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Maternity & Women's Health > Intrapartum Nursing Care > Flashcards

Intrapartum Nursing Care Flashcards

1
Q

What are the original 3 P’s of Labor?

A

Powers (contractions), passenger (fetus), passageway (pelvis)

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2
Q

Expanded P’s of labor

A
  • Powers
  • Passenger
  • Passageway
  • Physiology
  • Psychology
  • Preparation
  • Position: Choice
  • Professional providers
  • Place of birth
  • Procedures
  • People: Nonprofessionals
  • Policies (Social context)
  • Pressure interface
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3
Q

What is engagement during labor?

A

When the largest diameter of fetal presenting part passes the pelvic inlet

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4
Q

Lightening during labor is associated with?

A
  • Reduced dyspnea
  • Leg cramps
  • Pelvic pressure/pain
  • Edema
  • Urinary frequency
  • Vaginal secretions
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5
Q

Components of the Feto-Pelvic Relationship?

A

Lie, Attitude, Presentation, Position

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6
Q

Where is the largest diameter of the fetal head and what is the avg diameter at term?

A

biparietal diamater, avg is 9.5 cm

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7
Q

What is the relationship of the long axis of the fetus to the maternal long axis (fetal spine to maternal spine)?

A

Fetal Lie

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8
Q

What is the preferred fetal lie?

A

longitudinal vertex

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9
Q

What type of presentations can occur with a longitudinal lie?

A

vertex or breech

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10
Q

Types of fetal lie?

A

longitudinal, transverse, oblique

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11
Q

What type of presentations can occur with a transverse lie?

A

the shoulder

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12
Q

What type of presentations can occur with an oblique lie?

A

variable, unstable lie

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13
Q

Relationship of fetal parts to each other

A

Fetal attitude

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14
Q

What are the types of fetal attitude?

A
  • flexion (“vertex”)
  • military
  • partial extension (“brow”)
  • complete extension
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15
Q

Types of fetal presentations?

A

cephalic, breech, shoulder

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16
Q

Types of Breech?

A

complete (flexed), frank (extended), footling

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17
Q

What is the most common type of breech?

A

Frank or Extended breech

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18
Q

What is the shape of the (1) anterior and (2) posterior fontanel?

A

1) diamond

2) triangle

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19
Q

Describe a complete or flexed breech?

A
  • hips and knees are both flexed

- knees to chest

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20
Q

When does engagement usually occur in a primagravida?

A

2 weeks from onset of labor

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21
Q

Describe a frank or extended breech?

A

legs are extended along the torso (touch toes position)

22
Q

What is occiput?

A

back of the head

23
Q

Fetal Position (TPAO)

A

Transverse, Posterior, Anterior, Occiput

24
Q

S/S of fetus in Occiput Posterior position?

A
  • severe back pain or “back labor”
  • irregular contractions
  • slow labor progress
25
Q

Nursing interventions for Occiput Posterior?

A
  • turn mother toward side opposite of fetal back

- counter pressure on sacrum

26
Q

Leopold’s 4 maneuvers?

A

1) determines presentation by palpating the fundus
2) determines fetal lie & position of back
3) confirms #2
4) determines position of occiput

27
Q

When performing Leopold’s maneuver, you palpate a hard (1), soft (2) surface and nothing (3). What is being felt?

A

1) head
2) butt
3) fetus is in the transverse or oblique fetal lie

28
Q

What separates the false from the true pelvis?

A

linea terminalis

29
Q

4 Pelvic bone types?

A

gynecoid (oval), android (heart) anthropoid (oval), platypelloid (flattened, transverse oval)

30
Q

What is the most common pelvic bone type?

A

gynecoid (oval)

31
Q

What is the definition of ballotable?

A

when the presenting part of the fetus has not engaged and is movable

32
Q

When the presenting part is at the level of the ischial spines, the baby is at what station?

A

0 station

33
Q

What are the cardinal movements of delivery?

A

Engagement, descent, flexion, internal rotation, extension, restitution, external rotation, expulsion

34
Q

What is the purpose of the flexion cardinal movement of delivery?

A

so the head can be at the smallest diameter to fit the pelvis

35
Q

At which cardinal movement can the head be felt?

A

extension

36
Q

Methods of maintaining perineal integrity during childbirth?

A
  • spontaneous bearing down
  • warm compresses
  • perineal support ( hand on perineal)
  • position changes/alternative lithotomy
37
Q

Physiological effects of uterine contractions?

A
  • decreased uterine blood flow
  • dilates and effaces cervix in first stage of labor
  • ## increases maternal BP (vasoconstriction)
38
Q

Stages of labor?

A

1) 0-10 cm
2) 10 cm to delivery
3) delivery of the placenta
4) 1st hr PP

39
Q

What are the 3 phases of the 1st stage of labor?

A

1) early/latent = 0-3 cm
2) Active = 4-7 cm
3) Transition = 8-10 cm

40
Q

1st stage of labor?

A

begins with regular contractions and ends with dilation of the cervix to 10 cm (complete dilation)

41
Q

When does the “bloody show” appear during pregnancy?

A

24-48 hrs prior to labor, but can occur up to 4 wks prior to labor

42
Q

Signs of the “Bloody Show” during pregnancy?

A
  • loss of mucus plug
  • pink tinged secretions. thick consistency
  • not an immediate sign of labor
43
Q

Signs of impending Labor?

A 
Lightening (primigravida)
Return of urinary frequency
Backache
Stronger Braxton-Hicks contractions
Weight loss 1-2 lbs
Surge of energy (24-48 hours pre-labor)
Increased vaginal discharge, bloody show
Cervical ripening
Possible rupture of membranes
44
Q

What does PROM stand for?

A
  • Premature Rupture of Membranes

- > 37 wks with no contractions

45
Q

Membrane ruptures > 24 hrs prior to hospital visit?

A

Preterm Premature Rupture of Membranes (PPROM)

46
Q

Signs of true labor?

A
  • contractions increase in intensity
  • some consistency
  • PROGRESSIVE cervical change
47
Q

Signs of false labor?

A
  • Braxton Hicks
  • contractions stay in front
  • are inconsistent
  • NO cervical change
48
Q

When to go to the hospital or birth center?

A
  • Regular contractions
  • Rupture of membranes
  • Vaginal bleeding
  • Fetal movement
49
Q

Average labor duration considerations:

1) Primigravidas
2) Multigravidas

A
  • 9 hrs +/- 4 hrs

- 6 hrs +/- 3 hrs

50
Q

of contractions needed before going to the hospital:

1) nullipara
2) multipara

A

1) q 5 or less, lasting 60 sec. x 1-2 hours

2) q 5 or less, lasting 60 sec. x 1 hour

51
Q

Signs of Placental Separation?

A
  • Elongation of cord
  • Trickle of blood
  • Change in shape of uterus of discoid to globular
  • Uterus rises in abdomen

Maternity & Women's Health (18 decks)

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