Intrapartum

Question 1

Lightening

Answer 1

A premonitory sign of labor
Descent of the fetus into the true pelvis
Occurs about two weeks before term in first-time pregnancies
Easier breathing
Increased bladder pressure = urinary frequency

Question 2

Braxton-Hicks contractions

Answer 2

A premonitory sign of labor
Irregular UCs
No cervical change
Associated with false labor

Question 3

Premonitory sign - cervical changes

Answer 3

Cervix becomes soft (ripens)

Cervix may become partially effaced and begin to dilate

Question 4

Premonitory sign - surge in energy

Answer 4

A burst of energy

A need to put everything in order (nesting)

Question 5

Premonitory sign

Answer 5

Changes that occur a few weeks before labor to indicate the woman’s body’s preparation for the onset of labor

Question 6

Premonitory sign - gastrointestinal changes

Answer 6

Less common
A 1- to 3- pound weight loss
Diarrhea, nausea, indigestion preceding labor

Question 7

Premonitory sign - backache

Answer 7

Low backache and sacroiliac discomfort

Due in part to the relaxation of the pelvic joints

Question 8

Premonitory sign - bloody show

Answer 8

A brownish or blood-tinged cervical mucus discharge

Question 9

5 Ps of labor

Answer 9

Powers (contractions)
Passage (pelvis and birth canal)
Passenger (fetus)
Psyche (response of the woman)
Position (maternal postures and physical positions to facilitate labor)

Question 10

Powers

Answer 10

Involuntary UCs of labor
Voluntary pushing or bearing down powers
Combine to propel and deliver the fetus and placenta from the uterus

Question 11

Effacement

Answer 11

Thinning of the cervix

Question 12

First stage of labor - uterine contractions

Answer 12

Responsible for the dilation and effacement of the cervix

Question 13

Uterine contractions - resting phase

Answer 13

Blood flow to the uterus and placenta

Fetal exchange of oxygen, nutrients, and waste products occurs in the placenta

Question 14

UCs - frequency

Answer 14

Time from beginning of one contraction to the beginning of another
Recorded in minutes

Question 15

UCs - duration

Answer 15

Time from beginning of a contraction to the end of the contraction
Recorded in seconds

Question 16

UCs - intensity

Answer 16

Strength of the contraction
Evaluated with palpation using the fingertips on maternal abdomen
Mild, moderate, or strong

Question 17

Ferguson reflex

Answer 17

Triggers the urge to push once the cervix is fully dilated

Activated when the presenting part stretches the pelvic floor muscles

Question 18

Passage

Answer 18

Bony pelvis and the soft tissues of the cervix, pelvic floor, vagina, and introitus

Question 19

These two hormones soften cartilage and increase elasticity of the ligaments, thus allowing room for the fetal head (during pregnancy)

Answer 19

Estrogen

Relaxin

Question 20

Station

Answer 20

The relationship of the ischial spines to the presenting part of the fetus
Assists in assessing for fetal descent during labor
Station 0 = narrowest diameter the fetus must pass through

Question 21

Passenger

Answer 21

The fetus and its relationship to the passageway

Fetal skull
Fetal attitude
Fetal lie
Fetal presentation
Fetal position
Fetal size

Question 22

Fetal skull - molding

Answer 22

The ability of the fetal head to change shape to accommodate/fit through the maternal pelvis

Question 23

Fetal attitude

Answer 23

The relationship of fetal parts to one another

Noted by the flexion or extension of fetal joints

Question 24

Proper fetal attitude

Answer 24

Head in complete flexion in a vertex presentation and passes more easily through the true pelvis

Question 25

Fetal lie

Answer 25

The long axis (spine) of the fetus in relationship to the long axis (spine) of the woman

Question 26

Fetal lie - longitudinal lie

Answer 26

The long axes of the fetus and the mother are parallel (most common)

Question 27

Fetal lie - transverse lie

Answer 27

The long axis of the fetus is perpendicular to the long axis of the mother

Fetus cannot be delivered vaginally

Question 28

Fetal presentation

Answer 28

Determined by the part or pole of the fetus that first enters the pelvic inlet

Question 29

Fetal presentation - cephalic

Answer 29

Head first
Vertex presentation - the head is sharply flexed and the chin is touching the thorax; denominator = occiput
Frontum presentation - partial extension of the neck with the brow as the presenting part
Face presentation - neck is sharply extended and the back of the head (occiput) is arching to the fetal back; denominator = mentum-chin

Question 30

Fetal presentation - breech

Answer 30

Pelvis first
Presenting part = buttock and/or feet
Complete breech - complete flexion of the thighs and the legs extending over the anterior surfaces of the body
Frank breech - complete flexion of thighs and legs
Footling breech - extension of one or both thighs and legs so that one or both feet are presenting

Question 31

Fetal presentation - shoulder

Answer 31

Shoulder first
“Transverse presentation”
Associated with a transverse lie

Question 32

Presenting part

Answer 32

The specific fetal structure lying nearest to the cervix

Determined by the attitude or posture of the fetus

Question 33

Fetal presentation - compound presentation

Answer 33

Fetus assumes a unique posture usually with the arm or hand presenting alongside the presenting part