LABOR and BIRTH Flashcards by Gerard Abapo

What is the most valid SIGN that a woman is in LABOR?

The onset of REGULAR-PROGRESSIVE CONTRACTION

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What is DILATION?

The OPENING of the CERVIX that goes from 0 - 10 cm.

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What is EFFACEMENT?

THINNING of the CERVIX (goes from thick to 100%)

A woman begins labor from thick and close /thick to zero cm.

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What is STATION?

The RELATIONSHIP of the FETAL PRESENTING PART to mothers’ ISCHIAL SPINE

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What is ISCHIAL SPINE?

Is the SMALLEST DIAMETER through which the baby has to fit to be born vaginally. The NARROWEST part of the PELVIS.

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What does NEGATIVE STATION mean?

The PRESENTING PART is ABOVE the NARROWEST part of the PELVIS [-1; -2]
(Positive Station/numbers [+3; +4] means the baby’s presenting part is below/made it through the NARROWEST PART of the Pelvis)
-1,-2,-1,-2 for 17 hrs., after FULLY DILATED and EFFACED
= Head too big - C-Section
+4 +3; +4 +3 for 17 hrs. = Vaginal Delivery
Remember: “Negative numbers are negative news” - baby way up and not coming down
“Positive numbers are positive news” - Baby’s coming out, it won’t be long now

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what STATION is ENGAGEMENT?

Station ZERO (meaning presenting part is at the ISCHIAL SPINE)

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What is LIE?

The RELATIONSHIP between the SPINE of the MOTHER and the SPINE of the BABY (If mom spine and baby’s spine are PARALLEL = GOOD; If mom’s spine and baby’s spine form an inverted “T” shape = Trouble=Transverse

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What is PRESENTATION?

PART of the BABY that ENTERS the BIRTH CANAL first
This is where you get the “Alphabet Soups” = ROA; ROP; LOA; LOP; RMP; RSA; RSP (Fetal Position) e.g. ROA - Right Occipital Anterior

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What are the 4 STAGES of LABOR and DELIVERY?

Stage 1 is LABOR

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What are the 3 PHASES of LABOR?

LATENT = Dilate from 0-4 cm.
Contractions Frequency is 5-30 mins apart
contraction Duration (how long they last) is 15-30 secs.; Intensity of contraction: Mild.
ACTIVE = Dilation from5-7cm.
Frequency is 3-5 mins.
Duration: 30-60 secs.
Intensity: moderate
TRANSITION = Cervical Dilation: 8-10 cm.
Frequency: 2-3 mins.
Duration: 60-90 secs.
Intensity: strong
(Remember the 1st 3 letters of the 1st phase: LAT)
NOTE: Contraction should NOT BE LONGER than 90 secs or CLOSER than EVERY 2 mins.

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What is STAGE 2 of LABOR?

DELIVERY of the BABY

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What is STAGE 3 of LABOR?

DELIVERY of the PLACENTA

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What is STAGE 4 of LABOR?

RECOVERY

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How long does RECOVERY STAGE last?

2 HOURS

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What is the PURPOSE of the UTERINE CONTRACTION in the 1ST STAGE of LABOR?

DILATE and EFFACE the CERVIX

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What is the PURPOSE of UTERINE CONTRACTION in the 2ND STAGE?

PUSH tHE BABY OUT

What is the PURPOSE of the UTERINE CONTRACTION in the 3RD STAGE?

PUSH the PLACENTA OUT

What is the PURPOSE of the UTERINE CONTRACTION in the 4TH STAGE?

STOP BLEEDING

When does POST PARTUM BEGINS?

2 HOURS AFTER DELIVERY OF THE PLACENTA

What is the PRIORITY in the 2ND PHASE of LABOR?

PAIN MANAGEMENT

What is the PRIORITY in the 2ND STAGE of LABOR?

CLEARING the AIRWAY

What is the IMPORTANT NURSING ACTION engaging in the 3RD PHASE of LABOR?

CHECKING DILATION, HELPING with PAIN, HELPING with BREATHING because woman is in the last intense part of labor to dilate

What is the MAJOR NURSING ACTION for the 3RD STAGE of LABOR?

Watching for Blood Loss, Check membranes in the Placenta make sure they are all intact, Make sure there are 3 vessels in the cord

A woman came into a Labor Suite. She is 5 cm., her contraction is every 5 mins. apart and they last for 45 secs. What Phase is she in?

ACTIVE PHASE

What are the signs of UTERINE TETANY/UTERINE HYPERSTIMULATION?

Contraction LONGER than 90 SECS. or CLOSER than EVERY 2 MINS.

What PARAMETERS to make you stop PTOCIN?

contraction LONGER than 90 SECS. or CLOSER than EVERY 2 MINS.

What is FREQUENCY?

The BEGINNING of ONE CONTRACTION to the BEGINNING of the NEXT CONTRACTION.

What would you teach a woman to time FREQUENCY? (these are 2 contractions)

A-beginning to C-beginning (including the contraction)

What is DURATION?

The BEGINNING to the END of ONE CONTRACTION

What NUMBER SEQUENCE would you tell a woman to time for DURATION?

A to B or C to D

What is INTENSITY?

The STRENGTH of CONTRACTION and is purely "Subjective" | Teach woman to PALPATE with ONE HAND OVER the FUNDUS with the PADS of the FINGERS (finger tips)

What are the COMPLICATIONS of LABOR?

1) PAINFUL BACK LABOR = LOP; ROP (think OP as Ohh Pain) Mgt.: You POSITION her on a knee-chest position, then PUSH (take your fist and push into her sacrum) ( facing back, knees and chest resting on the surface with buttocks up position) LOW PRIORITY

Another complication of labor?

PROLAPSE CORD = is a Meta OB emergency very bad that Baby can kill itself - When the cord is the presenting part, (which means to come out first) so when the head comes down and press on the cord, the baby dies. HIGH PRIORITY Mgt: PUSH - POSITION = PUSH the HEAD BACK UP (Head off the cord) then KNEE-CHEST POSITION - stay that way until they pull it out C-Section - you have to ride on the cart with the mother

What is the INTERVENTIONS for ALL OTHER COMPLICATIONS and LABOR BURDEN?

``` "LION" L - turn patient on their LEFT SIDE I - INCREASE I.V. O - OXYGENATE them N - NOTIFY PHYSICIAN ```

What do you do for MATERNAL HYPOTENSION?

"LION"

What do you do for ECLAMPSIA and TOXEMIA?

"LION"

What is PIT?

In an OB CRISIS, if PTOCIN is RUNNING, STOP IT | STOP the PIT then LION

What do you DO with PAIN MEDICATION in LABOR?

DO NOT ADMINISTER a PAIN MEDICATION to woman in LABOR if the BABY is LIKELY to be BORN when the MEDICATION PEAKS.

When does I.V. PUSH MEDICATIONS PEAK?

15-30 MINUTES after GIVING.

When does I.M. MEDICATION PEAKS?

30-60 MINUTES after GIVING