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OB > Ch 13-14 Labor & Birth Processes > Flashcards

Ch 13-14 Labor & Birth Processes Flashcards

1
Q

Factors Influencing Labor Initiation

A
  • Uterine stretch
  • Progesterone withdrawal- pregnancy mx hormone
    uterus gets crampy and then goes into labor
  • Increased oxytocin sensitivity
    • body’s natural hormone that is UTERUS specific and makes it contract
    • nipple stimulation is #1 method to increase oxytocin
      Pro: When done in moderation, it can get labor going
      Con: no control on amount of oxytocin you produce. Can hyperstimulate uterus
  • Increased release of prostaglandins
    • softens cervix and thins it out, effaces
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2
Q

Premonitory signs of labor

A 
cervical chgs
lightening (relief)
increased energy (nesting)
bloody show (mucus plug)
braxton hicks
spontaenous rupture of membranes (water break)
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3
Q 
Regular
Stronger over time
Increasing discomfort
UC’s continue despite position
5 min apart x2 hours
A

true labor

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4
Q 
Irregular
No increase in intensity
Localized pain (front)
UC’s come and go with position changes
Fluids helps
A

false labor

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5
Q

5 p’s

A

Passenger - this is where position of baby is covered
Passageway
Powers
Position - most confusing - of the MOTHER, not of fetus
Psyche (psychological response)

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6
Q

Passenger (fetus)

A 
size (macrosomia)
presentation
lie
attitude
position
placenta
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7
Q

what can you ask mom to do if baby is LOT?

A

positioning

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8
Q

If diamond is closer to anterior and triangle is posterior, it is …

A

OP

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9
Q

If diamond is L and triangle is R, it is …

A

LOT

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10
Q

most desirable position & presentation

A

cephalic, OA

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11
Q

the relation of the long axis (spine) of the fetus to the long axis (spine) of the mother

(longitudinal vs transverse)

A

Lie

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12
Q

which is most subjective

A

station

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13
Q

is true cephalopelvic disproportion common or rare?

A

COMMON

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14
Q

who would have problems w/ cervical dilation?

A

those w/ a leap
anyone w/ HPV w/ tissue removal
anyone w/ D&C or D&E (scar tissue)

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15
Q

what is a good indication that someone’s pelvic msks are strong?

A

good shape

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16
Q

effacement

A

shortening

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17
Q

dilation

A

opening of cervix

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18
Q

Cardinal movements

A

EDFI

ExExEx

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19
Q

entering of the biparietal diameter (widest) into the pelvic inlet.

A

Engagement

20
Q

The baby’s head (presenting part) moves deep into the pelvic cavity and is commonly called lightening. – greatest at deceleration phase of 1st stage and during 2nd stage of labor

A

descent

21
Q

occurs during descent, brought about by resistance felt by the baby’s head against the soft tissues of the pelvis. Smallest diameter of the baby’s head presents into the pelvis

A

flexion

22
Q

head reaches pelvic floor & rotates to accommodate for changes in diameter of the pelvis. Baby must move from sideways to facing posterior

A

internal rotation

23
Q

head passes through pelvis at nape of neck and there is a rest. Occurs as head, face, and chin are born

A

extension

24
Q

after baby’s head comes out, it sucks back in a little & rotates to face down

A

external rotation

25
Q

last big relieving push which results in baby

A

expulsion

26
Q

Involuntary uterine contractions

A

primary powers

27
Q

PUSHING
Bearing-down efforts
Augment the primary powers

A

secondary powers

28
Q

responsible for effacement and dilation

divided into frequency
duration
intensity

A

primary

29
Q

not letting the patient push so that primary powers can work baby down further into pelvis

effective for only 1 hr

longer the labor, the greater the risk of infx.

A

laboring down

30
Q

epidurals before what CM increases csection rate?

A

3 cm

31
Q

during transition, what position should they not be in? what postition should they be in?

A

NOT lithotomy. OK to have counterpressure and squatting, hands & knees = takes weight off back (can deliver baby on hands & knees)

32
Q

What affects psyche?

A 
Maternal exhaustion
Length of labor
Labor support
Fear
Chronic illness
Pregnancy related illness
33
Q 
Lightening
Braxton Hicks contractions
Increased vaginal mucous
Weight loss (0.5-1.5kg)
Energy surges
Diarrhea
N/V
Indigestion
Loss of operculum
A

preceding labor

34
Q

Uterine distention
Increasing intrauterine pressure
Regular, rhythmic contractions
Loss of operculum

A

onset of labor

35
Q

Stage 1 labor - from _____________ to __ cm

3 sub stages & their cm

A

onset of labor to 10 cm
Latent- 0-3 cm
Active- 3-7 cm
Transition- 7-10 cm

36
Q

Stage 2 labor - from ____ to _________

A

10 cm through delivery of fetus
Latent- passive descent and rotation
Active- active expulsion efforts
Completed within 2-3 hours

37
Q

Stage 3 labor: delivery of ______ through ______

A

delivery of fetus through placenta

Completed within 30 minutes

38
Q

Stage 4 labor: first _____ of postpartum recovery.

what is a big complication in stage 4?

A

first 1-2 hours of postpartum recovery; reestablishment of homeostasis - big thing right now b/c hemorrhage

39
Q

little cuts around periurethral area and skin. biggest problem: getting them to void - give warm soapy bottle for periurethral - may not require repair b/c vag is vascular and heals quickly. may heal b/c it’s bleeding + cosmetic

A

1st degree

40
Q

goes through skin, portion of vag wall & anal wall

A

3rd degree

41
Q

goes through perineal skin & msk - always gets repaired

A

2nd degree

42
Q

tear between vag floor & rectum - must be repaired through each layer of muscle.

A

4th degree

43
Q

biggest fear in 4th degree tear?

interventions

A

going to the bathroom

Give them sitz bath, medications, stool softener, hydrate, ice packs, tucks, foley

44
Q

greatest risk in 3rd/4th degree tears?

A

risk of infection

  • -good hygiene
  • -wipe front to back
  • -NOTHING in the vagina for at least 6 weeks (tampons, penises, etc)
45
Q

What can you do to prevent perianal tearing?

A

stretch

mineral oil/baby shampoo

OB (10 decks)

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