Be detailed.

What's the litmus paper for?

Shows pg - if it changes colors, yeah, you've ruptured. If not, you just wet yourself.

When calling provider, what should we provide?

All sorts of stuff - gravida, para, EDC, etc.

Fetal fibrinectin test - what do it do?

Shows , within a good amount of reason, that you're going to give birth soon!

If they say they want EXCLUSIVE breast feeding, we need an order for formula. If they say they don't care, we don't need an order. T/F?

True

Bishop score - what is it?

How ready the cervix is for labor.

Vitals/contraction assessments - ever 30 minutes until active, then every 15 minutes. T/F?

True

If uterus doesn't constrict, what can happen?

BLEEDING

Apgar's - 1 minute and then 5 minutes - repeat every 5 minutes if under 7. T/F?

True

Apgar - activity - 0 = 1 = 2 =

0 = Absent 1 = Arms and legs flexed 2 = Active movment

apgar - pulse ## Footnote 0 = 1 = 2 =

0 = absent 1 = below 100 2 = above 100

Apgar - grimace (reflex irritability) ## Footnote 0 = 1 = 2 =

0 = flaccid 1 = some flexion of extremities 2 = active motion, cough, pull away, sneeze

apgar - appearance (color) 0 = 1 = 2 =

0 = blue, pale 1 = body pink, extremities blue 2 = completely pink

apgar - respirations ## Footnote 0 = 1 = 2 =

0 = absent 1 = slow, irregular 2 = vigorous cry