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Nursing 387/388 > Labour & Birth > Flashcards

Labour & Birth Flashcards

(54 cards)

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1
Q

Process of Labour ?

A

Moving the fetus, placenta, and membranes out of the uterus and through the birth canal.

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2
Q

Various changes take place in a woman’s reproductive system in the days and weeks before labour begins.

Signs of labour include? And what are they?

A

Lightening- “dropping” , presenting part of fetus (usually head) drops downward into the true pelvis; usually occurs 2-4 weeks before term in first time pregnancies & during labour in multiparous

Braxton Hicks- strong, frequent; and irregular contractions

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3
Q

Onset of labour

A

Distinction of the uterine muscles causing > prostaglandin. Connective tissue loosens to permit softening thinning and opening of cervix

Change in biochemistry of fetal membrane leads : progesterone; prostaglandins, estrogen stimulating contractile response of fetus , resulting in strong, regular, rhythmic uterine contractions

Muscles of upper uterine segment shorten and exert an upward pull on cervix

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4
Q

Signs of impending labour besides lightening and Braxton Hicks

A 
Possible rupture of membrane 
Increase vaginal discharge ; bloody show
Weight loss 
GI upset
sudden burst of energy 
Low backache
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5
Q

False labour

A

Irregular contractions

Walking relieves contractions

Bloody show not present

No cervical change in effacement and dilation

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6
Q

True labour

A

Contractions regular and increase in frequency duration and intensity

Contractions are stimulated with walking

Discomfort in lower back / abdomen

Bloody show

Progressive effacement and dilation I’d cervix

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7
Q

Factors affecting labour (5 Ps)

A

Passenger, passageway, powers, position, psychological

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8
Q

Assess the passenger, you use:

A

Leopoldo maneuver - determine the position of the fetus:

1) determine fetal lie (longitudinal)and presentation
Identify part occupying the Fundus

2) palmar- feel for fetal back and irregularities (bumps/ lumps) identifies fetal presentation in breetch presentation FHR is above umbilicus

3) feeling uterus with fingers and thumb- slightly pressed
If head is presenting (not engaged) determine the attitude (flexed or not)

4) turn to face woman’s feet use both hands to outline the fetal head, cephalic prominence are with the irregularities
If the cephalic prominence with back= presenting face first

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9
Q

Fetal lie

A

Position of the baby in relation to the woman’s pelvis /spine

Longitudinal (vertical)

Cephalic (97) breetch is 3 and transverse oblique is 0.5

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10
Q

Presentation

A

Part of the fetus that enters the pelvic inlet

Cephalic- head first

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11
Q

Vertex presentation

A

Back part of the head. Flexed

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12
Q

Siniput

A

Military style presentation

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13
Q

Brow presentation

A

Brows presenting

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14
Q

Face presentation

A

Literally what it means

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15
Q

Frank presentation

A

Breetch presentation - everything is flexed except knees and legs

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16
Q

Complete position

A

Flexion I’d hope and knees - legs crossed

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17
Q

Footling

A

Extended hips and knees

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18
Q

Attitude

A

Relation of the fetal body parts to one another

Flexion

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19
Q

Stationary

A

Level of the head of fetus in relation to ischial spine

Relationship if the presenting part of the fetus to an imaginary line drawn between the ischial spine and is the measure of the degree of decent of the presenting part through the birth Canal

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20
Q

Fetal position

A

Reference point in the presenting part to the four quadrants of the mother’s pelvis
LOA LOP ROA ROP

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21
Q

Factors affecting passenger

A 
Size of the fetal head 
Fetal presentation (lie and attitude)
Fetal position
Engagement
Cardinal movements
Placenta
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22
Q

Fetal head

Study These Flashcards
A

Palpating reveals presentation position and attitude
Mcranium vault - 2 frontal 2 parietal 2 temporal and occipital
United by membranous/ suture lines (sagittal, coronal, frontal, lamboid
Where the sutures intersect = frontanelles

23
Q

Anterior fonteanelle closes at …

24
Q

Posterior fontenelle closes at

25
Shape of the fetal head adapts in labour called
Moulding
26
Engagement
Largest part of presenting part reaches of passes through pelvic inlet
27
Primigravida | Multigracida
Pregnant for the first time (2 weeks before term) Pregnant multiple times - several weeks to labour
28
Electronic fetal monitoring
Monitor continuously | Used when assessing to see fetal oxygenation
29
Intermittent auscultation
Listening every —- interval
30
Cardinal movements
Descent- process of the fetus through pelvis Flexion- fetal chin in contact with chest Internal rotation - occipitalanterior position come out straight Extension- fetal head reaches perineum Restitution- after head is born External rotation- shoulders rotate to midline Expulsions- birth!
31
passageway composed of
Bony pelvis- inlet; brim, mid pelvis; cavity, outlet Soft tissue- lower uterine segment , cervix, pelvic floor muscles, vagina opening
32
Bony pelvis
True pelvis -“bony canal” : inlet, pelvic cavity and outlet Pelvis widens and stretches Progesterone and relaxin facilitate softening and increase elasticity of muscles ligament and pelvic joints Whether or not the birth canal can accommodate presenting part of fetus determines whether vagina birth is possible
33
4 pelvis shape
1) gynecoid - classic female shape 2) Android - resembles male pelvis Anthropoid- ape -platypellod1 flat pelvis
34
Factors affecting birth- powers Primary forces
Uterine muscular contractions cause effacement and dilation of cervix ; signal beginning of labour Involuntary rhythmic intermittent to allow rest and restore iteriolacental circulation
35
Secondary power
Use of abdominal muscles to push 2nd stage of labour - adds to primary force after full dilation of cervix -bearing down efforts (trigger by endogenous oxytocin release)intraabdomjnal pressure compresses uterus leading to expulsion
36
Effacement
Drawing up of internal is and cervixal ealls into side walls of uterus
37
Position of women during labour
Affects woman’s anatomical and physiological adaptions to labour Frequent changes in position Relieve fatigue Increase comfort Improve circulation Labouring women find position comfortable for her
38
Impact of stress
Adrenaline Causes : lack of control and feeling judged Muscles tighten energy sent to limp increased sensitivity to pain, Signs, tension, high pitched voice
39
Impact of stress Oxytocin and endorphins
Muscles relax Energy sent to uterus Decreased sensitive to awareness of pain Feels loved, safe and supported
40
1 stage or labour: latent
Mild regular contractions with increasing in frequency duration and intensity defined as 0-3 dilated
41
2. Active stage of birth: active phase
Anxiety increases intensity, nulliparous- 4 cm | Multiparous- 4-5 cm
42
Primary goals of 1st stage labour
Safety of mother and infant Interventions based in the needs of the mother/ partner Assessment; FHR and contractions at least every hour Assess maternal status Assess status of fetal membrane Assess psychosocial state and ability to cope Provide physical and psychological care Communicating labour progress to family and team
43
Maternal adaption
Estrogen prostaglandins oxytocin increases Increases in endorphins- sedating and raises pain threshold Increase CO Heart rate WBC BP systolic, systolic and diastolic Elevated temp. And oxygen consumption doubles Higher metabolism
44
Fetal adaptions to labour
Fetal health surveillance- oxygen; FHR to uterine activity Fetal circulation: maternal position, uterine contractions, BP and umbilical coed flow Fetal respiration- changes prepare fetus for initiating respirations immediately after birth
45
Emotional support
Less fearful and anxious - interferes with progress of labour; reduce blood flow, increase pain
46
Assessing progress of labour
Bishops score To see if induction of labour is required ``` Dilation Effacement Position of cervix Consistency Station ```
47
2nd stage of labour
Completed cervical dilation and ends with birth of fetus - descent of fetal presenting part - bulging of perineum, uncontrollable urge to bear down, intraabdominal pressure increase bloody show Discomfort; contracting uterine muscle cells, distension of vagina and perineum and pressure of fetus
48
Crowning
Fetal head is encircled by external opening on the vagina
49
Nursing interventions for stage 2 labour
``` Emotional support Take vitals q15 Fetal heart test Q 15 if healthy ( mother no risk of birth complications) Access ability to buss Prepare of dil erg Change position of breathing ```
50
3rd stage of labour
Births of placenta After infant born, uterus contracts firmly and placenta start to separate from wall
51
Signs of separation of labour
Globular shapes uterus Rise in fundus Sudden trickle of blood Exclusion <30 Cord protrusion
52
4th stage of labour
1-2 hours after birth Physiologic readjustment if mother body - homestasis Mother may feel energize Optimal time for infant bonding- a
53
Nursing role for 4th stage of labourers
Infant assessment First period is reactivity - skin to skin contact Provide comfort measures Okay anaesthesia q15 Promote family relationships
54
Post partum assessment
BUBBLLEE ``` Breast Uterine fundus Bladder Bowel Lochia Legs (peripheral edema) Episiotomy Emotional support ```

Nursing 387/388 (2 decks)

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