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Mom/Baby Exam 3 > Ch. 16 Labor and Birth Process > Flashcards

Ch. 16 Labor and Birth Process Flashcards

1
Q

What five factors affect the birth process? (Five P’s)

A
  • Passenger (Fetus and placenta)
  • Passageway (Birth canal)
  • Powers (Contractions)
  • Position of mother
  • Phsychologic response
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2
Q

Are the first four of the five P’s the basis for the physiologic process of labor?

A

Yes

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3
Q

What is included under the category passenger?

A
  • Fetal head
  • Fetal attitude
  • Fetal lie
  • Fetal presentation
  • Fetal position
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4
Q

What is fetal attitude?

A

Attitude is relationship of fetal body parts to each other

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5
Q

What is fetal lie?

A

the relationship of the fetal spine to the maternal spine

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6
Q

What is fetal presentation?

A

the part of the fetus that enters the pelvic inlet first

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7
Q

What is fetal position?

A

relationship of the presenting part to four quadrants of the mothers pelvis

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8
Q

Is the fetal head composed of bony parts?

A

Yes

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9
Q

What is molding of the fetal head?

A

Overlapping of cranial bones

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10
Q

What are sutures of the fetal head?

A

Membraneous spaces between cranial bones

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11
Q

What are the fontanels of the fetal head?

A

Intersection of cranial suture

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12
Q

Are the anterior and posterior fontanels used as landmarks for assessment before and after birth?

A

Yes

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13
Q

What does the front of a fetal head close?

A

Around 18 months (diamond shaped)

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14
Q

When does the posterior of the fetal head close?

A

Around 8 weeks (triangular)

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15
Q

What make the skull flexible to accommodate the growing fetal brain?

A

Sutures and fontannels

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16
Q

Are infants born with a cone head?

A

Yes

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17
Q

What are the three main fetal presentations?

A

96% cephalic / vertex (head)
3% breech (butt)
1% shoulder

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18
Q

How do we determine fetal presentation?

A

Internal exam, ultrasound, or palpation

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19
Q

Do babies who present with a face presentation usually end up being delivered vaginally? Why or why not?

A

No due to potential trauma

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20
Q

What fetal presentation is most common?

A

Cephalic

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21
Q

What is the presenting part in a cephalic presentation?

A

Occiput

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22
Q

Why is cephalic presentation called “sunny side up”?

A

Baby looking up (or down)

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23
Q

What does vertex presentation mean?

A

Head completely flexed on chest

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24
Q

What does a complete breech presentation mean?

A

Knees and hips flexed

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25
Q

What are the presenting parts if a baby is complete breech?

A

Buttocks and feet

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26
Q

What does a frank breech presentation mean?

A

Hips flexed, knees extended

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27
Q

What are the presenting parts if baby is frank breech?

A

Buttocks

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28
Q

What does a footling breech presentation mean?

A

Hips and legs extended

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29
Q

What are the presenting parts of a footling presentation?

A

One or two feet first

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30
Q

Can the fetal lie mean being transverse or longitudinal?

A

Yes

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31
Q

Can a vaginal birth occur if there is a transverse lie?

A

No

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32
Q

In regards to fetal attitude, can deviations from morn cause difficult labors?

A

Yes

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33
Q

What does a normal fetal attitude mean?

A

Moderate flexion of head, arms on chest, leg flexed on abdomen

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34
Q

What is fetal attitude often referred to as?

A

“Chin up in air”

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35
Q

Can babies adapt to birth canal as they move through it?

A

Yes

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36
Q

What are the most common fetal positions?

A

LOA or ROA (delivery positions)

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37
Q

What is the first step in determining fetal position?

A

1st letter= side of maternal pelvic: left (L) or right (R)

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38
Q

What is the second step in determining fetal position?

A

2nd letter= presenting part of fetus:

  • occipital (O)
  • mentum (M)
  • sacrum (S)
  • acromion process (A)
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39
Q

What is the third step in determining fetal position?

A

3rd letter= means in relation to front or back of pelvis:

  • anterior (A)
  • posterior (P)
  • transverse (T)
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40
Q

Why is posterior fetal position often the cause of a difficult labor?

A

Baby is hitting mom’s spine causing back pain

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41
Q

What is the measurement of the degree of descent of the presenting part through the fetal pelvis?

A

Station

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42
Q

Does the station include the relationship of presenting part to ischial spine in pelvis?

A

Yes

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43
Q

What does -5 station mean?

A

floating and not engaged (don’t feel baby with vaginal exam)

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44
Q

What does +5 station mean?

A

Ready to deliver

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45
Q

Is station measured in cm?

A

Yes

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46
Q

What anatomical parts are included in the passageway?

A
  • Bony pelvis
  • Lower uterine segment (soft tissue)
  • Cervix
  • Pelvic floor muscles
  • Vagina
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47
Q

What does the frequency of contractions mean?

A

beginning of one to beginning of next

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48
Q

What does the duration of a contraction include?

A

timing of each contraction

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49
Q

What does the intensity of a contraction include?

A

strength as mild, moderate or strong (intrepreted by palpation, what a woman describes with external monitoring)

50
Q

What is the primary powers: forces of labor?

A

Uterine muscular contractions

51
Q

All contractions include what cycle?

A
  • Increment (building up)
  • Acme (peak)
  • Decrement (letting up)
52
Q

Does a contraction consist of the frequency, duration, and intensity?

A

Yes

53
Q

Is the duration of a contraction counted in seconds?

A

Yes

54
Q

Upon palpation what does a mild contraction feel like?

A

Tip of the nose

55
Q

Upon palpation what does a moderation contraction feel like?

A

a chin

56
Q

Upon palpation what does a strong contraction feel like?

A

Forehead

57
Q

Can a contraction intensity be measured by palpation?

A

Yes

58
Q

May moms with an epidural not feel involuntary uterine contraction?

A

Yes

59
Q

What does a contraction signal?

A

Beginning of labor

60
Q

Is a contraction responsible for dilation, effacement, and descent?

A

Yes

61
Q

When 10cm voluntary what occurs?

A

Secondary powers

62
Q

Is dilation 0 to 10cm?

A

Yes

63
Q

Is effacement thick to thin or 0 to 100%?

A

Yes

64
Q

Is descent measured by station?

A

Yes

65
Q

What does a 0 for station mean?

A

Middle rate meaning engaged

66
Q

Can a baby be delivered without the amniotic sac being ruptured?

A

Yes

67
Q

What are secondary powers?

A

Abdominal muscles during second stage of labor (bearing down)

68
Q

Are secondary powers important in the expulsion of the fetus?

A

yes

69
Q

During secondary powers the presenting part hits what?

A

The pelvis floor

70
Q

Do secondary powers cause the urge to push?

A

Yes

71
Q

Does the urge to push depend on pain relief?

A

Yes

72
Q

What do primary powers include?

A
  • Effacement
  • Dilation
  • Ferguson reflex (when mom needs to start pushing)
73
Q

What do secondary powers include?

A
  • Bearing down efforts

- Valsalva maneuver (holding and breathing while pushing)

74
Q

When secondary powers begin can the contraction power subside and the need for piton to help occur?

A

Yes

75
Q

Does labor begin irregular and become regular?

A

Yes

76
Q

Can labor be felt in the back and radiate to the front?

A

Yes

77
Q

Does walking during labor increase intensity?

A

Yes

78
Q

Does labor cause cervical changes?

A

Yes

79
Q

Is labor a bloody show?

A

Yes

80
Q

Does the fetus engage during labor?

A

Yes

81
Q

Does labor become stronger, last longer, and become more frequent?

A

Yes

82
Q

Does the position of a laboring women affect labor?

A

Yes

83
Q

What do frequent changes in position do during labor?

A
  • Relieve fatigue
  • Increase comfort
  • Improve circulation
84
Q

Does position affect the woman’s anatomic and physiologic adaptations to labor?

A

Yes

85
Q

Should a laboring women be encouraged to find positions most comfortable for her?

A

Yes

86
Q

What is the process of moving fetus, placenta, and membranes out of uterus and through the birth canal called?

A

Labor

87
Q

Do various changes take place in woman’s reproductive system in days and weeks before labor begins?

A

Yes

88
Q

What signs are seen preceding labor?

A
  • Lightening or dropping
  • Mucous plug
  • Bloody show
89
Q

Can the onset of labor be ascribed to a single cause?

A

No

90
Q

What is include in the mechanism of labor?

A

The seven cardinal movements

91
Q

What are the seven cardinal movements of labor?

A
  • Engagement (synclitic vs. asynclitic)
  • Descent
  • Flexion
  • Internal rotation
  • Extension
  • Restitution and external rotation
  • Expulsion (birth)
92
Q

What is it called when the fetal head moves into pelvis?

A

Descent

93
Q

What is it called when the head passes into pelvic inlet?

A

Engagement

94
Q

What is it called when the head meets resistance of cervix?

A

Flexion

95
Q

What is it called when the head rotates to fit pelvis?

A

Internal rotation

96
Q

What is it called when the head is under the symphysis pubis?

A

Extension

97
Q

What is it called when the head twists and turns to one side?

A

Restitution

98
Q

What is it called when the shoulders rotate and the head turns?

A

External rotation

99
Q

What is it called when the shoulders and then body is born?

A

Expulsion

100
Q

What is the fetal heart rate range and average?

A

Range =110-160

Avg=140bpm

101
Q

Why may the baseline fetal heart rate in early gestation be higher?

A

sometimes higher due to imbalance in neurological system

102
Q

Can most healthy fetuses are well able to withstand the normal stresses of labor and birth and exposure to increased pressure during labor and birth?

A

Yes

103
Q

1st stage: difficult to determine onset, longest stage,pariety has effect on length of 1st stage, can take >20 hours and includes what three phases?

A

latent, active and transition

104
Q

Can many factors can affect first stage of labor ( maternal weight, medications, risk status, age, clinical management of labor)?

A

Yes

105
Q

During the latent phase cervix effaces and woman are often doing what?

A

breathing, walking, sitting, rocking

106
Q

During the active phase and transition phase are woman more uncomfortable, contractions stronger, asking for pain medicine-cervix dilates, fetus descends?

A

Yes

107
Q

In what stage of labor is there 10 cm to birth of fetus, 30 minutes to 2 hours(primigravida) 5min-30 min for (multigravida), variable?

A

2nd stage

108
Q

During what stage of labor is there an increased bloody show. ,client often states I cannot continue, I want a c section, most difficult part of labor?

A

2nd stage

109
Q

studies have shown that ethnicity may play a role in length of 2nd stage, true or false?

A

true

110
Q

What stage of labor is birth to delivery of placenta 5-30 min.
Placenta separates and expels
Risk of PP hemm. Increases as stage lengthens

A

3rd stage

111
Q

What stage of labor is 2 hours after delivery of placenta, observe for complications and pp bleeding

A

4th stage

112
Q

Does blood pressure increases slightly during labor and are woman already at risk for hypertension due to stress of labor?

A

Yes

113
Q

Is there and increase in CO for women during labor?

400cc blood emptied from uterus into maternal vascular blood stream

A

Yes

114
Q

Is the mom’s heart rate elevated slightly and blood pressure increases slightly during labor?

A

Yes

115
Q

May there be maternal hypotension in labor which can lead to fetal hypoxia?

A

Yes (Due to compression of vena cava)

116
Q

Is there an increase WBC’s etiology unknown?

A

Yes (? Stress, tissue trauma, exercise)

117
Q

-Increased physical activity results in greater 02 consumption
-Anxiety results in increased 02 consumption
-May have hyperventiliation due to rapid breathing
… are what types of changes seen during labor?

A

Respiratory

118
Q
  • Difficulty voiding
  • Proteinuria

-GI changes
(Decreased motility-N and V)
… are what types of changes seen during labor?

A

GI/Renal

119
Q

-System stressed in labor
-Increase muscle use of muscles never used before
-Backache
-Joint pain
-Leg cramps
… are what types of changes seen during labor ?

A

Musculoskeletal

120
Q

-Life change for both parents
-May worry about unknown and competency
-Fear of loss of control
-Coping skills
-Knowledge helps decrease stress
… are what types of changes seen during labor?

A

Psychosocial

Mom/Baby Exam 3 (1 decks)

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