Exam 1: Chapter 13 Flashcards
Labor combination of factors:
progesterione ______ and _____ in estrogen levels
uterine stretch
_______ oxytocin
_____ release of prostaglandins
Labor: Combination of factors:
Progesterone withdrawal and increase in estrogen levels
Uterine stretch
Increased oxytocin sensitivity
Increased release of prostaglandins
What is lightening
fetal presenting part begins to descend into the maternal pelvis (2 weeks or more before labor begins)
What is nesting
increased energy levels usually 24 to 48 hours before onset labor
How do we combat a cord prolapse
we place the mother in sims, knee chest head down, or trendelenburg
Passageway: what is the most favorable for vaginal delivery
gynecoid
When the cervix thins through effacement what does it allow for
the presenting part to descend into the vagina
Passenger: fetal skull
sutures
allow for overlapping and changes in shape (molding) help identify the position of the fetal head
Passenger: fetal skull
fontanelles
intersections of sutures: help in identifying position of fetal head and in molding
Fluid can also collect in the scalp (__________) or blood can collect beneath the scalp (______)
caput succedaneum
cephalohematoma
Anterior vs posterior fontanelle
anterior: soft spot 12 to 18 months before closing
posterior: back of the head; 8 to 12 weeks before closing
The most common fetal altitude is
all joints flexed
Passenger: fetal lie
longitudinal: long axis of the fetus is parallel to the long axis of the moterh
transverse: long axis of the fetus is perpendicular to the long axis of the mother
What are the 3 main fetal presentations
cephalic (vertex)
breech
shoulder
What is fetal position?
Fetalpositiondescribes the relationship of a given point on the presenting part of the fetus to a designated point of the maternal pelvis
What are fetal position landmarks
Occipital bone (O): vertex presentation
Chin (mentum [M]): face presentation
Buttocks (sacrum [S]): breech presentation
Scapula (acromion process [A]): shoulder presentation
Fetal station
Refers to the relationship of the presenting part to the level of the maternal pelvic ischial spines.
Zero station means
presenting part is at the level of the maternal ischial spines
What does it mean when we say the fetus is engaged
they have their presenting part reaching 0 station
What is floating mean
no engagement
What are the cardinal movements of labor
Engagement
Descent
Flexion
Internal rotation
Extension
External rotation (restitution)
Expulsion
What are the 3 phases of contractions
increment (build up)
acme (peak)
Decrement (descent)
Powers: EARLY
Frequency
Duration
5 to 7 min
30 seconds
Powers: ACTIVE
Frequency
Duration
2 to 3 mins apart
60 seconds
Blood glucose level _______ because of stress of labor.
decreases
1st stage of labor: true labor to complete cervical dilation
10 cm
1st stage of labor: ________ of all stagest
longest
1st stage of labor: 3 phases
latent phase
active phase
transition phase
Latent phase: dilation and effacement
dilation 0 to 3 cm; effacement 0 to 40%
Active phase: dilation and effacement
dilation 4 to 7 cm and 40 to 80% effacement
Transition phase: dilation and effacement
dilation 8 to 10 cm and 80 to 100% efacement
Latent phase description
Mild anxiety, women can cope and focus
Uses relaxation techniques, rest/sleep, change positions, ambulate, eat light food & drink
Void q. 2 hrs.
Pain: mild/moderate
Eat/drink/void
Active phase description
Record: ROM, vaginal exams, medication given, care provided
comfort measures
position changes
Transition phase description
Loss of control, irritable, confused, narrow focus
ROM, vaginal exams, meds given, care provided
Provide relief/assistance for partner; may need to take charge
May have urge to push: teach to blow through the urge, change position
2nd stage of labor
cervix is dilated 10 cm to birth of baby
2nd stage of labor median duration
50 in nulliparous
30 in multipara
3rd stage of labor
birth of infant to placental seperation
4th stage of labor
restorative stage from 1 to 4 hours post delivery
