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patyi nalang mi > maternal midterm > Flashcards

maternal midterm Flashcards

1
Q

Medical and nursing care given to a pregnant woman
and her family during labor and delivery

A

intrapartum care

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2
Q

Extends from the beginning of contractions that cause
cervical dilation to the first 1-4 hours after delivery of
the newborn and placenta

A

intrapartum period

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3
Q

A series of processeLow Progesterone Theory / Progesterone
Deprivation Theorys by which the product of
conception is expelled from the maternal body.

A

labor

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4
Q

The actual event of giving birth

A

delivery

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5
Q

 Progesterone (uterine muscle relaxant) decreases in
late pregnancy
 With corresponding increase in Estrogen (uterine
muscle stimulant), labor starts.

A

Low Progesterone Theory / Progesterone
Deprivation Theory

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6
Q

 The pressure of the fetal head on the cervix in late
pregnancy stimulates the posterior pituitary gland to
secrete oxytocin which causes uterine contractions

A

oxytocin theory

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7
Q

All these have stimulating effect on uterine
musculature causing uterine motility.

A

Estrogenic, Fetal Hormone and Prostaglandin
Theories

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8
Q

As the placenta matures more and more pressure is
exerted on the fundal portion, the usual placental site,
and the most contractile portion of the uterus. It is
believed that the resultant diminished blood supply to
the area that causes contraction.

A

Theory of Aging Placenta

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9
Q

As the uterine muscles get stretched with fetal growth
and increasing amniotic fluid, irritability, and
contraction to empty the contents of the uterus are the
likely results.
 Most acceptable theory

A

Uterine Myometrial Irritability/ Uterine
Stretch Theory

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10
Q

Refers to the adequacy of the pelvis and birth canal in
allowing fetal descent.
 Depends to the ability of the uterine segment to
distend, the cervix to dilate and the vaginal canal to
distend.

A

passageway

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11
Q

cervix, vagina, perineum

A

soft passage

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12
Q

the pelvis; the true birth canal in labor

A

bony passage

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13
Q

From lower border of symphysis pubis to sacral
promontory

A

diagonal conjugate

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14
Q
  • Shortest distance
  • Usually 11cm
  • This is the important pelvic measurements
A

obstetric conjugate

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15
Q

Measured from upper margin of symphysis pubis
to sacral promontory

A

True Conjugate or Conjugate Vera

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16
Q

Measures the outlet between the inner borders of
ischia tuberosities and it should be at least 8-9cm.
- We can get the measurement by doing pelvic
exam

A

Tuber-ischial Diameter/Intertuberous Diameter

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17
Q

 Wide and round in all directions
 Classic female pelvis

A

gynecoid

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18
Q

Narrow, heart-shaped

A

android

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19
Q

Narrow and oval-shaped.
 Antero-posterior (AP) diameter is equal to or
greater than the transverse diameter.
 Resembles a pelvis

A

anthropoid

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20
Q

Flattened oval and transverse (side-to-side) shape.
 There is growth pelvis with shortened anteriorposterior diameter
 It is considered a less common pelvic shape.

A

Platypelloid

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21
Q

Shallow upper basin of the pelvis
 Supports the enlarging of the uterus

A

false pelvis

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22
Q

Plane dividing upper or false pelvis from lower true
pelvis.

A

linea terminalis

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23
Q

Consists of pelvic inlet, pelvic cavity, and pelvic outlet
 It has bony canal through which the infant will pass
 Measurements can significantly influenced the
conduct and progress of labor and delivery

A

true pelvis

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24
Q

Refers to the fetus and its ability to move through the
passageway

A

passenger

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25
Q

With seven bones (2 frontal, 2 parietal, 2 temporal and
1 occipital)

A

fetal head

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26
Q

Thin membranous spaces in between bones or closure
between bones

A

suture

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27
Q

– longitudinal, between 2 parietal bones

A

saggital

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28
Q

anterior, between 2 frontal bones.

A

frontal

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29
Q

posterior, between parietal and occipital
bone.

A

lambdoidal

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30
Q

anterior, located between the frontal and
parietal bones.

A

coronal

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31
Q

Points of intersection of cranial bones; membranous
spaces between cranial bones during fetal life and
infancy

A

fontanels

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32
Q

– formed by 2 frontal and 2 parietal
bones; diamond shaped; measures 2.5 cm by 2.5 cm;
also called as “bregma”. Ossifies or closes in 12 to 18
months.

A

anterior fontanel

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33
Q

– formed by the union of parietal
and occipital bones; forms junction which sagittal and
lambdoid sutures; triangular shaped; ossifies in 2
months

A

posterior fontanel

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34
Q

– 12.5 to 13.5 cm; from occiput to the
chin; widest

A

 Occipitomental

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35
Q

12 cm; from occiput to mid frontal
bone

A

occipitofrontal

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36
Q

9.5 cm; from occiput to the
anterior fontanel; narrowest AP diameter of the head

A

Suboccipitobregmatic

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37
Q

Fetal Head Diameters

A

occipitofrontal

occipitomental

suboccipitobregmatic

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38
Q

Posture or habitus.
 The relationship of the fetal parts of the trunk or one
another.
 The fetus forms an ovoid mass that corresponds to the
shape of the uterine cavity.

A

fetal attitude

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39
Q

The relation of the long axis of the fetus to the long
axis of the mother.

A

fetal lie

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40
Q

The fetal head is the presenting part.
- Occurs in about 95% of the cases.
- 4 Varieties

A

cephalic

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41
Q

occiput
(posterior fontanel) is the presenting part

A

Vertex (occiput) Presentation –

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42
Q

bregma (anterior fontanel) is the presenting part.
Fetal head is neither flexed nor extended

A

. Sinciput Presentation (Military Attitude)

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43
Q

. Sinciput Presentation (Military Attitude)

A

brow presentation

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44
Q

the fetal head is
hyperextended (complete extension). Face is the
presenting part.

A

face presentation

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45
Q

Occurs 5% of labors at term. When the fetus presents
with the buttocks toward the pelvis

A

breech

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46
Q

– fetal hips are flexed, and knees
are extended. The buttocks of the fetus present to
the maternal pelvis

A

frank breech

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47
Q

– the fetal hips and knees are
both flexed, the thighs are on the abdomen, and
the calves are on the posterior aspect of the
thighs. The buttocks and feet of the fetus present
to the maternal pelvis

A

complete breech

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48
Q

the hips and legs are extended. The
feet of the fetus present to the maternal pelvis.

A

footling

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49
Q

Also called as ___________ which is extremely rare
presentation.
- Shoulder is usually presenting into the pelvic inlet.

A

transverse

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50
Q

The relationship of a particular reference point of the
presenting part and the maternal pelvis described
with a series of 3 letters.

A

fetal position

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51
Q

may be mild, moderate, and strong. With
uterine contractions, these uterine changes occur:

A

intensity

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52
Q

– uterine contractions

A

primary power

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53
Q

voluntary bearing down,
abdominal muscle contractions of levator ani muscle

A

secondary power

54
Q

the phase of increasing
intensity of contraction; the first phase; the onset.

A

Increment (crescendo)

55
Q

– the height of the uterine contractions.

A

Acme (apex)

56
Q

– the phase of decreasing
contraction; the last phase; end

A

Decrement (decrescendo)

57
Q

pregnant woman’s general behavior and influences
upon her also influence labor progress:

A

person

58
Q

Refers to the frequency, duration, and strength of
uterine contractions to cause complete cervical
effacement and dilation

A

power

59
Q

– the period from increment to decrement of
the same contraction

A

duration

60
Q

– period from the increment of the first
contraction to the increment of the second
contraction.

A

frequency

61
Q

– period from the decrement of the first to the
increment of the second contraction

A

interval

62
Q

Descent of the fetus and uterus into pelvic cavity
before labor onset.

A

lightening

63
Q

the process by which the cervix opens.

A

dilation

64
Q

thinning and obliteration of the cervix.
 Expressed in terms of shortening of the cervical
length (the average length of the cervix is around 2
cm to 2.5 cm).
 Described as “thinning”, “shortening”, or
“narrowing”.
 Expressed in Percentage

A

effacement

65
Q

Premonitory Signs of Labor

A

lightening

increased braxton hick’s contractions
show

  1. Increased maternal energy or burst of energy because of
    hormone epinephrine.
  2. Slight decrease in maternal weight by 2 to 3 lbs

. Ripening of the cervix becomes as soft as butter.

  1. Spontaneous rupture of the BOW or membranes

Progressive fetal descent.

  1. Increased backache and sacroiliac pressure due to fetal
    pressure
66
Q

cardinal movements
of labor:

A

: descent,

flexion,

internal rotation,

extension,

external rotation, and expulsion

67
Q

– mechanism by which the greatest transverse
diameter of the fetal head (biparietal diameter is 9.5 cm)
passes through the pelvic inlet

A

engagement

68
Q

– passage of the presenting part through the pelvis;
first requisite for the birth of the baby

A

descent

69
Q

when the chin is brought in contact with the chest.
This results to the smallest anteroposterior diameter of the
fetal head (Suboccipitobregmatic diameter of 9.5 cm) to
present

A

flexion

70
Q

– turning of the head so that the occiput
moves anteriorly toward the symphysis pubis.

A

internal rotation

71
Q

: In primigravida, descent of the fetus into the true
pelvis occurs about _______ days before labor. This descent
is referred to as _____ and results in engagement

A

10 - 14, lightening

72
Q

delivery of the fetal head in vertex presentation

A

extension

73
Q

– restitution; the movement or the
rotation of the head visible externally due to internal
rotation of the shoulders.

A

external rotation

74
Q

birth of the baby

A

expulsion

75
Q

involved the superficial vaginal mucosa or
perineal skin but not the underlying fascia and muscle.

A

first degree

76
Q

– involved the vaginal mucosa, perineal skin,
deeper tissues, may include fascia and muscles of the
perineum but not the anal sphincter.

A

second degree

77
Q

same as 2nd degree but involved the anal
sphincter

A

third degree

78
Q

extends through the anal sphincter into the
rectal mucosa

A

fourth degree

79
Q

 Surgical incision extending from the soft tissue of the
vaginal opening into the true perineum

A

Episiotomy (Clean Surgical Incision)

80
Q

An incision from the vaginal opening straight down
toward but not extending into the anus.
 Not commonly done and it easily extends to the anal
and region increasing the risk of sepsis.

A

median epsiotomy

81
Q

This begins at the midline above the anus but angles to
the left or right.

A

Mediolateral Episiotomy

82
Q

Stages of Labor

A

latent

active

transition

83
Q

Dilation stage from the onset of the first contraction to
full cervical dilation.
- Power necessary: uterine contractions

A

First Stage of Labor – Three Phases

84
Q

First Stage of Labor – Three Phases

A

External or Indirect Monitoring

85
Q

– disk over fundus,
secured with belt; provides continuous
record of external pressure created by
contractions, allow measurement of
frequency and duration of contraction

A

Tocodynamometer –

86
Q

– at site of loudest
FHR; secured with belt; provides
continuous FHR recording, which is
interpreted in relation to uterine activity.

A

Ultrasonic Transducer

87
Q

– applied when
membranes have ruptured, cervix 2 to 3 cm
dilated

A

Internal or Direct Monitoring

88
Q

– intrauterine catheter
filled with water is inserted beyond
presenting part; allows measurement of
frequency, duration, and intensity of
contractions

A

 Pressure Transducer

89
Q

applied to fetal
scalp; allows measurement of FHR, baseline
variability, and periodic changes.

A

Internal Spiral Electrode

90
Q

 Location of most audible FHR:
– usually above the
umbilicus

A

Breech Presentation

91
Q

 Location of most audible FHR:

– usually below the
umbilicus

A

a. Vertex Presentation –

92
Q

is equal to or less than 100/min.

A

bradycardia

93
Q

it is when FHR is more than 170/min.

A

tachycardia

94
Q

– periodic decrease in FHR

A

decelerations

95
Q

– FHR decreases but not
below 100/min; occurs early before acme;
indicates fetal head compression; it is normal and
requires no nursing intervention.

A

Early deceleration

96
Q

FHR decreases rarely below
100/min; occurs late, after acme (usually begins
as contraction peaks); cause by uteroplacental
insufficiency

A

late deceleration

97
Q

– due to umbilical cord
compression

A

variable deceleration

98
Q

Delivery stage
* From fully dilated cervix to the delivery or expulsion
of the baby

A

second stage of labor

99
Q

– progresses from irritability to
participation, eagerness, and excitement.

A

maternal behavior

100
Q

From the delivery of the newborn to the delivery of
the placenta.

A

third stage of labor

101
Q

 Power necessary for third stage of labor

A

strong uterine contractions to
effect separation; may need maternal pushing to effect
final delivery

102
Q

power necessary for second stage of labor

A

primary and secondary powers.
Pushing with contractions; panting at intervals and at
crowning time.

103
Q

power necessary for first stage of labor

A

uterine contractions

104
Q

the delivery of placental with
the side closest to the baby emerging first.
More common; present in 80% of cases.
 Placenta is expelled with the shiny “clean” side
first, bluish side.
 Inverted umbrella shaped.
 Less external bleeding because blood is usually
concealed first behind the placenta.
 The type where separation starts from the center
to the edges

A

Schultze’s Mechanism

105
Q

less common; present in 20% of
cases.
 Roughly “dirty”, reddish maternal side out first.
 Umbrella shaped, more external bleeding so it
appears “bloody”.
 The amount of blood loss in delivery (whether
placenta is delivered by Schultze or Duncan
Mechanism) is 300 cc with 500 cc as the upper
limit. Bleeding exceeding 500 cc means
hemorrhages.
 Inspect the placenta for completeness (first
nursing action after placenta is delivered).
 Feel the fundus for contraction or firmness.
 The initial activity of the nurse is to massage
fundus until firm. Ice cap may be applied to
further contract the uterus. * The term “soft”,
“boggy” or “non-palpable”, means uterine atony

A

Duncan Mechanism

106
Q

Types of Placental Delivery or Presentation:

A

Schultze’s Mechanism

duncan mechanism

107
Q

Signs of Placental Separation:

A

Calkin’s sign

Uterus becomes mobile

Sudden gushing of blood.

  1. Lengthening of the umbilical cord.
108
Q

– the 1st sign.
 This is when the uterus changes in shape, it
becomes globular, and the consistency becomes
firm.

A

calikin’s sign

109
Q

Recovery stage.
* From the delivery of the baby to the first hour after
birth.

A

Fourth Stage of Labor

110
Q

Pharmacologic Pain Management:

A

analgesic

anesthetics

111
Q

power necessary for Fourth Stage of Labor

A

uterine contractions to prevent bleeding from
placental site.

112
Q

drugs that relieve pain or alter its
perception may alter level of consciousness (LOC) and
reflex activity; administer as ordered and monitor
effects;

A

analgesic

113
Q

Meperidine – Demerol)
- May initially slow labor, have depressive
effect on neonatal respirations.
- Administered when client in active labor (4 to
5 cm).

A

narcotics

114
Q

Produce sedation and relaxation; often given
with narcotics because of potentiating effects;
when given alone, there may be little or no
analgesia; may also cause excitement and
disorientation in presence of pain.
- Examples are promethazine HCI (Phenergan),
hydroxyzine pamoate (Vistaril), promazine
HCI (Sparine) and diazepam (Valium)

A

tranquilizers

115
Q

Produce sedation and alter memory.
- Example: scopolamine (belladonna alkaloid).

A

amnesics (rarely used today)

116
Q

Produce sedation and alter memory.
- Example: scopolamine (belladonna alkaloid).

A

anesthetics

117
Q

3 terms sa anesthetics

A

general, local, regional

118
Q

induces sleep

A

general anesthetics

119
Q

– used for pain during episiotomy and perineal
repair.
aanesthetics

A

local

120
Q

 For relief of perineal and uterine pain.
 Usually safe for infant unless maternal
hypotension occurs.

anesthetics

A

regional

121
Q

 A tool to help in management of labor.
 Guides birth attendant to identify women whose labor
is delayed and therefore decide appropriate action.
 To avoid unnecessary interventions so maternal and
neonatal morbidity are not needlessly increased, to
intervene in a timely matter to avoid maternal and
neonatal morbidity or mortality

A

partograph

122
Q

Types of Blocks

A

paracervical block

peridural block

intradural block

pudendal block

local anesthesia

123
Q

given in 1st stage active phase;
rapid relief of uterine pain; relieves pain contractions;
has no effect on perineal area and does not interfere
with bearing down reflex.

A

paracervical block

124
Q

given in 1st stage active phase or 2nd
stage of labor; produce rapid relief of uterine and
perineal pain; may be given in single doses or
continuously

A

peridural block

125
Q

– given in the 2nd stage

A

intradural block

126
Q

rapid onset; relieves uterine and
perineal pain; may also cause maternal
hypotension

A

spinal block

127
Q

– rapid onset of pain
relief; used for forceps delivery and the client
must remain flat for 8 to 12 hours

A

saddle block

128
Q

– given in the 2nd stage of labor; affects
perineum for about ½ hour; safe for newborn; no effect
on contractions.

A

pudendal block

129
Q

Four Time Bound Interventions:

A

immediate drying

early skin to skin contact

properly timed cord clamping and cutting

Non-separation of the newborn from the mother for
early breastfeeding initiation and rooming

130
Q

– blocks primary nerve pathways in
2nd stage; for delivery and episiotomy; short term
inhibition of pain receptor

A

local anesthesia

131
Q

Non-separation of the newborn from the mother for
early breastfeeding initiation and rooming-in –

A

immediate drying

132
Q

 The first feed provides _____

A

colostrum

patyi nalang mi (14 decks)

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