Ch 16 Flashcards
0
Q
0-4cm
A
Probably not in labor but recheck in an hour
-probably won’t be admitted if they are three or less
1
Q
First stage of labor
A
- begins with the onset of regular contractions and ends with complete cervical effacement and dilation
- latent
- active
- transition
2
Q
True labor contractions
A
- contractions occur regularly becoming stronger lasting longer and occur close together
- contractions are more intense with walking and are felt in lower back radiating to lower portion of abdomen
- contractions continue despite use of comfort measures
3
Q
True labor cervix
A
- by vaginal exam
- shows progressive change softening, effacement,and dilation signaled by appearance of bloody show
- moves to an increasingly anterior position
4
Q
True labor fetus
A
- presenting part usually becomes engaged and pelvis which results in increased ease of breathing
- at the same time presenting part prices downward and compresses bladder resulting and urinary frequency
5
Q
False labor contractions
A
- Occur irregularly or become regular only temporarily
- often stopped with walking or position change
- can be felt in back or abdomen above navel
- can be stopped with comfort measures
6
Q
False labor Cervix
A
- by vaginal exam
- soft with no significant change in effacement or dilation or evidence of bloody show
- is often in posterior position
7
Q
False labor fetus
A
Presenting part is usually not engaged and pelvis
8
Q
First stage of labor vaginal exam
A
Cervical exam
- is water broken?
- broken don’t do exam because of risk for infection
9
Q
Nitrazine ph test
A
- to determine backchat of membranes
- acidic and 5-6 membranes still in tact
- alkaline and 6.5-7.5 they prob ruptured
10
Q
Latent phase first stage
A
- last 6 to 8 hours
- contractions are irregular,mild to moderate, 5 to 30 minutes apart lasting 30 to 45 seconds
- station 0 to -2
- Brown discharge, mucous plug, or pale pink mucus
- 0 to 3 cm
11
Q
Active phase first stage of labor
A
- 4 to 7 CM
- contractions moderate to strong, regular, 3 to 5 minutes apart lasting 40 to 70 second
- last about 3 to 6 hours
- station +1 to +2
- pink to bloody mucus
12
Q
Transition phase first stage
A
- 8 to 10 CM
- last 20 to 40 minutes
- contractions are very strong regular 2 to 3 minutes apart lasting 45 to 90 seconds
- station +2 to +3
- bloody mucus
13
Q
Leopold maneuvers
A
- Performed with the woman briefly lying on her back
- identifies the number of fetuses
- identifies presenting part ,fetal lie, and fetal attitude
- identifies degree of dissent into the pelvis of the presenting part
- expected location of the PMI and the FHR on the woman’s abdomen
- do this before putting on monitor for the correct FHR placement and position of the baby
14
Q
Fetal PMI
A
- location on the mom’s abdomen where the FHR is heard the loudest
- usually directly over the fetal back
- Asssess FHR after ROM because this is the most common time for the UC to prolapse, after any change in the contraction pattern or maternal status and before and after the woman receives medication or procedures performed
15
Q
PMI and FHR in vertex presentation
A
- you can hear the FHR below the mothers umbilicus
- in either the right or left lower quadrant of the abdomen
16
Q
PMI and FHR in breech presentation
A
-you usually hear the FHR above the moms umbilicus
17
Q
Leopold procedure
A
- Identify fetal part that occupies the fundus aka fetal lie. The head feels round, for him, freely movable, and palpable by ballottement. Breach feels less regular and softer. The maneuver identifies fetal lie (longitudinal or transverse)and presentation (cephalic or breach)
- Using palm of one hand locate and palpate the smooth convex contour of the fetal back in the irregularities that identify the small fetal parts (feet, hands, elbows). This maneuver helps identify fetal presentation.
- With right-hand determine which fetal part it’s presenting over the inlet of the true pelvis. Gently grasp the lower pole of the uterus between thumb and fingers pressing in slightly. If they had his presenting and not engaged determine attitude of the head (flexed or extended)
- Turn to face the women’s feet. Using both hands outline the fetal head with that palmar surface of the fingertips. When the presenting part has descended deeply only a small portion of it maybe outlined. Palpation of the cephalic prominence helps identify the attitude of the head. If the cephalic prominence is found on the same side as a small parts this means that the head must be flexed and the vertex is presenting. If the cephalic prominence is on the same side as the back this indicates that the presenting head is extended in the face is presenting
- Document fetal presentation, position, lie and whether presenting part is flexed or extended, engaged, or free-floating (vtx, LOA, floating)
18
Q
Mild contractions felt on palpation
A
Slightly tense fundus that is easy to indent with fingertips. Feels like touching tip of nose
19
Q
Moderate contractions felt on palpation
A
- firm fundus that is difficult to indent with fingertips
- feels like touching finger to Chin
20
Q
Strong contractions felt on palpation
A
- rigid board like fundus that is almost impossible to indent
- feels like touching finger to forehead
21
Q
Leopold findings
A
- hands together = head is high
- hands apart = head in pelvis
22
Q
Second stage of labor
A
- duration is usually 50 to 60 minutes and Nulliparous women and 20 to 30 minutes in multi Parous
- only objective sign that it has begun is the inability to feel the cervix during a vaginal exam indicating that it is fully dilated and effaced
- urge to push or feeling the need to have a bowel movement is another sign
23
Q
Third stage of labor
A
- lasts from the birth of the baby until the placenta is expelled
- placenta is almost always expelled within 15 minutes after birth if it has not been completed within 30 minutes it is considered retained and interventions to hasten its separation and expulsion are usually instituted
24
Q
Fourth stage of labor
A
- first one to two hours after birth
- crucial time for mother newborn
- Channel organs undergo their initial readjustment to the nonpregnant state in the functions of the body systems begin to stabilize
- hemorrhage is the most dangerous potential complication during this stage
- titles are checked every 15 minutes for one hour
25
Q
Breast-feeding
A
Is initiated in the first hour after birth
