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NURS 3800 > Intrapartal Period > Flashcards

Intrapartal Period Flashcards

0
Q

Intrapartal period begins with first sign if true labor when what happens?

A

Contractions cause cervix to change

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1
Q

What is the intrapartal period?

A

The time from the onset of true labor to the birth of the infant and delivery of the placenta

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2
Q

Are contractions regular or irregular during true labor?

A

Regular. They are regular contractions that increase in frequency, duration, and intensity

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3
Q

Series of processes by which the products of conception are expelled from the maternal uterus

A

Labor

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4
Q

Delivery is also known as….

A

Confinement,childbirth, parturition

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5
Q

What is the preferred pelvic shape for vaginal birth

A

Gynecoid pelvis

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6
Q

Characteristics of gynecoid pelvis

A

True female pelvis, 50% of women have it! inlet is round and outlet is roomy, most favorable for vaginal birth

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7
Q

Characteristics of anthropoid pelvis

A

Most common in men occurs in 25% of women, pelvic inlet is oval and the sacrum is long, producing a deep pelvis. Not as good as gynecoid but better than android and platypelloid

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8
Q

Characteristics of android pelvis

A

Considered male shaped pelvis. Funnel shape. Occurs in 20% of women. Pelvic inlet is heart shaped and the posterior segments are reduced in all pelvic planes. Prognosis for labor is poor leading to C/S

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9
Q

Characteristics of platypelloid pelvis

A

Flat pelvis, least common, 5% incidence, pelvic cavity is shallow but widens at the pelvic outlet making it difficult for fetus to descend through mid-pelvis. Poor labor prognosis

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10
Q

What is false pelvis composed of

A

Upper flared parts of the two iliac bones with their cavities and the wings of the base of the sacrum.

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11
Q

What divides false pelvis from true pelvis

A

Linea terminalis—-Imaginary line drawn from the sacral prominence at the back of the superior aspect of the symphysis pubis at the front of the pelvis.

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12
Q

What is above linea terminalis what is below it?

A

False pelvis is above, true pelvis is below

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13
Q

What are the parts of a true pelvis

A

Inlet, outlet, cavity

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14
Q

Why are joints and connective tissue more relaxed, elastic?

A

Under influence of relaxin (released from placenta) and estrogen (from placenta)

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15
Q

Diagonal conjugate is a ________ measurement

A

Manual

It’s an estimate

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16
Q

What is Subpubic angle to middle of sacral promontory? What is normal?

A

Diagonal conjugate

12.5 cm

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17
Q

What is obstetric measurement

A

(Estimate)Distance estimated from the diagonal conjugate subtract 1.5 cm to get the true measurement

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18
Q

Are we expecting the transverse diameter to be wider or narrower than the front to back measurement

A

We are expecting the transverse diameter to be wider than the front to back ( AP diameter)

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19
Q

Where does the coccyx move at?

A

Sacrococcygeal joint

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20
Q

What is the pelvic floor/diaphragm largely formed by

A

Levator ani muscles and coccygeal muscles

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21
Q

Changed shape of the fetal skull at birth as a result of overlapping of the cranial bones

A

Molding

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22
Q

What should you tell parents if they are concerned about the distortion of their newborns head?

A

Reassure the oblong shape is only temporary is usually all that is needed to reduce their anxiety

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23
Q

What does fetal lie refer to

A

Relationship of the cephalocaudal axis of the fetus and the cephalocaudal axis of the pregnant woman

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24
Q

What is the fetal lie most of the time

A

Longitudinal (99.5%) head or butt coming first

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25
Q

Relationship of fetal parts to one another

A

Fetal attitude

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26
Q

What is most common fetal attitude when labor begins?

A

With all joints flexed- the fetal back is rounded, the chin is on the chest, the thighs are flexed on the abdomen, and the legs are flexed at the knees

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27
Q

What are the three fetal presentations

A

Cephalic, breech, shoulder

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28
Q

What is fetal presentation determined by

A

Fetal lie and body part of fetus that enters the maternal pelvis first

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29
Q

The relationship of a given point on the presenting part of the fetus to a designated point on the maternal pelvis

A

Fetal position

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30
Q

What are the cephalic landmarks

A

Vertex
Occiput
Face= mentum (M), brow or military

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31
Q

Mentum also means

A

Chin

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32
Q

The chin (mentum) designates a ______ presentation

A

Face

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33
Q

Most common fetal position

A

Occiput anterior

34
Q

What are positions other than Occiput called

A

Malpositions

35
Q

What does a posterior position cause

A

More pain for mom, trauma for fetus, may prolong labor

36
Q

Blunted prominences, mark the narrowest diameter through which the fetus must pass

A

Ischial spines

37
Q

Presenting part BELOW the spine =assign _______ numbers

A

Positive numbers

38
Q

Presenting parts ABOVE spines = assign _______ numbers

A

Negative numbers

39
Q

What does +4 mean

A

Crowning

40
Q

Ischial spines are ___ station

A

“0” Station

41
Q

The largest part of the presenting part reaches or passes through the pelvic inlet

A

Engagement

42
Q

Where are fetal heart tones heard best

A

On back

43
Q

Largest area to pass through the inlet in a breech presentation

A

Intertrochanteric diameter

44
Q

Flexed, in a cephalic presentation, largest part of fetal skull to pass through pelvis

A

Biparietal diameter

45
Q

The fetal head is freely movable above the inlet

A

Floating

46
Q

Just before engagement occurs, the head begins to descend into inlet

A

Dipping

47
Q

Rebound of fetus in response to push against woman’s cervix

A

Ballottment

48
Q

What questions does Leopolds Maneuvers answer

A
  • what fetal part (head or buttocks) is located in the fundus?
  • on which maternal side is fetal back located?
  • what is the presenting part?
  • is the fetal head flexed and engaged in the pelvis?
49
Q

Primary contractions are known as ________ contractions

A

Involuntary

50
Q

Secondary are _________ contractions

A

Voluntary

51
Q

3 parts of contraction

A

Increment= increase
Acme=strongest
Decrement= decreasing

52
Q

Period of increase in intensity. Longer than other two combined.

A

Increment

53
Q

Period of greatest intensity of a contraction

A

Acme

54
Q

Decreasing/ letting go period of the contraction

A

Decrement

55
Q

Timed from beginning of one contraction to the beginning of the next

A

Frequency

56
Q

Timed from beginning of one contraction until it ends

A

Duration

57
Q

Strength of a contraction

A

Intensity

58
Q

How can you tell intensity

A

Palpate uterine wall with fingers
Can be easily indented= mild
Cannot be indented= strong
Moderate in between

59
Q

You must have a _______ period between contractions

A

Resting

60
Q

What should you do with early decelerations

A

Just watch, turn on left side

61
Q

What happens with early deceleration

A

Happens with head compression then heart rate does back up after

62
Q

Are late decelerations okay?

A

No! Means there is uteroplacental insufficiency. The fetus is not responding after contraction has stopped squeezing

63
Q

What is going on with variable decelerations?

A

Umbilical cord compression

64
Q

when do you do assessments on the laboring mother in a low risk situation

A

Every 30 minutes during 1st stage

Every 15 minutes during 2nd and 3rd stages

65
Q

What are two things you can do to help a laboring mother

A

Encourage slow breathing

Offer support to decrease anxiety

66
Q

When should you check vitals on the mother during the laboring process

A

In between contractions

67
Q

After ROM what is the most precise way to monitor the fetus

A

Fetal Scalp Electrode

It is a direct ECG of the fetal heart rate

68
Q

What can be inserted into the uterus to give a true measurement of the strength of a contraction

A

Intrauterine pressure catheter

69
Q

What should a nurse and doctor try to eliminate if the woman is bleeding

A

Vaginal exams

70
Q

How do you preform vaginal exams differently if a woman has ROM and if she has not

A

If she has you must use sterile gloves

If she has not you can just use clean gloves

71
Q

What could pushing before woman is 10 cm dilated cause

A

Prolonged labor and more chance of a tear

72
Q

What are the different emotions the women will experience during the latent phase?
Active phase?
Transition phase?

A

Latent- talking, laughing, walking
Active- more quiet/sleepy
Transition- very irritable

73
Q

What is significant about the second stage

A

Baby is born

74
Q

Why would you obtain a fetal scalp blood sample during labor

A

If baby is having decreased HR you need to see if it is affecting the fetus

75
Q

Fetal fibronectin

A

Glycoprotein produced by trophoblast and other fetal tissues

76
Q

What is fetal fibronectin a strong predictor of

A

Preterm labor if found in cervicovaginal secretions between 24-34 weeks

77
Q

Why do you need to obtain a lecithin/sphingomyelin sample

A

Make sure baby does not have RDS due to lack of surfactant

78
Q

What is phosphatidylglycerol

A

A phospholipid found in surfactant

Often obtained with the lecithin/sphingomyelin ratio

79
Q

When is best to ambulate with laboring mother

A

First stage

80
Q

Abruptio placenta

A

Placenta tears from uterine wall abruptly

81
Q

Uterine atony

A

Failure for uterus to contract properly

82
Q

If you are inducing a women into labor with oxytocin and within an hour her contractions are lasting 60-90 seconds and coming every 3 minutes what is the first action you would do

A

Stop oxytocin immediately

83
Q

What are four things you can do to help mother with comfort during labor

A

Change bed linens
Empty bladder
Keep feet warm
Coach with breathing

NURS 3800 (19 decks)

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