CARE OF MOTHER 3-10

Question 1

Although a number of theories have been proposed
to explain why labor begins, it is believed that labor is
influenced by a combination of factors originating
from the mother and the fetus (____).

Answer 1

Katz, 2003

Question 2

Possible Causes of the Onset of Labor
Maternal Factor Theories

Pressure on the cervix stimulates nerve plexus,
causing release of oxytocin by maternal posterior
pituitary gland. This is known as

Answer 2

Ferguson reflex

Question 3

Possible Causes of the Onset of Labor
Maternal Factor Theories

Answer 3

Uterine muscles stretch, causing release of
prostaglandin.

Ferguson reflex.

Oxytocin and
prostaglandin work together to inhibit calcium
binding in muscles cells, raising intracellular calcium
and thus activating contractions.

Estrogen/progesterone ratio shift

Question 4

Possible Causes of the Onset of Labor

Fetal Factor Theories

Answer 4

Placental aging and deterioration triggers initiation of
contractions

Fetal cortisol, produced by the fetal adrenal glands,
rises and acts on the placenta to reduce
progesterone formation and increase prostaglandin

Prostaglandin produced by fetal membrane s
(amnion and chorion) and the decidua stimulates
contractions. When arachidonic acid stored in fetal
membranes is released at term, it is converted to
prostaglandin

Question 5

Factors Affecting Labor

Passageway

Answer 5

Type of pelvis (e.g. gynecoid, android, anthropoid,
or platypelloid)

Structure of pelvis (e.g. true versus false pelvis)

Pelvic inlet diameters
Pelvic outlet diameters

Ability of the uterine segment to distend, the cervix
to dilate, and the vaginal canal and introitus to
distend

Question 6

Factors Affecting Labor

Passenger

Answer 6

Size of the fetal head and capability of the head
to mold to the passageway

Fetal presentation

Fetal attitude

Fetal position

Question 7

Factors Affecting Labor

Power

Answer 7

frequency, duration, and strength (intensity)
of uterine contractions to cause complete cervical
effacement and dilation

Question 8

Factors Affecting Labor

Placental factors

Answer 8

site of placental insertion.

Question 9

Factors Affecting Labor

Psyche

Answer 9

refers to the client’s psychological state;
available support systems, preparation for child birth,
experiences , and coping strategies.

Question 10

Signs and symptoms of impending labor

Answer 10

(Premonitory
Signs)

Question 11

are irregular, intermittent
contractions that have occurred throughout the
pregnancy, become uncomfortable, and produce a
drawing pain in the abdomen and groin

Answer 11

Braxton Hicks contractions

Question 12

Signs and symptoms of impending labor (Premonitory
Signs)

Answer 12

Lightening

Braxton Hicks

Cervical changes include softening , “ripening” and
effacement of the cervix

Rupture of amniotic membranes

Burst of energy or increased tension and fatigue may
occur right before the onset of labor

Question 13

Cervical changes include

Answer 13

softening , “ripening” and
effacement of the cervix that will cause expulsion of
the mucous plug (bloody show).

Question 14

Characteristics of True Labor

Answer 14

Contractions occur at regular intervals

Contractions e back and sweep around to the abdomen , increase in intensity and duration , shortened intervals.

Walking intensifies contractions.

Bloody show”

Cervix becomes effaced and dilated

Sedation does not stop contractions

Question 15

Characteristics of False Labor

Answer 15

Contractions occur at irregular intervals.

Contractions are located chiefly in the abdomen, the
intensity remains the same or is variable, and the
intervals remain long.

Walking does not intensify contractions and often
gives relief.

Bloody show usually not is not present. If present, it is
usually brownish rather than bright red and may be
due to a recent pelvic examination or intercourse.

There are no cervical changes.
Sedation tetends to decrease the number of
contractions.

Question 16

primiparas

Answer 16

(longer)

Question 17

multiparas

Answer 17

shorter),

Question 17

“ occurs when the newborn’s head or
presenting part appears at the vaginal opening.

Answer 17

“Crowning“

Question 18

(surgical incision in perineum)

Answer 18

Episiotomy

Question 19

Second Stage

Answer 19

begins with complete dilation of the cervix and ends
with delivery of the newborn

Contractions are severe at <2- to 3-minute intervals, with a duration of 50 to 90 seconds

birth canal with help from the
following cardinal movements, or mechanisms, of
labor.

“Crowning“

Episiotomy

Question 20

second stage

The newborn exits the birth canal with help from the
following cardinal movements, or mechanisms, of
labor.

Answer 20

Descent
Flexion
Internal rotation
Extension
External rotation (restitution)
Expulsion
“Crowning

Question 21

what is called the Third stage

Answer 21

(Placental stage)

Question 22

Third stage (Placental stage)
It occurs in two phases

Answer 22

placental separation and placental expulsion

Question 23

Third stage (Placental stage)

Signs of placental separation include the

Answer 23

uterus
becoming globular,

the fundus rising in the abdomen,

lengthening of the cord, and

increased bleeding
(trickle or gush).

Question 24

Third stage (Placental stage)
Generally, ____ are administered to help
the uterus contract

Answer 24

oxytocic drugs

Question 25

Third stage (Placental stage)

Answer 25

This stage begins with delivery of newborn, and ends
with delivery of the placenta.

placental separation

Contractions of the uterus controls uterine bleeding
and aids with placental separation and expulsion

oxytocic drugs a

Question 26

Fourth stage (recovery and bonding)

Answer 26

This stage lasts from 1 to 4 hours after birth.

The mother and newborn recover from the physical
process of birth.

The maternal organs undergo initial readjustment to
the nonpregnant stage

The newborn body system begin to adjust to
extrauterine life and stabilize.

The uterus contracts in the midline of the abdomen
with the fundus midway between the umbilicus and
symphysis pubis.

Question 27

4 Core Steps of ENC

Answer 27

Immediate Drying
Skin-to-skin contact
Proper cord clamping and cutting
Non-separation of newborn and mother

Question 28

EENC transfers___ from the mother to the
newborn

Answer 28

life-saving warmth, placental blood
and protective bacteria

Question 29

Early Essential Newborn Care (EENC)

Prolonged skin-to-skin contact is recommended for
no less than ____ minutes.

Answer 29

90

Question 30

Kangaroo Mother Care or KMC is care for ____ through prolonged and continuous ____

Answer 30

preterm
infants

skin-toskin contact.

Question 31

_____ can also provide skin-to-skin contact through
KMC

Answer 31

Fathers

Question 32

Exclusive breastfeeding is where the infant only
receives ____

Answer 32

breast milk without any additional food or
drink, not even water, for the first 6 months

Question 33

Exclusive breastfeeding protects your baby from
common childhood illnesses such as _______, and helps with a quicker recovery if the
infant falls ill.

Answer 33

diarrhea and
pneumonia

Question 34

Exclusive breastfeeding also contributes to health
and well-being of mothers:

Answer 34

helps to space children,
reduces the risk of ovarian and breast cancer, and is
a secure and low-cost way of feeding.

Question 35

Can Early Essential Newborn Care apply to all types of
deliveries?

Answer 35

yes includinng pre term

Question 36

How do I know my baby is getting enough milk from
breastfeeding?

Answer 36

At birth, a newborn’s stomach is only the size of your
thumbnail and requires a very small amount of milk
per feed

closing her or his mouth and taking no
more breast milk

Try breastfeeding 8 to 12 times over the day and night,
when the baby shows early feeding cues

Question 37

How do I know when my baby is ready to breastfeed?

Answer 37

drooling, then mouth opening, licking and biting of
their fingers or hand.

Question 38

I don’t have enough breast milk. Should I add infant
formula?

Answer 38

The more you breastfeed, the more milk you produce.

Question 39

My nipples hurt when I breast feed. What can I do?

Answer 39

Adjust the baby’s position and attachment to resolve
nipple pain while breastfeeding.

Question 40

Signs of good attachment:

Answer 40

More areola is visible above the baby’s mouth than
below

Mouth is wide open with the lower lip turned outward

Baby’s chin is touching the breast

Baby’s sucking is slow and deep with occasional
pauses

Question 41

one newborn dies
every 4 minutes – largely due to inappropriate clinical
practices at the time of birth.

Answer 41

Western Pacific Region,

Question 42

from the first
breastfeeding, essential nutrients, antibodies and
immune cells are transferred from mothers to their
babies to protect them from infection

Answer 42

colostrum or “first milk”

Question 43

4 Time-Bound Interventions in ENC

Immediate and thorough drying

Answer 43

prevents hypothermia which is extremely important to
newborn survival

Question 44

4 Time-Bound Interventions in ENC

Early skin-to-skin contact

Answer 44

prevents hypothermia, hypoglycemia and sepsis,
increases colonization with protective bacterial flora
and improved breastfeeding initiation and exclusivity

Question 45

4 Time-Bound Interventions in ENC

Properly-timed clamping and cutting of the cord

Answer 45

properly-timed clamping and cutting of the cord after
1 to 3 minutes until the umbilical cord pulsation stops
decreases anemia in one out of every seven term
babies and one out of every three preterm babies.
It also prevents brain (intraventricular) hemorrhage in
one of two preterm babies.

Question 46

4 Time-Bound Interventions in ENC

Non-separation of the newborn from the mother

Answer 46

for early breastfeeding initiation
Breastfeeding initiation within the first hour of life
prevents an estimated 19.1% of all neonatal deaths.

Question 47

What has the government done to ensure
implementation of the Essential Newborn Care Protocol?

Answer 47

The signing of the Administrative Order 2009-0025 l last
Dec. 1, 2009

Question 48

Newborn Care Practices in the Delivery Room
that should no longer be continued

Answer 48

routine suctioning of secretions
if the baby is crying and breathing normally

e newborn on a cold or wet surface.

Wiping or removal of vernix caseosa

Foot printing

Bathing earlier than 6 hours of life

Unnecessary separation

neonatal intensive care unit without any indication