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Ngozi's Family Health > L&D I > Flashcards

L&D I Flashcards

Exam 2

1
Q

What are the components of the birthing process?

A

Powers, Passage, Passenger, Psyche

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2
Q

What do the powers refer to in the birthing process?

A

Forces responsible for moving the fetus through the birth canal

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3
Q

What does the passage refer to in the birthing process?

A

The mother’s pelvis and its role in facilitating the passage of the fetus

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4
Q

What does the passenger refer to in the birthing process?

A

The fetus and its position and presentation in relation to the maternal pelvis

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5
Q

What does the psyche refer to in the birthing process?

A

The emotional and psychological well-being of the mother during labor

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6
Q

Why are contractions intermittent?

A

Gives baby time to rest

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7
Q

Why is it best to take a clients vital signs during the interval between contractions?

A

BP increases when blood shunts away from the uterus during contractions

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8
Q

How can supine hypotension be managed?

A

Tilt hips with pillows to a lateral positions to promote blood return

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9
Q

What can cause hyperventilation during labor?

A

Pain, anxiety

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10
Q

How can hyperventilation be managed?

A

Help them breathe

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11
Q

What effect does the birth process have on gastric motility?

A

Reduced gastric motility

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12
Q

What dietary recommendation is given for reduced gastric motility during labor?

A

Clear liquids

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13
Q

How often should a woman void her bladder during labor?

A

Void every two hours

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14
Q

What can happen if the bladder is full during labor?

A

Decreased fetal descent

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15
Q

How much blood loss is expected during labor?

A

500 to 1000 mL

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16
Q

How much does blood volume increase during pregnancy?

A

40 to 45%

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17
Q

What are the hemoglobin and hematocrit levels during labor that do not require nursing interventions ?

A

Hemoglobin of at least 11, hematocrit of 30

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18
Q

Why do mom only get clear liquids?

A

Aspiration

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19
Q

How often should the mother be encouraged to void?

A

Every two hours

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20
Q

What should be monitored for during labor?

A

Blood clots

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21
Q

What is the normal heart rate range in utero?

A

110 to 160

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22
Q

What are the physiologic effects of the birth process on the fetus?

A

Placenta circulation, cardiovascular system, and pulmonary system

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23
Q

Can diabetes and hypertension impair placental circulation?

A

Yes

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24
Q

What is a potential effect of fetal anemia during labor?

A

Difficulty during labor for the fetus

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25
Q

What is the significance of labor in terms of the fetal pulmonary system?

A

Helps move fluids out of the lungs

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26
Q

Are c-section babies at higher risk for respiratory distress and crackles in their lungs?

A

Yes

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27
Q

What is the primary force moving the fetus through the maternal pelvis during the first phase of labor?

A

Uterine contractions

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28
Q

What can happen if uterine contractions are not strong enough?

A

Labor will not progress

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29
Q

What does the woman use to add power to the contraction and push the fetus through the pelvis during the second stage of labor?

A

Her voluntary pushing efforts

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30
Q

What can happen to pushing efforts if the epidural is not working properly?

A

They will be decreased

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31
Q

What can help make contractions stronger?

A

Oxytocin IV

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32
Q

How may pain tolerance affect pushing?

A

May not be able to push well

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33
Q

What is cervical dilation and effacement?

A

The process of opening and thinning of the cervix during labor.

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34
Q

Who does effacement typically take longer for?

A

First-time mothers (primigravida) and does not take a s long for multigravida mothers

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35
Q

What does nulliparous mean?

A

A female who has never carried a pregnancy beyond 20 weeks.

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36
Q

What is the most important factor for the outcome of childbirth?

A

Maternal pelvis

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37
Q

What can cause a c section during childbirth?

A

Maternal pelvis shape

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38
Q

What hormone causes the cartilage linking the pelvic bones to soften near term?

A

Relaxin

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39
Q

What is the best pelvis shape for delivery?

A

Gynecoid

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40
Q

Which pelvis shape can deliver vaginally but may result in the fetus being in the opposite posterior position?

A

Anthropoid

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41
Q

Which pelvis shapes are harder to deliver vaginally?

A

Android and platypelloid

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42
Q

Can you determine the pelvic shape prior to birth?

A

No

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43
Q

What allows the head to move through the cervix?

A

suture lines are not fused so the bones can overlap event and allows the head to move through.

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44
Q

What is shoulder dystocia?

A

Difficulty delivering the shoulders

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45
Q

Why is it easier to deliver the shoulders if the head is already out?

A

Typically if head is out, shoulders can also be delivered

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46
Q

What are the two types of lie?

A

Longitudinal or transverse

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47
Q

Which type of lie do we want?

A

Longitudinal

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48
Q

What is the likely outcome if the baby is in a transverse lie?

A

C-section

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49
Q

What is an external version?

A

Attempting to move the baby into the right position

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50
Q

What is a major risk with external version?

A

Placental abruption

51
Q

What is the most common preparation for a transverse lie?

A

C-section

52
Q

What is the preferred position during childbirth?

A

Flexion

53
Q

What position should be avoided during childbirth?

A

Extension

54
Q

What cephalic presentation would you ideally want?

A

vertex with complete flexion because it does not cause as much pressure on the cervix

55
Q

What is the ideal position for a baby during birth?

A

Complete flexion with cephalic presentation

56
Q

Why is complete flexion with cephalic presentation ideal?

A

The head is harder and larger in diameter, putting more pressure on the cervix

57
Q

What is the term for the ideal position of the baby’s head during birth?

A

Vertex position

58
Q

Why won’t a vaginal birth be done if the baby is in the frank position?

A

Baby cannot breath if cord is in frank

59
Q

What are some risk factors for a breech presentation?

A

Multiple gestation, placenta previa, hydrocephaly

60
Q

What are the possible positions for a baby during childbirth?

A

First letter Right (R) or Left (L)
Occiput (O), Mentum (M), or Sacrum (S)
and Anterior (A), Posterior (P), or Transverse (T)

61
Q

What does LOA stand for?

A

Left Occiput Anterior

62
Q

What does ROA stand for?

A

Right Occiput Anterior

63
Q

What does OP stand for?

A

Occiput Posterior

64
Q

What does OA stand for?

A

Occiput Anterior

65
Q

Why is it preferable for a baby to be in the OA position?

A

Baby will be looking down when it first comes out

66
Q

What is the OP position?

A

Baby’s face is looking up at the ceiling

67
Q

What can be done to help a baby get into the OA position?

A

Different position changes/movement of the mother

68
Q

What is the occipital?

A

The back of the head

69
Q

What is an important aspect of childbirth?

A

Mother’s psyche

70
Q

How can anxiety affect labor?

A

Affect coping and progression

71
Q

What can culture and expectations influence during childbirth?

A

Experience of birth

72
Q

What can help decrease anxiety and fear during childbirth?

A

Prenatal classes, hospital tour, education

73
Q

How can culture and expectations affect childbirth?

A

Men in the room, epidural, hospital preference

74
Q

What is the goal when providing care during labor?

A

Safe delivery while honoring their desired experience

75
Q

What are some premonitory signs of labor?

A

Braxton Hicks contractions, lightening, increase in vaginal secretions, bloody show, energy spurt, small weight loss

76
Q

What are Braxton Hicks contractions?

A

False contractions

77
Q

What can cause Braxton Hicks contractions?

A

Dehydration and being hot

78
Q

What can make Braxton Hicks contractions go away?

A

Resting after being active

79
Q

When should you seek medical attention regarding Braxton Hicks contractions?

A

If they do not go away after rest

80
Q

What should you do if you’re leaking fluid and your baby is not good?

A

Seek medical attention

81
Q

What is lightening?

A

When the baby drops lower and allows mom to breath

82
Q

What is the possible significance of a bloody show?

A

Could indicate the mucus plug being expelled, but not necessarily true labor

83
Q

Is small weight loss at the end of pregnancy normal?

A

Yes, 1-3 pounds can be normal

84
Q

What are the signs of true labor?

A

Increased contractions, increased discomfort, cervical change

85
Q

What are the signs of false labor?

A

Inconsistent contractions, discomfort is more annoying than painful

86
Q

What is the most important sign of true labor?

A

Progressive effacement and dilation of the cervix

87
Q

When should a patient enter the birth center for evaluation?

A

If she is uncertain or has concerns

88
Q

What does false labor contractions feel like?

A

Inconsistent in frequency, duration, and intensity.
A change in activity, such as walking, does not alter contractions, or activity may decrease them.

89
Q

What does cervical change look like in true labor?

A

Effacement and/or dilation of cervix occurs. Progressive effacement and dilation of cervix are most important characteristics.

90
Q

What does true labor contractions feel like?

A

A consistent pattern of increasing frequency, duration, and intensity usually develops.
Walking tends to increase frequency and strength of contractions.

91
Q

What does discomfort feel like in true labor?

A

Begins in lower back and gradually sweeps around to the lower abdomen like a girdle.
Back pain may persist in some women. Early labor often feels like menstrual cramps.

92
Q

Where is false labor discomfort feel like?

A

abdomen and groin
may feel more annoying than truly painful

93
Q

What are the mechanisms of labor?

A

Descent, Engagement, Flexion, Internal rotation, Extension, External rotation, Expulsion

94
Q

What is engagement of the presenting part?

A

Positioning of the baby’s head in the pelvis

95
Q

What is flexion of the fetal head?

A

Bending of the baby’s head towards the chest

96
Q

What is internal rotation?

A

Rotation of the baby’s head to align with the mother’s pelvis

97
Q

What is extension of the fetal head?

A

Baby’s head moving out of the birth canal with the neck extended

98
Q

What is external rotation?

A

Rotation of the baby’s shoulders to facilitate delivery

99
Q

What is expulsion of the fetal shoulders and body?

A

Delivery of the rest of the baby’s body after the head

100
Q

What are the stages of labor?

A

First, second, third, and fourth stage

101
Q

What happens during the latent (0-5) phase of the first stage?

A

Mom is socially engaged and excited
This is a good time to educate

102
Q

What happens during the active phase (6-9) of the first stage?

A

Contractions get stronger and closer together

103
Q

How long is the second stage of labor for multiparas?

A

1 to 3 hours

104
Q

What happens during the third stage of labor?

A

Birth to delivery of placenta, expect a gush of blood

105
Q

How long is the fourth stage of labor?

A

4 hours

106
Q

What is the first stage of labor?

A

Latent phase

107
Q

What is the cervix dilation range during the latent phase?

A

0-5 cm

108
Q

What is characteristic of moms during the latent phase?

A

Engaged, excited, social

109
Q

What is the best time for education during labor?

A

Latent phase

110
Q

What is the second stage of labor?

A

Active phase

111
Q

What is the cervix dilation range during the active phase?

A

6-9 cm

112
Q

What happens to contractions during the active phase?

A

They become stronger and closer together

113
Q

What symptom may occur during the active phase?

A

Nausea and vomiting

114
Q

What primary characteristic might the mom exhibit during active phase if experiencing natural childbirth?

A

Less social

115
Q

What happens during the second stage of labor?

A

Cervix dilation from 10 cm to birth

116
Q

How long does it typically take for multiparas to deliver during the second stage?

A

1 to 3 hours

117
Q

How long does it typically take for primiparas to deliver during the second stage?

A

2 to 4 hours

118
Q

What is normal during the delivery of placenta?

A

A gush of blood

119
Q

How long does it take for the placenta to be delivered?

A

Approximately 6 minutes

120
Q

What may be felt during the delivery of placenta?

A

A little pain

121
Q

What should be checked in the fourth stage of birth?

A

Fundus and bleeding

122
Q

How long does the recovery stage last?

A

4 hours

123
Q

What is the main concern during the fourth stage?

A

Hemorrhaging

Ngozi's Family Health (7 decks)

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