care of the mother and fetus during the intrapartal period

Question 1

fetus settles or descends into pelvic inlet
occurs 10-14 days before onset of labor (primi)
Increase in urinary frequency.
Relief of dyspnea; abdominal tightness and diaphragmatic pressure.
Shooting leg pain due to pressure on sciatic nerve

Answer 1

Lightening

Question 2

settling of the presenting part into pelvic inlet (station 0)

Answer 2

engagement

Question 3

increased frequency of contraction
produce gnawing pain in abdomen and groin.
The pregnant mother may return home if not yet true labor

Answer 3

increased braxton-hick’s contraction

Question 3

coordinated sequence of events.
involuntary uterine contraction causes progressive effacement and dilatation.
voluntary bearing down efforts allows expulsion of fetus

Answer 3

labor/eutocia

Question 4

the actual expulsion of the products of conception

Answer 4

delivery

Question 5

Less than 37 weeks

Answer 5

Preterm

Question 6

within 37 - 42 weeks
* 2 weeks before or after EDD (Expected date of delivery)

Answer 6

Term or Normal

Question 7

beyond 42 weeks

Answer 7

Post term

Question 8

Settling of the presenting part into pelvic inlet (station 0)

Answer 8

Engagement

Question 9

“butter-soft”
Internal sign felt only on pelvic exam

Answer 9

Ripening of the Cervix

Question 10

Increased frequency of contraction
Produce gnawing pain in abdomen and groin
* The pregnant mother may return home if not yet true labor
* The nurse should show sympathetic support and explain true labor contractions

Answer 10

Increased Braxton-Hick’s Contraction

Question 11

Due to ^ epinephrine, initiated by v progesterone produced by placenta.
epinephrine prepares mom’s body for labor work.

Answer 11

. Sudden Burst of Energy of the Mother

Question 12

nesting instinct

Answer 12

preparing for the baby

Question 13

About 2-3 lbs
* 2-3 days before onset of labor
* Related to changes in estrogen and progesterone levels

Answer 13

Allowable Weight Loss

Question 14

Impending Signs of Labor (3)

Answer 14

Increase Vaginal Mucus Discharge
8. Fetal Movement Less Active
9. Episodes of False Labor

Question 15

begin and remain irregular

Answer 15

false labor

Question 16

begin irregularly but become regular and predictable

Answer 16

true labor

Question 17

no increase

Answer 17

false labor

Question 18

increase

Answer 18

true labor

Question 19

often disappear with ambulation and sleep

Answer 19

false labor

Question 20

continue no matter what the woman’s level of activity

Answer 20

true labor

Question 21

felt first abdominally and remain confined to the abdomen and groin.

Answer 21

false labor

Question 22

felt first in lower back and sweep around to the abdomen in a wave

Answer 22

true labor

Question 23

do not achieve cervical dilatation

Answer 23

false labor

Question 24

achieve cervical dilatation

Answer 24

true labor

Question 25

Expulsion of mucus plug (operculum) due to softening of cervix PLUS blood from ruptured capillaries due to pressure from fetus * Pink/ brown-tinged discharge

Answer 25

Bloody Show

Question 26

Surest sign that labor has begun its productive uterine contractions * The nurse will remind mother to do breathing exercises to reduce anxiety and pain

Answer 26

True Labor Contractions

Question 27

Sudden gush or trickle of amniotic fluid from vagina * May occur before or after labor * Labor will occur within 24 hrs

Answer 27

Spontaneous Rupture of Membrane (SROM)

Question 28

Observe aseptic technique; less manipulation (IE) * Risks associated: a. ? b. ?

Answer 28

a. Intrauterine Infection b. Prolapsed of Umbilical Cord

Question 29

Cuts off oxygen supply to fetus

Answer 29

Prolapsed of Umbilical Cord

Question 30

Effacement * thinning and shortening of cervix * Measured in percentages (100% : fully effaced) * Dilation * Widening of the external cervical os * 0 to 10 cm (10 cm: fully dilated)

Answer 30

Cervical Changes

Question 31

dried amniotic fluid and mucus looks like crystallized ferns by microscopic exam

Answer 31

fern test

Question 32

PAIN Assessment:

Answer 32

Facial tension * Flushing or pallor * Hand clenched in a fist * Increased PR and BP * Difficulty with ability to reason clearly * Increased duration and strength of contractions * Decreased interval between contractions

Question 33

Labor Pain: Intervention

Answer 33

Breathing techniques * Bathing * Massage * Focusing and imagery * Biofeedback * Yoga * Aromatherapy and Essential oils * Herbal preparations * Prayer

Question 34

From beginning of contraction until it increases Contraction starts at fundal area

Answer 34

Increment or Cresendo

Question 34

Height or peak of contraction Contraction continues at the side of abdomen

Answer 34

Acme

Question 35

From the height of contraction until it decreases Contraction ends at the lower portion of uterus

Answer 35

Decrement or Decresendo

Question 36

From increment decrement of same/single contraction

Answer 36

Duration

Question 37

From beginning of increment increment of another contraction

Answer 37

Frequency

Question 38

From decrement of 1 contraction period of increment of next contraction No contraction : best time to check FHT and maternal BP

Answer 38

Interval of Rest

Question 39

Considers the peak on contraction Palpate with fingertips (light movement only)

Answer 39

Strength

Question 40

Placental Stage ** From delivery of fetus → delivery of placenta

Answer 40

third stage

Question 41

From full cervical dilation → delivery of fetus * Shortest stage

Answer 41

second stage

Question 41

dilating stage. From true contraction ----> full cervical dilation * Longest stage

Answer 41

first stage

Question 42

Immediate Recovery Period (Recovery Room) * From delivery of placenta → 1 to 4 hrs after delivery

Answer 42

fourth stage

Question 43

Period from onset of contractions to full dilatation and effacement of the cervix

Answer 43

First Stage of Labor

Question 44

first stages Averages : nullipara multipara : 8 to 9

Answer 44

12 to 18 hrs.

Question 45

first stages Averages : multipara :

Answer 45

8 to 9

Question 46

Divided into three Phases : (LAT)

Answer 46

Latent Active Transitional

Question 47

1st Stage of Labor Fetal Heart Monitoring Indications for Fetal Monitoring

Answer 47

1. Decrease fetal movement 2. Abnormalities in FHR 3. Passage of meconium 4. Abnormal position (breech) 5. Premature and postmature 6. Maternal complications PIH, DM, fever) 7. Oxytocin augmentation or induction 8. Bleeding Page

Question 48

NORMAL FHR OF A FETUS, FULL TERM

Answer 48

120 TO 160 BPM

Question 49

FHR > 160 bpm lasting > 10min period

Answer 49

Tachycardia