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ENRP > Normal Labor and Delivery > Flashcards

Normal Labor and Delivery Flashcards

1
Q

Define Labor

A

Progressive cervical dilation resulting from uterine contractions that last 30-60 seconds and occur at least every 5 minutes

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2
Q

Define Labor

A

Progressive cervical dilation resulting from uterine contractions that last 30-60 seconds and occur at least every 5 minutes

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3
Q

False Labor (Braxton Hicks)

A

Irregular uterine contractions WITHOUT cervical change

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4
Q

1st stage of labor

A

Onset of labor to complete cervical dilation

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5
Q

Onset of labor to complete cervical dilation

A

1st stage of labor

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6
Q

2nd stage of labor

A

Complete cervical dilation to delivery of infant

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7
Q

Complete cervical dilation to delivery of infant

A

2nd stage of labor

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8
Q

3rd stage of labor

A

Delivery of infant to delivery of placenta

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9
Q

Delivery of infant to delivery of placenta

A

3rd stage of labor

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10
Q

4th stage of labor

A

Delivery of placenta to stabilization of patient

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11
Q

Delivery of placenta to stabilization of patient

A

4th stage of labor

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12
Q

What phases are included in the 1st stage of labor and what are they?

A
  1. Latent phase = Onset of labor with slow cervical dilation
  2. Active phase = Faster cervical dilation
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13
Q

When technically does the Active phase of the 1st stage of labor begin?

A

When the cervix is dilated to 6 cm

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14
Q

With a primipara patient (1st birth), what is the usual duration of the 1st stage of labor and the usual rate of cervical dilation?

A

1st stage duration = 6-18 hours

Cervical dilation rate = 1.2 cm/hour

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15
Q

With a multipara patient (has had previous births), what is the usual duration of the 1st stage of labor and the usual rate of dilation of the cervix?

A

1st stage duration = 2-10 hours

Cervical dilation rate = 1.5 cm/hour

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16
Q

With the 1st and 2nd stages of labor, how often should you monitor the baby in an uncomplicated pregnancy?

A

1st stage = every 30 minutes

2nd stage = every 15 minutes

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17
Q

With the 1st and 2nd stages of labor, how often should you monitor the baby in a complicated pregnancy?

A

1st stage = every 15 minutes

2nd stage = every 5 minutes

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18
Q

What type of fetal monitoring gets you the most accurate tracings?

A

Internal monitoring

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19
Q

How often should cervical checks occur during the active phase of the 1st stage of labor?

A

Every 2 hours

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20
Q

What does a Tocodynamometer or Internal Pressure Catheter measure?

A

Strength of uterine contractions

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21
Q

How will the mom act during the 2nd stage of labor?

A

Increase in bloody show and will want to bear down with each contraction

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22
Q

List the typical duration of the 2nd stage of labor with a primipara and multipara mother with AND without an Epidural

A

Primipara without epidural = 2 hours
Primipara with epidural = 3 hours
Multipara without epidural = 1 hour
Multipara with epidural = 2 hours

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23
Q

During the 2nd stage of labor, in what position should the mom be and what should she do with each contraction?

A

Dorsal Lithotomy = on back with hips flexed to 90

– hold breath, bear down and push with each contraction

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24
Q

With the delivery of the baby, how do you deliver the anterior and posterior shoulders?

A
  • Pull head down to get anterior shoulder out

- Pull head up to get posterior shoulder out

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25
With delivery of the baby, you may need an episiotomy or Ritgen Maneuver. What are those respectively?
Episiotomy = surgical cut at vaginal opening to aid in delivery Ritgen Maneuver = extension of the delivered head with counterpressure
26
With an Episiotomy, what type of cut is the best and has less postpartum pain?
Medial (midline) | -- mediolateral cut = worse pain/bleeding/etc.
27
What are the 7 cardinal movements of labor?
EDFIEEE - Engagement - Descent - Flexion - Internal rotation - Extension - External rotation - Expulsion
28
What are the 7 cardinal movements of labor?
EDFIEEE - Engagement - Descent - Flexion - Internal rotation - Extension - External rotation - Expulsion
29
Engagement movement of labor
Presenting part at zero station
30
What brings about the Descent movement of labor?
Force of uterine contractions and valsalva efforts
31
Flexion movement of labor
Baby's chin brought to chest | -- presenting part = suboccipitobregmatic
32
Internal Rotation movement of labor
Baby's head rotates occiput anteriorly or posteriorly toward pubic symphyses
33
Extension movement of labor allows what to be delivered?
Head
34
Crowning occurs with the Extension movement of labor. What is that?
Largest diameter of head is encircled by vaginal introitus
35
External Rotation movement of labor
Head returns to original position to align with back and shoulders once it is free
36
Expulsion movement of labor
Anterior shoulder - -> posterior shoulder - -> body
37
1st degree perineal laceration
Involves vaginal mucosa and/or perineal skin
38
2nd degree perineal laceration
Extends into muscles of perineal body
39
3rd degree perineal laceration
Extends into anal sphincter
40
4th degree perineal laceration
Involves rectal mucosa
41
With the 3rd stage of delivery, how long does it usually take? What is a Retained Placenta?
2-10 minutes | -- Retained placenta = one that has not delivered within 30 minutes
42
What are the signs of placental separation with the 3rd stage of labor?
- Gush of vaginal blood - Lengthening of umbilical cord - Uterine fundus rises up and changes to globular shape
43
What are the signs of placental separation with the 3rd stage of labor?
- Gush of vaginal blood - Lengthening of umbilical cord - Uterine fundus rises up and changes to globular shape
44
What should you do during the 3rd stage of labor?
Apply counterpressure between the uterine fundus and pubic symphyses
45
If you do NOT see signs of placental separation during the 3rd stage of labor, what should you NOT do and why?
Do NOT pull on the umbilical cord | --> uterine inversion
46
What should you do during the 4th stage of labor?
Monitor patient Uterine fundal checks Assess for vaginal bleeding
47
In what stage of labor are postpartum hemorrhages most common?
4th stage of labor
48
What are some contraindications for Induction? (4)
- UNSTABLE fetus - Previous C-section/uterine surgery - Placenta previa - Contraindications for vaginal delivery
49
What are some contraindications for Induction? (4)
- UNSTABLE fetus - Previous C-section/Uterine surgery - Placenta previa - Any contraindications for vaginal delivery
50
What 5 things does the BISHOP score take into account?
``` Cervical dilation Cervical effacement Cervical consistency Cervical position Station ```
51
If a BISHOP score is less than 6, what does that mean?
Induction is UNFAVORABLE
52
If a BISHOP score is greater than 8, what does that mean?
Probability of vaginal delivery after induction will be EQUAL TO that of a spontaneous labor
53
What is a drug that can be used for induction and augmentation of labor?
Pitocin (synthetic oxytocin)
54
What are 3 side effects that can occur with Pitocin?
Uterine Tachysystole Antidiuretic effect Uterine muscle fatigue
55
What spinal levels correlate with uterine contractions/cervical dilation and the pelvic floor/vagina/perineum?
Uterine contractions/cervical dilation = T10-L1 | Pelvic floor/vagina/perineum = S2-S4
56
Regional anesthesia with labor will cause loss of pain sensation below what level?
T10
57
Are parenteral pain methods effective? What can they cause?
Only early in the 1st stage of labor | --> can cause neonatal respiratory depression
58
What are 2 regional pain methods?
1. Epidural | 2. Spinal
59
Regional pain methods involve local anesthesia and a narcotic. What is the difference between an Epidural and Spinal?
Epidural - inserts catheter for continuous infusion | Spinal - 1 shot only
60
What is a General Anesthetic that can be used in emergent cases and what does it cause?
Propofol | --> maternal LOC

ENRP (45 decks)

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