T2 - Labor and Birth Process PPT (Josh) Flashcards Preview

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Flashcards in T2 - Labor and Birth Process PPT (Josh) Deck (59):
1

With a --- woman, Effacement precedes Dilation.

With a --- woman, Effacement and Dilation occur together.

Primagravida

Multigravida

2

What is effacement?

thinning and shortening of cervix

**Measured in % (ex: 100%)

3

How is fetal position determined?

identify the presenting part (ex: head)

identify the maternal quadrant the presenting part is facing (ex: right anterior)

4

Which women can experience a slowed or ineffective progress of cervical dilation?

history of STD or PID

5

What are the four basic pelvic shapes?

Gynecoid (classic and most favorable)

Android (resembles male pelvis)

Anthropoid (oval shaped w/ wider AO diameter)

Platypelloid (flat pelvis)

6

What are Premonitory Signs of Labor

Braxton Hick (strong)

Lightening

Energy INCREASED

Ripening of cervix

Mucus plug expelled

Bloody Show (as effacement ruptures cervical capillaries)

7

What do the stretch receptors in cervix do when stretched by fetal head?

release oxytocin which causes mom to have urge to push

8

How is Descent measured?

station (+5 to -5)

9

The normal uterus is about --- thick and has a neck that is --- long.

1 cm thick

2-3 cm long

10

What do following abbreviations mean? - ROP- LOT- RMA

Right Occipitoposterior

Left Occipitotransverse

Right Mentoanterior

11

Phases of First Stage of Labor:

1st Phase =

2nd Phase =

3rd Phase =

0-3 cm

4-7 cm

8-10 cm

12

What happens to mom's Hematopoietic System during labor?

leukocytosis (WBCs increase)

fibrinogen increase

***More blood loss in vaginal delivery than open heart surgery b/c blood volume increased by 50%

13

What degrees mean baby is ABOVE spines?

What degrees mean baby is BELOW spines?

-1, -2, -3, -4, -5

+1, +2, +3, +4, +5

14

What are signs of Placental Separation?

Cord lengthens

Uterus changes shape to GLOBULAR

Gush of blood from vagina

15

What is Dilation?

widening of cervical canal to accomodate head of baby

**measured in cm (1-10)

16

The anterior fontanel is at the junction of which bones?

What about the posterior fontanel?

anterior = frontal and parietal

posterior = occipital and parietal

17

What is Fetal Position?

relationship of fetal presenting parts to a DESIGNATED POINT on maternal pelvis

ex: ROA (Right Occipitoanterior)

18

Anterior position has the OCCIPITAL bone facing ---

Posterior position has the OCCIPITAL bone facing ---

symphisis pubis

sacrum

19

When can the cervix no longer e palpated by examiner's finger?

when it is fully dilated and completely retracted

20

When does the First Stage of Labor end?

dilation at 10 cm

21

What happens to mom's CV system during labor?

CO increases

Intrathoracic pressure increases from pushing in 2nd stage

22

Which Cardinal Movement is AKA restitution?

External Rotation

- when head realigns to original position after rotating internally

23

When does the Ferguson Reflex occur?

maternal urge to push and happens at 7-10 cm through second stage of labor

24

UC Frequency =

UC Duration =

Frequency is BEGINNING of one UC to the BEGINNING of next

Duration is BEGINNING of one UC to the END of same UC

25

Which stage of Labor is True Labor?

First Stage

**until cervix is effaced and dilated 10cm

26

Involuntary UC cause what to take place in the cervix?

effacement and dilation

27

What are disadvantages of Breech Presentation?

not effective at dilating cervix

head is last part to be born

umbilical cord can become compressed

28

Where are True Contractions first felt?

lower back and sweep around to abdomen in a wave

***false UC felt in abdomen and groin

***ATI DOESN'T SAY THIS

29

Which presentation CANNOT be delivered vaginally?

shoulder

30

What are Leopold's Maneuvers?

1st Maneuver = palpate fundus (soft is butt, hard is head)

2nd Maneuver = run fingers along sides of pelvis (smooth is back, knobby is knees)

3rd Maneuver = determine presentation

4th Maneuver = determine attitude of head

31

--- is the degree of descent of presenting part above/below ischial spines

--- is when presenting part is AT ISCHIAL SPINES

Fetal Station

Engagement

32

What is an Extended Fetal Attitude?

when baby presents wider part of the skull in the inlet- examiner would palpate the mentum (chin) or brow

33

How do we know if they're false contractions?

Irregular

Begin and remain in abdominal and groin region (ATI DOESN'T SAY THIS)

Disappear w/ ambulation and sleep

Do not increase in duration, frequency or intensity

Do not dilate cervix

34

Which fontanel is DIAMOND shaped?

Which fontanel is TRIANGLE shaped?

Anterior

Posterior

35

The normal delivery position (feet in stirrups) is called?

Lithotomy

36

What is BPD?

Bioparietal Diamter

- the largest transverse diameter of fetal head

37

When would Stadol be given?

at top of contraction to maximize profusion to mom and minimize profusion to baby

38

What happens to mom's Respiratory System during labor?

hyperventilation r/t increased O2 needs

***breathe into cupped hands or brown bag

39

What happens to mom's GI System during labor?

Gastric motility decreased

Blood shunted to major organs

***NPO except for ice chips

40

--- is known as secondary powers--- is known as primary powers.

Voluntary bearing down (secondary)

Involuntary UC (primary)

41

What is the Fetal Presentation?

body part of fetus that FIRST enters the pelvic inlet

42

What signals the beginning of labor?

INVOLUNTARY uterine contractions

43

What is difference b/t a Complete Breech and a Frank Breech?

Frank Breech = baby's legs are extended up to face

Complete Breech = baby's legs are crossed Indian Style

44

Positional Abbreviations:

First letter means =

Second letter means =

Third letter means =

1st = R or L of maternal pelvis

2nd = specific presenting part (occiput, mentum, sacrum, acromium process)

3rd = location of presenting part in relation to maternal pelvis (Anterior, Posterior, Transverse)

45

In the nulliparous woman, which comes first, effacement or dilation?

Effacement usually precedes Dilation

46

Which part of pelvis is narrowest?

ischial spines

- less space for baby's head to get through

47

Which position is best for delivery?

Occipitoanterial (OA)

48

Nursing action w/ a Frank Breech Presentation?

don't attempt to pull legs down post birth or you could break leg or pull muscle

49

What is the Ferguson Reflex?

maternal urge to bear down "push"

***occurs when cervix is dilated 7-10 cm and continues through second stage of labor

50

5 P's of Labor

Passenger (fetus and placenta)

Passageway (birth canal)

Powers (UC)

Position of mother

Psychologic responses

51

Which stage results in delivery of baby?

Second Stage

**from 10 cm to baby

52

What is the Third Stage of Labor?

separation and delivery of placenta

53

What are the 7 Cardinal Movements of Labor?

1) Engagement

2) Descent

3) Flexion (head bends down)

4) Internal Rotation (head rotates to OA)

5) Extension (head extends out of canal)

6) External Rotation (realignment of infant had to back/shoulders)

7) Expulsion

54

What is the Fetal Lie?

relation of the long axis (spine) of the fetus to the long axis (spine) of the mother

- Longitudinal (Vertical)

- Transverse (Horizontal)

55

What are the major fetal presentations?

Cephalic (Vertex)

Breech (butt or feet)

Shoulder

56

What is the Fetal Attitude?

relation of the fetal body parts to one another

- flexion or extension

57

Where is the BPD when head is Engaged?

pelvic inlet

58

In an appropriate fetal presentation, which part of the baby's head would the nurse first be able to palpate?

posterior fontanel

59

Mother's will have a longer labor if baby is coming -- --

face up (Occipitoposterior)