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MCN Lecture > Labor Part 2 (Components - Stages) > Flashcards

Labor Part 2 (Components - Stages) Flashcards

1
Q

enumerate the mechanism of labor in order

A 
engagement
descent
flexion
internal rotation
extension 
external rotation and restitution
expulsion
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2
Q

term used if the presenting part is in the ischial spine

A

engagement

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3
Q

term if the fetal head goes down to the pelvic floor as a result of ______ (3)

A

descent; as a result of uterine contractions, abdominal contractions and amniotic fluid pressure

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4
Q

descent is in what station? how about engagement?

A

descent +1

engagement 0

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5
Q

this allows the widest part of the fetal head to fit through the widest part of the pelvic inlet

A

engagement

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6
Q

how does cervical flexion occur

A

when the fetal head comes in contact with the pelvic floor

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7
Q

cervical flexion allows the presenting part to be _____

A

sub-occipito bregmatic

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8
Q

in this position, the fetal skull has a smaller diameter which assists passage through the pelvis

A

sub-occipito bregmatic

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9
Q

what is the change of position in internal rotation

A

from occipito-transverse to occipito-anterior

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10
Q

this is the encirclement of fetal skin in the birth canal

A

crowning

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11
Q

delivery of the head is via _____, where the occiput is born

A

extension

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12
Q

the baby goes back to its initial position (transverse)

A

external rotation

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13
Q

refers to the alignment of the shoulders to the fetal head

A

restitution

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14
Q

TRUE OR FALSE

when the baby is out, they encourage the mother to push

A

false

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15
Q

how do the doctors deliver the baby in external rotation and restitution?

A

pull upward to deliver the posterior

downward to deliver the anterior (this is delivered FIRST)

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16
Q

delivery of the entire body of baby

A

expulsion

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17
Q

what is power in 4ps

A

uterine contractions

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18
Q

uterine contractions serve as the ______ of labor

A

force of labor

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19
Q

increment

A

increasing intensity of UC

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20
Q

acme

A

peak of UC; uterus is hard and firm

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21
Q

decrement

A

decreasing intensity of UC

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22
Q

frequency

A

start of one UC until start of another UC; measured in minutes

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23
Q

duration

A

how long one contraction lasts; start and end of one UC; measured in seconds

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24
Q

interval

A

space between 2 UC; resting phase

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25
Q

contour of cervix (3)

A

upper portion is thick and active

lower portion is thin and passive

from round to ovoid to elongated ;
elongated - baby is controlled

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26
Q

TRUE OR FLASE

discourage mother to push in acme

A

false

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27
Q

normal length of labor in HOURS in nullipara and multipara

latent phase

A

nulli- ave. 8.6 | UN 20

multi - ave 5.3 | UN 14

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28
Q

normal length of labor in HOURS in nullipara and multipara

active phase

A

nulli- ave. 5.8 | UN 12

multi - ave 2.5 | UN 6

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29
Q

normal length of labor in HOURS in nullipara and multipara

second stage

A

nulli- ave. 1 | UN 1.5

multi - ave 0.25 | UN -

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30
Q

shortening and thinning of the cervix

A

cervical effacement

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31
Q

widening of the diameter of the cervix

A

dilatation

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32
Q

effacement and dilatation in primipara and multipara

A

primi - effacement first, then dilatation

multi - dilatation first then effacement

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33
Q

refers to the psychological state or feeling that women undergo

A

psyche

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34
Q

part responsible for uterine contractions

A

myometrium

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35
Q

what are observed in pregnant clients (psyche) 6

A 
culture
preparation
support system
previous births
current pregnancy
pain, fear, anxiety - observed in primiparas
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36
Q

1st stage of labor

A

start of uterine contraction until FULL cervical dilatation

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37
Q

latent phase nursing interventions

A

Let the patient ambulate, change of position, squat

Allow the client to eat, drink fluids, chew ice chips

The couple needs to participate in care

Encourage client to void q 2 hrs, VS monitoring q 30-60 mins except temp (4hrs) including FHT UC Perineum

No analgesia

The couple should be updated on the progress of the labor

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38
Q

what happens in active phase (4)

A

rapid dilatation of the cervix

mother feel helpless, anxious

show

spontaneous rupture of membrane

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39
Q

transition phase nursing interventions

A

Transfer the client to the delivery room (nulli - 10 cm; multi- 8 cm) and cold compress on forehead

Rest in between contractions

Assist effective breathing that is level 3 - shallow and more rapid

Note for the rupture of membrane regarding time and color

Sensitive, irritable and out of control

Ice chips and fluids

Take VS every 15-30 mins, UC q 10-15 mins, perineum q 15 mins

Intense discomfort

Offer ointment on dry lips

Nasuea and vomiting

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40
Q

second stage of labor (2)

A

full cervical dilatation to the delivery of the baby

mechanisms of labor is observed

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41
Q

third stage of labor

A

delivery of the baby until the delivery of the placenta/ placental delivery

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42
Q

happens when umbilical cord is pulled when there is no contraction.

A

uterine inversion

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43
Q

this refers to the pelvis, route for the baby to travel from the uterus down to the perineum

A

passage

44
Q

android pelvis

A

male pelvis, heart shape, narrow or small, poor prognosis

45
Q

anthropoid pelvis

A

oval shaped pelvis, longer apd , shorter td, good prognosis

46
Q

plattypoid pelvis

A

flat , smaller apd, longer td, poor prognosis

47
Q

gynecoid pelvis

A

has equal APD (anterio-posterior) and TD (transverse diameter) good prognosis

48
Q

passenger

A

baby

49
Q

bones that comprise the head (8)

A

4 superior bones
(frontal, 2 parietals, occupital)

4 other bones
(ethmoid
sphenoid
2 temporals)

50
Q

active phase nursing interventions

A

Ambulation is required if still tolerable

Comfort measures

The surrounding should be quiet

Ice chips, fluids, foods

Void q 2 hrs, VS q 30-60 mins, FHT and UC q 15-30 mins, perineum 30 mins

effective breathing that is level 2 (lighter and more rapid)

51
Q

test in identifying what fluid is coming out during rupture of membrane

A

nitrazine test
blue-amniotic
yellow-urine

52
Q

what is the position of client when giving birth

A

semi-upright

53
Q

cervical dilatation/hour of primipara in second phase; multipara

A

primi- 1 cm per hr

multi - 1.5 cm per hr

54
Q

what is the breathing pattern for second stage of labor

A

level 4 - pant blow breathing/ 3-4 quick/ with a sound of choo choo

55
Q

Second stage labor nursing interventions

A

Stay with your patient at all times

Encourage effective breathing that is level 4 - pant blow/ 3-4 quick breaths/ choo choo

Closely monitor the fetal heart rate, mechanisms of labor, vital signs every 5 mins

Observe sterile technique

No Valsalva maneuver

Discourage pushing until the cervix is dilated

56
Q

signs of placental separation 5

A

sudden gush of blood
lengthening of the umbilical cord
change in the shape of uterus or calkin’s sign
presence of firm contractions in the uterus
appearance of placenta in the vaginal opening

57
Q

AMTSL

A

Active management of the third stage of labor

58
Q

3 intervention in AMTSL

A

oxytocin admin. (check BP first)

cord traction with counter traction or crede’s maneuver

uterine massage (one hand on symphysis; one hand on fundus)

59
Q

fetal side of placenta

A

Shultz;shiny

detaches from center to edges

60
Q

maternal side of placenta

A

Duncan;dirty

detaches from edges to center

61
Q

Locate uterus

A

midway of symphysis pubis and umbilicus

do this immediately after delivery

62
Q

third stage labor nursing interventions

A

The vital signs monitoring is q 15 mins

Have the client and the baby feel warm

Inspect the placenta, membrane, and location of the uterus, umbilical cord

Refer to the doctor

Do not pull umbilical cord when uterus in not contracted

63
Q

fourth stage

A

delivery of placenta until the first 4 hours postpasrtum

64
Q

they move and overlap each other in order to facilitate the passing of fetal head to birth canal

A

suture lines

65
Q

where is the sagittal suture lines located

A

between 2 pareitals

66
Q

where is thecoronal suture lines located

A

between paretals and frontal

67
Q

where is the lambdoidal suture lines located

A

between parietals and occipital

68
Q

these are spaces in between the suture lines

A

fontanelle

69
Q

anterior fontanelle is known as _____

A

bregma

70
Q

what forms the bregma? what is the shape?

A

sagittal and coronal suture lines; diamond shape

71
Q

APD and TD of anterior fontanelle

closing time?

A

APD 3-4 cm
TD 2-3 cm

closes at 12 to 18 months

72
Q

posterior fontanelle is known as

A

lambda

73
Q

lambda is formed by _____. The shape is _____.

A

parietal and occipital; triangular shape

74
Q

APD and TD of lambda.

closing time?

A

APD 2 cm TD 2 cm

closes at 2 months

75
Q

space in bet. 2 fontanelles

A

vertex

76
Q

what is the sinciput

A

frontal

77
Q
  • narrowest diameter
  • most favorable measurement
  • facilities easy delivery

how many cm?

A

Suboccipitobregmatic

9.5 cm

78
Q

bridge of nose to occipatal prominence

how many cm?

A

Occipitofrontal

12 cm

79
Q

widest anterioposyerior diameter, from chin to posterior fontanelle

how many cm?

A

Occipitomental

13.5 cm

80
Q

denotes the body part that is in first contact to the cervix

A

fetal presentation

81
Q

relationship bet. long axis of baby and mother

A

fetal lie

82
Q

degree of flexion of fetal head

A

fetal attitude

83
Q

what is a good fexion (4)

A

baby’s thighs are flexed to the abdomen

arms flexed and folded on chest

head is bended forward wherein chin is touching the chest

back is convex (VERTEX) narrowest diameter; subocciptobregmatic

84
Q

what is a moderate flexion

A

baby is in military position, chin is not touching chest

85
Q

what is partial flexion

A

baby tries to present the brows , somewhat tilted

86
Q

what is poor flexion

A

bad attitude of baby

neck is hyperextended

presenting part is chin or face

back is concave occipitomental presentation (face and lips is edematous; prevents the baby to do sucking)

87
Q

this is where the doctor can determine if the baby is engaged and identify the relationship between presenting part to the ischial spine

A

station

88
Q

-1 to -5 station

A

not yet engaged -ABOVE ischial spine

89
Q

+1-+5

A

BELOW ischial spine, starting to descend

90
Q

-1

A

the baby is 1 cm above the ischial spine - near to be engaged

91
Q

-2

A

baby is floating

92
Q

+1

A

baby is 1 cm below the ischial spine

93
Q

+3

A

crowning

94
Q

+4

A

baby head out

95
Q

change in the shape of fetal head that is brought by not dilated cervix and ineffective uterine contraction; it will return to its normal shape after 1-2 days

A

molding

96
Q

presence of blood on the scalp

A

Cephalohematoma

97
Q

presence of edema/swelling in skull , related on the manner of how the mother pushes

A

Caput succedaneum

98
Q

Is the relationship of the presenting part to a specific

quadrant of the woman’s pelvis

A

fetal position

99
Q

defines the landmark of the mother

  • right (R) left (L)
A

1st letter

100
Q

denotes fetal landmark

O- occiput

M- mentum

A- acromium

Sa- sacrum

A

2nd letter

101
Q

defines whether the landmark points are Anteriorly (A). Posteriorly (P), Transversely (T)

A

3rd letter

102
Q

ideal fetal position

A

LOA

103
Q

the ideal degree of rotation (fetal position)

A

90 degrees anteriorly

104
Q

fetal position towards the maternal abdomen; prone position

A

anterior

105
Q

fetal position of the baby when it is in a supine position

A

posterior

MCN Lecture (2 decks)

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