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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
Q

What are some factors that can affect labor?

A
  • Position of baby’s head
  • Size of baby
  • Pelvic anatomy
  • Effectiveness of contractions
  • Physical and emotional stage
  • Medications
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26
Q

How is this baby positioned, and is it optimal?

A

Occiput anterior, is optimal

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27
Q

How is this baby positioned, and it is optimal?

A

Occiput posterior, is not optimal

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28
Q

What is the 7th leading cause of maternal deaths?

A

Anesthesia

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29
Q

What is the drug of choice for delivery?

A

Nubain

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30
Q

When is birth recommended after Nubain administration?

A

Birth not recommended within 4 hours of administration

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31
Q

What are maternal complications with Nubain?

A
  • Decreased respiration
  • Nausea and vomiting
  • Slowing of labor
  • Drowsiness
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32
Q

What are fetal complications with Nubain?

A
  • Decreased fetal activity
  • Decreased respiration
  • Decreased Apgar
  • Respiratory acidosis
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33
Q

Where are local anesthetics injected?

A

Perineum

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34
Q

Where is a pudendal block administered?

A

Injected through the vaginal wall blocking the pudendal nerve along each side of the cervix to numb the vaginal walls and perineum

35
Q

Describe epidurals during pregnancy?

A

Thin catheter is injected into the epidural space and medication is administered as a bolus or continuous drop

36
Q

What type of anesthesia is given for c-sections?

37
Q

What are side effects of epidurals?

A
  • Maternal hypotension (fetal compromise)
  • Decreased ability to push
  • Increase/decrease length of labor
  • Spinal block and transient headache
38
Q

What is the chance of an ineffective epidural?

39
Q

When is general anesthesia administered?

A

Never during labor - used via endotracheal tube for emergencies

40
Q

What are maternal risks for using general anesthesia?

A
  • Aspiration
  • Respiratory depression
  • Post-partum uterine atony
41
Q

What are fetal risks for using general anesthesia?

A
  • Respiratory depression
  • Hypotonicity
  • Hyperbilirubinemia
42
Q

What is back labor?

A

Feeling contractions in the low back that can interfere with the mother’s ability to relax

43
Q

What is a common cause of back labor?

A

Occiput posterior position

44
Q

What is coccydnia?

A

Pain in coccyx related to delivering baby in occiput posterior position resulting in hyperextension of coccyx

45
Q

What areas are evaluated with Apgar?

A
  1. HR
  2. Color
  3. Breathing
  4. Muscle tone
  5. Reflexes
46
Q

What values would result in getting 0 Apgar points?

A
  1. HR absent
  2. Blue/pale color
  3. Absent breathing
  4. Absent/flaccid dont
  5. No reflexive response
47
Q

What values would result in getting 1 Apgar point?

A
  1. HR < 100
  2. Pink body, blue/pale hands/feet
  3. Irregular breathing
  4. Some movement
  5. Grimaces
48
Q

What values would result in getting 2 Apgar points?

A
  1. HR > 100
  2. Pink
  3. Crying
  4. Active movement
  5. Responds to stimulation
49
Q

What is an episiotomy?

A

Incision made into the perineum between vagina and anus

50
Q

Describe a midline incision episiotomy

A

4-12x more likely to experience rupture of the anal sphincter, will heal more quickly

51
Q

Describe a mediolateral incision episiotomy

A

More painful, increased trauma to PFM, more scar tissue

52
Q

What is a first-degree episiotomy?

A

Laceration extends through the skin and superficial structures above the muscles, heals well

53
Q

What is a second-degree episiotomy?

A

Laceration extends through the muscles of the perineum

54
Q

What are the consequences of second-degree episiotomy?

A

Scarring, incontinence, and difficulty with intercourse

55
Q

What is third-degree episiotomy?

A

Laceration extends into the external anal sphincter

56
Q

What are the consequences of third-degree episiotomy?

A

May experience difficulty holding back gas or fecal matter

57
Q

What is fourth-degree episiotomy?

A

Laceration extends into the anterior wall of the rectum - internal and external anal sphincter involvement

58
Q

What are the consequences of fourth-degree episiotomy?

A

Fecal incontinence, unable to differentiate between gas and fecal matter

59
Q

What are indications to use forceps during delivery?

A
  • Maternal exhaustion, decreased pushing
  • Posterior position of baby’s head
  • Fetal distress
60
Q

What are consequences for the mother following use of forceps?

A

More likely to have pain with intercourse, longer healing time, more scar tissue, 2x as likely to experience fecal incontinence

61
Q

What are consequences for the mother following use of vacuum extractor?

A

Pain with intercourse, longer healing time, more scar tissue production

62
Q

What is shoulder dystocia?

A

Head is delivered but then shoulders do not fit through pelvic outlet

63
Q

What are maternal risks during shoulder dystocia?

A

Post-partum hemorrhage, cervical/vaginal lacerations, ruptured pubic symphysis

64
Q

What are fetal risks during shoulder dystocia?

A

Humerus or clavicle fracture, Erb’s Palsy, asphyxia, death

65
Q

What is CVP?

A

Cephalopelvic disproportion - baby is too big or pelvis is too small that can lead to fetal distress

66
Q

What are the four indications for a c-section?

A
  1. CVP
  2. Breech
  3. Placenta problems
  4. Cord problems
67
Q

What is a footling breech?

A

One foot delivers first with increased risk for cord prolapse

68
Q

What is a complete breech?

A

Buttock presents with LE’s crossed

69
Q

What is a frank breech?

A

Buttock presents with LE’s extended

70
Q

What is a transverse breech?

A

Horizontal position

71
Q

What are three placenta problems that will indicate a c-section?

A
  1. Placenta previa
  2. Abruptio placentae
  3. Aged placenta
72
Q

Describe the effects of an aged placenta

A

Decreased ability to provide nourishments to the baby after 42 weeks of gestation leading to LBW

73
Q

What happens with a prolapsed cord?

A

Cord slides out of the cervix - medical emergency because the pressure on the cord decreases blood flow to the baby

74
Q

When is a prolapsed cord likely to occur?

A
  1. Preterm birth
  2. Breech
  3. Head is not well engaged in the pelvic with ROM
75
Q

What is VBAC?

A

Vaginal birth after cesarean - recommended

76
Q

When are you cleared to exercise post partum?

77
Q

Will weight loss impact milk supply?

78
Q

What exercise can you resume after pregnancy?

A

Gradual return to pre levels, lifting, high impact. PFM training and aerobic

79
Q

When do the breasts become engorged?

A

2-3 days post-partum

80
Q

What can cause a blocked duct?

A
  • Nursing from one breast
  • Changes in feeding frequency
  • Over abundant supply
  • Heavy breast tissue not well supported
  • Tight bra or underwire
81
Q

What is mastitis?

A

Breast infection of the tissue surrounding the blocked duct

82
Q

When can mastitis occur?

A

1-4 weeks post-partum

83
Q

What are symptoms of mastitis?

A
  • Red, sore, hard areas
  • Red streaking
  • Fever and chills
  • Flu-like

Health Promotion - Exam 1 (12 decks)

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