Maternity Nursing Chap 12 Flashcards
True labor or False labor: Contractions regular and progressive
True labor
True labor or False labor: Cervix soft and posterior
False labor
True labor or False labor: Contractions ceasing with ambulation
False labor
True labor or False labor: Cervix soft, 25%, 2 cm, midposition
True labor
True labor or False labor: Lightening in multiparous woman
True labor
True labor or False labor: Discomfort present in abdomen above umbilicus
False labor
True labor or False labor: Increased contraction intensity with activity and ambulation
True labor
True labor or False labor: Presenting part above ischial spines
False labor
True labor or False labor: Bloody show
True labor
True labor or False labor: Discomfort radiating from lower back to lower abdomen
True labor
True labor or False labor: Contractions continuing even after a shower or back rub
True labor
The second stage of labor is the stage when the __________. It begins with full cervical dilation and complete effacement. It ends with the baby’s birth. This stage has 3 phases (i.e., latent, descent, and transition). A second stage that is longer than 2 hours might be considered prolonged in a woman without regional anesthesia and should be reported to the primary health care provider.
-fetus is born
The third stage of labor lasts from the time the ____________ until the placenta is delivered. Detachment of the placenta from the wall of the uterus or separation is indicated by a firmly contracted fundus, change from a discoid shape to a globular (ovoid) shape, a sudden gush of dark blood from the introitus, apparent lengthening of the umbilical cord, and the finding of vaginal fullness.
-baby is born
Prolonged breath holding while bearing down (closed glottis pushing)?
valsalva maneuver
Artificial rupture of membrane?
amniotomy
Occurrence when widest part of the head (biparietal diameter) distends the vulva just before birth?
crowning
Incision into perineum to enlarge the vaginal outlet?
episiotomy
Test to determine if membranes have ruptured by assessing pH of the fluid?
amniotomy
Technique used to control birth of fetal head and protect perineal tissue?
Ritgen maneuver
Expulsion of placenta with fetal side emerging first?
schultze mechanism
Cord encircling the fetal neck?
nuchal cord
Occurrence when pressure of presenting part against pelvic floor stretch receptors results in a woman’s perception of an urge to bear down?
ferguson reflex
Classification of medication that stimulates the uterus to contract?
oxytocic
Expulsion of placenta with maternal surface emerging first?
duncan mechanism
Protrusion of umbilical cord in advance of the presenting part?
prolapse of umbilical cord
Primary powers of labor that act involuntarily to expel the fetus and the placenta from the uterus?
-uterine contractions
“Building up” phase of a contraction?
-increment
Peak of a contraction?
-acme
“Letting down” phase of a contraction?
-decrement
How often contractions occur, or period of time from the beginning of one contraction to the beginning of the next or from the peak of one contraction to the peak of the next?
-frequency
Strength of the contraction at its peak?
-intensity
Period of time that elapses between the onset and end of a contraction?
-duration
Tension of the uterine muscle during the interval between contractions?
-resting tone
Period of rest between contractions?
-interval
Involuntary urge to push in response to the Ferguson reflex?
-bearing down
True or False: Amniotic fluid turns nitrazine test paper greenish yellow.
False:
True or False: A partogram is used to diagram the progress of uterine contractions.
False:
True or False: A laboring woman should be encouraged to void at least every 2 hours during labor.
True
True or False: Ambulation should be encouraged only during the latent phase of the first stage of labor.
False:
True or False: A hands and knee position is recommended during contractions to facilitate the internal rotation of an occiput posterior position to a more anterior position.
True
True or False: The nurse should perform a vaginal examination immediately, using strict sterile technique, if bright red, fresh vaginal bleeding is noted during active labor.
False:
True or False: Maternal body temperature should be monitored at least every 2 hours after the amniotic membranes have ruptured.
True
True or False: Increased sensitivity to touch or hyperesthesia, which develops as labor progresses, results in a woman’s rejection of her partner’s or the nurse’s touch with comfort measures.
True
True or False: A woman should begin pushing as soon as the second stage of labor begins.
False:
True or False: For childbirth to progress safely and in a timely fashion, a woman’s bearing down efforts must be carefully regulated by the nurse and coach.
False:
True or False: For pushing to be effective, the woman should maintain a push and hold her breath for at least 10 seconds.
False:
True or False: The only certain objective sign of the onset of the second stage of labor is the woman’s perception of an urge to bear down.
False:
True or False: During the descent phase of the second stage of labor, pressure of the presenting part on the pelvic floor stimulates release
True
True or False: During birth of the head, the woman must continue to bear down fully with uterine contractions to ensure prompt expulsion.
False:
True or False: If stirrups are used during birth, it is important to place the legs into the stirrups one leg at a time.
False:
True or False: The time of birth is recorded as the precise time when the newborn takes her or his first breath.
False:
True or False: the priority goal for a newborn in the immediate postbirth period is that the newborn’s airway remains patent.
True
Critical factors to include in physical assessment of maternal-fetal unit during labor:
- maternal factors: vital signs, uterine activity, cervical changes, show and bleeding, amniotic fluid, behavior, appearance, mood, energy level, bearing down effort, and use of childbirth preparation methods
- fetal factors: FHR pattern, activity level, progress in cardinal movements of labor, and passage of meconium
A primigravida calls the hospital and tells a nurse on the labor unit that she knows that she is in labor. The nurse’s initial response would be:
a. tell me why you know that you’re in labor
b. how far do you live from the hospital
c. how far along are you in your pregnancy
d. have your membranes ruptured
a. tell me why you know that you’re in labor
A woman’s amniotic membranes apparently have ruptured. The nurse assesses the fluid to determine its characteristics and confirm membrane rupture. An expected finding would be:
a. pH 5.5
b. absence of ferning
c. pale, straw colored fluid with white flecks
d. strong odor
c. pale, straw colored fluid with white flecks
A vaginal examination is performed on a multiparous woman who is in labor. The results of the examination have been documented as 4 cm, 75%, 2, LOT. An accurate interpretation of these data is:
a. woman is in the latent phase of the first stage of labor
b. station is 2 cm above the ischial spines
c. presentation is vertex
d. lie is transverse
c. presentation is vertex
First stage of labor:
- stage of labor from the onset of regular uterine contractions to full effacement and dilation of the cervix
- (6-8 hours) (3-6 hours) (20-40 mins)
second stage of labor:
- stage of labor from full dilation of the cervix to the birth of the baby
- nulliparous woman: >2->3 hours depending on anesthesia
- multiparous women: >1 - >2 hours depending on anesthesia
Third stage of labor:
- stage of labor from the birth of the baby to the separation and expulsion of the palcenta
- 10 to 15 mins
Fourth stage of labor:
-First 1 to 2 hours after birth
