Brainscape's Knowledge GenomeTM

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


See full index

TEST 2 > Intrapartum > Flashcards

Intrapartum Flashcards

1
Q

Labor is a physiological event, involving sequential changes within the

A

myometrium, decidua, & cervix

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

Name the 6 signs of PREMONITORY SIGNS OF LABOR

( s/s labor is near)

A
  • Cervical Changes
  • Lightening- Fetus descend into true pelvis
  • INCR. Energy Level
  • Bloody Show
  • Braxton Hicks Contr.
  • SROM
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Cervical changes (dilation) occur

A

1 month - 1 hr BEFORE labor begins.

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

Cervical changes include

A
  • Shortened, thinned segment
  • Effacement - softer, more stretchable
  • Dilation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Lightening may occur

A

2 weeks or more bEFORE labor begins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

S/S of lightening occuring

A
  • Improvement in breathing
  • May experience:
    -increase Pelvic pressure
    -Leg cramping
    -Dependent edema Lower extremities
  • Low back discomfort
    -increase Vaginal discharge
  • Urinary frequency
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

INCREASE in energy levels

A
  • occurs 24 - 48 hrs BEFORE onset of labor
  • Mom begins to prep for childbirth
  • Increase of epinephrine, decr of progesterone
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Increased energy levels is called

A

NESTING

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

BLOODY SHOW sign of labor

A
  • pressure ruptures cervical capillaries
  • Expulsion of Mucous plug
  • Mucus and blood mix= Pink-tinged secretions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What do Braxton Hicks Contractions do?

A
  • become STRONGER AND MORE FREQUENT
  • FUNDUS feels Tightening or pulling sensation
  • felt in abdomen & groin then spread downward
  • Cervix moves from post. to ant. position.
  • Assist w/ cervical ripening & softening
  • Irregular
  • Last 30 secs to 2 min.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Spontaneous Rupture of Membranes (SROM) is

A
  • rupture of membranes with loss of amniotic fluid prior to the onset of labor.
  • begin labor w/i 24 hrs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

WHat to expect during SROM sign of labor

A
  • labor begins within 24 hrs
  • Sudden gush or a steady leakage of amniotic fluid
  • Risk for infection & Danger of cord prolapse
  • Advise women to notify HCP & get evaluated
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

True vs false labor

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

Factors Affecting the Labor Process

A
  • Passanger (Fetus and placenta)
  • PASSAGEWAY (maternal pelvis and soft tissues)
  • POWERS (contraction)
  • Position (moms position)
  • psyche
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

different types of pelvic shape becomes determining factor for

A

vaginal birth.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Pelvis shape is determined by 4 MAIN SHAPES

A
  1. GYNECOID
  2. ANTHROPOID
  3. ANDROID
  4. PLATYPELLOID
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

TYPE OF PELVIS:

  • True female pelvis
  • Less common in men
  • Most favorable for VB
  • Allows early & complete fetal internal rotation during labor
A

GYNECOID PELVIS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

TYPE OF PELVIS:

  • Common in men & non-white women.
  • ‘Deep pelvis’- oval inlet & long sacrum
  • Wider AP diameter than transverse)
A

ANTHROPOID PELVIS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

TYPE OF PELVIS:

  • Male-shaped pelvis
  • Funnel shape
  • Slow fetal head decent
  • Failure of fetus to rotate
  • Poor prognosis for VB, lead to CS
A

ANDROID PELVIS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

TYPE OF PELVIS:

  • Least common type
  • Difficult for fetus to descend
  • Labor prognosis is poor
  • Frequent arrest at inlet
  • Not favorable for VB
A

PLATYPELLOID (FLAT) PELVIS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Important PASSANGER factors are -

A
  • Fetal head (size & presence of molding)
  • Fetal attitude (POSTURING: degree of body flexion)
  • Fetal lie (SPINE of fetus vs SPINE of mother)
  • Fetal presentation (first body part in inlet- Presentation part)
  • Fetal position (relationship to maternal pelvis)
  • Fetal station
  • Fetal engagement (head in pelvic inlet)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Fetal Head factors

A
  • Cranial bones
    -Not fused, soft & pliable
    -2 frontal, 2 parietal, & 1occipital bone
  • Sutures present (gaps b/t cranial bones)
  • Molding: elongated shape of fetal sjull at birth
  • Caput Succedaneum- Fluid collection in the scalp
  • Cephalohematoma- Blood collection beneath scalp
    -reabsorbed over 6-8 weeks
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Fetal head diameter include

A
  1. Occipitofrontal
  2. Occipitomental
  3. Suboccipitobregmatic (9.5 cm)
  4. Biparietal (9.25 cm at term)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Fetal Head Diameters:

  • Largest transverse diameter of fetal skull
  • Distance between two parietal bones
A

Biparietal diameter
9.25 cm at birth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is CEPHALIC PRESENTATION

A
  • HEAD-FIRST presentation- in pelvis
  • occurs in 95% of all term births.
  • “Vertex”
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Most common Fetal attitude

A

Flexion:

* All joints flexed
-Back rounded
-Chin on chest
-Thighs flexed on abdomen
* Legs flexed at knees
* Most favorable for vaginal birth
* Smallest fetal parts presents to pelvis first

anything outside these norms is considered ABNORMAL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

There are 3 possible Fetal Lies

A
  1. longitudinal
  2. transverse
  3. oblique
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Which Fetal Lie is the MOST COMMON

A

longitudinal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

THe main 3 FETAL PRESENTATIONS

A
  1. CEPHALIC/VERTEX (head fist)
  2. BREECH (pelvis/butt first)
  3. SHOULDER (scapula /shoulder first)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Cephalic (also known as the VERTEX) presentation has 3 different variations.

Name them

A
  1. Military
  2. brow
  3. Face

basically 3 ways the baby’s head can come out during the CEPHALIC presentation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Most common fetal presentation is?

A

Cephalic presentation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Breech fetal presentation is when

A

Fetal buttocks or feet come FIRST

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Challenges at birth with a breeched baby

A
  1. Largest part (skull) becomes stuck in pelvis
  2. umbilical cord compressed (stops O2 to baby)
  3. buttocks are not cervical dilators (pelvis does not open more)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Breeched babys are associated with

A
  • prematurity
  • placenta previa
  • uterine abnormalities (fibroids)
  • congenital anomalities
  • possible trauma to head.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Shulder fetal presentation

A
  • Presents shoulders
  • Turtle sign- head slowly emerges into perineum but then retrachs back into vagina
  • TRANSVERSE LINE POSITION
  • Rare: 1 in 300
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
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.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Fetal position:

The landmark fetal PRESENTING PARTS include:

4 total

A
  • Occipital bone (O) - Vertex
  • Chin (Mentum [M]) - Face
  • Buttocks (Sacrum [S])- Breech
  • Scapula (Acromion [A]) - Shoulder
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Documenting:

Vertex Fetal presentation

A

Occipital bone (O)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Documenting:

Chin Fetal presentation

A

Mentum [M]-
FACE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Documenting:

Buttocks fetal presentation

A

Sacrum [S]
“Breech”

41
Q

Documenting:

Shoulder fetal presentation

A

Acromion [A]-
Scapula

42
Q

Fetal position:

Maternal pelvis is divided in 4 quadrants

A
  • Right anterior (RA)
  • Left anterior (LA)
  • Right posterior (RP)
  • Left posterior (LP)
43
Q

Fetal position FIRST LETTER is

A

First letter:

  • Left (L)
  • Right (R)
44
Q

Fetal position SECOND LETTER is

A

SECOND LETTER:

  • O - Occiput
  • S - Sacrum
  • M - Mentum
  • A - Acromion Process
  • D -Dorsal (fetal back)
45
Q

Fetal position THIRD LETTER is

A

Third letter

  • Anterior (A)
  • Posterior (P)
  • Transverse (T)
46
Q

Relationship of fetal presenting part to level of maternal pelvic ischial spines

A

FETAL STATION

47
Q

Fetal station is measured in

48
Q

above ischial spine the numbers are

A

negative -1 to -4

49
Q

below ischial spine the numbers are

A

positive
+1 to +4

50
Q

The entrance of largest fetal presenting part into smallest diameter of maternal pelvis.

A

Fetal head engagement

51
Q

Fetal head engagement

A
  • Engaged AT zero station.
  • Determined by pelvic exam
  • largest diameter of fetal head = biparietal diameter
  • Transverse diameter of maternal pelvis
52
Q

Fetal HEAD Engagement occurs

A

typically occurs in:
* PRIMIGRAVIDAS 2 weeeks before term
or
* multiparas- several weeks BEFORE onset of labor or not until labor starts.

53
Q

When fetal engagement has not occurred bc the presenting part is still freeliny moving above pelvic inlet

54
Q

Fetal positional changes as it travels through the passageway

A

CARDINAL MOVEMENTS

55
Q

Name the 6 cardinal movements

A
  1. Descent
  2. flecion
  3. internal rotation
  4. extension
  5. external rotation (restitituion)
  6. expulsion
56
Q

Cardinal movement:

downward movmnt of fetal heat.

57
Q

What causes DESCENT movement

A
  • contractions
  • Pressure of amniotic fluid
  • Pressure of fundus on fetus’s buttocks or head
  • Contractions of abdominal muscles (2nd stage)
  • Extension & straightening of fetus
58
Q

Cardinal movement:

  • vertex meets resistance from cervix, walls of pelvis or pelvic floor.
  • Chin TO fetal thorax
59
Q

Cardinal movement:

  • fetal heat (occiput part) meets resistance from one side of pelvic floor.
  • Head then rotates 45 degrees anteriorly to the midline under symphasis

q

A

Internal rotation

60
Q

Cardinal movement:

  • Head emerges under symphysis pubis along with shoulders
61
Q

cardinal movements:

  • Allows internal rotation of shoulders to fit maternal pelvis
A

external rotation

62
Q

cardinal movements:

  • Reducing risk of perineal injury
  • Manual control of fetus expulsion
  • Perineal support by HCP
63
Q

The primary powers in labor are

A

uterine contractions
(involuntary)

64
Q

the secondary powers in labor are

A

use of intra-abdominal pressure

65
Q

What can interfer with intra-abdominal pressure?

A
  • sedated or extremely anxious
  • compromise effectiveness of powers.
66
Q

what is EFFACEMENT

A

the cervix stretches and gets thinner

67
Q

Effacement:

  • 2 cm cervix lenght=
  • 1 cm cervix length =
  • 0 cm cervix length =
A
  • 0% effaced
  • 50% effaced
  • 100% effaced
68
Q

What is Dialation

A

the diameter of the Cervical os increases from 1 cm to 10 cm.

69
Q

Uterine contractions:

Early Labor – (Mild) contractions:

A
  • Last 30 secs
  • Occur every 5 to 7 min.
70
Q

Uterine contractions:

As labor progresses – (Moderate to High) contractions:

A

Last 60 secs, Occur Q 2 to 3 min.

71
Q

Information to ask when monitoring and assessing uterine contractions

A
  • Frequency - How often
  • Duration - How long it lasts
  • Intensity - How Strong
72
Q

best labor maternal POSITION

73
Q

2 ways to manipulate and speed up the process of labor through medical means.

A
  1. AROM (amniotomy)
  2. Synthetic Oxytocin (Pitocin)
74
Q

Induction of labor:

Used when Fetal head is -2 station or lower with cervix dialated at 3 cm

A

AROM
artificial rupture of membranes
(amniotomy)

75
Q

Induction of labor:
* Stimulates uterin contractions.
* administered piggyback into primary IV lines w/ an infussion pump titrated to uterine activity

A

Synthetic Oxytocin (pitocin)

76
Q

Pain management

A
  • Pain universal
  • No negative effect on Fetus
77
Q

Maternal Physioilogic responses include INCREASE of what VS

A
  • HR - 10 to 20 bpm.
  • CO - 12% to 31% , 50% 2nd stage
  • BP - 35 mm Hg with contractions
  • WBC - 25,000 to 30,000 cells/mm3
  • RR
  • Temp.
  • BMR
78
Q

Maternal Physioilogic responses include DECREASE of what VS

A
  • Blood glucose
  • Gastric motility & food absorption
  • Gastric emptying & gastric pH
  • Muscular aches and cramps
79
Q

Respiratory changes during labor prepare fetus for

A

extrauterine respiration immediately after birth.

80
Q

labor is divided into _____ stages

A

4 stages.

  • 1st stage
  • 2nd stage
  • 3rd stage
  • 4th stage
81
Q

FIRST stage has two phases

A

latent phase
Active phase.

82
Q

what happens in first stage- latent phase?

A
  • From start of reg. cont. to cervical dilation
  • Cervix dilates 6 cm (sedation prolongs)
  • Contractions:
    -Q 5 to 10 min.
    -Last 30 to 45 secs
    -Mild pain
  • Effacement of cervix - 0% to 40%.
  • May stay home
  • Contacting their hcp
83
Q

What happens in first stage-

active phase?

A
  • Complete (10 cm) Cervical dilation
  • Effacement complete
  • Rate of 1.2 to 1.5 cm/hr
  • Fetus descends in pelvis.
  • Contractions:
    -Q 2 to 5 mins
    -Last 45 to 60 secs
    -Moderate to strong
  • Use relaxation & paced breathing
84
Q

2nd stage is called the

A

pushing stage

85
Q

What happens in the 2nd stage

A
  • From complete dilation to birth of infant
  • Lasts up to 3 hours
  • Contractions:
    -Q 2-3 min or less,
    -Lasts 60-90 sec.
    -Strong Intensity
    -Urge to Push
86
Q

Two ways of conducting the second stage of labor.

2 ways of pushing

A
  1. Directive pushing
  2. spontaneous pushing
87
Q

Pushing directed by caregiver
epidural associated
May be harmful

A

directed pushing

88
Q

Pushing that:
* Follow mother’s natural urge
* Natural way of managing second stage
* Delay pushing until woman feels an urge to push

A

spontaneous pushing

89
Q

Stage that begins with the birth of newborn and ends with separation and birth of placenta.

A

Third stage

90
Q

Third stage consists of two PHASES

A
  1. placental separation
  2. placental expulsion
91
Q

What to know about placental separation

A
  • Within 5-30 min post-delivery
  • Contractions cause the placenta to pull AWAY from uterine wall.
  • Signs of separation that placenta is ready to deliver:
    -Uterus rises upward
    -Umbilical cord lengthens
    -Sudden gush or trickle of blood
    -Change in uterine shape

f

92
Q

Placental expulsion:

A
  • Expelled within 2 to 30 minutes
  • Massage uterus till FIRM
  • Normal blood loss - Over 1,000 ml - SEVERE
  • If placenta DOES NOT deliver, HCP will assist with removal called MANUAL EXTRACTION
93
Q

SPONTANEOUS DELIVER OF PLACENTA OCCURS IN TWO WAYS

A
  1. fetal side or
  2. maternal side
94
Q

Placenta delivery:

  • shiny gray side presenting first
  • Called the SHINY SCHULTZ
A

fetal side placental delivery

95
Q

Placenta delivery:
* red raw side
* ridges
* Called duncan mechanism (dirty duncan)

A

maternal side

96
Q

Begins with completion of the expulsion of the placenta and membranes and ends with the physiologic adjustment and stabilization of the mother.

A

FOURTH STAGE.

97
Q

FOURTH STAGE

A
  • 1-4 Hrs POST birth
  • initiates POST PARTUM period
  • Uterus: Should be firm & well contracted
98
Q

Focus of Care during FOURTH STAGE

A
  • Monitor uterus & bleeding
  • Watch for bladder distention & Venous thrombosis
  • Attachment promotion

TEST 2 (6 decks)

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