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N12 - MCN > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

There are _________ theories of labor.

A

four (4)

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2
Q

This theory of labor states that since all hollow organs have maximum capacity, the child eventually needs to be expelled by the body.

A

Uterine stretch theory

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3
Q

This theory states that cervical pressure causes the stimulation of the posterior pituitary gland which, in turn, releases a hormone responsible for labor contractions.

A

Oxytocin theory

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4
Q

This theory is based on the deprivation of a hormone that is believed to inhibit uterine motility. As pregnancy progresses, the body produces less and less of this hormone which causes eventual uterine contractions.

A

Progesterone Withdrawal / Progesterone Deprivation Theory

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5
Q

This theory states that there is an increase of a certain substance (not oxytocin) which, accompanied by a decrease in progesterone, increases uterine contractions and thus initiates labor.

A

Prostaglandin theory / Rising Fetal Cortisol Level

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6
Q

The advanced age of a certain fetal organ causes a decreased supply of blood to the uterus - thereby initiating labor.

A

Theory of Aging Placenta

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7
Q
  • a premonitory sign of labor
  • also known as nesting
  • is the descent of the fetal presenting part 10 to 14 days before labor
  • occurs earlier for primipara subjects because of their tighter abdominal muscles
  • usually occurs on the day of labor for multipara subjects
  • fundal height decreases
A

Lightening

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8
Q
  • the cervix becomes as soft as butter

- accompanied by cervical dilation

A

Cervical ripening

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9
Q
  • accompanied by an increase of maternal epinephrine

- epinephrine increase is attributed to decreased progesterone

A

Activity increase

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10
Q
  • this is the result of fluid and water loss attributed to the decrease in progesterone levels
A

Weight loss (1 to 3 lbs)

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11
Q
  • this happens when cervical mucus is expelled due to cervical compression
A

Mucus plug expulsion

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12
Q
  • this results from the action of relaxin which allows for the expansion and organ stretching to accommodate delivery
  • digestion is slowed
A

Backache

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13
Q

These are contractions before labor.

A

Braxton Hicks contractions

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14
Q

TRUE OR FALSE LABOR

Irregular contractions

A

FALSE LABOR

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15
Q

TRUE OR FALSE LABOR

Contraction interval shortening

A

TRUE LABOR

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16
Q

TRUE OR FALSE LABOR

Increase in pain intensity

A

TRUE LABOR

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17
Q

TRUE OR FALSE LABOR

Decrease in pain intensity when walking

A

FALSE LABOR

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18
Q

TRUE OR FALSE LABOR

Decrease in pain when lightly sedated

A

FALSE LABOR

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19
Q

TRUE OR FALSE LABOR

Bloody show

A

TRUE LABOR

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20
Q

TRUE OR FALSE LABOR

Cervical dilation

A

TRUE LABOR

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21
Q

TRUE OR FALSE LABOR

Pain is felt in the abdomen

A

FALSE LABOR

  • pain in true labor is felt from the back to the abdomen due to the fallopian tubes
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22
Q

This means that contractions occur over a certain period of time repeatedly.

A

Regularity

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23
Q

This refers to the number of contractions in a certain period.

A

Frequency

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24
Q

This is the time span between the end of one contraction to the beginning of another contraction.

A

Interval

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25
Q

This is the time span between the beginning of one contraction to the end of the same contraction.

A

Duration

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26
Q

These are the 5 Ps of labor

A
  • Passageway
  • Passenger
  • Position of the fetus
  • Power
  • Psyche
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27
Q

This refers to the route a fetus must travel from the uterus to the cervix and vagina to the external perineum.

A

Passageway

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28
Q

These are two innominate bones which are just three bones fused into one. Name the three.

A
  • Ileum
  • Ischium
  • Pubis
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29
Q

This is the bone used and is referred to as landmark zero.

A

Ileum

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30
Q

This is the bone that we sit on.

A

Ischium

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31
Q

This is the point from the sacrum to the superior pelvis. Its narrowest position is antero-posterior.

A

Pelvic Inlet

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32
Q

This is above the pelvic inlet.

A

False pelvis

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33
Q

This is the point from the sacrum to the inferior pelvis.

A

True pelvis

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34
Q

This is the point from the coccyx to the inferior pubis. Its narrowest portion is transverse.

A

Pelvic outlet

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35
Q

These pelvic types are suitable for vaginal birth.

A
  • Gynecoid

- Anthropoid

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36
Q
  • pelvic type
  • rounded inlet with adequate diameters
  • adequate midpelvis diameters with parallel side walls
A

Gynecoid

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37
Q
  • pelvic type
  • heart shaped inlet with short posterior sagittal diameter
  • arrest of labor is frequent
A

Android

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38
Q
  • pelvic type
  • oval inlet with long anteroposterior diameter
  • midpelvis diameters are adequate
A

Anthropoid

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39
Q
  • pelvic type
  • oval inlet with long transverse diameter
  • midpelvis diameters are reduced
A

Platypelloid

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40
Q

This is the progressive thinning of the cervix.

A

Cervical effacement

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41
Q

This refers to the progressive enlargement of the cervix which begins from the size of one’s fingertips to up to ten centimeters.

A

Cervical dilation / Cervical dilatation

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42
Q

These soft tissue organs are part of the fetal passageway.

A
  • Uterus
  • Cervix
  • Vagina
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43
Q
  • fetal skull landmark

- fetal chin

A

Mentum

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44
Q
  • fetal skull landmark
  • known as the brow
  • area over the frontal bone
A

Sinciput

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45
Q
  • fetal skull landmark

- anterior fontanel

A

Bregma

46
Q
  • fetal skull landmark

- posterior fontanel

A

Lambda

47
Q
  • fetal skull landmark

- area between the bregma and lambda

A

Vertex

48
Q
  • fetal skull landmark

- area occupied by the occipital bone beneath the lambda

A

Occiput

49
Q

This is the overlapping of cranial bones made possible by sutures. Changes in the shape of the fetal skull is produced by the force of uterine contractions.

A

Molding

50
Q

Membranous spaces between cranial bones.

A

Sutures

51
Q

This refers to the intersection of cranial sutures.

A

Fontanelles

52
Q

This refers to the rough, maternal side of the placenta.

A

Duncan’s fold

53
Q

This refers to the smooth, fetal side of the placenta.

A

Schultze fold

54
Q

This refers to the condition in which the placenta is implanted lower into the uterus.

A

Placenta previa

55
Q

This refers to the premature placental separation which may be complete or partial. Blood loss is inevitable when this happens.

A

Abruptio placenta

56
Q

Will you pass this subject?

A

Yes

57
Q

This is the relationship of the biparietal diameter (presenting part) of the infant to the ischial spines of the mother.

A

Station

58
Q

This is when the head of the infant is at the station zero. It is the settling of the infant’s head into the pelvis.

A

Engagement

59
Q

This is the relationship of the long axis of the baby to the mother’s long axis.

A

Fetal lie

60
Q

Uterine contractions are classified as a primary power of labor. Give its four elements.

A
  • Frequency
  • Regularity
  • Interval
  • Duration
61
Q

This is a secondary power of labor.

A

Maternal bearing down

62
Q

This refers to the psychological outlook of a woman and preparedness of a mother for birth.

A

Psyche

63
Q

These are the feelings and states that the woman brings into labor.

A
  • Maternal past experience
  • Preparedness
  • Support
  • Financial stability
  • Impact of another child
  • Other children to care for
  • Cultural meaning of children
  • Fertility
64
Q

The __________ probe is used to measure fetal heart tone.

A

first

65
Q

The ___________ probe is used to measure the contractions of the mother.

A

second

66
Q

This stage of labor is from the onset of labor to full cervical dilation and effacement.

A

First stage

67
Q
  • part of first stage of labor
  • preparatory phase
  • 0 to 3 cm cervical dilation
  • 20-40 second contractions
  • mild and short
A

Latent phase

68
Q
  • part of first stage of labor
  • amniotic sac rupture
  • 4 to 7 cm cervical dilation
  • 40-60 second contractions
  • occurs every 5 minutes
A

Active phase

69
Q
  • part of first stage of labor
  • 8 to 10 cm cervical dilation
  • 60-90 second contractions
  • occurs every 2-3 minutes
  • panic stage
A

Transitional phase

70
Q

Labor contractions cause a decrease in blood flow to this organ.

A

Uterus

71
Q

There is an increased amount of blood flow to this organ.

A

General circulation

72
Q

If a pregnant woman is left in the supine position for extended periods of time, her inferior vena cava is pressed on. What is the recommended position for pregnant women?

A

Left side lying position

73
Q

Pursed lip breathing is advised for mothers who are undergoing labor. This condition, remedied by the said technique, may be caused by labor and its accompanying pain.

A

Hyperventilation

74
Q

Why is defecating a normal occurrence when a woman is in labor?

A

Labor causes bowel loosening

75
Q

This is may be a cause of concentrated urine.

A

Poor fluid intake

76
Q

There is an increase of these two hormones and a decrease in one when women undergo labor.

A
  • increased oxytocin and prostaglandin

- decreased progesterone

77
Q

There is an increase __________ of the skin.

A

Diaphoresis / sweating

78
Q

Relaxin acts as a cartilage softener for labor. This, however, is accompanied by pain in what location.

A
  • back

- pubis

79
Q
  • fetal adaptation

- beat to beat changes in fetal heartbeat

A

Variability

80
Q
  • fetal adaptation

- positive indicator of fetal response to stress

A

Acceleration

81
Q
  • fetal adaptation

- decrease in fetal heart rate

A

Deceleration

82
Q
  • fetal adaptation
  • begin with contraction and return to baseline after contraction
  • normal
A

Early deceleration

83
Q
  • fetal adaptation
  • V or U shaped decelerations of variable onset
  • may mean umbilical cord prolapse (out of position)
A

Variable deceleration

84
Q
  • fetal adaptation
  • fetal heart rate does not return to baseline contraction
  • may mean something worse if accompanied by low variability
A

Late deceleration

85
Q

These are the three signs of transition.

A
  • increased bloody show
  • rectal pressure
  • tremors in thighs and legs
86
Q

These are possible nursing care practices that may be done by a nurse for a woman in labor.

A
  • support
  • encouragement
  • rest between pushes and contractions
  • positioning (not supine)
87
Q

These five elements first need to be prepared before a patient goes into labor.

A
  • the room
  • the warmer
  • infant supplies
  • delivery supplies
  • perineal prep
88
Q

This stage of labor is from the total dilation and effacement of the cervix to the delivery of the baby.

A

Second stage

89
Q

These are to be assessed in the second stage of labor.

A
  • FHT
  • contractions
  • BP
  • control
  • effectiveness of bearing down effort
  • perineal status (vulva, vestibule, fourchet)
90
Q
  • labor mechanism

- biparietal diameter reaches the ischial spines of the mother

A

Engagement

91
Q
  • labor mechanism
  • downward movement of biparietal fetal head into pelvic inlet
  • occurs due to pressure and uterine contractions
  • measured by stations rt to maternal ischial spines
A

Descent

92
Q
  • labor mechanism
  • child goes into suboccipitobregmatic form
  • caused by uterine pressure on breech
A

Flexion

93
Q
  • labor mechanism
  • baby turns from OT to OA/OP
  • done to accommodate shoulders into best possible position for entering pelvic inlet
A

Internal rotation

94
Q
  • labor mechanism

- head extends upward

A

Extension

95
Q
  • labor mechanism

- shoulder rotation

A

Restitution / external rotation

96
Q
  • labor mechanism

- baby is delivered

A

Expulsion

97
Q

This is a surgical incision done on the fourchet of a delivering woman to make the vagina larger - thereby assisting child birth. This may be done in a median or mediolateral incision.

A

Episiotomy

98
Q

This stage of labor is known as placental delivery.

A

Third stage

99
Q

This form of placental expulsion releases the maternal side first and happens 30% of the time.

A

Duncan’s mechanism

100
Q

This form of placental expulsion releases the fetal side first and happens 70% of the time.

A

Schultze’s mechanism

101
Q

This is a procedure done to reverse and repair the effects of an episiotomy - done with a local anesthetic.

A

Episiorrhaphy

102
Q

This stage of labor is from the end of placental expulsion to after four hours postpartum.

A

Fourth stage

103
Q

These positions are encouraged for people in the fourth stage of labor.

A
  • upright
  • left side lying
  • ambulation (if not contraindicated)
104
Q

Pain during labor is normal is caused by a number of different factors. Give all of them.

A
  • compressed muscle hypoxia
  • cervical nerve compression
  • cervical stretching
  • perineal stretching
  • bladder distension
  • tension/anxiety/fear
  • oxytocin-induced contractions
105
Q

There are three types of pain relief that may be given to patients in labor. Give the three.

A
  • non-pharmacologic pain relief
  • anesthesia
  • analgesia
106
Q

There are three types of analgesia possible. Give the three.

A
  • narcotics (may affect child)
  • sedatives
  • tranquilizers
107
Q

Anesthesia may be administered via these three methods.

A
  • local (subcute injection into perineum for episiotomy)
  • regional (for vaginal birth)
  • general (IV or inhaled; for emergency cases)
108
Q
  • obstetric emergency
  • ROM with presenting part is high and unengaged
  • malpresentation
A

Prolapsed cord

109
Q
  • obstetric emergency
  • late decelerations and prolonged variables
  • low or absent variability with bradycardia
A

Fetal distress

110
Q
  • obstetric emergency

- failure of uterus to completely relax between contractions

A

Uterine hyperstimulation

111
Q

Dystocia is also known as difficulty in labor and may be due to three factors. Give the three.

A
  • abnormal contraction pattern
  • soft tissue dystocia
  • bony dystocia

N12 - MCN (2 decks)

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