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Maternal/Child > Labor and Birth > Flashcards

Labor and Birth Flashcards

1
Q

dilation

A

the opening or enlargement of the external cervical

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2
Q

lightening

A

fetal presenting part begins to descend into the true pelvis

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3
Q

frequency

A

how often

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4
Q

duration

A

how long

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5
Q

intensity

A

how strong

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6
Q

false labor

A

occurs during the latter weeks of some pregnancies in which irregular uterine contractions are felt, but the cervix is not affected.

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7
Q

true labor

A

contractions occurring at regular intervals that increase in frequency, duration, and intensity. Progressive cervical dilation and effacement

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8
Q

5 P’s that affect the process of labor and birth

A 
Passageway (birth canal)
Passenger (fetus and placenta)
Powers (contractions)
Position (maternal)
Psychological response
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9
Q

5 P’s that can also affect the labor process

A 
Philosophy (low tech, high touch)
Partners (support caregivers)
Patience (natural timing)
Patient (client) preparation (childbirth knowledge base)
Pain management (comfort measures)
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10
Q

true pelvis

A

the bony passageway through which the fetus must travel

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11
Q

gynecoid pelvis

A

the true female pelvis, optimal shape

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12
Q

fetal attitude

A

degree of body flexion

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13
Q

fetal presentation

A

first body part that enters the pelvic inlet

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14
Q

molding

A

result of overlapping of the cranial bones

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15
Q

breech

A

feet or butt first

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16
Q

fetal station

A

the relationship of the presenting part to the level of the maternal ischial spines
measured in centimeters

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17
Q

fetal engagement

A

the entrance of the largest diameter of the fetal presenting part (usually head) into the smallest diameter of the maternal pelvis.

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18
Q

engagement

A

the greatest transverse diameter of the head passes through the pelvic inlet
1st cardinal movement

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19
Q

descent

A

the downward movement of the fetal head until it is within the pelvic inlet. Occurs with contractions.
Ends with birth.
2nd cardinal movement

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20
Q

flexion

A

the chin is brought into contact with the fetal thorax

3rd cardinal movement

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21
Q

internal rotation

A

as the head descends it rotates 45 degrees

4th cardinal movement

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22
Q

extension

A

resistance from the pelvic floor causes the fetal head to extend so that it can pass under the pubic arch.
anterior fontanel, brow, nose, mouth, chin are born
5th cardinal movement

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23
Q

external rotation (restitution)

A

the head realigns with the position of the back in the birth canal.
6th cardinal movement

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24
Q

expulsion

A

the rest of the body is born

7th cardinal movement

25
Q

7 cardinal movements

A 
engagement
descent
flexion
internal rotation
extension
external rotation (restitution)
expulsion
26
Q

amniotomy

A

artificial rupture of membranes

27
Q

what suppresses the spontaneous contractions of the uterus?

A

progesterone

28
Q

First stage of labor

A

progressive dilation of the cervix, ends when dilated to 10. BOW usually rupture during this stage but sometimes earlier or later. Divided into three phases-latent, active, transition

29
Q

latent phase of first stage of labor

A

begins with start of regular contractions and end when rapid cervical dilation begins. Cervix dilates from 0-3 cm.

30
Q

active phase of first stage of labor

A

starts at end of latent phase until complete cervical dilation. Dilates from 4-7 cm. Effacement 40%-80% More frequent contractions

31
Q

transition phase of first stage of labor

A

dilation slows, progresses from 8- 10 cm. 80%-100% effacement. Worst contractions happen

32
Q

Three phases of the first stage of labor

A

latent, active, transition

33
Q

Second stage of labor

A

begins with the complete cervical dilation and effacement and ends with the birth of the newborn.

34
Q

pelvic phase of second stage of labor

A

fetal head is negotiating the pelvis, rotating, and advancing in descent

35
Q

perineal phase of second stage of labor

A

the fetal head is lower in the pelvis and is distending the perineum.
Strong urge to push
phase AKA active pushing

36
Q

2 phases of the second stage of labor

A

pelvic

perineal

37
Q

third stage of labor

A

begins with the birth of the newborn and ends with the separation and birth of placenta

38
Q

placental separation of the third stage of labor

A

contractions cause the placenta to pull away from the uterine wall

39
Q

placental expulsion of the third stage of labor

A

continued uterine contractions cause the placenta to be expelled.
Uterus is then massaged.

40
Q

normal blood loss for vaginal birth

A

500 ml

41
Q

normal blood loss for c-section

A

1,000 ml

42
Q

2 phases of the third stage of labor

A

placental separation

placental expulsion

43
Q

Fourth stage of labor

A

begins after expulsion of placenta and membranes and ends with the initial physiologic adjustment and stabilization of the mother. Closely monitor mother

44
Q

how much should the cervix dilate an hour

A

1 cm/ hr

45
Q

cloudy or foul smelling amniotic fluid indicates?

A

infection

normal should be clear and odorless

46
Q

electronic fetal monitoring (EFM)

A

detects fetal pulse by sensing and analyzing tissue movements via doppler ultrasound.

47
Q

continuous cardiotocography (CTG)

A

predominant method of fetal monitoring.

External, two ultrasound transducers, attached to a belt, applied to womans abdomen.

48
Q

continuous internal monitoring

A

usually indicated for women or fetuses considered to be high risk
placement of a spiral electrode into the fetal presenting part.- FHR
AND pressure transducer placed internally to record uterine contractions

49
Q

4 criteria for continuous internal monitoring to be used

A

ruptured membranes
cervical dilation of at least 2 cm
fetus low enough for placement of electrode
skilled practitioner available to insert the electrode

50
Q

baseline FHR

A

the average FHR that occurs during a 10 minute segment that excludes periodic or episodic rate changes, such as tachy or bradycardia.
Assessed when no contractions are happening

51
Q

causes of fetal bradycardia

A

fetal hypoxia
prolonged maternal hypoglycemia, fetal acidosis, analgesics to mother, hypothermia, epidural, maternal hypotension, fetal hypothermia, prolonged umbilical cord compression, fetal congenital heart block.

52
Q

causes of fetal tachycardia

A

asphyxia, fetal hypoxia, maternal fever, maternal dehydration, amnionitis, drugs, maternal hyperthyroidism, maternal anxiety, fetal anemia, prematurity, fetal infection, chronic hypoxemia, congenital abnormalities, fetal heart failure, fetal arrhythmias.

53
Q

periodic baseline changes

A

temporary, recurrent changes made in response to a stimulus such as a contraction.

54
Q

deceleration

A

a transient fall in FHR caused by a stimulation of the parasympathetic nervous system.

55
Q

early decelerations

A

gradual decrease in the FHR in which the nadir (lowest point) occurs at the peak of the contraction

56
Q

late decelerations

A

occur after the peak of the contraction. NOT GOOD, can indicate fetal hypoxia

57
Q

variable decelerations

A

abrupt decreases in FHR below baseline and have an unpredictable shape on the FHR baseline, possibly demonstrating no consistent relationship to uterine contractions.
Associated the cord compression

58
Q

effleurage

A

light, stroking, superficial touch of the abdomen, in rhythm with breathing during contractions.

59
Q

epidural

A

injection of drug into the epidural space, entered through the third and fourth lumbar vertebrae

Maternal/Child (4 decks)

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