Chapter 12 & 15 Flashcards
Exam 1
How far apart should contractions be before you decide to go to the hospital/ birth center?
regular, 5 minutes apart, lasting 1 minute, for 1 hour
A gush or trickle of fluid from the vagina, with or without contractions is what?
a ruptured membrane
When your membrane ruptured should you go to the hospital/ birth center?
yes
If you are bleeding- bright red blood
go to the hospital/ birth center
if you have concerns or feelings that something might be wrong..
go to the hospital/ birth center
Ways to establish a therapeutic relationship with your laboring mother:
*convey confidence
*assign a primary nurse
*use touch for comfort
*respect cultural values
*determine family expectations
Characteristics of contractions
*Coordinated
-Frequency (beginning of one uterine contraction to the beginning of the next)
-Durations (beginning of a uterine contraction to the end of the same contraction)
-Intensity (strength of a contraction)
-Involuntary
-Intermittent
Beginning of one uterine contraction to the beginning of the next
Frequency
Beginning of a uterine contraction to the end of the same contraction
Duration
strength of a contraction
intensity
Contraction Cycle
1.)Increment
2.)Peak or acme
3.)Decrement
period of increasing strength
increment
period during which the contraction is most intense
peak or acme
period of decreasing intensity
decrement
Which part of the uterus contracts actively to push the fetus down during a contraction?
the upper two thirds
Which part of the uterus remains less active during a contraction?
the lower third
During a contraction what is the cervix?
passive
thinning and shortening of the cervix
effacement
opening of the cervix during labor
dilation
What occur concurrently during labor but at different rates?
effacement and dilation
a client who has not completed a pregnancy of at least 20 weeks gestation and will complete most cervical effacement early in the process of cervical dilation
nullipara
a client who has given birth after a pregnancy of a at least 20 weeks of gestation; it also designates the number of pregnancies that end after at least 20 weeks gestation; the cervix is usually much thicker than that of a nullipara at any point during labor
parous
Why does blood flow to the placenta decreases during a contraction?
*the muscle fibers of the uterus constrict around the maternal spiral arteries, which supply the placenta
*there is a relative increase in the woman’s blood volume
*this temporary change increases her blood pressure slightly an slower her pulse rate
When should vitals be assessed during labor?
during the interval between contractions
What may occur if the laboring woman lies on her back during labor?
supine hypotension
Why is the laboring woman encouraged to rest in positions other than supine during labor?
it promotes blood return to her heart and decreases the risk for supine hypotension
What may occur during rapid, deep breathing of labor?
hyperventilation
What may occur as the laboring mother exhales too much carbon dioxide (hyperventilation)?
respiratory alkalosis
What may the laboring mother feel if she is hyperventilating (in resp. alkalosis)?
tingling of her hands & feet; numbness and dizziness
What should the nurse do if the laboring mother is hyperventilating?
help her slow her breathing; breath into a paper bag or cupped hands to restore normal blood levels of carbon dioxide and relieve symptoms
A reduction in gastric motility can affect a laboring client resulting in what?
n/v
What is commonly provided to laboring mothers experiencing n/v during labor?
ice chips; small amounts of other clear liquids may be allowed; solid foods are usually withheld to prevent vomiting and aspiration if general anesthesia is required.
A full bladder can inhibit what in a laboring client?
fetal descent
Why can a full bladder inhibit fetal descent?
occupies space in the pelvis ; increases risk of bladder hypotonia and infection
Most research suggests that there is how much normal blood loss for a vaginal delivery?
500 to 1000mL
Elevated levels of several clotting factors (esp. fibrinogen) during pregnancy and continue to be higher during labor and after delivery increase what for the client?
can provide protection from hemorrhage yet it increases the mother’s risk for a venous thrombosis during pregnancy and after birth
The exchange of oxygen, nutrients, and waste products through what system?
placental circulation
When does most placental exchange occur?
during the interval between contractions
Fetal intolerance to the stress of labor causes their HR to be what?
110- 160 bpm