Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

VEEB > Labor and Delivery(HD) > Flashcards

Labor and Delivery(HD) Flashcards

1
Q

Labor

A
  • process by which the baby is expelled
  • 4 stage process or sequence of events that begin with progressive consistent uterine contractions and ends 1hr after delivery of baby
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Stage 1 of Labor

A

rhythmic contractions to 10cm cervix dilation
1-latent phase-slow/mild
2-active phase-alot of activity
3-transition phase-from baby being inside to out

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Stage 2 of Labor

A

-dilated cervix to birth of baby

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Stage 3 of Labor

A

-birth of baby to delivery of placenta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Stage 4 of Labor

A

-1-4 hrs after delivery of placenta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

how long stage of labor 1-4

A

-16-36hrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Factors Effecting Labor(Passageway)

A
  • the structure the fetus passes through(size) of pelvis

- size of pelvis, cervix, vagina, baby

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Factors Effecting Labor(Passenger)

A

-size and position of fetus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Factors Effecting Labor(Power)

A

-intensity of contractions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Factors Effecting Labor(placenta)

A

-can separate to early where placenta is attached

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Factors Effecting Labor(Psyche)

A

-moms emotional status

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Factors Effecting Labor(Position)

A

-maternal position and gravity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Passageway

A
  • True vs False pelvis- linea terminals
  • True pelvis: pelvic inlet, cavity, outlet
  • size and shape of pelvis has effect on delivery of baby
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Soft tissue(passageway)

A

-vagina cervix

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Effacement(passageway)

A
  • dilation of internal os
  • shorteining/flattening
  • measured in percentage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Dilation(Passageway)

A
  • cervix thins out
  • 0-10cm
  • how open it is
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

vagina(passageway)

A

-rugae is going to stretch as baby is coming through

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Fetal Skull(passenger)

A
  • molding
  • cephalo pelvic relationship(CPD)
  • size of head/size of pelvis is disproportion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Fetal lie(passenger)

A
  • how baby is lieing in mother uterus
  • position of fetus long axis in relation to moms long axis
  • longitudinal transverse,oblique
  • how do the vertebrae line up
  • if the baby vertebrae lines up with mothers=longitudinal lie
  • tranverse= ——-
  • oblique= baby at an angle
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Fetal Presentation(passenger)

A
  • what part of the fetus is coming into the pelvis first
  • ideally we want head first
  • cephalic
  • vertex=ideal presentation=tip of head
  • military=top head
  • brow=forhead coming first= chance for neck injury
  • face=face first=least preferable
  • breech=any other part of the body=feet,buttock,shoulder
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Fetal Attitude

A
  • relationship of fetal parts to its self/ one another

- flexion-head down, arms and legs up, smallest part of head entering first

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Fetal Position

A
  • relationship of the presenting parts to moms pelvic 4 quadrants
  • 3 letters used
  • side of moms pelvis (L or R)
  • reference point of presenting part
  • O=ossiput(head first)
  • M=mentum(face first)
  • S Sacrum(back first)
  • anterior or posterior quadrant(A or P)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Fetal station/engagement

A
  • relationship of presenting part to ischial spine
  • measured in cm
  • represents descent
  • negative to positive
  • engaged at zero station
  • how up high the fetus is
  • -5-+5
  • +5 you get to see fetus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Powers(contractions)

A

-involuntary contractions of the uterus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Phases of contractions(Increment)

A

-build up of contractions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Phases of contractions(Acme/Peak)

A

-peak of contractions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Phases of contractions(Decrement)

A

-letting up phase of contractions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Frequency

A
  • how often from beginning of one to start of the next
  • period of relaxation
  • o2 goes down during contraction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Duration

A
  • how long from beginning to end of one contraction
  • how long each contraction last
  • beginning very short
  • ready for delivery if a min or more
  • lasting 90secs is too long fetus is without oxygen
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Intensity

A
  • how strong contractions are
  • subjective
  • relying on what mom tells us
  • document by feeling the uterus
  • stiff/hardening during contraction
  • increase as birth becomes iniment
  • fhr decrease 110, fetal distress during a contraction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Placenta

A
  • upper portion of uterus

- detaches from wall with contractions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Position(Maternal)

A
  • prior to delivery standing/walking
  • traditional lithatomy position
  • using gravity to assist with descent
  • left side lying(fetal distress)-off of blood vessels
  • knee chest(prolapse cord)
  • birthing beds
  • water delivery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Psyche

A
  • can lengthen /shorten behavior
  • mothers emotional state
  • support system
  • previous history
  • can interfere with progression
  • keep mom calmn and focus and trust
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Pain control(natural alternative)

A
  • postitioning
  • relaxation techniques
  • control breathing w/ effleurage(massaging circular motion in abdomen
  • positive imagery
  • distractions
  • accupressure
  • massage
  • individual comfort measures
  • cultrual implications
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Pain control(Analgesics)

A
  • provides emotional and physiological benefits but can interfer with resp. system of newborn. not given if birth is anticipated within one hour
  • opiates=decrease perception of pain
  • sedatives-used in latent phase(allows mom to rest)
  • tranquillizer-relaxes mom
  • narcotics-given during active phase
  • cultural implications-some culures view medication as sign of maternal weakness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Anesthesia(general)

A

-mom is completely asleep

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Anesthesia(pudenal block)

A
  • local in the perinieum

- good for episiotomy

38
Q

Anesthesia(Epidural)

A
  • blocks pain sensation
  • catheter in epidural space(med dripping in)
  • must have i/v
  • potentential for hypotension(monitor bp)
39
Q

Anesthesia(spinal)

A
  • injection in the 3,4,5 space
  • must lie flat
  • potential for headache
40
Q

Continuous Fetal Monitoring

A
  • FHR decreases during contraction
  • temporary lack of oxygen
  • HR should return to 120 btw contractions
  • monitoring gives ongoing fetal status
41
Q

External Assessment of fetus

A
  • fetal heart rate(120-160)
  • intensity of contractions
  • permanent record
  • frequent adjustments needed
42
Q

Internal assessment of fetus

A
  • ruptured membrances
  • accurate assessment
  • monitor FHR
  • intensity of contractions
  • risk of infection
  • permanent record
43
Q

Variable FHR deceleration

A
  • deceleration begins and ends abruptly
  • not consistent
  • umbilical cord compression
44
Q

Late FHR deceleration

A
  • delay in decrease
  • does not go back to baseline
  • uteroplacental insufficiency=not enough oxygen to placenta
45
Q

Maternal Response to Labor

Cardiovascular

A
  • BP and HR increase during first and second stage
  • Return to pre-labor levels during the 3rd and 4th stage
  • increase in HR during secong stage
46
Q

Maternal Response to Labor

Respiratory

A

-increase in respiration rate prine to blood gas disturbances

47
Q

Maternal Response to Labor

Renal

A
  • trace of protein as a result of muscle breakdown during labor
  • potential for derease urinary flow due to postition
48
Q

Maternal Response to Labor

GI

A
  • peristalsis and absorption decreases

- NPO: except ice chips

49
Q

Maternal Response to Labor

Fluid balance

A
  • muscle activity increase body temp
  • increase sweating and fluid evaporation
  • increase rate can alter balance
50
Q

Signs and Symptoms of Impending Labor

A
  • lightening=baby drops into pelvic cavity
  • Braxton Hicks contractions
  • cervical changes=effacement and dilation
  • increased energy(nesting)
  • weight loss(fluid shift)
  • rupture of amniotic membranes
  • 1000ml of fluid
  • nitrazine to determine ph of
  • amniotic=alkaline
  • urine is acidic
51
Q

Characterisitcs of True Labor

A
  • regular intervals
  • located in the back
  • increase frequency,duration,intensity
  • walking intensifies
  • cervica; changes
  • sedation doesnt decrease number
52
Q

Characteristics of False Labor

A
  • irregular intervals
  • located in abdomen
  • NO increase of frequency,duration,intensity
  • walking eases
  • no cervical changes
  • sedation decreases number
53
Q

Mechanism of Labor(cardinal movements)

pg. 128

A 
1-Engagement
2-Descent
3-Flexion
4-Internal Rotation
5-Extension
6-External Rotation
7-Expulsion
54
Q

First stage of Labor

A
  • Starts with onset of contractions and ends at 10cm dilation
  • longest stage of labor(10-16hrs)
  • higher the parity(number of births) shorter the labor
  • has 3 stages: Latent,Active,Transition

Latent Stage:

  • sedative may be given
  • 0-3cm
  • longest stage
  • effacement starts
  • contractions q20-q5
  • 15-40secs/mild

Active Stage:

  • 4-7cm
  • amniotic rupture
  • contractions 2-5mins
  • 40-60secs/mild-moderate
  • pain med can slow down contraction
  • pain medication given end of the latent phase
  • once get to 7cm no more pain medication

Transition Stage:

  • 8-10cm; fully effaced and completly dilated
  • difficult for mom
  • moody,argumentive,combative
  • contractions q2mins
  • 60-90secs/firm
  • shortest phase of first stage but most difficult for mom
55
Q

Nursing care for First stage of Labor

A
  • Monitor FHR
  • Time and assess contractions; beginning of one end to next, feeling uterus tightening
  • Monitor mothers vs/ i&o; for increased vital signs
  • NPO-ice chips(limited), peristalsis has slowed down
  • IV fluids(change frequently)
  • vaginal exams by MD and RN
  • encourage breathing techniques
  • pain management
  • monitor mothers response
  • change postition(what ever makes more comfortable and non-compromising)
  • positive encouragement
56
Q

Second Stage of Labor

A
  • Mechanisms of Labor
  • Begins with 10cm dilation and ends with birth of baby
  • Bulging perineum
  • Elevated Bp during contractions
  • Episiotomy may be done
  • Bladder distention(impedes descent)
  • unable to dollow directions
  • uncontrollable urge to push
  • for head of baby to come out(multipara=30mins)(primi=3hrs)
  • check perineum when mom feels pressure in area and she wants to go to the bathroom
57
Q

Nursing Care-Second stage of Labor

A
  • continued monitoring of mothers Vs and FHR
  • Vs between contractions
  • mother is pushing
  • episotomy done if needed
  • support back or assume appropriate positions
  • check for bladder distention
  • assist with breathing and pushing
  • prepare resuscitation equipment for baby
  • cord is clamped and cut when pulsating stops
  • baby is shown to mom and support person
58
Q

Third Stage of Labor

A

-Begins with birth of baby ends with placental expulsion
-5-60min after baby is born
-signs and symptoms of placenta detachment
-cord stops pulsating
-lengthening of cord
-gush of blood
Mechanisms
-Schultz-fetal side=shiny
-Duncan-maternal side=raw/lumpy

59
Q

Nursing Care-Third stage of Labor

A

Mom

  • assess placenta
  • monitor mothers VS
  • potential for hemorrhage(Diaphoresis,decreae Bp, increase HR/Pulse
  • massage uterus
  • obtain cord blood if needed for stem cells

Baby

  • dry off and assess infant
  • apgar score
  • apply id bands to infant and parents
  • assess and allow for parent/infant bonding
60
Q

Apgar Score

A
  • 8-10 acceptable
  • 1min and 5min of life
  • 4-7=ok
  • below 3 baby is in trouble
61
Q

Fourth Stage of Labor

A
  • recovery stage
  • begins with delivery of placenta
  • involution takes place-takes about 6weeks for everything to go back into place
  • lasts 1- hrs
  • frequent assessment of mother
  • potential for hemorrhage
62
Q

Nursing care-4th stage of Labor

A 
monitor moms VS
-q15min then q30mins then q1hour
asses fundus
-firm-ripe plum
-if boggy-massage
-if ridged-cal MD
-just below umbilicus
-midline
-if to one side have mom empty bladder
I&O
-assess bladder
Monitor Lochia color and amount
-lochia is post partum bleeding
-pain in urination is normal
-lochia no oder, should progress forward
-300cc-500cc=normal blood loss during birth
-Lochia Rubra=red,small clots=should not bleed through pad less than 2hrs-2-3days
-Lochia Serosa=pinkish 4-7days
-Lochia Alba=whitish color-up to couple weeks
Pain Management
-after pain
-ice to peri area
Allow mom to rest
-allow for parent/infant bonding
63
Q

Nursing care of neonate

A 
immediate care
-suction
-clean secretions
-vernix=cheesy substance
-instillation of neomycin drops for opthalmia neonatorum
Provide warmth
-warm blanket
-heated bassinet
-radiant heat
-hat
General Observation
-body structures intact
-skin-milia(white spot)(clogged pores)
-acrocyanosis-blueish color of hands and feet
-fontanels-triangular
-caput succedaneum: pointed shape of head due to edema
-cephalo hematoma: accumulation of blood btw skull and periosteum
64
Q

Labor

A

process of that begins with uterine contractions and ends one hour after delivery of the baby

65
Q

Effacement

A

thinning and shortening of the cervix

66
Q

Dilation

A

opening of the cervix

67
Q

Cephalo-pelvic relationship

A

size of fetal head in relation to mom pelvis

68
Q

Lie

A

relation of fetus long axis to moms long axis

69
Q

Attitude

A

degree of flexion of fetus; relationship of fetal body parts to each other

70
Q

Presentation

A

the part of the fetus that enters the pelvis first

71
Q

Position

A

relationship of the fetus presenting part to the mothers 4 quadrants of the pelvis

72
Q

Station

A

relationship of the presenting part to moms ischial spine

73
Q

contraction

A

uterine activity that is part of the labor process

74
Q

increment

A

beginning of contraction

75
Q

acme

A

height of contraction

76
Q

decrement

A

contraction starts to subside

77
Q

intensity

A

mild moderate firm, strength of contraction

78
Q

frequency

A

how often contraction occur, measured from the beginning of one to the beginning of the other

79
Q

duration

A

how long a contraction lasts measured for increment to decrement

80
Q

lightening

A

descent of fetus into the pelvis

81
Q

Braxton hicks contraction

A

random mild abdominal contractions-false labor

82
Q

mechanism of labor

A

rotation the fetus goes through while descending out of the body

83
Q

apgar score

A

assessment tool of the neonate

done 1min and 5min after birth

84
Q

crowning

A

appearance of fetal head in the vagina during contraction

85
Q

loccia

A

bleeding that occurs after delivery

86
Q

loccia rubra

A

bright red with small clots

87
Q

loccia serosa

A

thin pinkinsh, brown discharge

88
Q

Loccia Alba

A

white creamy discharge

89
Q

after pain

A

contractions of the uterus after delivery may last 48-72hrs

90
Q

involution

A

returning of the reproductive organs to the pre pregnant state

VEEB (25 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions