IP-general

Question 1

Steps in checking station & postion of infant.

Answer 1

Check arch, come down to ischial spines, feel ligaments between spines & sacrum. Center your fingers from spines & place middle finger on infant’s head to determine station.
Spines, sutures, & fontanels
Diamond (anterior) –will have sutures on all sides
Triangle (posterior–ideal)

Question 2

Longest suture on infant’s head

Answer 2

Sagital suture

Question 3

Cardinal moves of labor:

Answer 3

1. Engagement, descent, flexion
2. Descent, internal rotation
3. Complete rotation, beginning extension
4. Complete extension
5. Restitution (external rotation)
6. Delivery of anterior then posterior shoulder
7. Expulsion, following CURVE of CARUS

Question 4

4 P’s that influence labor

Answer 4

1. Passage (Pelvis, cervix, ligaments)
2. Passenger
3. Power (uterus)
4. Psyche

Question 5

When does cervical change occur?

Answer 5

Goodells sign (softening/remodeling): Starting at LMP (4wks)
Chadwicks (inc vascularity) starts at 6wks

Question 6

Where does effacement & dilation occur?

Answer 6

Internal Os: Effacement
External Os: Dilation
-usually occurs simultaneously

Question 7

4 Hormone systems interconnected for childbearing:

Answer 7

1. Oxytocin
2. Beta-endorphins
3. Epinephrine & norepinephrine (stress)
4. Prolactin

Question 8

Where is oxytocin (OT) released?

Answer 8

Posterior pituitary from hypothalamus

Question 9

Roles of oxytocin:

Answer 9

1. Sexual behavior & pair bonding (peaks at orgasm, causing rhythmic contractions of pelvic floor contractions)
2. Lactation: released in pulses to mediate milk injection & prolactin release, which stimulates milk production
3. Maternal adaption
4. Warming (vasodilation)
5. Social-affiliative behavior (trust, empathy, generosity, eye contact, recognition, etc.)
6. Autonomic nervous system
7. Stress reduction

Question 10

Roles of Beta-endorphins

Answer 10

1. Endogenous analgesia
2. Altered state of consciousness
3. Fetal neuroprotection
4. peaks during PP period –euphoria
5. NB support with stress via colostrum
6. Reward & reinforcement of BF

Question 11

Epinephrine & norepinephrine during labor

Answer 11

Stress hormones–protective via support of family & caregivers (predominantly, female companions).

Question 12

Roles of Prolactin (PRL)

Answer 12

1. Stimulates breastmilk production (lactogenesis)
2. Support conception & early pregnancy
3. Adjusting appetite & fluid balance
4. Immune fxn
5. Maternal-infant attachment
6. Enhances infant growth & brain development

Question 13

4 Phases of parturition:

Answer 13

PHASES:

1. Quiescence: prelude to parturition-contractile, unresponsiveness, cervical softening
2. Activation: Preparation for labor–uterine preparedness, cervical ripening
3. Stimulation: processes of labor–uterine cxn, cervical dilation, fetal & placenta expulsion (3 stages of labor)
4. Involution: parturient recovery, BF, cervical repair, uterine involution

Question 14

When does phase 1: quiescence start and finish?

Answer 14

conception to initiation of parturition

Question 15

When does phase 2: Activation start and finish?

Answer 15

Initiation of parturition to onset of labor

Question 16

When does phase 3: Stimulation start and finish?

Answer 16

Onset of labor to delivery of placenta

Question 17

When does phase 4: Involution start and finish?

Answer 17

Delivery of placenta to return of fertility

Question 18

When should membrane stripping be done?

Answer 18

Anytime after 40 wks, & can be repeated in 36-42hrs