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Maternal- Newborn & Women's Health Nursing > Chapter 12 & 15 > Flashcards

Chapter 12 & 15 Flashcards

Exam 1

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1
Q

How far apart should contractions be before you decide to go to the hospital/ birth center?

A

regular, 5 minutes apart, lasting 1 minute, for 1 hour

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2
Q

A gush or trickle of fluid from the vagina, with or without contractions is what?

A

a ruptured membrane

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3
Q

When your membrane ruptured should you go to the hospital/ birth center?

A

yes

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4
Q

If you are bleeding- bright red blood

A

go to the hospital/ birth center

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5
Q

if you have concerns or feelings that something might be wrong..

A

go to the hospital/ birth center

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6
Q

Ways to establish a therapeutic relationship with your laboring mother:

A

*convey confidence
*assign a primary nurse
*use touch for comfort
*respect cultural values
*determine family expectations

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7
Q

Characteristics of contractions

A

*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

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8
Q

Beginning of one uterine contraction to the beginning of the next

A

Frequency

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9
Q

Beginning of a uterine contraction to the end of the same contraction

A

Duration

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10
Q

strength of a contraction

A

intensity

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11
Q

Contraction Cycle

A

1.)Increment
2.)Peak or acme
3.)Decrement

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12
Q

period of increasing strength

A

increment

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13
Q

period during which the contraction is most intense

A

peak or acme

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14
Q

period of decreasing intensity

A

decrement

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15
Q

Which part of the uterus contracts actively to push the fetus down during a contraction?

A

the upper two thirds

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16
Q

Which part of the uterus remains less active during a contraction?

A

the lower third

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17
Q

During a contraction what is the cervix?

A

passive

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18
Q

thinning and shortening of the cervix

A

effacement

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19
Q

opening of the cervix during labor

A

dilation

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20
Q

What occur concurrently during labor but at different rates?

A

effacement and dilation

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21
Q

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

A

nullipara

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22
Q

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

A

parous

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23
Q

Why does blood flow to the placenta decreases during a contraction?

A

*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

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24
Q

When should vitals be assessed during labor?

A

during the interval between contractions

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25
Q

What may occur if the laboring woman lies on her back during labor?

A

supine hypotension

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26
Q

Why is the laboring woman encouraged to rest in positions other than supine during labor?

A

it promotes blood return to her heart and decreases the risk for supine hypotension

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27
Q

What may occur during rapid, deep breathing of labor?

A

hyperventilation

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28
Q

What may occur as the laboring mother exhales too much carbon dioxide (hyperventilation)?

A

respiratory alkalosis

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29
Q

What may the laboring mother feel if she is hyperventilating (in resp. alkalosis)?

A

tingling of her hands & feet; numbness and dizziness

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30
Q

What should the nurse do if the laboring mother is hyperventilating?

A

help her slow her breathing; breath into a paper bag or cupped hands to restore normal blood levels of carbon dioxide and relieve symptoms

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31
Q

A reduction in gastric motility can affect a laboring client resulting in what?

A

n/v

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32
Q

What is commonly provided to laboring mothers experiencing n/v during labor?

A

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.

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33
Q

A full bladder can inhibit what in a laboring client?

A

fetal descent

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34
Q

Why can a full bladder inhibit fetal descent?

A

occupies space in the pelvis ; increases risk of bladder hypotonia and infection

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35
Q

Most research suggests that there is how much normal blood loss for a vaginal delivery?

A

500 to 1000mL

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36
Q

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?

A

can provide protection from hemorrhage yet it increases the mother’s risk for a venous thrombosis during pregnancy and after birth

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37
Q

The exchange of oxygen, nutrients, and waste products through what system?

A

placental circulation

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38
Q

When does most placental exchange occur?

A

during the interval between contractions

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39
Q

Fetal intolerance to the stress of labor causes their HR to be what?

A

110- 160 bpm

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40
Q

In the fetal pulmonary system, the lungs produce what to allow normal development of the airways?

A

fluid

41
Q

Four major factors interact during normal childbirth (4Ps)

A

Power
Passage
Passenger
Psyche

42
Q

Primary force that moves the fetus through the maternal pelvis

A

uterine contractions

43
Q

Woman feels an urge to push and bear down as the fetus distends her vagina and puts pressure on her rectum

A

maternal pushing efforts

44
Q

During the 1st stage of labor

A

uterine contractions- onset to full cervical dilation

45
Q

During the 2nd stage of labor

A

pushing efforts- full cervical dilation to birth of the baby

46
Q

usually more important to the outcome of labor than the soft tissue

A

the bony pelvis

47
Q

What do not readily yield to the forces of labor?

A

bones and joints

48
Q

pelvic brim

A

the linea terminalis

49
Q

what divides the bony pelvis

A

the linea terminalis

50
Q

Where is the false pelvis located?

A

(top) above linea terminalis

51
Q

Where is the true pelvis located?

A

(bottom) below linea terminalis

52
Q

The 3 subdivisions of the true pelvis

A

*Inlet
*midpelvis
*outlet

53
Q

Who is the passenger?

A

fetus, membranes, and placenta

54
Q

Several fetal anatomic and positional variables influence what?

A

the course of labor

55
Q

Components of the birth fetal head

A

*Bones
*Sutures
*Fontanels

56
Q

Bones of the fetus head

A

-2 frontal bones on the forehead
-2 parietal bones at the crown of the head
-1 occipital bone at the back of the head

56
Q

Sutures of the fetal head

A

Narrow areas of flexible tissue that connect fetal skull bones

57
Q

Fontanels of the fetal head

A

-Wider spaces at the intersections of the sutures connecting the skull hones
-Anterior fontanel diamond shape
-Posterior fontanel triangular shape

58
Q

The fetus enters the birth canal in what presentation?

A

cephalic

59
Q

At what percentage does the fetus enter the birth canal in the cephalic presentation?

A

96- 97% of the time

60
Q

What serves as key landmarks for assessing fetal position and head flexion during vaginal exams?

A

the sutures and fontanels

61
Q

What enables the fetal head to mold and adjust to the pelvis’s shape?

A

sutures and fontanels

62
Q

the orientation of the long axis (spine) of the fetus to the long axis (spine) of the woman client

A

fetal lie

63
Q

In more than 99% of pregnancies, the lie is longitudinal and parallel to the what of the woman?

A

long axis (spine)

64
Q

relationship of fetal body parts to one another

A

attitude

65
Q

normal attitude

A

flexion

66
Q

Presentation examples

A

*Cephalic
vertex, military, brow, face
*Breech
frank, full, footling
*Shoulder

67
Q

the fetal part that first enters the pelvis and termed the presenting part

A

presentation

68
Q

The most common presentation?

A

the cephalic presentation with the fetal head flexed

69
Q

Other presentations besides the cephalic are associated with what?

A

associated with prolonged labor and are more likely to require caesarean birth

70
Q

location of fixed reference point on the presenting part in relation to the four quadrants of the maternal pelvis

A

location

71
Q

Position references

A

*Right or Left
*Occiput (O)
Mentum (M)
Sacrum (S)
*Anterior (A)
Posterior (P)
*Transverse (T)

72
Q

The 4 Ps are an interrelated what?

A

whole

73
Q

Factors that appear to have a role in starting labor

A

1.) progesterone levels fall
2.) increase release of prostaglandins
3.) Increased secretion of natural oxytocin
4.) Increased oxytocin receptors in the uterus
5.) Fetal membrane release prostaglandins
6.) Cortisol secreted by fetal adrenal glands
7.) Increased stretching and pressure of the uterus and cervix

74
Q

When does labor normally start?

A

when the fetus is mature enough to adjust easily to extrauterine life but after it grows so large that vaginal birth is impossible

75
Q

Normal Labor: Premonitory Signs

A

*Braxton Hicks contractions
*Lightening
*Increased vaginal mucus secretion
*cervical changes (softening, possible dilation, bloody show)
*energy spurt and weight loss

76
Q

true labor

A

*increased contractions; tend to increase with walking
*increased discomfort; lower back; resembles menstrual cramps
*cervical change; progressive effacement and dilation most important

77
Q

false labor

A

*contractions inconsistent; decrease with activity (walking)
*discomfort is felt in the abdomen and groin an can be annoying
*cervix does not change

78
Q

movement of fetus through the birth canal

A

descent

79
Q

fetal presenting part reaches 0 station

A

engagement

80
Q

Normal Labor: Labor Mechanisms

A

1.) Descent
2.) Engagement
3.) Flexion
4.) Internal rotation
5.) Extension
6.) External rotation
7.) Expulsion

81
Q

the mechanism of labor that accompanies all the others; without it none of the mechanisms will occur

A

descent

82
Q

occurs when the largest diameter of the fetal presenting part (normally cephalic) has passed the pelvic inlet and entered the pelvic cavity

A

engagement

83
Q

the fetal head is flexed farther as it meets resistance from the soft tissues of the pelvis; presents the smallest anteroposterior diameter to the pelvis

A

flexion

84
Q

allows the largest fetal head diameter to align with the largest pelvic diameter

A

internal rotation

85
Q

of the fetal head as the neck pivots on the inner margin of the symphysis pubis, allowing the head to align with the curves of the pelvis outlet

A

extension

86
Q

of the fetal head, aligning the head with the shoulders during expulsion

A

external rotation

87
Q

the fetal shoulders and fetal body exit the pelvis- birth canal

A

expulsion

88
Q

1st stage of labor

A

-latent phase
-active phase

89
Q

How many phases of labor is there?

A

4

90
Q

labor duration varies significantly between first time mothers and whom?

A

experienced mothers

91
Q

first time mothers & experienced mothers may have…

A

fast labor

92
Q

1st stage of labor this position is ideal for pushing because it enlarges the pelvic outlet slightly and adds the force of gravity to the client’s efforts

A

squatting

93
Q

positions of labor

A

-standing
-lunge
-abdominal left and tuck
-counter-pressure
-sitting/ squatting
-side lying with peanut ball

94
Q

allowing uterine contractions to cause most of the fetal internal rotation and descent after full dilation

A

laboring down

95
Q

lower extremity nerve injury

A

LENI

96
Q

What is the goal of maternity care?

A

To protect the health of the mother, fetus, and newborn while enhancing the birth experience.

97
Q

What does technology do in the birth experience?

A

aids in identifying and addressing issues quickly but can make care feel impersonal

Maternal- Newborn & Women's Health Nursing (16 decks)

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