Labor/Delivery Flashcards by Emily Pastore

Truest sign of labor

Onset of regular, progressive contractions

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Cervix that is zero is

Closed

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Cervix at 10 is

Fully dilated

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Thinning of cervix thick to 100% is

Effacement

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Relationship of fetal presenting part to mom’s ischeal spine

Station

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Negative station

Above the spine
(Positive is POSITIVE good news, baby is coming out soon)

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Positive station

Below the spine
(Negative is NEGATIVE news)

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Engagement

Station “0”

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Relationship between the spine of the mother and the spine of the baby
(You want parallel)

Lie

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Part of baby that enters birth canal first
(Most common: ROA or LOA)

Presentation

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Stage 1 of labor

Dilate and phase cervix
3 phases of stage 1:
1. Latent phase
2. Active phase
3. Transitional phase

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Stage 2 of labor

Delivery of baby

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Stage 3

Delivery of placenta

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Stage 4 of labor

First 2 hours of recovery to stop bleeding

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What is the purpose of uterine contractions in the first stage of labor?

To dilate and efface the cervix

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What is the purpose of uterine contractions in the 2nd stage of labor?

To push the baby out

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What is the purpose of uterine contractions in the 3rd stage of labor

To push the placenta out

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What is the purpose of uterine contractions in the 4th stage of labor?

To stop bleeding

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When does post partum technically begin?

2 hours after delivery of placenta
(End of 4th stage)

What is the number one priority in the 2nd PHASE of labor

Pain management

Stage 1: Latent phase

Cervix dilated: 0-4 cm
Contractions: every 5-30 minutes
Duration of contraction: 15-30 seconds
Intensity: mild

Stage 1: active phase

Cervix dilated: 5-7 cm
Contractions: every 3-5 minutes
Duration of contraction: 30-60 minutes
Intensity: moderate

Stage 1: Transition phase

Cervix dilated: 8-10 cm
Contractions: 2 minutes
Contraction duration: 60-90 seconds

What are signs of uterine tetany?

Contractions longer than 90 seconds or closer than 2 minutes apart

What's uterine hyperstimulation

Contractions longer than 90 seconds or closer than 2 minute apart

What parameters would you stop pitocin during labor

Contractions longer than 90 seconds or closer than 2 minutes apart

How to assess frequency of contractions

Beginning of one contraction to beginning of next

How to assess duration of contractions

Beginning to end of one contraction

How to assess intensity of contraction

Purely subjective

What teaching do you give mother during intense contractions

Palpate with one hand over fundus with pads of fingers

Painful back labor position

Knee chest (Rear end up, head down)

What is a prolapsed cord

When cord is presenting part OB EMERGENCY

What to do with prolapsed cord

PUSH Position knee chest Push head back up DO NOT TOUCH CORD

Interventions for all other labor complications (Not prolapsed cord)

LION -Left side position -Increase IV -Oxygenate them -Notify physician

What to do with pitocin in an OB crisis

Stop it.

Do not administer pain meds during labor if

The baby is likely to be born when the med peaks

What to do if low fetal heart rate (Bad)

LION pit (Left side, IV, O2, Notify, STOP PITOCIN)

What to do if low baseline variability -FHR stays the same & doesn't change (Bad)

LION pit (Left side, IV, O2, Notify, STOP PITOCIN)

What to do if high baseline variability -FHR is always changing (Normal)

Record it

What to do if early decelerations (FHR lowers before contraction)

Normal - document

What can variable decelerations indicate (Very bad)

Can mean prolapsed cord

FHR tracings that indicate LION (Leftside, IV, O2, Notify)

Ones that start with L (Lion)

FHR tracings that start with variable are

VERY BAD

VEAL CHOP

Variable - Cord compression Early - Head compression Accelerate - Ok Late - Placenta

What to suction on newborn baby first

Mouth then Nose

What do you check after delivery of placenta

AVA - 2 Arteries, 1 Vein

What 4 things do you do 4 times an hour for 4th stage of delivery (recovery)

1. Vital signs (assess for signs of shock) 2. Check fundus (massage if boggy, void or cath if displaced) 3. Check pads (pad saturated in 15 minutes = excessive lochia) 4. Roll onto side (to check for bleeding)