Intrapartum Flashcards
What is the Ferguson reflex?
An uncontrollable urge to push or “bearing-down” – stretch receptors in the posterior vagina release endogenous oxytocin
What is the difference in lightening in first-time preganancies and reccurent pregnancies?
- In first-time pregnancies the uterus sinks downward and forward about 2 weeks before term, when the presenting part of the fetus (usually the fetal head) descends into the true pelvis
- In a multiparous pregnancy, lightening may not take place until after uterine contractions are established and true labor is in progress
What are s/s(x) that lightening has just occured.
After lightening women feel less congested and breathe more easily, but usually more bladder pressure results from this shift; consequently, there is a return of urinary frequency
A new mother asks the nurse when the “soft spot” on her son’s head will go away. What is the proper response by the nurse?
The anterior fontanel closes after birth by – 18 months – the larger of the two fontanels, the anterior fontanel, closes by 18 months after birth
When assessing a woman in labor, the nurse is aware that the relationship of the fetal body parts to one another is called?
The relationship of fetal body parts to one another is called fetal attitude.
What is the normal attitude of the fetus called?
General flexion
Birth is imminent when the presenting part is at what station?
What is important for the nurse to assess at the beginning of labor?
Birth is imminent when presenting part is at +4 to +5 cm below the spine
The presenting part should be documented/noted at the beginning of labor so that the rate of descent can be determined
What are primary powers responsible for in regards to birth? Secondary powers?
Primary powers are responsible for dilation and effacement.
Secondary powers are concerned with expulsion of the fetus.
If a patient reports rupture of membrane what should the nurse assess for?
The nurse should auscultate the FHR before and after ambulation and rupture of membranes.
A multiparous woman has been in labor for 8 hours, her membranes have just ruptures, the nurse’s initial response would be to?
Assess FHR and pattern
Signs that precede labor include
lightening, bloody show, and rupture of membranes
also….
urinary frequency, backache, weight loss, surge of energy,
Explain how true labor compares to false labor?
True labor contractions increase with activity such as ambilation
Contractions get stronger longer and closer together. (8-10 min in interval for an hour)
Cervical change in dilation/effacement
which occurrence is associated with cervical dilation and effacement?
Bloody show
as the cervix
begins to soften, dilate, and efface, expulsion of the mucous plug that sealed the cervix during
pregnancy occurs
The nurse would expect which maternal cardiovascular finding during labor?
Increased Cardiac Output
during each contraction, 400 mL of blood is emptied from the uterus into the
maternal vascular system
The nurse caring for a laboring woman is aware that maternal cardiac output can be increased
by?
Changing Position
maternal supine hypotension syndrome is caused by the weight and
pressure of the gravid uterus on the ascending vena cava when the woman is in a supine
position; this reduces venous return to the woman’s heart, as well as cardiac output, and
subsequently reduces her blood pressure
