Intrapartum

Question 1

Oxytocin

Answer 1

primary hormone/ factor that initiates labor

made by post pituitary gland

Question 2

relaxin

Answer 2

made by the placenta

makes the placenta irritable

Question 3

prostoglandin

Answer 3

made by fetal membranes that make the uterus contract at any stage of pregnancy

Question 4

lightening

Answer 4

decent of fetal head into the pelvis

Question 5

braxton-hicks

Answer 5

strong iregular uterine contractions

Question 6

signs of oncoming labor

Answer 6

dilation to 10cm
effacement
blood tinged cervical mucus
ROM

Question 7

False VS True Labor

Answer 7

false: irregular, stops with activity/change, no decent
true: regular, does not stop, pink mucus, progressing

Question 8

5 P’s of labor

Answer 8

passageway
passenger
powers
position
psychological response

Question 9

powers define

Answer 9

how strong are the contractions

10cm= 4inches

Question 10

pelvic inlet size

Answer 10

must be 11cm

Question 11

pelvic cavity (transverse) sizes

Answer 11

should be 10.5cm. critical spot to navigate around

approx width of fist

Question 12

Fetal Head Bones/ Fontanelles

how many, what kind

Answer 12

2 frontal
2 parietal
1 occipital
2 fontenelles

Question 13

separation of fontanelles

Answer 13

the bones are not fused together yet to allow for passage. separated by sutures

Question 14

Molding

Answer 14

overlapping of head bones to allow for passage

Question 15

Stations related to birth

Answer 15

crowning: +3
birth: +4
station 0: ischial spine

Question 16

Stages of Labor (4)

Answer 16

1: onset of labor, 10cm
2: 10cm to birth
3: birth, then delivery of placenta
4: 2 hours after placenta delivery

Question 17

Stage 1 labor

Answer 17

0-3 cm: admision, all the workup, paperwork, etc
4-7cm: still monitoring, paperwork, etc
5cm: epidural
8-10: irritable, may vomit, worst part of stage 1, wants to be alone

Question 18

Stage 2 labor

Answer 18

crowning, mother is pushing with the contractions

Question 19

Episiotomy

Answer 19

surgical incision into perineal space to allow for extra space

Question 20

Stage 3 Labor

Answer 20

placental seperation

repair of episiotomy

Question 21

Stage 4 Labor

Answer 21

monitor vitals, HR, assess for bleeding (rubra, serosa, alba) and fundal heights
give warm blanket to help with shakes
keep in L&D for approx. 1 hr
give the patient a partial bath

Question 22

APGAR SCORING

Answer 22

give at min1 and min5 of life

aim for 7-10

Question 23

Eye Care of newborn

Answer 23

give erythromycin after bonding

Question 24

care of the cord post birth

Answer 24

clamp for 24 hours, then unclamp

run with alcohol to help dry out and prevent infection

Question 25

Vitamin K

Answer 25

must be given because intestinal flora is not yet present

done right after baby bath

Question 26

HR Monitoring

Answer 26

brady: less than 120
tachy: over 160

Question 27

Fetal HR Patterns (decels) (3)

Answer 27

Type I: early decels (head compression)
Type II: late decels (most problematic)
Type III: variable (cord compression)

Question 28

Assisting in birth (tools)

Answer 28

forceps used to pull out/rotate the head

vacuum: attached to the head to pull out using negative pressure

Question 29

Emergency Birth (C-Section)

Answer 29

in life threatening situations