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Maternal > Intrapartum: Process of Labor and Delivery > Flashcards

Intrapartum: Process of Labor and Delivery Flashcards

1
Q

Preliminary Signs of Labor

A

Lightening
Slight weight loss
Excess energy
Backache
Ripening of the cervix

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2
Q

Signs of TRUE Labor

A

Rupture of membranes
Show
Contractions

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3
Q

True Labor

A
  • Timing of contractions regular
  • Radiating contraction pain
  • Unable to relieve contraction pain with activity
  • Exam changes present
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4
Q

Fake Labor

A
  • Fails to cuase changes to cervix and baby’s position
  • Activity diminishes contractions
  • Keep feeling contractions above belly button (they don’t radiate from back to abdomen)
  • Erratic timing of contractions
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5
Q

5Ps

A
  • Passenger
  • Passage
  • Power
    -Placenta
  • Psyche
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6
Q

PASSENGER

A

a. the size,
b. presentation,
c. position of the fetus
d. fetal attitude,
e. and fetal lie.

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7
Q

With a big baby, you have a ____________ chance of a difficult vaginal delivery. You may also have an increased risk of _______________________________________________

A

greater; preterm birth, perineal tearing, and blood loss

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8
Q

Portion of the body of the fetus that is foremost within the birth canal or in closest proximity to it.

A

Presentation

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9
Q

The most common presentation

A

Cephalic

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10
Q

Types of Cephalic Presentation

A

VERTEX/OCCIPUT
BROW
MILITARY/SINCIPUT
FACE

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11
Q

BUTTOCKS FIRST

A

BREECH

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12
Q

Types of Breech Presentation

A

Frank
Complete
Footling

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13
Q

Fetus is in a _____________________, or the arm, back, abdomen, or side could present.

A

transverse lie

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14
Q

shoulder or acromion is presenting into the pelvic inlet

A

shoulder presentation

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15
Q

bisacromial dimatere (11 cm) presents

A

shoulder presentation

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16
Q

fetal hand or foot prolapses alongside the presenting vertex or breech

A

Compound presentation

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17
Q

relationship of the chosen portion of the fetal presenting part in reference to one of the 4 quadrants or transverse diameter of birth canal

A

Position

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18
Q

the relationship of the fetal body parts to one another

A

attitude

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19
Q

Fetal Position

A

Occiput (cephalic/vertex position)
Mentum or chin (face presentation)
Sacrum (breech presentation)
Acromion or scapula (shoulder presentation)

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20
Q

Feta lspine is parallel to the mother’s spine.

A

longitudinal or vertical

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21
Q

Fetal spine is at a right angle, or perpendicular, to the mother’s spine

A

transverse or horizontal

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22
Q

this position is very rare and occurs in fewer than 5% of pregnancies

A

oblique

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23
Q

PASSENGER ASSESSMENT

A

Leopold’s maneuvers
Vaginal examination

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24
Q

The mother’s rigid bony pelvis and the soft tissues of the cervix, pelvic floor, vagina, and introitus (external opening to the vagina)

A

PASSAGE/ PASSAGEWAY

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25
Q

most common, 55%, inlet transverse diameter is wider than the antero-posterior diameter

A

Gynaecoid

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26
Q

20% of women, heart shaped inlet, funnel-shaped cavity, narrow inlet

A

Android

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27
Q

20% women, oval-shaped inlet, maximam diameter AP with a long and narrow cavity

A

Anthropoid

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28
Q

5% of women, flattened transversely oval, shallow cavity and spacious outlet

A

Platypoid/Platypelloid

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29
Q

Forces of labor acting in concert to expel the fetus and placenta

A

Power

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30
Q

Contractions more than _________________ must be referred

A

90 seconds

31
Q

usually very painful, can be difficult to talk during one

A

Contractions (True Labor)

32
Q

have a pattern and contractions will become closer together with time

A

Contractions (True Labor)

33
Q

associated with dilation of the cervix

A

Contractions (True Labor)

34
Q

will continue despite changes in your body positioning

A

Contractions (True Labor)

35
Q

typically, not as painful and you are able to talk

A

Braxton Hicks (False Labor)

36
Q

no specific pattern, and do not get closer together with time

A

Braxton Hicks (False Labor)

37
Q

the cervix does not dilate

A

Braxton Hicks (False Labor)

38
Q

may stop if you shift body positions or go to the bathroom

A

Braxton Hicks (False Labor)

39
Q

placenta usually forms in the

A

fundus of the uterus

40
Q

the cervix relaxes, causing it to dilate and thin out

41
Q

uterine contractions increase in strength and the infant is delivered

42
Q

the placenta is expelled

43
Q

recovery stage

44
Q

from the onset of labor until full dilatation of the cervix

A

CERVICAL DILATION STAGE

45
Q

From full dilation of cervix to birth of baby

A

EXPULSION STAGE

46
Q

From birth of baby to expulsion of placenta.

A

PLACENTAL STAGE

47
Q

Time after birth of immediate recovery

A

RECOVERY STAGE

48
Q

RECOVERY STAGE
CRITICAL:

49
Q

LATENT PHASE
- ___ cm
- ______ hours in multipara
- _______ hours in nullipara

A
  • 0-3 cm
  • 4.5 hours
  • 6 hours
50
Q

Contractions in Laten Phase

A

Contraction:
Frequency - (every 20 minutes decreasing to every 5 minutes)
Intensity – (mild to moderate)
Duration – 20– 40 seconds

51
Q

Latent Phase Assessment:

A
  1. Contraction
  2. Membranes: intact or ruptured
  3. BLOODY SHOW present
    4.Time of onset
  4. Cervical changes
  5. Time of last ingestion of food
  6. FHR every 15 minutes, after rupture of membrane
  7. Maternal V/S- temperature every 2 hours (rupture
    membrane), every 4 hours if intact membrane
  8. Progress of descent (station)
  9. client’s knowledge of labor process is caused by cephalopelvic disproportion
  10. Client’s affect: woman is sociable and excited
  11. client’s birth plan
52
Q

In Latent Phase, have the client attempt to void every ______________

53
Q

ACTIVE PHASE
- ___ cm
- ______ hours in multipara
- _______ hours in nullipara

A

4-7cm
3-6hrs in nullipara
2 hrs in multipara

54
Q

Contractions in Latent Phase

A

Frequency - every 3-5 minutes apart
Intensity – moderate to firm
Duration – 40 - 60 seconds

55
Q

fetus descends in pelvis and internal rotation begins.

A

Active Phase

56
Q

more anxious and may feel helpless.

A

Active Phase

57
Q

complete effacement

A

Active Phase

58
Q

TRANSITION PHASE
_____ cm
length:

A

8-10 cm
30 MINUTES-2HOURS

59
Q

Contractions in Transitional Phase

A

Frequency: every 2 – 3 minutes.
Intensity: firm
Duration :60 – 90 seconds

60
Q

irritable or aggressive and loss of control, maybe tiring or unable to cope.

A

Transitional Phase

61
Q

Breathing pattern may be hyperventilating

A

Transitional Phase

62
Q

Feeling the urge to push/bear down with contractions.

A

Transitional Phase

63
Q

Loss of control is common

A

Transitional Phase

64
Q

Signs of nausea, vomiting, trembling, crying, irritability

A

Transitional Phase

65
Q

Membrane ruptured, bloody show, cervix fully dilated

A

Transitional Phase

66
Q

SECOND STAGE OF LABOR
Assessment:

A

a. Signs of imminent delivery.
b. Progress of descent.
c.Maternal/fetal vital signs.
d. Maternal pushing effort (active pushing)
e. vaginal distention
f. Bulging of the perineum
g.Crowning
h. Birth of baby

67
Q

Signs of placental separation:

A

a. Calkin’s sign – earliest sign of placental separation;
change in shape of uterus (from discoid uterine shape to globular).
a. Sudden gush of vaginal blood.
b. Lengthening of the umbilical cord

68
Q

earliest sign of placental separation

A

Calkin’s sign

69
Q

change in shape of uterus (from discoid uterine shape to globular).

A

Calkin’s sign

70
Q

placenta separates from the center of the edge

71
Q

Clean presentation

72
Q

Placenta separates from the edge to the center

73
Q

Dirty presentation

Maternal (12 decks)

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