Exam 2 - Labor & Birth

Question 1

An approach that recognizes the impact of trauma on individuals and creates a safe, supportive environment for healing

Answer 1

trauma-informed care

Question 2

what are the 3 common settings for childbirth?

Answer 2

(1) traditional hospital rooms
(2) free-standing birth centers
(3) home births

Question 3

regular uterine contractions with cervical change; process when fetus, amniotic fluid, placenta, and membranes are separated and expelled from the uterus to the outside world

Answer 3

labor

Question 4

onset of labor in gravid person with gestational age prior to 37 weeks

Answer 4

preterm labor

Question 5

abnormally slow or protracted labor

Answer 5

distocia

Question 6

never given birth to a child

Answer 6

nulliparous / “nullip”

Question 7

has given birth before

Answer 7

multiparous “multip”

Question 8

labor at 37-42 weeks, low-risk throughout, and spontaneous birth of infant in vertex presentation describes what?

Answer 8

normal components of labor

Question 9

Lightening occurs ____ weeks before term

Answer 9

2-3

Question 10

subjective feeling by pregnant person as baby settles in lower uterine segment

Answer 10

Lightening

Question 11

Engagement occurs ___ weeks before term in first time parents

Answer 11

2-3

Question 12

Widest part of the baby’s head passes through the pelvic inlet and into the pelvis

Answer 12

Engagement

Question 13

pushing phase is ___ stage of labor

Answer 13

second

Question 14

first / latent stage of labor is ____

Answer 14

cervical dilation

Question 15

third stage of labor is ____

Answer 15

delivery of the placenta

Question 16

fourth stage of labor is ____

Answer 16

maternal stabilization

Question 17

first and second stages of labor go faster for ___ than ____

Answer 17

multip, nullip

Question 18

if the placenta has not been delivered in ___ minutes, it can be concerning

Answer 18

30

Question 19

if the placenta has not been delivered in 30 minutes this is called ___

Answer 19

retained placenta

Question 20

the first stage has 3 main parts:

Answer 20

latent, active, transition

Question 21

name 4 things about the latent stage

Answer 21

(1) steady but spaced contractions
(2) slow dilation (0-5cm)
(3) lasts 12-24 hours
(4) not as strenuous on birthing person

Question 22

during the normal active phase, dilation progresses to _____

Answer 22

~5-8 cm

Question 23

the fetal head engages during the ___ stage

Answer 23

normal active (first)

Question 24

effacement becomes complete in which stage of labor?

Answer 24

normal active (first)

Question 25

Name at least 4 components of the normal transition stage (first)

Answer 25

(1) contraction frequency is 2-3m (2) dilation goes from 8 to 10cm (3) contractions are intense (4) emesis (5) sweating (6) shaking

Question 26

the process of thinning and softening in prep for childbirth

Answer 26

cervical effacement

Question 27

when does coping and discomfort start with labor (typically)?

Answer 27

normal active phase

Question 28

cervical effacement goes from 0 to __ and dilation goes from 0 to ___

Answer 28

100%; 10 cm

Question 29

how do we assess cervical effacement and dilation?

Answer 29

vaginal exam

Question 30

swelling that appears as a cone-shaped head

Answer 30

caput

Question 31

what happens during the second stage of labor?

Answer 31

(1) spontaneous urge to push (2) contractions increase & intense (3) fetal head may caput, mold, rotate (4) completion of labor mechanics

Question 32

the second stage of labor takes longer for ___ than ____

Answer 32

nullips; multips

Question 33

Name at least 4 physiologic changes during labor

Answer 33

(1) CO increases (2) HR increases (3) BP increases during contractions (4) RR increases (5) WBC increases (6) Temp can be slightly elevated (7) GI motility and absorption decrease (8) Blood glucose levels decrease

Question 34

nurses should take vitals during what phase of contractions?

Answer 34

resting phase

Question 35

name the 5 Ps of labor

Answer 35

(1) Passengers (fetus and placenta) (2) Passageway (birth canal) (3) Powers (contractions) (4) Position (of the birthing person and fetus) (5) Psychological response

Question 36

part of the fetus entering into the pelvic inlet first

Answer 36

presentation

Question 37

____ is shoulder/scapula first presentation

Answer 37

transverse

Question 38

we want ____ presentation for the fetus

Answer 38

cephalic / head down

Question 39

which presentation can you not delivery vaginally with?

Answer 39

transverse lie

Question 40

relationship of the maternal longitudinal axis (spine) to fetal spine

Answer 40

lie

Question 41

2 types of lie are

Answer 41

longitudinal and transverse

Question 42

relationship of fetal body parts to one another

Answer 42

attitude

Question 43

2 types of attitude are

Answer 43

flexion and extension

Question 44

chin flexed to chest and extremities to torso

Answer 44

flexion

Question 45

chin & extremities extended away

Answer 45

extension

Question 46

relationship of presenting part of fetus in relation to its directional position of one of the 4 maternal pelvic quadrant

Answer 46

position

Question 47

____ is the optimal position for vaginal delivery

Answer 47

Left Occiput Anterior (LOA)

Question 48

passageway refers to

Answer 48

the pelvis and its shape

Question 49

___ is the most common pelvic shape

Answer 49

gynecoid

Question 50

____ is the most optimal pelvic shape for vaginal delivery

Answer 50

gynecoid

Question 51

____ is the least common pelvic shape and is not conducive for vaginal birth

Answer 51

platypelloid

Question 52

birth can occur but may not progress with ____ pelvic shape

Answer 52

android

Question 53

anthropoid pelvic shape often results in ____ positioning / birth

Answer 53

occiput posterior birth (OP)

Question 54

the 3 major parts of the fetal head are

Answer 54

face, base of skull, and vault of the cranium

Question 55

which part of the fetal head is not well-fused?

Answer 55

vault of the cranium

Question 56

relationship of the presenting part to an imaginary line drawn between the ischial spines of the maternal pelvis

Answer 56

fetal station

Question 57

station 0 means what?

Answer 57

fetal head is engaged

Question 58

+3/+4 station means what?

Answer 58

almost crowning

Question 59

we typically want baby's head to be at station 0 before ____

Answer 59

starting to push

Question 60

when the largest diameter of the presenting part reaches or passes through the pelvic inlet

Answer 60

engagement

Question 61

power refers to ___

Answer 61

contractions

Question 62

time b/w the beginning of one contraction and the beginning of the next contraction

Answer 62

frequency of contractions

Question 63

how do you measure contraction intensity?

Answer 63

palpation

Question 64

mild contractions feel like

Answer 64

tip of the nose (soft)

Question 65

moderate contractions feel like

Answer 65

chin (medium hard)

Question 66

strong contractions feel like

Answer 66

forehead (hard)

Question 67

Frequent position changes for birthing person to increase comfort, relieve fatigue, promote circulation

Answer 67

position - birthing person

Question 68

moving during labor helps to promote ____

Answer 68

optimal fetal position

Question 69

____ is unpleasant sensations in the body we may want to avoid

Answer 69

pain

Question 70

____ is distressing state that feels helpless

Answer 70

suffering

Question 71

what are the 3 ways to provide physical comfort during labor?

Answer 71

(1) promote self-comforting behaviors (2) give partner suggestions (3) encourage use of birth place areas

Question 72

what is the important nursing intervention of the 3rd stage of labor?

Answer 72

once placenta is delivered, assess if it is intact

Question 73

placenta should be delivered within ___ or it is a _____

Answer 73

30 minutes; retained placenta

Question 74

why do we inspect the placenta for intactness?

Answer 74

we don't want to leave anything in the uterus b/c it can lead to infection and bleeding

Question 75

during labor, name the 5 nursing assessments that should be completed

Answer 75

(1) maternal health history (2) physical assessment (3) fetal assessment (4) lab studies (5) psychological assessment

Question 76

Feel and palpate fetus externally to get a sense where the back is / general positioning

Answer 76

Leopold's Maneuvers

Question 77

during labor, name at least 3 things that nurses should do for assessment

Answer 77

(1) VS (2) Leopold's Maneuvers (3) heart (4) lungs (5) headache, dizziness, vision changes (6) pulses (LE, UE) (7) cervical dilation / effacement (8) membrane status (9) contractions (10) pain

Question 78

during the 1st stage of labor and we assess membranes, fluid should be ____

Answer 78

clear

Question 79

during the active phase assessment, what should you always assess?

Answer 79

fetal surveillance - contractions and FHR

Question 80

during the second / pushing stage, what nursing prep should occur?

Answer 80

(1) support position changes (2) have delivery meds ready (3) continue monitoring status (4) be prepared for the unknown

Question 81

during the third stage, the fundus maintains ____ to ____

Answer 81

tone; deliver the placenta

Question 82

during stage 4 of labor, continue to check ____

Answer 82

fundus