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Kol- OB > Intrapartum Care > Flashcards

Intrapartum Care Flashcards

1
Q

first stage of labor is divided into what 3 stages (in order!)

A

latent
active
transition

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2
Q

stage of labor characterized by

		‣ Irregular, Mild, Moderate 
		‣ Contractions: 5-30 Minutes
		‣ Duration 30-45 seconds
		‣ dilation (.95)
		‣ talkative, eager
A

latent phase of first stage

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3
Q

which stage of labor is characterized by
‣ Regular, Moderate, Strong
‣ Contractions: 3-5 minutes
‣ duration 40-70 seconds
‣ rapid dilation and effacement
‣ increased anxiety and helplessness

A

active phase of first stage

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4
Q 
stage of labor characterized by 
		‣ Strong to very strong 
		‣ Frequency every 2-3 minutes 
		‣ Duration 45-90 seconds
		‣ Completely dilated
A

transition phase of first stage of labor

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5
Q

during what stage of labor is the is the infant born unto the world a goopy slimey potato bean?

A

second stage

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6
Q

what happens during the third stage of labor?

A

the placenta is expelled

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7
Q

what happens during the 4th stage of labor?

A

recovery

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8
Q

there are 3 main fluids that are coming out of the vagina before the baby can slip out. What are they

A

• mucus plug- can happen a couple weeks before labor
• blood showy- happens in labor
• water breaking/ amniotic fluid / ROM
◦ water can break after labor starts or before
◦ water can break before or after bloody show

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9
Q

re: Physiological changes preceding labor

fetal head descends into true pelvis 14 days before labor, feeling the uterus has dropped =

A

lightening

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10
Q

re: Physiological changes preceding labor

irregular, get better with hydration and rest, practice contractions , will not cause true labor =

A

braxton hicks contractions

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11
Q

definition of true contractions

A

happen at uterus and CAUSE DILATION and EFFACEMENT

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12
Q

physiological changes preceding labor- list some!

A

• Lightening: fetal head descends into true pelvis 14 days before labor, feeling the uterus has dropped
• Braxton-Hicks contractions: irregular, get better with hydration and rest, practice contractions , will not cause true labor
◦ True Contractions happen at uterus and cause dilation and effacement
• Cervical ripening
• Nesting
• Bloody show : brownish or blood tinged mucus plug resulting from onset of cervical dilation and effacement
• Backache
• Weight loss

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13
Q

what is a brownish or blood tinged mucus plug that is expelled resulting from onset of cervical dilation and effacement ?

A

bloody show

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14
Q

labor usually occurs within ____ hours of ROM

A

24

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15
Q

what is Chorioamnionitis- what can cause it?

A

inner lining gets infected, s/s of pain and tenderness, increased fetal HR , can occur with prolonged rupture of membrane

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16
Q

what do we want to assess for after ruputre of membranes (think baby #1 vital sign)

A

fetal decels

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17
Q

Vital sign to be checking every 2 hours for preggo after ROM?

A

temp!

infection

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18
Q

Normal color for amniotic fluid?

A

straw

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19
Q

what does it mean if the amniotic fluid is brownish or green? What’s the big deal?

A

meconium stained fluid
◦ concerned if that is expelled in utero if post term birth or baby is distressed
◦ concern about respiratory distress for baby, let NICU know

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20
Q

What is nitrazine paper used for?

A

test amniotic fluid (turns blue – alkaline)

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21
Q

five p’s of intrapartum care

A 
Passenger (Fetus and Placenta)
Passageway (Birth Canal / Maternal Pelvis)
Powers (Contractions)
Position (mom's)
Psychological response
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22
Q

Primary and secondary forces that bring fetus into vaginal canal?

A

primary mary = uterine contractions

secondary berry= maternal pushing efforts

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23
Q

3 characteristic of uterine contractions

A

◦ Increment- rising of contraction
◦ Acme - peak of contraction
◦ Decrement - fall of contraction

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24
Q

wtf is ACME?

A

peak of contraction

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25
Q

which part of the uterus is contracting to get that damn baby out?

A

upper myometrium (muscle)

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26
Q

opening of cervix =

VS

thinning of cervix =

A 
opening = dilation
thinning = effacement
27
Q

we want to assess what 3 main things with cotnractions

A

frequency, duration, intensity

28
Q

how am I going to determine the intensity of a contraction manually? (think about touching your face)

A

• Intensity = strength of contraction at its peak
‣ you have to feel the fundus when client is having a contraction at peak
◦ Mild =tip of nose, slightly tense
◦ Moderate = finger to chin, firm
◦ Strong = finger forehead, rigid

29
Q

what does an intrauterine pressure catheter measure?

A

strength/intensity of contractions

30
Q

2 main risks we are watching for with contractions

A
  • Watch for prolonged contractions

* Watch for too frequent

31
Q

> _____ contractions in a 10 minute period does not allow time to restore resting tone!

A

5

32
Q

if contractinos are coming to fast/strong what meds are we going to admin/stop

A

stop pitocin

give tocolytic like terbutaline if other interventions don’t work

33
Q

fully dilated = ____ cm

A

10

34
Q

how do we measure effacement- what increment? how long/thick is cervix before labor?

A

◦ Before labor, cervix is 2 –3 cm long and approximately 1 cm thick
◦ Effacement is in % and goes from 0 to 100%

35
Q

cheese and crackers- there are 4 types of pelvises and I pracy to god we don’t need to memorize these words but what are they:

A
  1. Gynecoid: most common; 50% of women
  2. Android: heart shaped
  3. Anthropoid: oval brim and a slightly narrow pelvic cavity
  4. Platypelloid: flat oval; least common; 3% of women
36
Q

most common pelvis shape

A

gynecoid

37
Q

heart shaped pelvis

A

android

A(my hearts her fold up android phone)

38
Q

oval brim and a slightly narrow pelvic cavity pelvis shape

A

Anthropoid

trending girl wearing oval brim hat from anthropologie

39
Q

re pelvic shape: flat oval; least common; 3% of women

A

Platypelloid

platypus is least common

40
Q

Station ____ is the narrowest diameter the fetus must pass through = ischial spine

A

0

41
Q
  • station =
A

baby is high up

42
Q

+ station =

A

baby is lower, moving towards delivery

43
Q

re: passenger, fetal position:

relationship of fetal body parts to one another=

A

fetal attitude

posture

44
Q

flexion vs extension fetal attitiude (posture) - what are they and which one is best for delivery

A

◦ Flexion (chin to chest, extremities flexed in) - what we want
◦ Extension (chin and extremities extended)

45
Q

3 types of fetal presentations

A

cephalic
breech
shoulder

46
Q

what does “breech frank” presentation mean

A

legs extended toward shoulders , butt first

47
Q

what is complete breech mean?

A

legs flexed, but first

48
Q

what is a breech footling ? what is the risk?

A

One or both feet present first into maternal pelvis

risk:Cord prolapse, cord compression, prolonged labor

49
Q

this presentation occurs when the fetus is in a transverse lie

A

shoulder

50
Q

3 types of cephalic presentations

A

brow, vertex, face

i have no idea what this means

51
Q

position abbreviateios

  • Vertex: Occiput ( ___)
  • Face: Chin (or mentum) (___)
  • Breech: Sacrum (___)
  • Shoulder: acromion process (___)
A
  • Vertex: Occiput (O)
  • Face: Chin (or mentum) (M)
  • Breech: Sacrum (S)
  • Shoulder: acromion process (A)
52
Q

example: ROA- what is the first letter?

A

First letter – the side of the maternal pelvis that the presenting part of the fetus is located

Right

53
Q

example: ROA- what is the second letter?

A

Second letter – the part of the fetus that is closest to the cervix

Occiput

54
Q

example ROA: what is the third letter?

A

Third letter – where the fetal part is located in the maternal pelvis – anterior, posterior, or transverse

55
Q

Characteristics of true labor vs falce labor

A

TRUE:

  • regular intervals
  • increase in frequency, duration, intensity
  • cause changes in cervical dilation and effacement

FALSE:

  • irregular intervals
  • little or no cervical change
56
Q

During stage 1 of labor there are three phases: latent, active, and transition. What is the cervical dilation for these phases?

A

◦ Latent phase: 0 – 3 cm
◦ Active phase: 4 – 7 cm
◦ Transition: 8 – 10 cm

57
Q

cardinal movements of birth

A
  • Engagement
  • Descent
  • Flexion
  • Internal Rotation
  • Extension
  • Restitution / External rotation
  • Expulsion
58
Q

what is leopolds maneuver

A

External palpations of uterus through abdominal wall to determine:
Number of fetuses.
Presenting part, lie, attitude.
Degree of descent of presenting part into pelvis.
Expected location of PMI.

59
Q

Preparation for birth signs in stage 2 of labor

A
  • Bulging of perineum and rectum
  • Flattening and thinning of the perineum
  • Increased bloody show
  • Labia begin to separate
60
Q

signs of imminent birth

A
  • Crowning
  • Burning sensation
  • Intense pressure in rectum
  • Episiotomy - treat as wound and assess frequently
61
Q

during stage 3 of labor there is a gush of ____ from the vagina

A

blood

remember this is when the palcenta is delivered

62
Q

how often do we want to check for firmness of uterus during stage 4 of labor?

A

every 15 minutes

63
Q

a boggy uterus feels like

A

a bag of iv fluids

Kol- OB (20 decks)

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