MCN Midterm Reviewer 1 Flashcards
(66 cards)
1
Q
onset of true labor to complete dilation = 10cm.
A
First stage
2
Q
hours for primi - first stage
A
6-18 hrs
3
Q
hours for multipara - first stage
A
2-10 hrs
4
Q
at first stage Cervix becomes
A
more anterior
5
Q
3 PHASES
A
- Latent
- Active
- Transition
6
Q
Latent Phase 1. Dilation 2. Intensity 3. Duration 4. Interval 5. Length of time A. Primi B. Multi
A
- 0-3 cms
- Mild/ Irregular
- 20- 30 sec
- 5-10 mins
- A. 6hrs
B. 4hrs
7
Q
7 to consider during latent phase
A
- Discomfort is minimal
- Mother admitted to the hospital during this phase
- Pelvic examination to determine the dilation of the cervix
- Pregnant women is very alert and talkative, nervous
- The best time to teach breathing exercises and breathing (pant breathing) techniques and to give instruction to the women.
- Consider that the pain is still mild and mom can fully understand the information or conversation well.
- Push - during contraction only.
8
Q
Active Phase 1. Dilation 2. Intensity 3. Duration 4. Interval 5. Length of time A. Primi B. Multi
A
- 4-7cm
- Moderate/Strong
- 40-60sec
- 5-8 mins
- Length of time
A. 3hrs
B. 2hrs
9
Q
4 Supportive Measures / Nursing Intervention During Active phase
A
- Massage
- Encouragement
- Provide supportive measures
- Deep breathing technique
10
Q
Massage using finger tips
A
Effleurage
11
Q
Expectation during Active Phase
A
- Membranes may rapture
- Increase reliance on the nurse
- Difficulty following directions
12
Q
Transitional Phase 1. Dilation 2. Intensity 3. Duration 4. Interval 5. Length of time A. Primi B. Multi
A
- 8-10cm
- Strong
- 60-90sec
- 1-2mins
- A. 1hr
B. 30mins
13
Q
The most difficult period during labor
A
Transitional Phase
14
Q
Most difficult period of labor because
A
severe uterine contraction
15
Q
Things to consider during Transitional phase
A
- Irritated
- cry
- shouting
- bloody show increases
16
Q
what stage is when Mother is unable to follow instruction and communicate due to severe contraction and pain
A
Transitional Phase
17
Q
- Birthing of the Baby or Pushing Stage
- Start from dilatation up to the delivery of the baby
A
Second Stage
18
Q
hours of Delivery of infant- Primi
A
1 hr or 20 contraction
19
Q
hours of Delivery of infant- Multi
how long will it last?
A
20 min or 10 contraction
* can last up to 3hrs
20
Q
what movements will occur during second stage
A
Cardinal movements
21
Q
most difficult and uncomfortable part of labor
A
second stage
22
Q
crowning occurs at what station
A
+4 to +5 stations
23
Q
Position during second stage
A
Sitting Side Lying Standing Squatting All fours Kneeling
24
Q
Why pull the head DOWNWARD first
A
it will allow drainage of secretion
25
Bowel movement during this stage
second stage
26
Mnemonic- D.F.IR.E.ER.E
```
Descent
FLexion
Internal Rotation
Extension
Restitution
External Rotation
Expulsion
```
27
internal motions, fetal position changes during labor or mechanism of labor.
Cardinal Movements
28
downward movement of the fetal head within the pelvic inlet. * causes mother to experience pushing sensation
Descent
29
process of the fetal head nodding forward towards the fetal chest.
Flexion
30
it is when the head reach the spines *it rotates from transverse diameter to anterior posterior diameter so that its largest is presented to the largest diameter of the pelvic outlet. * allows the fetal head to pass through the outlet
Internal Rotation
31
begins after crowning *when the head after crowning * forces of uterine contractions, pushing effort of the mother and the resistance of the pelvic floor causes the head to extend towards the vaginal opening.
Extension
32
this is the realignment of the fetal head with the body after the head emerges or comes out
Restitution
33
shoulder externally rotates after the head emerges and restitution occurs so that the shoulders are in the anterior posterior diameter of the pelvis.
External Rotation
34
birth of the entire body or the delivery of the entire body of the fetus.
Expulsion
35
place towel over the rectum and push to support the perineum
Ritgent's Manuever
36
Clamp cord (3) how and why?
1. 1-3 min or after pulsation
2. prevent iron deficiency anemia
3. 50-100ml blood
37
Stage when Delivery of placenta
| How Long?
Third Stage
| 5-30min.
38
Separatin should be
Automatic
39
Don't palpate possibility when non-contracted uterus
possible eversion-Maternal vessels still open.
40
Separation of the placenta starts from the placenta
| Schultz first to come out
Schultz mechanism
41
- Separation starts from the edges of the placenta
- The maternal side is delivered first
- Characterize as Dirty, dull rough maternal surface
Duncan mechanism
42
do not rush delivery of the placenta to avoid, wait the 3 signs
uterine inversion
43
wait placental separation, 3 signs
1. uterus becomes firm and globular rising to the level of the umbilicus
2. sudden gush of blood
3. lengthening of the cord
44
uterus becomes firm and globular rising to the level of the umbilicus- *called
calkin's sign (first sign)
45
lengthening of the cord,
tract the cord slowly, winding or coiling it around the clamp until the placenta spontaneously comes out, rotating it slowly so that no membranes are left inside the uterus.
Brandt Andrew Maneuver
46
examine the _________ of the placenta after delivery. normal #
cotyledon
| normal 16-25
47
MD/MW presses on contracted uterus.
CREDE's Maneuver
48
placental delivery to avoid retained placenta.
Pitocin
49
If no spontaneous deliver of placenta,
manually removed
| Administer Antibiotic
50
Stage when Placenta out; mother recovers in "LDR"
| LDR?
Fourth Stage
| Labor, Delivery, Recovery
51
Lasts
1 hr. unless complications arise.
52
Then patient transferred to after delivery
Post Partum unit
53
Discharges from the vagina from the vessels of the placental site
Lochia
54
3 types of Lochia
1. Rubra
2. Serosa
3. Alba
55
Red, Bright Red *occurs day 1-3 bloody odor
Rubra
56
Brownish pink * occurs day 4-7 or 8 fleshy odor
Serosa
57
Whitish discharge * occurs day 9-10 or 14 fleshy odor
Alba
58
what will do when Baggy or Relax uterus
massage gently
59
Main dangers in the last stage in labor is
Hemorrhage
60
Check the fundus every
15 minutes
61
Rapid decrease in the size of the uterus as if returns to non pregnant state
INVOLUTION
62
During breast feed their baby will have more chances of having
rapid Involution
63
NURSING INTERVENTIONS DURING LABOR
1. Emotion support & encourage rest
2. Progress of labor
3. Monitor/document contractions & FHR q 15 min.
4. Monitor/ document maternal VS q 1-4 hrs
5. Assess pain & provide pain relief as prescribed.
6. Provide comfort measures [ back rub, ice ships]
7. Explain equipment & procedures.
8. Observe & document time of ROM ( Rapture of Membrane)
64
Admit client to birthing area
Triage
65
position on side- pressure off vena caveSupine hypotention
Supine hypotention
66
Things to consider during labor
- Supine hypotention- position on side- pressure off vena cave
- Role of coach during active / traditional stages
- Assist with pushing during 2nd stage.
- Record time of delivery, Apgar score, spontaneous cry & resuscitative effort to infant.
- Monitor infant for extrauterine life adjustment.
- Encourage family bonding >delivery
