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CMC(EINC) > [Module 4.2] Intrapartum > Flashcards

[Module 4.2] Intrapartum Flashcards

1
Q

an involuntary physiologic process whereby the contents of the gravid uterus are expelled through the birth canal into the external environment

A

Labor

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2
Q

What are the Five [5] theories why labor begins?

A
  1. Uterine stretch theory
  2. Low progesterone theory
  3. Oxytocin theory
  4. Estrogenic, fetal hormones & prostaglandins theory
  5. Theory of aging placenta
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3
Q

The sinking of the fetal head into the true pelvis

A

lightening

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4
Q

As progesterone level falls, more fluid is excreted, slightly lowering body weight. what signs and symptoms of labor is this?

Additionally, how much weight can actually be loss?

A

Slight loss of weight

Between 1 to 3 lbs

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5
Q

signs and symptoms of labor where a burst of adrenaline to provide energy for labor

A

Excess energy

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6
Q

signs and symptoms of labor showing the beginning but unrecognized uterine contractions

A

Backache

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7
Q

In primiparas, lightening approximately occur how many days before the labor begins?

A

10-14 days

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8
Q

in multiparas, lightening occurs how many days before the labor begins?

A

usually occurs on the day of labor
or a day before labor.

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9
Q

As the fetus sinks lower into the pelvis, what are the things that a woman may experience?

A
  1. Shooting leg pains from the increased pressure on a sciatic nerve
  2. Increased amounts of vaginal discharge
  3. Urinary frequency from pressure on her bladder
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10
Q

This is the sign of a true beginning of labor

A

uterine contractions

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11
Q

the characteristic of braxton hicks contraction to the mother is that is enables the dilation of cervix. [T or F]

A

False, they do not dilate the cervix

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12
Q

This is know as false labor contractions and is irregular in nature

A

Braxton Hicks

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13
Q

how can you relieve braxton hicks?

A

Through walking and enema

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14
Q

when the bag of water of the mother is ruptured, it is an indication of ______.

Moreover, this kind of event is associated with the risk such as ____ and _____

A

Hospitalization

intrauterine infection, prolapse of the umbilical cord.

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15
Q

it is characterized as a blood-tinged mucus discharged from the cervix, shortly before or during labor

A

Show

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16
Q

Give the characteristic of true labor in terms of:

  • Contraction
  • Discomfort
  • Effects on Cervix
  • Effects of walking
  • Enema
  • Show
A

Contraction
Regular, Progressive

  • Discomfort
    Lumbo-sacral, radiating to the front; increasing the intensity
  • Effects on Cervix
    Dilated: most important sign
  • Effects of walking
    Intensifies the contractions
  • Enema
    Intensifies contractions
  • Show
    Present and increasing
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17
Q

Give the characteristic of false labor in terms of:

  • Contraction
  • Discomfort
  • Effects on Cervix
  • Effects of walking
  • Enema
  • Show
A

Contraction
irrregular, non-Progressive

  • Discomfort
    Abdominal
  • Effects on Cervix
    No dilation
  • Effects of walking
    No effect
  • Enema
    No effect
  • Show
    Absent
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18
Q

What are the components of labor process [5Ps]

A

Power
Passenger
Passageway
Position
Psychologic Response

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19
Q

refers to the route a fetus must travel from the uterus through the cervix and vagina to the external perineum

A

Passageway

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20
Q

serves to support and protect the reproductive organs. A bony ring formed by four united bones:

A

Pelvis

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21
Q

refers to the fetus in the 5Ps

A

passenger

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22
Q

structure of the fetal skull described as uppermost portion of the fetal skull, is composed of
8 bones

A

Cranium

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23
Q

what are the four superior bones in the fetal skull>

A

1 frontal
2 pareital
1 occipital

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24
Q

this is where the bones
of the skull meet

A

suture lines

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25
Q

a membranous inter-space that joins the parietal bones

A

sagittal suture

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26
Q

the line of junction of the frontal bone and the two parietal bones

A

Coronal suture

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27
Q

the line of junction of the occipital bone and the two parietal bones

A

lambdoid suture

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28
Q

the membranes that are
found at the junction of the main
suture line.

A

fontanelles

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29
Q

the anterior fontanelle is also known as the?

A

bregma

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30
Q

lies in the junction of the coronal and sagittal sutures and in diamond shape

A

anterior fontanelle

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31
Q

the anterior fontanelle measures ___ cm.
(anterior-posterior), and ___ cm (transverse) in diameter

A

3-4, 2-3

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32
Q

lies at the junction of the lambdoid
and sagittal sutures.

A

posterior fontanelle

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33
Q

the posterior fontanelle is also known as the?

A

lambda

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34
Q

is overlapping of skull bones along the suture lines, which causes a change in the shape of the fetal skull to one long and narrow

A

Molding

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35
Q

describes the degree of flexion a fetus assumes during labor or the relation of the fetal parts to each other

A

Fetal Attitude

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36
Q

what causes molding

A

force of uterine contractions as the vertex of the head is pressed against the not yet dilated cervix

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37
Q

the relationship of the long (cephalocaudal) axis of the fetus to the long (cephalocaudal) axis of the woman’s body.

A

fetal lie

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38
Q

fetal lie where the - head is the presenting part (Vertex or Occiput, Brow and Face or mentum)

A

Cephalic

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39
Q

fetal lie where the buttocks or feet are presented. [Complete, Frank, Footling (single or double)

A

Breech

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40
Q

this denotes the body part that will first contact the cervix or be born first

A

fetal presentation

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41
Q

this is determined by the combination of fetal lie and the degree of fetal flexion (attitude)

A

fetal presentation

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42
Q

a type of cephalic presentation where the head is sharply flexed, making the parietal bones or the space between the fontanelles the presenting part.

A

Vertex cephalic presentation

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43
Q

cephalic presentation where head is only moderately flexed, the brow or sinciput becomes the presenting part

A

Brow

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44
Q

cephalic presentation where the face is the presenting part

A

face

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45
Q

cephalic presentation where the head has completely hyperextended to present the chin.

A

Mentum

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46
Q

occurin approximately 4% of births

A

breech presentation

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47
Q

type of breech presentation where thighs are tightly flexed on the abdomen

A

complete breech presentation

48
Q

type of breech presentation where both the buttocks are tightly flexed feet present to the cervix.

A

complete

49
Q

type of breech presentation where hips are flexed, but the knees are extended to the rest of the chest. the buttocks alone present at the cervix.

A

frank

50
Q

type of breech where neither thighs nor lower legs are flexed. foot is the presenting part.

A

footling

51
Q

presenting part: one of the shoulders (acromion process) an iliac crest a hand, or an elbow

A

shoulder presentationt

52
Q

this type of presentation usually affects the contour of the mother’s abdomen at term may appear fuller side to side rather than top to bottom

A

shoulder presentation

53
Q

what causes shoulder presentation to happen during pregnancy?

A
  • Pelvic contractions
  • Placenta previa
  • Relaxed abdominal walls from grand multiparity, which allow the unsupported uterus to fall forward
54
Q

the relationship of the presenting part of the fetus to the level of the ischial spines.

A

station

55
Q

the presenting part is at the level of the ischial spine.

A

station 0

56
Q

what station where the presenting part is at the perineum seen if the vulva is separated (crowning)

A

station 3-4

57
Q

Mechanisms (Cardinal Movements) of Labor

A

Engagement
Descent
Flexion
Internal Rotation
Engagement
External Rotation
Expulsion

58
Q

refers to the settling of the presenting part of a fetus far enough into the pelvis that it rests at the level of the ischial spines, the midpoint of the pelvis.

A

Engagement

59
Q

A presenting part that is not engaged is said to be “_______”

A

Floating

60
Q

One that is descending but has not yet reached the ischial spines may be referred to as “_______.”

A

Dipping

61
Q

is the downward movement of the biparietal diameter of the fetal head within the pelvic inlet.

A

Descent

62
Q

when does full descent occur?

A

when the fetal head reaches the when the fetal head protrudes beyond the dilated cervix and touches the posterior vaginal floor

63
Q

the twisting of the neck action

A

restitution

64
Q

it is considered as the primary power of labor and is supplemented by the use of abdominal muscles after full dilatation.

A

powers

65
Q

it is accomplish by the fundus of the
uterus by contraction.

A

pwers

66
Q

explain the origin of the uterine contractions.

A

begins at pacemaker at the myometrium, goes down to over the uterus as a wave, after a short rest period, another contraction is initiated and the downward sweep begins again.

67
Q

what are the phases of contraction

A

increment
acme
decrement

68
Q

shortening and thinning of the cervical canal

A

effacement

69
Q

enlargement or widening of the cervical canal

A

dilatation

70
Q

in primiparas, which is accomplished first. effacement or dilatation

A

EFFACEMENT

71
Q

T OR F multiparas also needs to accomplish effacement before dilatation begins.

A

f - dilatation may proceed before effacement is complete

72
Q

what are the 4 stages of labor.

A

Dilatation
Delivery of the baby
Delivery of the Placenta
Recovery Stage

73
Q

This is the onset of the
first true labor contraction up to full
cervical dilatation ( 0-10cm)

A

Dilatation stage

74
Q

1-4cm dilation, what phase is this.

A

latent phase

75
Q

what is the common duration in the latent phase

A

30 seconds average

76
Q

what is the frequency in latent phase of dilation stage

A

over 10 minutes, but can also be within 5-8mins

77
Q

what is the nursing intervention during latent phase

A

proper positioning [side lying]
Backrub
Bring Support system

78
Q

Cervix dilate 4-8cm [1cm/hr] / what phase of dilation is this?

A

active phase

79
Q

what is the duration and frequency of the contractions in the active phase of dilation stage?

A

45-60 seconds [duration
3-5minutes [Frequency

80
Q

identify what phase of the dilation phase is this:

Less talkative: more anxious

A

active phase

81
Q

identify what phase of the dilation phase is this:
May not want to be alone:

A

active phase

82
Q

in this phase, the mother may experience hyperventilation

A

active phase

83
Q

if unmanaged, hyperventilation may result to?

A

Respiratory Alkalosis

84
Q

what are the nursing intervention that may be applicable during the active stage?

A

Warm shower
Monitor FHB and V/S
Breathing technique
Kept the bladder empty

85
Q

what is the duration and frequency of contractions during the transition phase?

A

60-90 secs duration
every 2-3mins frequency

86
Q

what phase is this maternal behavior.
Increased perspiration, n/v, cramps

A

transition

87
Q

what phase is this maternal behavior.
Restlessness, panic, irritability

A

transition

88
Q

what phase is this maternal behavior.
Amnesia at intervals, lost control of labor

A

transition

89
Q

what phase is this maternal behavior.
Tends to push during contractions & circumo

A

transition

90
Q

The mother in transition phase may have a
strong desire to push, but she should not. Why?

A

As pushing when the cervix is not yet fully dilated
can result in caput succedaneum

90
Q

what phase is this maternal behavior.
increase in anxiety with skin warm and flushed

A

active phasse

91
Q

identify what phase comes with this nursing intervention.

Provide physical comfort with dry linens and cool
clothes

A

transition

92
Q

identify what phase comes with this nursing intervention.

Clean up vomitus

A

transition

93
Q

identify what phase comes with this nursing intervention.
Coach on breathing pattern- Pant-blow pattern of
breathing

A

transition

93
Q

identify what phase comes with this nursing intervention.
backrubs

A

transition and latent

94
Q

identify what phase comes with this nursing intervention.
Provide psychologic comfort: help focus on the task, be understanding of her irritability

A

transition

95
Q

this stage is characterized as a spontaneous pushing with contractions, panting at
interval and at crowning time

A

Delivery Stage

96
Q

described as from fully dilated cervix to the delivery or
expulsion of the baby

A

Delivery stage

97
Q

what is the hallmark of the delivery stage?

A

crowning

98
Q

When the head crowns, the mother is advised to jsut pant and do not push, why?

A

to prevent meconium aspiration and to avoid perinial lacerations

99
Q

: progress from irritability to participation,
eagerness and excitement is one of the maternal behavior in this stage

A

Delivery stage

100
Q

Perineum bulges
Increase bloody show
BOW-Ruptures

A

Delivery stage

101
Q

in the second stage, it is important for the nurse to support the mother using the PREIST method. what is this?

A

P-raise
R-eassurance
E-ncouragement
I-nform mother of progress
S-upport system
T-ouch

102
Q

what cm should you transfer the patient to the DR?

A

Primigravida: cervix 10cm w/ certain degree of bulges
Multigravida: 8-9cm

103
Q

Period from the delivery of the baby to the
delivery of the placenta

A

Placental stage

104
Q

Period of recovery, stabilization, usually____ hours up to __ hours

A

1-2, 4hrs

105
Q

what stage is the nursing intervention:

Monitor v/s every 15 min, check the perineum (appearance, swelling etc

A

recovery

106
Q

what stage is the nursing intervention:
Palpate the fundus every 15 min

A

recovery

107
Q

what stage is the nursing intervention:
Assess for the lochia (rubra, serosa and alba)

A

recovery

108
Q

what stage is the nursing intervention:
Administered oxytocin if needed

A

recovery

109
Q

what stage is the nursing intervention:
check episiotomy site

A

recovery

110
Q

Give the 3 Active management of Third Stage of labor

A
  1. Administration of uterotonic within 1 min. after the
    delivery of the baby.
  2. Controlled traction with countertraction
    on the uterus.
  3. Uterine massage
111
Q

Coaching the mother to push is recommended

A

no

112
Q

to alleviate the pain of the mother during the second stage, a nursing intervention that can be done is to massage the perineal area.

A

no

113
Q

it is vital to put fundal pressure during the
second stage to assist the mother in the delivery

A

no

114
Q
A

CMC(EINC) (8 decks)

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