Module 5 Objectives - First Half (Exam 2) 1 Flashcards
Attitude
Relationship of fetal parts to one another
Dilation
Progressive opening of the diameter of the cervical os
Effacement
Progressive thinning and shortening of the cervix
Engagement
Fixation of the fetal presenting part into the true maternal pelvis
Fetal Lie
Relationship of the long axis of the fetus to the long axis of the mother
Presentation
Fetal body part that enters the maternal pelvis first
Station
Relationship of the presenting part to the ischial spine
Vertex
Top or crown of fetal head
Four types of maternal pelves
- Gynecoid * good
- Anthropoid * good
- Android
- Platypelloid
Identify theroies of onset of normal labor
- Hormonal Influences: changes in estrogen to progesterone ratio
- Prostaglandin secretion: Prepares the uterus to respond to oxytocin
- Development of oxytocin receptors
- Fetal cortisol
- Uterine irritability secondary to stretching and pressure near term
Impending signs of labor
- Lightening
- Braxton-Hicks Contractions
- Bloody show
- Energy Spurt
Lightening
Movement of the fetus downward into the pelvic cavity (engagement)
Braxton-Hicks Contactions
Mild, intermittent, contractions that occur throughout pregnancy
Bloody Show
Pink-tinged mucous secretions resulting from cervical dilation
Energy Spurt
Sudden increase in energy; also called nesting
What factors distinguish tru labor from false labor?
True labor has
- Contractions are consistently increasingin frequency, duration, and intensity and tend to increase with walking. They begin in the lower back and gradually sweep around to lower abdomen
- Discomfort may persist as back pain in somewomen and often resembles menstrual cramps during early labor
- Cervical Change (caused by contractions) includes progressive effacement and dilation
- Possible ROM
False Labor:
- Contractions are inconsistent in frequency, duration, and intensity and do not change or may decrease with activity
- Discomfort is felt in the abdomen and groin…feels annoying more than painful
- Cervix does not significantly change in effacement or dilation
Four primary sources of pain during labor
- Tissue ischemia
- Cervical dilation
- Pressure on pelvic structures
- Vaginal and perineal distention
What is the most accurate assessment for labor progress?
Progressive cervical effacement and dilation
Purpose and description of leopold’s maneuver’s during labor
To determine and presentation and position of the fetus and aid in location of fetal heart sounds
- Palpate uterine fundus to distinguish if the breech or head is at the uterine fundus
- Palpate each side of the uterus to determine which side the back is on
- Palpate the suprapubic area to confirm the presentation determined in the first maneuver. Attempt to grasp the presenting part gently between the thumb and fingers, if not engaged, the presenting part will move upward in the uterus
- Only if cephalic - Slide hands on the bottom sides of the uterus to determine if the head is flexed or extended (prominence felt on opposite side of fetal back)
Priority nursing responsibilities for spontaneous rupture of membranes
- Assess Fetal HR
- Color
- Odor
- Amount
- Time of Rupture
Duration of second stage of labor for primipara
53-57 minutes without an epidural, 79 minutes with an epidural
Sterile Vaginal Exam (SVE)
Used to assess labor progress
- Fetal presentation/position
- Cervical effacement/dilation
- Station
- Integrity of Rupture of Membranes
Duration of second stage of labor for the multipara
17-19 minutes without an epidural, 45 minutes with an epidural
