406 4 Flashcards by Richard smith

latent phase is from the beginning of true labor until

3 to 4 cm dilation

How well did you know this?

Not at all

Perfectly

active phase is from 4 cm to __ cm

How well did you know this?

Not at all

Perfectly

transition phase is from _ to _ cm

8 to 10 cm

How well did you know this?

Not at all

Perfectly

active phase: contraction frequency and duration

every 2 or 3 minutes for 30 to 60 seconds

How well did you know this?

Not at all

Perfectly

Intrapartum Description:

Begins with true labor and consists of four stages

How well did you know this?

Not at all

Perfectly

Intrapartum stage: From the beginning of regular contractions or ROM to 10 cm of dilatation and 100% effacement

1st

How well did you know this?

Not at all

Perfectly

Intrapartum stage: 10 cm to delivery of the fetus

2nd

How well did you know this?

Not at all

Perfectly

Intrapartum stage: Delivery of the fetus to delivery of the placenta

3rd

How well did you know this?

Not at all

Perfectly

Intrapartum stage: Arbitrarily lasts about 2 hours after delivery of the placenta (recovery)

4th

How well did you know this?

Not at all

Perfectly

True or false labor: pain in lower back that radiates to abd

true

How well did you know this?

Not at all

Perfectly

True or false labor: pain plus regular rhythmic contractions

true

How well did you know this?

Not at all

Perfectly

True or false labor: contractions that intensify with ambulation

true

How well did you know this?

Not at all

Perfectly

True or false labor: progressive cervical dilation and effacement

true

How well did you know this?

Not at all

Perfectly

True or false labor: discomfort localized in abd

false

How well did you know this?

Not at all

Perfectly

True or false labor: no lower back pain

false

How well did you know this?

Not at all

Perfectly

True or false labor: contractions decrease with ambulation

false

How well did you know this?

Not at all

Perfectly

Lightening

fetus drops into true pelvis

How well did you know this?

Not at all

Perfectly

“practice contractions”

Braxton Hicks contractions

How well did you know this?

Not at all

Perfectly

Prodromal labor signs include: burst of

energy

How well did you know this?

Not at all

Perfectly

FHR best heard over the fetus’

back

How well did you know this?

Not at all

Perfectly

Location of presenting part of the fetus in relation to midpelvis or ischial spines

fetal station

How well did you know this?

Not at all

Perfectly

Fetal station 0

Fetus is “engaged”

How well did you know this?

Not at all

Perfectly

Fetal station is expressed in terms of cm below the

ischial spines

How well did you know this?

Not at all

Perfectly

Fetal presentation: The part of the fetus that presents to the inlet: Vertex presentation is

head

How well did you know this?

Not at all

Perfectly

Fetal presentation: The part of the fetus that presents to the inlet: Vertex acromion is

shoulder

Fetal presentation: The part of the fetus that presents to the inlet: Vertex breech is

buttocks

The relationship of the point of reference | (occiput, sacrum, acromion) on the fetal presenting part (vertex, breech, shoulder) to the mother’s pelvis.

Fetal position

most common Fetal position is

LOA (left occiput anterior)

Relationship of the fetal parts to one another

Fetal attitude

Fetal attitude: ____ is desirable so that the smallest diameters of the presenting part move through the pelvis.

Flexion

normal FHR during labor:

110 to 160

normal maternal BP during labor

140/90

normal maternal pulse during labor

less than 100

normal maternal temp during labor

less than 100.4

when should you take BP (relative to contractions)

between

during labor, take BP in what position

side-lying

if infant's head is floating, watch for

cord prolapse

assess the strength of a contraction according to

how indentable the fundus is

if membranes/water broke, vaginal fluid ___s under microscope

ferns

Woman should be allowed to ambulate during labor only if the

FHR is within a normal range and if the fetus is engaged (zero station)

If mother ambulates during labor when the fetus is not yet engaged, there is an increased risk for

prolapsed cord

Prolonged latent phase lasts over ___ hours in primigravida

Prolonged latent phase lasts over __ hours in multipara

___-stained fluid is yellow-green-gold and may indicate distress

meconium

intrapartum: Allow sips of clear fluid if

no general anesthesia is anticipated

Offer anesthesia or analgesia in ___ phase of labor.

midactive

If given too late, narcotics increase the risk of

neonatal respiratory depression

Heralded by the involuntary need to push, 10 centimeters of cervical dilatation, rapid fetal descent, and birth

Second Stage of Labor

if you start pushing to early, the cervix can get

edema and never fully dilate

At crowning, put gentle ____ against the | perineum

counterpressure

Third Stage of Labor

From complete expulsion of the baby to complete expulsion of the placenta (so basically the placenta coming out)

Give oxytocin ___ the placenta is delivered

AFTER (if you give it before the placenta might get stuck in there)

Estimation of blood loss after delivery

done by the doctor

after delivery, dry and __ the infant

suction

during the episiotomy, the baby is held by

father

Fourth Stage of Labor

first 1 to 4 hours after delivery of placenta

withhold oxytocin if BP is

greater than 140/90

methergine is not given to clients with

HTN

never give methergine or hembate to a client while

in labor or before passing the placenta

vaginal discharge after giving birth

lochia

after delivery, fundus should be firm and

at or below umbilicus

one of the most common reasons for uterine atony or hemorrhage in the first 24 h after delivery

full bladder

After delivery: if the fundus is soft/boggy

massage the fundus, then have the client void. | Re-check fundus periodically

after delivery: If the uterus does not become firm from the massage

escalate

after delivery: if the 2nd perineal pad is soaked in only 15 min

escalate

safety regarding analgesics

she should stay in the bed

after delivery: to minimize edema of the perineum, apply

ice pack

after delivery, Apply witch hazel compresses to perineum for

comfort

after delivery, Provide a warm, darkened environment so newborn will

open eyes

newborn: suction mouth and nose with ___ syringe

bulb syringe

newborn: position head

slightly lower than body

newborn: Expiratory grunt can indicate

breathing problem

Do not ____ the newborn neck at any time

hyperextend

a "good" apgar score is

7 to 10

___ prophylaxis is mandatory in the U.S.

eye

in addition to erythromycin, another med that may be used for the newborn's eyes is

silver nitrate

Moro

startle

If parents desire an open-eye bonding period, may | delay eye prophylaxis for up to

1 hour

Regional blocks (epidural, caudal, and subarachnoid) cause a temporary interruption of nerve impulses (especially pain) but also cause

vasodilation

pain meds during labor cannot be given via

pain meds during labor: between IV and IM

IV is preferred because it only takes 20 min for it to work

pain meds during labor: give the IV push at the beginning of a

contraction (so that less meds go to the fetus)

pain meds during labor: explain the purpose of the drug but

don't promise results

If baby delivers during peak drug absorption time,

tell provider you might need narcan for the baby

___ anesthesia is rarely used in today’s obstetric units.

General

the first sign that a block (medication) is working is

warmth or tingling in the foot

block (medication): if hypotension occurs, position

on left side

block (medication): begin oxygen face mask at

10 L/min

block (medication): have ___ ready at the bedside

ephedrine

stop block medication infusion at the end of ___ _ or during ____

stage 1 or during transition

stop block medication infusion at the end of stage 1 or during transition to

increase effectiveness of pushing

____ rotation is harder to achieve when the pelvis is relaxed by anesthesia

internal rotation

the cardinal sign of persistent posterior fetal position

maternal back pain

regional blocks commonly result in

assisted delivery (forceps or vacuum) because you can't push effectively