Labor Flashcards

1
Q

6 PRODROMAL/PRELIMINARY SIGNS PRIOR TO TRUE LABOR

A

Lightening
Weight Loss
Increase Energy/ Activity Level
Braxton Hicks
Ripening of the Cervix
Rupture of Membranes

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2
Q

PRODROMAL/PRELIMINARY SIGNS PRIOR TO TRUE LABOR

Settling or descent of the fetal head into the
pelvic inlet, experience of “dropping” of the
baby (it happens 2 weeks before EDC)

A

Lightening

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3
Q

PRODROMAL/PRELIMINARY SIGNS PRIOR TO TRUE LABOR

why do they loss 1-3 pounds; 1-2 days; prior to labor onset

A

because of the decrease of
progesterone, may decrease in fluid
retention

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4
Q

PRODROMAL/PRELIMINARY SIGNS PRIOR TO TRUE LABOR

1-2 days prior to labor onset
why there is an increase in energy and activity level

A

; because of the increase of adrenaline
for the work ahead

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5
Q

PRODROMAL/PRELIMINARY SIGNS PRIOR TO TRUE LABOR

  • irregular painless “practice” contractions
  • -during at night
  • usually confine at abdomen only
A

Braxton-Hicks

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6
Q

PRODROMAL/PRELIMINARY SIGNS PRIOR TO TRUE LABOR

from Goodell sign to butter soft

A

Ripening of Cervix

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6
Q

PRODROMAL/PRELIMINARY SIGNS PRIOR TO TRUE LABOR

labor is inevitable (labor should occur within next the 24 hours and delivery should occur within 24 hours to avoid infection)
* sa ER, ask the client to lie down, check the fetal heart rate, tell the patient to avoid, to ambulate

A

Rupture of Membranes

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7
Q

4 SIGNS OF TRUE LABOR

A
  • Uterine contractions
  • Cervical Dilation and Effacement
  • Pain in the back that radiates around to the abdomen
  • Bloody Show/Show
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8
Q

SIGNS OF TRUE LABOR

  • surest signs of labor onset
  • it occurring during regular intervals and
    increases in duration and intensity, the
    intensity usually occurs in walking
A

Uterine Contractions

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9
Q

SIGNS OF TRUE LABOR

enlargement of external cervical
os up to 10 cm as a result of uterine
contractions and because of pressure of both presenting part and bag of water

A

Dilation

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10
Q

SIGNS OF TRUE LABOR

  • shortening and thinning of the
    cervical canal from 1 to 2 cm to one in which
    no canal as Distinct from the uterus exist
  • express in percentage
  • in a primipara, the cervix will first efface then, dilate; in a multipara, effacement and
    dilation occur simultaneously.
A

Effacement

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11
Q

SIGNS OF TRUE LABOR

expulsion of mucus plug, labor begins 2 to 3
days after bloody show or bloody show may be observed at the onset of labor
* pressure of the descending part of the fetus causes rupture of capillaries in the mucus
membrane of cervix

  • blood mixes with operculum in released
     result: pinkish vaginal discharge
     *if bright red, it means active ang
    bleeding
A

Bloody Show/Show

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12
Q

Phases of Uterine Contractions

s the first
phase during which the intensity of
contraction Increases

A

Increment (Crescendo)

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13
Q

Phases of Uterine Contractions

the hike of the uterine
contractions

A

Acme (Apex)

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14
Q

Phases of Uterine Contractions

the last phase during which intensity contraction decrease

A

Decrement (Decrescendo)

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15
Q

2 Distinct Portions of Uterus

becomes thick and active in order to expel the fetus
- The only part that contracts

A

Upper Uterine Segment

16
Q

2 Distinct Portions of Uterus

becomes a thin wall, supple and passive, that the fetus pushes out easily

A

Lower Uterine Segment

16
Q

formed at the boundary of the upper and lower uterine segment

A

Physiological Retraction Ring

17
Q

when the Fetus is larger than the birth canal the round ligament of the uterus becomes tense during expulsion, this tense will result
in the formation of abdominal indentation

 Danger sign of labor

A

Pathological Retraction Ring (Bandal’s
Ring)

18
Q

MECHANISM OF LABOR

the Fetus has reached the pelvic inlet

A

Engagement

19
Q

MECHANISM OF LABOR

From AP to transverse, then AP to AP, fetal head rotates to
accommodate itself to changing diameter of the pelvis

A

Internal Rotation

19
Q

MECHANISM OF LABOR

as descent occurs, pressure from
the pelvic floor causes the fetal chin to bend towards the chest

A

Flexion

19
Q

MECHANISM OF LABOR

fetus goes down the birth canal

A

Descent

20
Q

MECHANISM OF LABOR

as head comes out, the back of
the neck beneath the pubic arch l, the head
extends and the forehead, nose, mouth the chin
appear

A

Extension

20
Q

MECHANISM OF LABOR

the delivery of the rest of the
baby’s body

A

Expulsion

20
Q

1ST STAGE OF LABOR

begins with onset of the regular contractions and ends with complete dilation and effacement

A

CERVICAL DILATION

20
Q

MECHANISM OF LABOR

anterior shoulder rotates externally to the AP position so that it is just behind the symphysis pubis

A

External Rotation (Restitution)

21
Q

2ND STAGE OF LABOR

begins with complete Cervical dilation and effacement and ends with delivery of the Fetus

A

EXPULSION

21
Q

3RD STAGE OF LABOR

begins immediately after Fetus is born and ends when the placenta is delivered

A

PLACENTAL STAGE

22
Q

STAGE OF CERVICAL
DILATION

 Cervical Dilation: 0-3 cm
 Cervical effacement in primipara is usually complete before dilatation; in multipara, it occurs with dilatation
 Duration: 8-10 hours
 Uterine contractions are mild, 5-30 minutes apart, and last 10-30 seconds
 Membranes ruptured or intact
 Scant brown or pink vaginal discharge or mucus plug
 Station: primipara usually 0; multipara -2 to 0
 FHR: clearest at level or below umbilicus (dependent on fetal position)
 Woman’s reaction: alert, talkative, nervous, excited with some degree of apprehension but still with ability to communicate
 Breathing techniques: deep chest or abdominal breathing

A

Latent Phase

22
Q

4TH STAGE OF LABOR

begins after the delivery of the placenta and continues for 1-4 hours after delivery

A

MATERNAL
HOMEOSTATIC STABILIZATION STAGE

22
Q

STAGE OF CERVICAL
DILATION

 Cervical Dilation: 8-10 cm
 Duration: 1-2 hours
 Uterine contractions are strong, 2-3 minutes apart, last 45-60 second
 Copious bloody mucus
 Station: +2, +3
 FHR: clearest directly about symphysis pubis
 Woman’s reaction: mood suddenly changes, fatigue, perhaps nauseated
 If spontaneous BOW rupture does not occur, Amniotomy (snipping of BOW with a sterile pointed object) is done to let AF drain out, preventing fetus from aspisting AF into lungs
 Breathing Techniques: high chest, pant blow breathing
 Presence of uncontrollable urge to push with contractions so profuse perspiration and
neck vein distention are seen

A

Transition Phase

23
Q

STAGE OF CERVICAL
DILATION

 Cervical Dilation: 4-7 cm
 Duration: approximately 6 hours
 Uterine contractions are moderate, 3-5 minutes apart, last 30-45 seconds
 Scant to moderate bloody mucus
 Station: 0 to +1
 FHR: heard slightly below umbilicus or lower abdomen
 Woman’s reaction: with fears of losing control of self, becoming less outgoing, more introverted, concentrating on breathing patterns
 Breathing techniques: accelerate shallow panting (pant-shallow rapid respirations)

A

Active Phase