Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NUR 102 OB Assessment #1 > Giving Birth > Flashcards

Giving Birth Flashcards

1
Q

Maternal Response to Labor

* Coordinated, involuntary, intermittent contractions

* Cervical changes: effacement & dilation

* Increased BP & decreased pulse

* Decreased gastric motility

* Decreased bladder sensation

* Hematopoietic changes

A

Coordinated, involuntary, intermittent contractions

  • Coordinated as begin @ uterine fundus & spread down towards cervix

> Lower 3rd of uterus stays relaxed to help in cervical dilation

  • Involuntary as labor can’t be stopped by conscious effort
  • Intermittent to allow relaxation of muscle & resumption of maternal blood flow to & from placenta & fetus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

?

Is the thinning & shortening of the cervix

A

Effacement

Non-laboring cervix begins @ about 2cm long; called 0% effaced

100% effaced ⇒ paper thin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

?

Is opening of the cervix

From uterus pulling upward

A

Dilation

Cervix must dilate to 10cm to allow for passage of average size term fetus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Increased BP & decreased pulse

140/90 is abnormal & concerning

With each contraction, blood flow to placenta decreases

A

Decreased gastric motility

Causes dry mouth & thirst

Decreased bladder sensation

If unmedicated, empty bladder every 2 hours

For an epidural (block), intermittent catheterization every 2 hours or an indwelling catheter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Hematopoietic changes

  • EBL - estimated blood loss
  • QBL - quantitative blood loss [exact]
  • With vaginal blood loss, up to 500mL is normal
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Contractions

2 - 2-1/2 minutes apart (frequency)

60-90 seconds long (duration)

* Intensity can’t be measured on a fetal monitor without using a specialized invasive device

* Palpated at uterine fundus (in order to measure); mild, moderate or strong

A

Increment = as contraction begins

Decrement = decrease intensity as uterus relaxes

Interval (uterine relaxation) = uterine resting tone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Fetal Response to Labor

* Decreased placental exchange during contractions

* Cardiovascular system responds quickly to labor events

* Labor speeds the absorption of fetal lung fluid, & compression from vaginal delivery helps expel remaining fluid

  • HTN & DM cause narrowing of arteries
  • Affects fetal gas exchange
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

The Four “P’s” of Labor

Powers

Passage

Passenger

Psyche

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Powers

  • Uterine contractions (primary force)
  • Maternal pushing

> Push fetal head against cervix to help efface & dilate it

> Don’t push in-between contractions

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Passage

  • Maternal pelvis (false pelvis, true pelvis)
  • Soft tissues

?

is a condition in which the fetal head will not fit through the pelvis

___ will soften cartilage, connecting the bones

A

cephalopelvic disproportion (CPD)

Relaxin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Passenger

* Fetus

* Membranes

* Placenta

  • Cephalic presentation
  • Adapt to size & shape of pelvis
  • Skull bones are not yet fused; connected by sutures

___ - spaces where sutures meet

> Anterior & posterior (gives an idea to infant’s position in utero)

A

Fontanels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

1) Longitudinal lie

Could be a cephalic or breech presentation

Is what’s desired for a vaginal birth

2) Transverse lie

Rare; contraindicates a vaginal birth

Shoulder-first presentation

A

3) Oblique sideways

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Breech Presentations

* Frank

* Full

* Single footling

  • Risk of umbilical cord compression when head is last thing born
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q
  1. Determine landmark

Occiput - a presenting part

Mentum - fetal chin

Sacrum

Scapula (not favorable)

  1. Where to feel fixed reference point? To right, left, or directly on horizontal line
  2. Anterior, posterior, or transverse plane?
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Psyche

  • Ease fear & anxiety into confidence & empowerment
  • Provide education; be an advocate
  • Respect cultural, religious, & individual preferences
  • Creating a birth plan
A

Now remember, at this point we are looking at what normal labor and childbirth look like…

18
Q

How does labor begin?

Process begins gradually over the last few weeks of pregnancy

___ decreases, while ___ increases

Prostaglandins are released from the fetal membranes (helps to soften cervix)

Natural secretion of ___ (from pituitary)

Fetal ___ and ___ are secreted

Cervical stretching also causes secretion of maternal ___

A

progesterone; estrogen

oxytocin

oxytocin, cortisol

oxytocin

19
Q

___ Labor

Braxton-Hicks contractions

Lightening

Bloody show

A

Premonitory

20
Q

?

Is a discharge of the mucous plug that occurs as the cervix softens

Means that the cervix is softening, effacing, or dilating

___ - a spurt of energy during a tired period; slight weight loss

A

Bloody show

Nesting

21
Q

?

A dropping sensation as fetus descends toward pelvic inlet

Stomach looks lower; lung capacity increases

2-3 weeks

A

Lightening

22
Q

?

Are contractions that shouldn’t be painful

False labor; not doing anything to the cervix

Are irregular, mild; stop & decrease spontaneously

A warm shower will help settle these down

A

Braxton-Hicks contractions

23
Q

True Labor vs False Labor

___ labor means no cervical change is occurring

* Assess the cervix

24
Q

Stages and Phases of Labor

1st / 2nd / 3rd / 4th

25
? A term used to describe a woman who has not given birth before
nulliparous
26
First Stage \* Begins w/the onset of true labor contractions, & ends w/complete cervical effacement & dilation \* Shortest / longest stage of labor (?) \* 3 phases: Latent / Active / Transition
Longest
27
? Faster Intense contractions 7-8 until 10cm Tremors, nausea, vomiting, irritability
Transition
28
? 3-5cm of dilation Some discomfort
Latent
29
? Cervix dilates more rapidly Nulliparous - 1cm every 1-2 hours Much faster for multiparous women; 4-6cm dilation
Active
30
Second Stage \* Complete dilation & effacement until the birth of the baby \* Fetal descent places pressure on the rectum & pelvic floor, leading to an involuntary pushing response \* Often gives sensation of "I need to poop," or "I need to push" \* Pain is often relieved w/the ability to push w/contractions \* Stretching & burning occurs w/crowning of the fetal head
Cardinal Movements of Labor *"**E**very **D**ay **F**armers **I**ncubate **E**ggs **E**ggs **E**ggs"* Engagement / Descent / Flexion / Internal rotation Extension / External rotation / Expulsion
31
Third Stage \* Begins w/the birth of the baby, ends w/the expulsion of the placenta \* Some pain here; not as much as childbirth
Fourth Stage \* Stage of physical recovery \* Delivery of the placenta - through the first 1-4 hours post-birth \* Monitor uterine contractions, vaginal drainage, perineal trauma (tears, episiotomy, hemorrhoids), & "afterpains" (contractions after delivery that should feel like menstrual cramps) \* Promote familial bonding
32
How does labor differ between a nulliparous woman and a multiparous woman? \* Delivers quicker \* Body & labor progress quickly \* A history of rapid labor can lead to another labor
The Role of the Nurse in Labor and Delivery
33
Determine the Setting to Care for the Patient - Hospital, birth center, or home birth \> Hospital setting for high-risk cases; pharmacological approach needed - Who to contact for problems or questions
Establish a Therapeutic Relationship - Level of knowledge & preparation - Determining expectations surrounding birth - Convey confidence in the woman's choices & abilities - Assign a primary nurse (helps to ensure continuity of care) - Respect personal, religious, & cultural values
34
Admission Assessment - Review prenatal care records (if present) - Interview the woman regarding pregnancy, labor, & conditions that may affect her care - Review current labor pattern; evaluate contractions - Review client background (rx's, food, environment, allergies, infections)
- Assess birth preferences (birth plan, culture/personal preferences) - Evaluate fetal status (via intermittent auscultation or electronic monitoring for HR; assess fetal membranes [intact or ruptured?]) - Evaluate labor status (strength of contraction by palpation) - Physical examination \> Perform vaginal examination to determine cervical dilation & effacement \> Leopold's maneuvers to estimate size & position in utero \> Evaluate pain; vital signs; heart/lung sounds; palpate breasts; assess GI system; midstream urine collection (look for protein, UTI's); assess DTR's
35
Leopold's Maneuvers 1st / 2nd / 3rd / 4th
36
Ongoing Assessments \* Fetal Assessments \> Fetal HR \> Amniotic fluid \* Maternal Assessments \> Vital signs \> Contractions \> Labor progress \> I&O (look for urinary retention) \> Response to labor
Rupture? \> spontaneous or artificial Clear fluid \> cloudy, yellow, foul = infection \> Meconium - stained fluid - Light yellow to pea soup green 8 cervical exams total throughout labor
37
How much amniotic fluid? \_\_\_ \>1000mL \_\_\_ 500-1000mL \_\_\_ 100-500mL \_\_\_ small
Large Moderate Small Scant
38
Labor Support Focus is on oxygenation, maternal discomfort, & maternal injury - Look for S/S of fetal compromise - Soft, indirect lighting - Comfortable temperature - Showers if able; oral care; hydrotherapy - Empty bladder every 2 hours; focus on positioning
39
Nursing Care **During** Birth Preparation of a sterile delivery table Perineal cleansing preparation Preparation for initial care & assessment of the newborn Administration of rx's as needed Important to be certified in neonatal resuscitation for those present
Nursing Care **After** Birth \* Immediate care & assessment of the neonate - Maintaining cardiopulmonary function - Supporting thermoregulation - Provide proper newborn identification \* Immediate care & assessment of the mother - Monitor for S/S of postpartum hemorrhage \> Fundus, bladder, lochia - Vital signs - Pain management
40
Promote Early Attachment First hour after birth "The Golden Hour" Infant can remain w/the parents for assessments Initiate breastfeeding, if desired; in 1st hour = positive effects Siblings can be introduced to the new family member Observe & document signs of early attachment Be cognizant of cultural variations

NUR 102 OB Assessment #1 (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions