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CHN104 > care of the mother and fetus during the intrapartal period > Flashcards

care of the mother and fetus during the intrapartal period Flashcards

1
Q

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

A

Lightening

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2
Q

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

A

engagement

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3
Q

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

A

increased braxton-hick’s contraction

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3
Q

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

A

labor/eutocia

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4
Q

the actual expulsion of the products of conception

A

delivery

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5
Q

Less than 37 weeks

A

Preterm

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6
Q

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

A

Term or Normal

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7
Q

beyond 42 weeks

A

Post term

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8
Q

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

A

Engagement

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9
Q

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

A

Ripening of the Cervix

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10
Q

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

A

Increased Braxton-Hick’s Contraction

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11
Q

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

A

. Sudden Burst of Energy of the Mother

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12
Q

nesting instinct

A

preparing for the baby

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13
Q

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

A

Allowable Weight Loss

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14
Q

Impending Signs of Labor (3)

A

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

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15
Q

begin and remain irregular

A

false labor

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16
Q

begin irregularly but become regular and predictable

A

true labor

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17
Q

no increase

A

false labor

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18
Q

increase

A

true labor

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19
Q

often disappear with ambulation and sleep

A

false labor

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20
Q

continue no matter what the woman’s level of activity

A

true labor

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21
Q

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

A

false labor

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22
Q

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

A

true labor

23
Q

do not achieve cervical dilatation

A

false labor

24
Q

achieve cervical dilatation

A

true labor

25
Q

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

A

Bloody Show

26
Q

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

A

True Labor Contractions

27
Q

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

A

Spontaneous Rupture of Membrane (SROM)

28
Q

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

A

a. Intrauterine Infection
b. Prolapsed of Umbilical Cord

29
Q

Cuts off oxygen supply to fetus

A

Prolapsed of Umbilical Cord

30
Q

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)

A

Cervical Changes

31
Q

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

A

fern test

32
Q

PAIN Assessment:

A

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

33
Q

Labor Pain: Intervention

A

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

34
Q

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

A

Increment or Cresendo

34
Q

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

A

Acme

35
Q

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

A

Decrement or Decresendo

36
Q

From increment decrement of same/single contraction

A

Duration

37
Q

From beginning of increment increment of another contraction

A

Frequency

38
Q

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

A

Interval of Rest

39
Q

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

A

Strength

40
Q

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

A

third stage

41
Q

From full cervical dilation → delivery of fetus
* Shortest stage

A

second stage

41
Q

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

A

first stage

42
Q

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

A

fourth stage

43
Q

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

A

First Stage of Labor

44
Q

first stages Averages :
nullipara
multipara : 8 to 9

A

12 to 18 hrs.

45
Q

first stages Averages :
multipara :

A

8 to 9

46
Q

Divided into three Phases : (LAT)

A

Latent
Active
Transitional

47
Q

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

A
  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
48
Q

NORMAL FHR OF A FETUS, FULL TERM

A

120 TO 160 BPM

49
Q
A
49
Q

FHR > 160 bpm lasting > 10min period

A

Tachycardia

50
Q
A
51
Q
A

CHN104 (2 decks)

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