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MCN > Intrapartum > Flashcards

Intrapartum Flashcards

1
Q

Series of events by which uterine contractions and abdominal pressure expels the fetus and other by products of pregnancy via the birth canal

A

Labor

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2
Q

Descent and settling of the fetal head into the pevis

A

Engagement

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3
Q

Spaces b/n bones of the fetal head

A

Fontanels

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4
Q

Division b/n bones f the fetal head

A

Sutures

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5
Q

What are the 5 theories in labor

A
  1. Uterine stretch theory
  2. Oxytocin theory
  3. Progesterone deprivation theory
  4. Prostaglandin cascade theory
  5. Theory of aging placenta
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6
Q

The idea of this theory is based on the concept that any hollow body organ, when stretched to its capacity will inevitably contract to expel its contents

A

Uterine stretch theory

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7
Q

According to this theory, the uterus, a hollow organ, bcms stretched due to the growing fetal structures, in return, the pressure increases causing physiologic changes (uterine contractions) that initiate labor.

A

Uterine stretch theory

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8
Q

According to this theory, pressure on the cervix stimulates the hypophysis to release oxytocin from the maternal posterior pituitary gland.

A

Oxytocin theory

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9
Q

What is released due to the pressure on the cervix which would then stimulate the hypophysis to release it

A

Oxytocin

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10
Q

The presence of this hormone causes the initiation of contraction of the smooth muscles of the body

A

Oxytocin

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11
Q

According to this theory, progesterone has the ability to inhibit motility, thus, if its amount decreases, labor pains occur

A

Progesterone deprivation theory

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12
Q

This hormone is designed to promote pregnancy and is believed to inhibit uterine motility

A

Progesterone

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13
Q

What theory indicates that increase in prostaglandin causes uterine contraction thus, labor is initiated

A

Prostaglandin Cascade theory

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14
Q

What hormone does fetal membrane and uterine increase?

A

Prostaglandin

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15
Q

A decrease in progesterone amounts also elevates what hormone?

A

Prostaglandin

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16
Q

According to this theory, Uterine contractions is caused by the decrease in blood supply to the uterus due to advance placental age

A

Theory of aging placenta

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17
Q

What are the 6 steps in initiation of labor

A
  1. Baby moves deeper into mother’s birth canal
  2. Pressoreceptors in cervix of uterus excited
  3. Afferent impulses to hypothalamus
  4. Hypothalamus sends efferent impulses to posterior pituitary, where oxytocin is stored
  5. Posterior pituitary releases oxytocin to blood; oxytocin targets mother’s uterine muscle
  6. Uterus responds by contracting more vigorously
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18
Q

What are the 7 preliminary signs of labor

A
  1. lightening
  2. activity level
  3. braxton hick’s contraction
  4. overt loss of weight
  5. ripening of cervix
  6. Buttersoft ruptured BOW
  7. Show
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19
Q

Does activity during labor increase or decrease?

A

Increase

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20
Q

Does false labor would later on turn into true labor?

A

Yes

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21
Q

False labor or True labor:
Contractions remain irregular

A

False labor

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22
Q

False labor or True labor:
Contractions may be slightly irregular at first but become regular and predictable in a matter of hours

A

True labor

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23
Q

False labor or True labor:
The pain is generally confined to the abdomen

A

False labor

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24
Q

False labor or True labor:
The pain is first felt in the lower back and sweep around to the abdomen in a girdle like fashion

A

True labor

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25
Q

False labor or True labor:
There is no increase in contractions in terms of duration, frequency, and intensity. Interval remain long

A

False labor

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26
Q

False labor or True labor:
There is an increase in contractions in terms of duration, frequency, and intensity. Intervals remain short

A

True labor

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27
Q

False labor or True labor:
Contractions often disappear if the mother ambulates, relieved when walking

A

False labor

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28
Q

False labor or True labor:
Contractions continue no matter what the woman’s level of activity and is not relieved by walking

A

True labor

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29
Q

False labor or True labor:
Absent cervical changes

A

False labor

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30
Q

False labor or True labor:
Accompanied by cervical effacement and dilation

A

True labor

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31
Q

False labor or True labor:
Absent or brownish discharge

A

False labor

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32
Q

False labor or True labor:
Show:present:pink tinged

A

True labor

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33
Q

What is considered as the Passenger

A

Fetus

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34
Q

It is the largest part of the fetal body, most frequent presenting part, and least compressible of all parts

A

Fetal head

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35
Q

Alteration of the shape of fore-coming head while passing through the resistant birth passage during labor

A

Moulding

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36
Q

What are the 4 sutures of the fetal head

A
  1. Sagittal or longitudinal
  2. Coronal
  3. Frontal
  4. Lambdoid
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37
Q

Suture b/n the two parietal bones

A

sagittal or longitudinal suture

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38
Q

Suture b/n parietal and frontal bones on either side

A

Coronal suture

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39
Q

Suture b/n two frontal bones

A

Frontal suture

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40
Q

Suture that separates occipital bone and the two parietal bones

A

Lambdoid sutures

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41
Q

Wide gap in the suture line

A

Fontanel

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42
Q

What are the two fontanels

A

Anterior and Posterior fontanels

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43
Q

This fontanel has a diameter of 3 cm

A

Anterior

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44
Q

When is the ossification of the anterior fontanel

A

18 months after birth

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45
Q

This fontanel is found on the junction of sagittal suture anteriorly and lambdoid suture on either side

A

Posterior fontanel

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46
Q

The measurement of this fontanel is 1.2 x 1.2 cm

A

Posterior fontanel

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47
Q

When does the posterior fontanel close

A

3-4 months after birth

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48
Q

In the transverse diameter of the fetal head, what is the measurement of:
Biparietal:__________
Bitemporal:_________
Bimastoid:___________

A

Biparietal: 9.25cm
Bitemporal:8 cm
Bimastoid: 7 cm

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49
Q

In the anterior-posterior diameter of the fetal head, what is the measurement of:
Suboccipitobregmatic:
Occipitofrontal:
Occipitomental:
Subementobregmatic:

A

Suboccipitobregmatic: 9.25 cm
Occipitofrontal: 12 cm
Occipitomental: 13.5 cm
Subementobregmatic: 9.5 cm

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50
Q

What is the smallest AP diameter

A

Suboccipitobregmatic

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51
Q

This is when the mother is having difficulty in labor; the fetal head goes in and out repeatedly resulting in an elongated fetal head

A

Caput succedaneum

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52
Q

Formation of diffuse, boggy swelling due to stagnation of sero-sanguineous fluid in the layers of the scalp beneath girdle of contract crossing midline suture

A

Caput succedaneum

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53
Q

the formation of diffuse, boggy swelling in caput succedaneum is due to the stagnation of?

A

sero-sanguineous fluid

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54
Q

Refer to the fetal part that is above the pelvic inlet

A

Fetal presentation

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55
Q

What are the three types of fetal presentation

A
  1. Cephalic
  2. Breech
  3. Shoulder
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56
Q

It is also called as the mucus plug

A

Operculum

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57
Q

What are the 4 types of cephalic presentation

A
  1. Vertex
  2. Brow
  3. Face
  4. Mentum (sinciput or military presentation)
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58
Q

What are the 3 types of breech presentation

A

1.Complete
2. frank
3. footling

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59
Q

This presentation is where the head is showing first

A

Cephalic presentation

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60
Q

This presentation is where the head is showing first

A

Cephalic presentation

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61
Q

This presentation is where the butt or foot of the fetus is showing

A

Breech presentation

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62
Q

This presentation is where the butt or foot of the fetus is showing

A

Breech presentation

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63
Q

This presentation is where the fetus is lying transveraslly

A

Shoulder presentation

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64
Q

What are the two types of shoulder presentation

A

1.acromium
2. Hand or elbow

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65
Q

Relationship of the long axis (spine) of the fetus to the long axis of the mother

A

Fetal lie

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66
Q

Three types of fetal lie

A

Longitudinal
Transverse
Oblique

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67
Q

The relationship of the fetal parts to one another

A

Attitude or Habitus or Posture

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68
Q

True or false:
The fetus forms an ovoid mass that corresponds to the shape of the uterine cavity

A

True

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69
Q

What are the 4 fetal attitudes

A

Complete flexion
Moderate flexion
Poor flexion
Full flexion

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70
Q

Relationship of he fetal reference point to specific quadrant of the mother’s pelvis

A

Fetal Position

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71
Q

Identify what each letter means according to fetal position:
L-
R-
Fetal presentation:
O-
M-
Sa-
A-
Fetal landmark:
A-
P-
T-

A

L- Left
R- Right
Fetal presentation:
O- Occiput
M- Mentum
Sa- Sacrum
A- Acromium
Fetal landmark:
A- Anterior
P- Posterior
T- Transverse

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72
Q

In Fetal position, what are the first letters

A

L or R

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73
Q

In Fetal position, what are the second letters

A

O, M, Sa or A

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74
Q

In Fetal position, what are the third letters

A

A, P or T

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75
Q

4 parts of fetus as landmarks:
VERTEX – (2)
BREECH – (1)
SHOULDER – (2)

A

VERTEX – OCCIPUT, MENTUM
BREECH – SACRUM
SHOULDER – SCAPULA, ACROMIUM PROCESS

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76
Q

Measure of descent of
the presenting part

A

Station

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77
Q

What part is considered as station 0

A

Pelvic inlet / Ischial spine

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78
Q

If the fetus is on stations -3, -2, -1, the fetus is what?

A

Floating

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79
Q

If the fetus is on stations +3, +2, +1, the fetus is what?

A

At outlet / nearing in delivery

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80
Q

What stations are considered as the inlet

A

-3 and -2

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81
Q

What stations are considered as the midpelvis

A

-1, 0, +1

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82
Q

What stations are considered as the outlet

A

+2 and +3

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83
Q

when the widest part of the baby’s presenting part (usually the head) enters the pelvic brim or inlet

A

Fetal Engagement

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84
Q

Invisible line that is b/n the true and false pelvis

A

Linea Terminalis

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85
Q

What is the direction of the upper part and lower part of the passageway

A

Upper: Downward backward
Lower: Downwards forward

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86
Q

Superior half of the pelvis

A

FALSE PELVIS

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87
Q

Supports the uterus during late months pregnancy

A

FALSE PELVIS

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88
Q

Aids in directing the fetus into the true pelvis

A

FALSE PELVIS

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89
Q

Inferior half of the pelvis

A

TRUE PELVIS

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90
Q

Imaginary line from sacral prominence at the back of the pelvis to the superior aspect of the symphysis pubis at the from

A

LINEA TERMINALIS

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91
Q

Also called as Pelvic Brim (Pelvic Inlet)

A

LINEA TERMINALIS

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92
Q

3 major parts of the pelvic passageway

A
  1. PELVIC INLET
  2. PELVIC OUTLET
  3. PELVIC CAVITY
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93
Q

Part of the pelvic passageway:
Entrance to the true pelvis

A

PELVIC INLET

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94
Q

Part of the pelvic passageway:
At the level of Line terminalis

A

PELVIC INLET

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95
Q

Part of the pelvic passageway:
Appears heart shaped

A

PELVIC INLET

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96
Q

Part of the pelvic passageway:
Wider transversely than anterio-posterior diameter

A

PELVIC INLET

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97
Q

Part of the pelvic passageway:
Inferior Portion

A

PELVIC OUTLET

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98
Q

Part of the pelvic passageway:
At the level of Linea terminalis

A

PELVIC OUTLET

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99
Q

Part of the pelvic passageway:
Greatest Diameter is the anterio-posterior diameter

A

PELVIC OUTLET

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100
Q

Part of the pelvic passageway:
Mid pelvis

A

PELVIC CAVITY

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101
Q

Part of the pelvic passageway:
Curved Passage to slow down and control speed of birth

A

PELVIC CAVITY

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102
Q

the only way to assess the dimensions of the pelvis in labor.

A

CLINICAL PELVIMETRY

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103
Q

What are the 3 AP diameters of the pelvic inlet

A
  1. Diagonal Conjugate
  2. Obstetric Conjugate
  3. Conjugate Vera
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104
Q

AP diameter between anterior sacral prominence and posterior Symphysis Pubis

A

Diagonal Conjugate

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105
Q

What is the measurement of the Diagonal Conjugate

A

Measurement: 12.5cm to 13cm

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106
Q

Smallest AP Diameter

A

Obstetric Conjugate

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107
Q

AP diameter that is a Sacral promontory to the inner surface of the symphysis pubis

A

Obstetric Conjugate

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108
Q

How is the Obstetric Conjugate solved?

A

OC= DC – (1.5 to 2cm)

109
Q

What is the measurement of the Obstetric Conjugate?

A

Measurement: 10.5cm – 11cm

110
Q

AP diameter that is Between the posterior aspect of the symphysis pubis and the promontory of the sacrum

A

Conjugate Vera

111
Q

How is the Conjugate Vera solved?

A

CV= DC– (1 to 1.5cm)

112
Q

What is the measurement of the Conjugate Vera?

A

Measurement: 10.5 – 11 cm

113
Q

The pelvic inlet diameter that is the greatest Distance between the linea terminalis on either side

A

Transverse Diameter

114
Q

The pelvic inlet diameter that is the Segment posterior to the intersection

A

Transverse Diameter

115
Q

The pelvic inlet diameter that Facilitates the descent of fetal head

A

Transverse Diameter

116
Q

What is the measurement of Transverse Diameter of the Pelvic Inlet

A

Measurement: 13.5 cm

117
Q

The pelvic inlet diameter that Extends from sacroiliac joint on one side to ilio eminence on other side

A

Oblique Diameter

118
Q

What are the two sides of the Oblique Diameter of the Pelvic Inlet

A

Left OD
Right OD

119
Q

What are the two points of the pelvic inlet that indicates the oblique diameter

A

sacroiliac joint on one side to ilio eminence on other side

120
Q

What is the measurement of Oblique Diameter of the Pelvic Inlet

A

Measurement: 13 cm

121
Q

The pelvic Cavity diameter is Mid-symphysis to fused S2, S3

A

AP Diameter

122
Q

What is the measurement of the AP diameter of the pelvic cavity

A

Measures: 11.5 to 12 cm

123
Q

The Transverse or Interspinous Diameter is found b/n the base of what?

A

Between the base of ischial spines

124
Q

The pelvic Cavity diameter that is the Smallest Diameter of pelvis

A

Transverse or Interspinous Diameter

125
Q

What is the measurement of the Transverse or Interspinous Diameter of the pelvic cavity

A

Measures: 10cm

126
Q

The pelvic Cavity diameter is the Midpoint between ischial spines and sacrum

A

Posterior Sagittal Diameter

127
Q

What is the measurement of the Posterior Sagittal Diameter of the pelvic cavity

A

Measures: 4.5 to 5 cm

128
Q

The AP Diameter of the pelvic outlet is on the Inferior border of ________ to posterior aspect of ___________

A

pubic symphysis
sacrum tip

129
Q

What is the measurement of the AP Diameter of the Pelvic Outlet

A

Measures: 9.5 to 11.5 cm

130
Q

The Transverse or Interspinous Diameter is found b/n the base of inner edges of what?

A

ischial tuberosities

131
Q

What is the measurement of the Transverse or Interspinous Diameter of the Pelvic Outlet

A

Measures: 9 to 11cm

132
Q

The Posterior Sagittal Diameter is found at midpoint b/n ___________ and ___________ of the tip of the sacrum

A

ischial tuberosities
external surface

133
Q

What is the measurement of the Posterior Sagittal Diameter of the Pelvic Outlet

A

Measures: 7.5 cm

134
Q

A disorder where a pelvis with a measurement of less than 1.5 to 2 cm in any of its important diameters

A

CONTRACTED PELVIS

135
Q

Contracted Pelvis is suspected if:
✓ __________ has not yet taken place after 37 weeks in primis
✓ there is a history of ______, _______ and _______ in multi

A

lightening
stillbirth
difficult labor
forceps delivery

136
Q

Contracted pelvis is suspected if lightening has not yet taken place after how many weeks in primis?

A

37 weeks

137
Q

True or false:
Mothers with contracted pelvis can still have a vaginal delivery?

A

False

138
Q

Refer to the force generated by the contraction of the uterine myometrium

A

Power Uterine contractions

139
Q

Power Uterine contractions refer to the force generated by the contraction of the __________

A

uterine myometrium

140
Q

3 types of Power Uterine contractions

A

Mild
Moderate
Strong

141
Q

A power where uterine muscle are somewhat tense but can be indented by a gentle pressure

A

Mild

142
Q

A power where uterus is moderately firm and a firmer pressure is needed to indent

A

Moderate

143
Q

A power where the uterus becomes very firm that at the height of contraction cannot be indented

A

Strong:

144
Q

The abdomen of the mother is compared to be _____________ when she is having strong power uterine contractions

A

board-like

145
Q

2 kinds of Power

A
  1. PRIMARY POWER
  2. SECONDARY POWER
146
Q

Primary or Secondary power:
* Physiologic
* Involuntary urge
* Uterine muscular contractions
* Measurable

A

PRIMARY POWER

147
Q

Primary or Secondary power:
* Psychologic
* Voluntary urge
* Use of abdominal muscles to push

A

SECONDARY POWER

148
Q

PHASES OF CONTRACTION

A

o Increment
o Acme
o Decrement

149
Q

A phase of contraction when the intensity of the contraction increases

A

Increment

150
Q

A phase of contraction when the contraction is at its strongest

A

Acme

151
Q

A phase of contraction when the intensity decreases

A

Decrement

152
Q

Between contractions, the
uterus ________

A

Relaxes

153
Q

What labor is where the cervix is at 0 - 3 cm

A

LATENT-EARLY LABOR

154
Q

What labor is where the cervix is at 4 -7 cm.

A

ACTIVE LABOR

155
Q

What labor is where the cervix is at 8 -10 cm

A

TRANSITION LABOR

156
Q

LATENT-EARLY LABOR
Duration: ____________secs
Frequency: ________ mins

A

Duration: 20-40 secs
Frequency: 5-10 mins

157
Q

ACTIVE LABOR
Duration: ____ secs
Frequency: _____ mins
___ hr ____hr

A

Duration: 40-60 secs
Frequency: 3-5 mins
3 hr 2 hr

158
Q

TRANSITION LABOR
Duration: ____ secs
Frequency: _____ mins

A

Duration: 60-90 secs
Frequency: 2-3 mins

159
Q

What power uterine contraction is experienced in latent-early labor

A

Mild

160
Q

What power uterine contraction is experienced in active labor

A

Moderate

161
Q

What power uterine contraction is experienced in Transition labor

A

Strong

162
Q

What Power and Labor is this:
Excited, euphoric with some apprehension but still with ability to communicate

A

MILD
LATENT-EARLY LABOR

163
Q

What Power and Labor is this: Takes up 6 - 12-hour 1ST stage

A

MILD
LATENT-EARLY LABOR

164
Q

What Power and Labor is this:
Mother fears losing control of herself

A

MODERATE
ACTIVE LABOR

165
Q

What Power and Labor is this:
Feeling of losing control, anxiety, panic, irritability

A

STRONG
TRANSITION LABOR

166
Q

What Power and Labor is this:
Perspiration, neck vein distention

A

STRONG
TRANSITION LABOR

167
Q

What Power and Labor is this:
N and v due to decreased gastric motility, urge to push

A

STRONG
TRANSITION LABOR

168
Q

In the contour changes of the uterine, it is separated by what?

A

physiologic retraction ring

169
Q

What portion of the uterine becomes thicker and active during labor

A

Upper portion

170
Q

What portion of the uterine becomes thin-walled,
supple, and passive during labor

A

Lower portion

171
Q

Uterine Changes
o Contour changes
- Round, ovoid uterus to _________

A

elongate

172
Q

What are the two Cervical Changes

A

Effacement
Dilatation

173
Q

A cervical change that is the Shortening and thinning of the cervical canal

A

Effacement

174
Q

Why must effacement occur at the peak of dilation

A

cervical tearing may happen

175
Q

When does effacement happen in primipara

A

occur before cervical dilation

176
Q

A cervical change where there is Enlargement or widening of the cervix canal

A

Dilatation

177
Q

What are the 2 main methods of cervical ripening

A

Non-Pharmacologic methods
Pharmacologic methods

178
Q

What are the 3 Non-Pharmacologic methods

A

Membrane stripping
Foley bulb
Amniotomy

179
Q

A Non-Pharmacologic method where it needs favorable cervix, if cervix is favorable it can get labor started

A

Amniotomy

180
Q

Is the artificial rupturing of membranes

A

Amniotomy

181
Q

This scoring system is used to identify if the cervix is favorable by measuring its parameters

A

Bishop’s score

182
Q

What pharmacologic agents aid in cervical ripening

A

Dinoprostone (Prepadil and Cervadil) PGE₂
oxytocin
Misoprostol (Cytotec) PGE₁

183
Q

What PGE is important for cervical maturation

A

PGE₂

184
Q

What PGE causes myometrial contractions

A

PGF ₂ alpha

185
Q

Ultrasound grading system of the placenta based on its maturity

A

PLACENTAL GRADING

186
Q

Placental grading is related to what?

A

gestational age.

187
Q

At what weeks (AOG) is where blood flow is easily demonstrable

A

12–13 weeks

188
Q

At what weeks (AOG) is where Placenta is well established

A

14–15 weeks

189
Q

What are the 4 placental grades

A

Grade 0, 1, 2, 3

190
Q

What placental grade is this:
Homogenous placenta, uniform echogenicity—first and early second trimester

A

Grade 0

191
Q

What is uniform in grade 0 of placental grading

A

echogenicity

192
Q

What placental grade is this:
Occasional hypo-/hyperechoic areas—late second trimester

A

Grade 1

193
Q

What placental grade is this:
Larger calcifications along the basal plate—early third trimester

A

Grade 2

194
Q

What placental grade is this:
Larger and denser calcifications along with compartmentalization of placenta—late third trimester

A

Grade 3

195
Q

It is based on the Readiness of the mother

A

PSYCHE

196
Q

what trimester is where the mother Accept the pregnancy; Fetus as part of self

A

1st Tri

197
Q

what trimester is where there is Quickening, mother accepts

A

2nd Tri

198
Q

what trimester is where the mother prepares for child birth; baby layette

A

3rd tri

199
Q

12 positions in labor
(Wa, Si, Ta, Se, Ha, Sta, Squa, Kne, Li, La, Up, Si)

A
  1. Walking
  2. Sitting/leaning
  3. Tailor sitting
  4. Semi-recumbent
  5. Hands and knees
  6. Standing
  7. Squatting
  8. Kneeling and leaning forward with support
  9. Lithotomy
  10. Lateral recumbent
  11. Upright
  12. Side lying
200
Q

7 Mechanisms of Labor (Cardinal Movements)

A
  1. ENGAGEMENT
  2. DESCENT
  3. FLEXION
  4. INTERNAL ROTATION
  5. EXTENSION
  6. EXTERNAL ROTATION
  7. EXPULSION
201
Q

A mechanism of labor where there is Settling of the presenting part of the fetus far enough
into the pelvis to be at the level of the ischial spine

A

ENGAGEMENT

202
Q

A mechanism of labor where there is Downward movement of the biparietal diameter of the fetal head to within the pelvic inlet

A

DESCENT

203
Q

A mechanism of labor where it Allows the longest fetal head diameter (anteroposterior) to conform to the longest diameter of the maternal pelvis

A

INTERNAL ROTATION

204
Q

A mechanism of labor where the head meets resistance from the soft tissues of the pelvis

A

FLEXION

205
Q

A mechanism of labor where the Head bends forward to present the smallest antero-posterior diameter (suboccipito-bregmatic diameter) to the birth canal

A

FLEXION

206
Q

A mechanism of labor that Occurs as a result of negotiation of the fetal head to the curve of the pelvis

A

EXTENSION

207
Q

A mechanism of labor where there is Rotation of the head, immediately after it was born, back to the diagonal or transverse position

A

EXTERNAL ROTATION

208
Q

A mechanism of labor where the rotation Brings the shoulder into an anteroposterior position

A

EXTERNAL ROTATION

209
Q

External rotation of the head accompanies ___________ of the shoulders

A

internal rotation

210
Q

A mechanism of labor where the baby is delivered

A

EXPULSION

211
Q

What are the stages of labor

A

Stage 1, 2, 3, 4

212
Q

LENGTH OF LABOR in PRIMI
First Stage
Second Stage
Third Stage
Fourth Stage

A

First Stage: 12-14 hours
Second Stage: 80 minutes
Third Stage: 10 mins
Fourth Stage: 2-4 hours

213
Q

Total of hours of labor in primis

A

14-16 HOURS

214
Q

LENGTH OF LABOR in MULTI
First Stage
Second Stage
Third Stage

A

First Stage: 7 hours
Second Stage: 20-30 minutes
Third Stage: 10 mins

215
Q

Total of hours of labor in multi

A

8 hours

216
Q

What stage of labor is where there is Onset of labor to full dilatation

A

STAGE 1

217
Q

Duration of stage 1 in nullipara (average and range)

A

8-10 hours average; 6-18 hours range

218
Q

Duration of stage 1 in multipara (average and range)

A

6-7 hours average; 2-10 hours range

219
Q

Cervical dilation per hour of stage 1 in nullipara

A

1.2 cm/hr

220
Q

Cervical dilation per hour of stage 1 in Multipara

A

1.5 cm/hr

221
Q

labor curve; used to identify & monitor progression of cervical dilation

A

Friedman’s curve

222
Q

3 phases of stage 1 of labor

A

LATENT
ACTIVE
TRANSITION

223
Q

What phase of stage 1 is:
Onset of labor until cervix starts to make change

A

LATENT

224
Q

What phase of stage 1 is:
Greater rate of cervical change

A

ACTIVE

225
Q

What phase of stage 1 is:
8-10 cm dilation

A

TRANSITION

226
Q

What are the care given in first stage:
Latent:
E-
B-
A-

A

Latent:
E- elimination, voiding
B- breathing - chest breathing
A- ambulation

227
Q

What are the care given in first stage:
Active:
A-
D-
A-
N-

A

Active:
A- assessment inc: v/s, cervix, FHT
D- Dry lips (oral care)
A- Abdominal breathing
N- By mouth

228
Q

What are the care given in first stage:
Transient:
T-
I-
R-
E-
D-

A

Transient:
T- Tired
I- Inform of progress
R- Rest and breathing technique
E- Encourage and praise
D- Discomforts

229
Q

DURATION CONTRACTION (LATENT)
Strength/ Intensity
Rhythm
Frequency
Duration
Show/Mucus Plug Color

A

S: Mild to moderate
R: Irregular
F: 5-30 min apart
D: 30-45 sec
Show: Brownish discharge, or pale pink mucus

230
Q

DURATION CONTRACTION (ACTIVE)
Strength/ Intensity
Rhythm
Frequency
Duration
Show/Mucus Plug Color

A

S: Moderate to strong
R: more regular
F: 3-5 min apart
D: 40-70 sec
Show: Pink to bloody mucus

231
Q

DURATION CONTRACTION (TRANSITION)
Strength/ Intensity
Rhythm
Frequency
Duration
Show/Mucus Plug Color

A

S:Strong to very strong
R:Regular
F:2-3 min apart
D:45-90 sec
Show: Bloody Mucus

232
Q

What stage of labor is where there is Full dilation to delivery

A

STAGE 2

233
Q

This stage of labor Begins from full cervical dilation to fetal expulsion

A

STAGE 2

234
Q

Duration in nullipara and multipara of stage 2 of labor

A

Nullipara—30-min to 3 hours
multipara—5-30 minutes

235
Q

Contractions change from the characteristic ___________

A

crescendo-decrescendo

236
Q

This stage of labor is where Perspiration and the blood vessels in the neck may become distended

A

STAGE 2

237
Q

Signs of imminent delivery (5)

A
  1. Mother feels as if to move her bowel
  2. “The baby is coming!”—classic sign
  3. Intense and unstoppable need to push
  4. Bulging perineum to crowning
  5. Increased bloody show
238
Q

Extracting the fetal head, using one hand to pull the fetal chin from between the maternal anus and the coccyx, and the other on the fetal occiput to control speed of delivery.

A

Modified Ritgen’s Maneuver

239
Q

a cut (incision) through the area between your vaginal opening and your anus

A

Episiotomy

240
Q

This stage of labor is where there is:
Modified Ritgen’s Maneuver
Episiotomy
Perineal Bulging
Care of the newborn

A

STAGE 2

241
Q

This stage of labor is when the placenta is delivered

A

STAGE 3

242
Q

Delivery of placenta-can take up to ____

A

30 minutes

243
Q

This stage of labor Begins from expulsion of the baby to placental expulsion

A

STAGE 3

244
Q

Duration of stage 3 of labor

A

5-10 minutes

245
Q

What is the normal blood loss of stage 3 of labor

A

300-500 mL

246
Q

What are the two phases of stage 3 of labor

A

Signs of Placental separation
Placental expulsion

247
Q

What are the 4 signs of Placental separation

A

✓Rising of the fundus
✓Lengthening of the umbilical cord
✓Sudden gush of vaginal blood
✓Globular shape of the uterus (Calkin’s sign)

248
Q

Globular shape of the uterus

A

Calkin’s sign

249
Q

What placental presentation appears shiny and glistening from the fetal membranes

A

Schultze presentation

250
Q

What placental presentation appears raw, red, and irregular, with the ridges or cotyledons that separate blood collection spaces showing

A

Duncan presentation

251
Q

This stage of labor Begins from the delivery of placenta to the first 1-2 hours after birth

A

STAGE 4

252
Q

This stage of labor is where the Contracted uterus is below the level of umbilicus

A

STAGE 4

253
Q

vaginal discharges after birth

A

Lochia

254
Q

What should you WOF in stage 4 of labor

A

bleeding

255
Q

What kind of lochia is seen at the first 3 days after birth, consists
almost entirely of blood, with only small particles of decidua
and mucus

A

lochia rubra

256
Q

What kind of lochia is seen at the 4th day where involved in the cast-off tissue decreases and leukocytes begin to invade the area, the
flow becomes pink or brownish

A

lochia serosa

257
Q

What kind of lochia is seen at the 10th the amount of the flow decreases and becomes colorless
or white

A

lochia alba

258
Q

Pharmacologic Management of Discomforts (6)

A
  1. Local anesthesia
  2. Intravenous – narcotic analgesic
  3. Paracervical block
  4. Pudendal block
  5. Epidural block
  6. General anesthesia
259
Q

Median or Mediolateral:
Easy to repair

A

Median

260
Q

Median or Mediolateral:
More difficult to repair

A

Mediolateral

261
Q

Median or Mediolateral:
Faulty healing rare

A

Median

262
Q

Median or Mediolateral:
Less painful in puerperium

A

Median

263
Q

Median or Mediolateral:
Faulty healing more common

A

Mediolateral

264
Q

Median or Mediolateral:
Pain in 1/3 cases for few days

A

Mediolateral

265
Q

Median or Mediolateral:
Dyspareunia rarely follows

A

Median

266
Q

Median or Mediolateral:
Dyspareunia occasionally follows

A

Mediolateral

267
Q

Median or Mediolateral:
Anatomic end results almost always excellent

A

Median

268
Q

Median or Mediolateral:
Anatomic end results more or less faulty in some 10% of cases

A

Mediolateral

MCN (5 decks)

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