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NUR 359: OB > Labor and Birth > Flashcards

Labor and Birth Flashcards

1
Q

def labor

A

progressive cervical changes, in the presence of regular, frequent, painful uterine cxns

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2
Q

factors that contribute to the birth passage

A
  • size of pelvis
  • type of pelvis
  • ability of cervix to dilate
  • ability of vaginal canal to distend
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3
Q

birth of fetus

A
  • head
  • attitude
  • lie
  • presentation
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4
Q

def fetal attitude

A
  • relation of the fetal body parts to one another
  • “characteristic posture”
  • usually a position of general flexion
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5
Q

def fetal lie

A

-relation of the spine of the fetus in relation to spine of the mom

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6
Q

what position do you want the fetal lie to be?

A

parrallel, vertical

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7
Q

def fetal presentation

A

the part of the fetus that enters the pelvis first

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8
Q

what fetal presentation do you want and is most common

A

cephalic

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9
Q

what factors contribute to passage

A

engagementstationfetal position

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10
Q

def engagement

A

the largest diameter of the presenting part that has passed into the true pelvis

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11
Q

true pelvis is considered what station

A

“0” station

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12
Q

when does engagement typically happen

A
  • weeks before labor

- “baby has dropped”

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13
Q

what might mom experience with engagement

A
  • urinary freq
  • back ache
  • easier breathing
  • less heart burn and reflux
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14
Q

def station

A

relation of the presenting part of the fetus to the ischeal spine
- determining the rate of descent

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15
Q

what station does real labor start

A

“0” station

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16
Q

def fetal position

A

position of the baby in utero

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17
Q

what are the physiologic forces of labor?

A
  • freq of cxns

- effectiveness of pushing

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18
Q

def interval of cxns

A

the period from the end of one cxn to the beginning of the next

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19
Q

def acme of cxn

A

the peak of a cxn

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20
Q

do we want the cxns to be regular or irregular?

A

regular

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21
Q

flow of cxns

A

increment
peak
decrement

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22
Q

ROM puts mom at risk for what?

A

infec

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23
Q

if mom is tired of pushing after a few hours, what should we do?

A

section mom

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24
Q

psychosocial considerations r/t labor and birth

A
  • mental and phys preparation
  • sociocultural values
  • previous experience
  • support
  • emotional status
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25
Q

stages of labor

A

stage 1-4

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26
Q

stage 1 of labor

A

-from onset to full dilation

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27
Q

what happens during stage 1 labor?

A
  • thinning and dilation of the cervix
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28
Q

stage 2 of labor

A

full dilation to delivery of baby

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29
Q

stage 3 labor

A

delivery of the placenta

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30
Q

stage 4 labor

A

recovery from delivery

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31
Q

how long does stage 4 labor last

A

approximately 2 hours

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32
Q

what are the 3 phases of labor

A

latency
active
transition

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33
Q

latency phase of labor

A
  • (0-3 cm) dilation

- 4-24 hrs

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34
Q

active phase of labor

A

(4-7 cm) dilation

3-5 hrs

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35
Q

transition phase of labor

A

(8-10 cm) dilation

1/2- 2 hrs

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36
Q

when can mom not be given an epidural

A

during the transition phase

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37
Q

why might mom be given an epidural during the latency phase of labor

A
  • to relax mom enough for labor to progress and allow descent of the baby
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38
Q

what is done upon admission of mom to the labor suite?

A 
hx
cxns
when they last ate
VS
US
vaginal exam
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39
Q

what might we ask mom upon admission to the suite pertaining to the cxns

A
  • when did they start
  • what were you doing when they started
  • how often are they
  • pain scale
40
Q

what in the hx should we ask mom upon admission to the labor suite?

A
  • how was the preg
  • GTPAL
  • previous births
41
Q

why do we ask mom about when they last ate when they get admitted to the labor suite?

A

in case they need to be sectioned

for the anesthesia

42
Q

when the mom is admitted to the labor suite, what do we determine with the US

A

station
gest age
placement

43
Q

what is determined when a vaginal examination is done upon admitting mom to the labor suite

A

effacement

dilation

44
Q

what do we measure with cxns?

A

freq
duration
strength

45
Q

how much fluid is expelled when ROM occurs

A

600-800 cc

46
Q

how do we determine of it is a true membrane rupture

A
  • speculum exam
  • pH 7.0-7.5
  • (+) ferning
47
Q

what color should the amniotic fluid be?

A

clear straw color

48
Q

if the amniotic fluid is greenish/black, what could this indicate?

A

infecmeconium

49
Q

does amniotic fluid normally have an odor?

A

no

50
Q

what should we suspect if the amniotic fluid has an odor

A

infec

51
Q

what is used to determine if there is a true ROM

A

nitrazine paper

52
Q

describe the device used for external fetal monitoring

A

2 belts

53
Q

what do the 2 belts on the external fetal monitoring do?

A
  • measure cxns

- FHR

54
Q

benefits of external fetal monitoring

A

see if baby is having decelsmonitor contractions

not invasive

55
Q

drawbacks to external fetal monitoring

A
  • mom cant get up an walk around

- not as accurate as internal

56
Q

what comprises the internal fetal monitoring system?

A
  • fetal scalp electrode

- intrauterine pressure cath

57
Q

what does the fetal scalp electrode do?

A

-internal FHR monitor

58
Q

what is the avg pressure of the internal fetal monitor

A

50-80

59
Q

what does the intrauterine pressure cath do?

A

measures and monitors cxns

60
Q

how does an intrauterine pressure cath work

A

coil needle is placed on the babys head

61
Q

what is the benefit of using internal fetal monitoring

A

more accurate than external

62
Q

what is the drawback of the internal fetal monitoring system

A

invasive

63
Q

what is the normal FHR range in utero?

A

110-160

64
Q

variability in FHR is ______

A

good

65
Q

def minimal variability

A

< 5 bpms

66
Q

def moderate variability

A

6-25 bpms

67
Q

def marked variability

A

> 25 bpms

68
Q

def accelerations

A

a 15 bpm incr for greater than 15 secs with return to baseline in less than 2 mins

69
Q

if an accel or decel occurs for longer than 2 mins, it is considered

A

a change in baseline

70
Q

accelerations are signs of

A
  • fetal awakeness

- well being

71
Q

when do early decels occur

A

when the cxn starts, the babys HR decr

72
Q

what causes early decels

A

head compression

vaginal exam

73
Q

when do late decels occur

A

they begin after the peak of the cxn

74
Q

what do late decels indicate

A
  • fetal hypoxemia
75
Q

are late decels cause for concern?

A

yes- take action immediately!!!

76
Q

def variable decels

A
  • a visually abrupt decel in FHR below the baseline
77
Q

what characterizes variable decels

A
  • a 15 bpm or more for at least 15 secs
78
Q

when do variable decels occur

A

can happen at any time

79
Q

what do variable decels indicate?

A

cord compression

80
Q

placental delivery sequence

A

cxn
globular uterus
cord lenthens
rush of vaginal blood

81
Q

def globular uterus

A

uterus becomes very soft

82
Q

what do we do when the cord lengthens?

A

gently guide it out

83
Q

if the placenta is expelled in fragments, mom is at a very high risk for what?

A

hemorrhage

84
Q

common analgesics used during labor

A

stadol

nubain

85
Q

what adverse rxn do analgesics cause and what should we monitor for?

A

resp depression

86
Q

regional anesthesia techniques

A

epidural
spinal
pudendal

87
Q

epidural anesthesia

A
  • cath inserted into epidural space
  • indwelling
  • hooked up to a pump
    -delivers continuous meds
88
Q

spinal anesthesia

A

-needle is injected, admin med, and removed

89
Q

what is a pudendal used for?

A
  • episiotomy or tear

- pain relief if mom needs stitches

90
Q

what is given before a pudendal

A

lidocaine

91
Q

what position should mom be in for the admin of regional anesthesia

A

sitting position nurse bear hugs mom

92
Q

what should we do with mom immediately after the admin of regional analgesics

A

have mom lie down immediatelyput feet up

93
Q

major side effects of regional anestesia

A
  • hypotension

- bladder distention

94
Q

natural pain mgmt methods

A 
lamaze
dick read
bradley
hypnobirthing
hydrotherapy
95
Q

what is a doula

A
  • a natural birth coach

- not a nurse

NUR 359: OB (15 decks)

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