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Health Promotion - Exam 1 > 10: Labor and Post-Partum > Flashcards

10: Labor and Post-Partum Flashcards

1
Q

When does lightening occur with labor?

A

Within a week prior to delivery

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2
Q

What is lightening with labor?

A

Increased pressure on the pelvis and bladder causing frequent urination

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3
Q

What is happening with the fetus during lightening?

A

The head is settling into the pelvis

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4
Q

When are Braxton-Hicks likely?

A

Beginning of second trimester but more common closer to delivery

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5
Q

What is effacement?

A

Thinning of the cervix secondary to prostaglandins

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6
Q

What is the length of the normal cervix?

A

1.5-2” long

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7
Q

What is dilation of the cervix?

A

Cervix gradually opened from 0-10cm

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8
Q

What is station?

A

Relationship of the top of the baby’s head or presenting part to the spines of the pelvic bone

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9
Q

If the baby is stationed above the ischial spine, is it a positive or negative value?

A

Negative

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10
Q

If the baby is stationed below the ischial spine, is it a positive or negative value?

A

Positive

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11
Q

What does it mean if the station of the baby is “floating”?

A

-4 above the ischial spine

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12
Q

What does it mean if the station of the baby is “crowning”?

A

+4 below the ischial spine

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13
Q

What is the function of the mucous plug?

A

Prevents bacteria from getting to the uterus

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14
Q

What is the “bloody show”?

A

When the mucous plug is dislodges due to the softening of the cervix

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15
Q

What type of contractions happen with true labor?

A

Consistent, intensity increases, and contraction interval decreases

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16
Q

What type of contractions happen with false labor?

A

Inconsistent, intensity and interval does not change

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17
Q

How will walking effect true and false labor?

A

Tue labor: discomfort stays
False labor: discomfort relieved

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18
Q

Does the cervix dilate with false labor?

A

No

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19
Q

When is the first stage of labor?

A

Occurring from the onset of true labor until the cervix is completely dilated

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20
Q

What is early first stage labor?

A

4 cm dilated, 10-20 minutes between contractions

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21
Q

What is the active first stage of labor?

A

8 cm dilated, 5 minutes between contractions

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22
Q

What is the transition first stage of labor?

A

Up to 10 cm dilated, 1-2 minutes between contractions

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23
Q

What is the second stage of labor?

A

Occurring from complete cervical dilation until delivery

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24
Q

What is the third stage of labor?

A

Delivery of the placenta

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25
What are some factors that can affect labor?
- Position of baby's head - Size of baby - Pelvic anatomy - Effectiveness of contractions - Physical and emotional stage - Medications
26
How is this baby positioned, and is it optimal?
Occiput anterior, is optimal
27
How is this baby positioned, and it is optimal?
Occiput posterior, is not optimal
28
What is the 7th leading cause of maternal deaths?
Anesthesia
29
What is the drug of choice for delivery?
Nubain
30
When is birth recommended after Nubain administration?
Birth not recommended within 4 hours of administration
31
What are maternal complications with Nubain?
- Decreased respiration - Nausea and vomiting - Slowing of labor - Drowsiness
32
What are fetal complications with Nubain?
- Decreased fetal activity - Decreased respiration - Decreased Apgar - Respiratory acidosis
33
Where are local anesthetics injected?
Perineum
34
Where is a pudendal block administered?
Injected through the vaginal wall blocking the pudendal nerve along each side of the cervix to numb the vaginal walls and perineum
35
Describe epidurals during pregnancy?
Thin catheter is injected into the epidural space and medication is administered as a bolus or continuous drop
36
What type of anesthesia is given for c-sections?
Spinal
37
What are side effects of epidurals?
- Maternal hypotension (fetal compromise) - Decreased ability to push - Increase/decrease length of labor - Spinal block and transient headache
38
What is the chance of an ineffective epidural?
15%
39
When is general anesthesia administered?
Never during labor - used via endotracheal tube for emergencies
40
What are maternal risks for using general anesthesia?
- Aspiration - Respiratory depression - Post-partum uterine atony
41
What are fetal risks for using general anesthesia?
- Respiratory depression - Hypotonicity - Hyperbilirubinemia
42
What is back labor?
Feeling contractions in the low back that can interfere with the mother's ability to relax
43
What is a common cause of back labor?
Occiput posterior position
44
What is coccydnia?
Pain in coccyx related to delivering baby in occiput posterior position resulting in hyperextension of coccyx
45
What areas are evaluated with Apgar?
1. HR 2. Color 3. Breathing 4. Muscle tone 5. Reflexes
46
What values would result in getting 0 Apgar points?
1. HR absent 2. Blue/pale color 3. Absent breathing 4. Absent/flaccid dont 5. No reflexive response
47
What values would result in getting 1 Apgar point?
1. HR < 100 2. Pink body, blue/pale hands/feet 3. Irregular breathing 4. Some movement 5. Grimaces
48
What values would result in getting 2 Apgar points?
1. HR > 100 2. Pink 3. Crying 4. Active movement 5. Responds to stimulation
49
What is an episiotomy?
Incision made into the perineum between vagina and anus
50
Describe a midline incision episiotomy
4-12x more likely to experience rupture of the anal sphincter, will heal more quickly
51
Describe a mediolateral incision episiotomy
More painful, increased trauma to PFM, more scar tissue
52
What is a first-degree episiotomy?
Laceration extends through the skin and superficial structures above the muscles, heals well
53
What is a second-degree episiotomy?
Laceration extends through the muscles of the perineum
54
What are the consequences of second-degree episiotomy?
Scarring, incontinence, and difficulty with intercourse
55
What is third-degree episiotomy?
Laceration extends into the external anal sphincter
56
What are the consequences of third-degree episiotomy?
May experience difficulty holding back gas or fecal matter
57
What is fourth-degree episiotomy?
Laceration extends into the anterior wall of the rectum - internal and external anal sphincter involvement
58
What are the consequences of fourth-degree episiotomy?
Fecal incontinence, unable to differentiate between gas and fecal matter
59
What are indications to use forceps during delivery?
- Maternal exhaustion, decreased pushing - Posterior position of baby's head - Fetal distress
60
What are consequences for the mother following use of forceps?
More likely to have pain with intercourse, longer healing time, more scar tissue, 2x as likely to experience fecal incontinence
61
What are consequences for the mother following use of vacuum extractor?
Pain with intercourse, longer healing time, more scar tissue production
62
What is shoulder dystocia?
Head is delivered but then shoulders do not fit through pelvic outlet
63
What are maternal risks during shoulder dystocia?
Post-partum hemorrhage, cervical/vaginal lacerations, ruptured pubic symphysis
64
What are fetal risks during shoulder dystocia?
Humerus or clavicle fracture, Erb's Palsy, asphyxia, death
65
What is CVP?
Cephalopelvic disproportion - baby is too big or pelvis is too small that can lead to fetal distress
66
What are the four indications for a c-section?
1. CVP 2. Breech 3. Placenta problems 4. Cord problems
67
What is a footling breech?
One foot delivers first with increased risk for cord prolapse
68
What is a complete breech?
Buttock presents with LE's crossed
69
What is a frank breech?
Buttock presents with LE's extended
70
What is a transverse breech?
Horizontal position
71
What are three placenta problems that will indicate a c-section?
1. Placenta previa 2. Abruptio placentae 3. Aged placenta
72
Describe the effects of an aged placenta
Decreased ability to provide nourishments to the baby after 42 weeks of gestation leading to LBW
73
What happens with a prolapsed cord?
Cord slides out of the cervix - medical emergency because the pressure on the cord decreases blood flow to the baby
74
When is a prolapsed cord likely to occur?
1. Preterm birth 2. Breech 3. Head is not well engaged in the pelvic with ROM
75
What is VBAC?
Vaginal birth after cesarean - recommended
76
When are you cleared to exercise post partum?
4-6 weeks
77
Will weight loss impact milk supply?
No
78
What exercise can you resume after pregnancy?
Gradual return to pre levels, lifting, high impact. PFM training and aerobic
79
When do the breasts become engorged?
2-3 days post-partum
80
What can cause a blocked duct?
- Nursing from one breast - Changes in feeding frequency - Over abundant supply - Heavy breast tissue not well supported - Tight bra or underwire
81
What is mastitis?
Breast infection of the tissue surrounding the blocked duct
82
When can mastitis occur?
1-4 weeks post-partum
83
What are symptoms of mastitis?
- Red, sore, hard areas - Red streaking - Fever and chills - Flu-like

Health Promotion - Exam 1 (12 decks)

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