Part 5 - TBN: Mother Baby

Question 1

5 factors that affect the process of labor & birth

Answer 1

Passenger (fetus & placenta)
Passageway (the birth canal)
Position (position of the mother)
Powers (contractions)
Psychology (emotional response)

Question 2

Fontanelles

Answer 2

Space between the bones of the skull allow for molding
- ANTERIOR
Diamond-shaped
Closes in 12–18 months
- POSTERIOR
Triangle shaped
Closes in 8–12 weeks

Question 3

Refers to the part of the fetus that enters the pelvic inlet first through the birth canal during labor.

Answer 3

Fetal Presentation

Question 4

Presenting Part:
Occipital (back of head/skull)
What’s first? Head

Answer 4

Cephalic

Question 5

Presenting Part:
Sacrum
What’s first? Buttocks, feet, or both

Answer 5

Breech

Question 6

Presenting Part: Scapula
What’s first: Shoulders

Answer 6

Shoulder

Question 7

Fetal Attitude: Back of the fetus is rounded so that the chin is flexed on the chest, thighs are flexed on the abdomen, legs are flexed at the knees

Answer 7

General Flexion

Question 8

Fetal Attitude: 9.25 cm at term, the largest transverse diameter and an important indicator of fetal head size

Answer 8

Biparietal Diameter

Question 9

Fetal Attitude: Most critical & smallest of the anteroposterior diameters

Answer 9

Suboccipitobregmatic Diameter

Question 10

• Where the baby’s presenting part is located in the pelvis
• Measured in centimeters (cm)

Answer 10

Fetal Station

Question 11

Fetal station is at ZERO (meaning at the ischial spine) = baby is ENGAGED.

Answer 11

Engagement

Question 12

Presenting parts have entered down into the pelvic inlet & are at the ischial spine line (0)

Answer 12

Engaged

Question 12

When does engagement happen if NULLIPARA?

Answer 12

38 weeks

Question 13

When does engagement happen if MULTIPARA?

Answer 13

CAN happen when labor starts

Question 14

Rigid/bony pelvis, soft tissue of cervix, pelvic floor, vagina & introitus

Answer 14

Birth Canal

Question 15

Classic female type of pelvis; most common

Answer 15

Gynecoid

Question 16

Pelvis that resembles the male pelvis

Answer 16

Android

Question 17

Female pelvis that is oval-shaped; wider anteroposterior diameter

Answer 17

Anthropoid

Question 18

The flat pelvis; the least common.

Answer 18

Platypelloid

Question 19

Positions of the Mother During Birth

Answer 19

UPRIGHT POSITION
- Sitting on a birthing stool or cushion
“ALL FOURS” POSITION
- On all fours: putting your weight on your hands & feet or commonly on a medicine ball
LITHOTOMY POSITION
- Most common
- Supine position with buttocks on the table
- Most common in women who receive epidurals
LATERAL POSITION
- Lying on their side

Question 20

Gradual enlargement or widening of the cervical opening

Answer 20

Dilation

Question 21

Shortening & thinning of the cervix during the first stage of labor

Answer 21

Effacement

Question 22

When the stretch receptors release oxytocin, it triggers the maternal urge to bear down. She uses secondary powers to aid in the expulsion of the baby.

Answer 22

Ferguson Reflex

Question 23

Blue extremities

Answer 23

Acrocyanosis
- normal during first 24 hrs of birth

Question 24

What are the signs of respiratory distress in a newborn?

Answer 24

Retractions Nasal flaring Grunting

Question 25

Expected length

Answer 25

44-55 cm 17-22 in

Question 26

Expected weight

Answer 26

2,500-4,000 g 5 lb, 8 oz - 8 lb, 14 oz

Question 27

Head circumference

Answer 27

32-39 cm 14-15 in *measure above eyebrows

Question 28

Chest circumference

Answer 28

30-36 cm 12-14 in *measure above nipple line

Question 29

Causes of decreased temperature or heat loss

Answer 29

EVAPORATION - moisture from skin & lungs CONVECTION - body heat to cooler air CONDUCTION - body heat to a cooler surface in direct contact RADIATION - body heat to a cooler object nearby

Question 30

Post-Delivery Newborn Medications

Answer 30

ERYTHROMYCIN OPHTHALMIC OINTMENT (Antibiotic Ointment) - This is given to all newborns as a prophylaxis for ophthalmia neonatorum (conjunctivitis of the newborn) - It's required by law in the U.S - ROUTE: Ophthalmic VITAMIN K - A newborn's gut is sterile, meaning they do not have any intestinal flora that produce vitamin K until 7 days after birth - Vitamin K is essential for blood clotting - Given to all newborns to prevent hemorrhage & bleeding - ROUTE: Intramuscularly in the vastus lateralis HEPATITIS B VACCINE - Given to immunize against hepatitis B virus (HBV) - ROUTE: Intramuscularly in the vastus lateralis

Question 31

- Typically taken in the newborn 24 hours after birth (should be done before discharge!) - Done to test for medical conditions such as Phenylketonuria (PKU), cystic fibrosis, sickle cell anemia, etc.

Answer 31

Heelstick (Heel Puncture)

Question 32

Yellow discoloration of the skin, mucous membranes, and/or sclera caused by ↑ bilirubin levels. Bilirubin is caused by the breakdown of red blood cells (RBCs). - High levels of bilirubin in the blood.

Answer 32

Hyperbilirubinemia (jaundice)

Question 33

An abnormal jaundice that happens within the first 24 hours of life

Answer 33

Pathological Jaundice - CAUSES: Hemolytic disease RH / ABO incompatibility Premature infants (the liver is not fully developed) Failure to pass meconium Sepsis

Question 34

Treatment for Pathological Jaundice

Answer 34

Phototherapy: fluorescent light is used to convert the bilirubin to a water-soluble substance so it can be excreted by the body via stool or urine

Question 35

Complication of Pathological Jaundice

Answer 35

KERNICTERUS The excess bilirubin (if untreated) can cause brain damage

Question 36

REFLEX: When the bottom of the foot is stroked from the heel upward, the big toe dorsiflexes (bends back) and the other toes spread out

Answer 36

Babinski Reflex (Should disappear after 1 year of age)

Question 37

REFLEX: When the baby's mouth is stroked, the baby will turn its head and open the mouth. This helps the baby fi nd the food source when feeding.

Answer 37

Rooting Reflex (Should disappear after 3–4 months but can last up to a year)

Question 38

REFLEX: Can be triggered by a sudden loud noise or unexpected movement. The infant will extend the arms with palms up and then move the arms back to the body.

Answer 38

Moro Reflex (Startle Reflex) (Should disappear after 6 months)

Question 39

REFLEX: When an infant is lying on its back and quickly turns its head to one side. The leg and arm on that side will extend, while the leg and arm on the opposite side will flex.

Answer 39

Tonic Neck Reflex (Fencing) (Should disappear after 3-4 months)

Question 40

When a finger is touching the inside of the infant's palm, the hand will close.

Answer 40

Palmar Grasp (Response should lessen around 3–4 months)

Question 41

When a finger is placed or touching under the toes, the toes will curl

Answer 41

Plantar Grasp (Response should lessen around 8 months)