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Nursing 101 - Exam #2 > Labour & Delivery > Flashcards

Labour & Delivery Flashcards

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1
Q

What defines true labour?

A

increase in frequency, duration and strength of contractions

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2
Q

How many phases of labour are there in the 1st stage of labour? and what are they called?

A
  1. latent
  2. active
  3. transition
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3
Q

In the latent stage of labour how many cm’s does the cervix stretch to?

A

1-3cm

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4
Q

In the active stage of labour how many cm’s does the cervix stretch to?

A

4-8cm

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5
Q

In the transition stage of labour how many cm’s does the cervix stretch to?

A

8–10cm

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6
Q

What happens during the 2nd stage of labour?

A

pushing and birth of baby

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7
Q

How long can pushing last for primips vs multips?

A

primip - 2 hours

multips - 15min - 1 hour

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8
Q

What happens during the 3rd phase of labour?

A

between birth of baby and the delivery of the placenta

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9
Q

When does the 4th stage of labour happen?

A

1-4 hours after the delivery of the placenta

watching for hemorrhaging

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10
Q

How long does the latent phase typically last for in a primip vs a multip?

A

primip: 8.6 hours
multip: 5.3 hours

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11
Q

How many cms/hour does the cervix dilate in a primip vs a multip?

A

primip: 1.2 cm/hour
multips: 1.5 cm/hour

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12
Q

How long does the active phase typically last for in a primip vs a multip?

A

primip: 4.6 hours
multip: 2.4 hours

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13
Q

How long does the transition usually last for in a primip vs. a multip?

A

primip: 3 hours
multip: less then 1 hour

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14
Q

When can you tell if someone is in false labour? what is the name for these contractions?

A

when there is no increase to strength, length and duration. Random contractions and tightening of uterus.

Braxton-hicks contractions

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15
Q

What are a few benefits of “passive decent” (natural birth)?

A
  • decreased FHR decels, better fetal O2 levels
  • cost effective
  • decreased length of pushing time
  • decreased maternal fatigue
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16
Q

What are signs a woman in labour should be going to the hospital?

A 
regular contractions - 5 mins apart
bleeding
water broken (breaks)
painful contractions
lightening - baby drops lower
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17
Q

What theory describes the onset of labour as being the uterus can only stretch so big and then PE2 (prostaglandins) are released and start labour?

A

Mechanical theory

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18
Q

What theory suggests that the pressure on the cervix releases oxytocin and then contractions begin?

A

Neurological theory

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19
Q

What theory suggests that the increase in estrogen then stimulates contractions and more irritability on the uterus?

A

Progesterone Withdrawal Hypothesis

20
Q

Which theory focuses on the amnion and decidua?

A

prostaglandin hypothesis

21
Q

What is the theory that has an increased CRH hormone throughout prenancy with a sharp increase at term? CRH is also known to stimulate what?

A

corticotrophin releasing hormone (CRH) hypothesis

known to stimulate synthesis of prostaglandin

22
Q

Was is the length of time a contraction can last from?

A

30 - 90 secs

23
Q 
The intensity can be measured as mmHg.  For example at rest the measurement is 10-12mmHg. Describe the measurements at the following stages and describe their intensity:
early labor
active labor
transition
pushing
A

early labor: 25-40 mmHg - mild
active labor: 50-70 mmHg - moderate
transition: 70-90 mmHg - strong
pushing: 70-100 mmHg - strong

24
Q

What are the critical factors during labor known as the 5 P’s?

A
  1. passage - pelvis & soft tissue, joints, inlet, outlet, perineum, vagina, pelvic floor
  2. passenger - baby longitudinal, lie, presentation, presenting part , position
  3. relationship of passage & passenger
  4. physiological forces (contraction and pushing)
  5. psychosocial
25
Q

What are 6 psychosocial considerations? and give examples

A
  1. mental preparedness - readings and prenatal class
  2. physical preparedness - prenatal fitness
  3. socio-cultural values & beliefs - do their beliefs assist or impede?
  4. previous reproductive experience - horrific experience may afftect 2nd birth (positive or negative)
  5. support from signifciant others - positive influences?
  6. emotional status - reactions, responses towards labor - what are they bringing with them emotionally?
26
Q

What are the 7 cardinal movements (mechanism of labour) a fetus takes through the birthing canal?

A
  1. decent
  2. flexion
  3. internal rotation
  4. extension
  5. restitution
  6. external rotation
  7. expulsion
27
Q

What is happening in the 1st stage of labour in terms of mechanism of labour?

A

decent and flexion

28
Q

What is happening in the 2nd stage of labour in terms of mechanism of labour?

A 
decent & flexion
internal rotation
extension
restitution
external rotation
expulsion
29
Q

What happens during the 3rd stage of labor?

A

placenta separation and expulsion

30
Q

What are the signs of placental separation?

A
  1. globular shaped uterus
  2. rise of the fundus in the abdomen
  3. sudden gush or trickle of blood
  4. further protrusion of umbilical cord out of the vagina
31
Q

What is the placenta known as when it delivers with the fetal (shiny) side presenting?

A

shiny schultz

32
Q

What is the placenta known as when it delivers sideways with maternal surface delivering first?

A

dirty duncan

33
Q

Which area of the uterus controls the bleading after the placenta is delivered?

A

the middle layer of the myometrium

34
Q

How often is the mother monitored in the 4th stage of labour?

A

every 5 mins for 1-4 hours

35
Q

What is the first thing to check in the initial care of the newborn?

A

check neck for umbilical cord

36
Q

While the cord is being clamped and cut where is the baby?

A

being kept at level of vagina with head down

37
Q

Once baby dried off where is he/she placed?

A

under radiant heat or directly on mom

38
Q

What is the apgar system evaluating?

A

the physical condition of the newborn at birth

39
Q

When is the newborn rated with the apgar system?

A

1 minute and at 5 minutes after birth

40
Q

If the apgar score is less than 7 at 5 minutes what should happen?

A

the test should be repeated every 5 minutes up to 20 minutes

41
Q

What 5 things are being assessed in the apgar test?

A 
heart rate
respiratory effort
muscle tone
reflex irritability
skin color
42
Q

If a baby shows a heart rate of less than 100 bpms what needs to happen?

A

immediate resuscitation

43
Q

The blood from the cord is obtained for what purpose?

A

to test the blood gases, group, type and possible stem cells

44
Q

If a newborn scores anywhere between 7-10 what does this indicate?

A

newborn is in good condition

45
Q

What does an apgar score of 4-7 indicate?

A

indicates need for stimulation

46
Q

If score is less than 4 what may this indicate?

A

possible resuscitation

47
Q

If score is less than 3 at 5 minutes what may this indicate?

A

neonatal mortality

Nursing 101 - Exam #2 (7 decks)

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