Part 5 - TBN: Mother Baby Flashcards
5 factors that affect the process of labor & birth
Passenger (fetus & placenta)
Passageway (the birth canal)
Position (position of the mother)
Powers (contractions)
Psychology (emotional response)
Fontanelles
Space between the bones of the skull allow for molding
- ANTERIOR
Diamond-shaped
Closes in 12–18 months
- POSTERIOR
Triangle shaped
Closes in 8–12 weeks
Refers to the part of the fetus that enters the pelvic inlet first through the birth canal during labor.
Fetal Presentation
Presenting Part:
Occipital (back of head/skull)
What’s first? Head
Cephalic
Presenting Part:
Sacrum
What’s first? Buttocks, feet, or both
Breech
Presenting Part: Scapula
What’s first: Shoulders
Shoulder
Fetal Attitude: Back of the fetus is rounded so that the chin is flexed on the chest, thighs are flexed on the abdomen, legs are flexed at the knees
General Flexion
Fetal Attitude: 9.25 cm at term, the largest transverse diameter and an important indicator of fetal head size
Biparietal Diameter
Fetal Attitude: Most critical & smallest of the anteroposterior diameters
Suboccipitobregmatic Diameter
- Where the baby’s presenting part is located in the pelvis
- Measured in centimeters (cm)
Fetal Station
Fetal station is at ZERO (meaning at the ischial spine) = baby is ENGAGED.
Engagement
Presenting parts have entered down into the pelvic inlet & are at the ischial spine line (0)
Engaged
When does engagement happen if NULLIPARA?
38 weeks
When does engagement happen if MULTIPARA?
CAN happen when labor starts
Rigid/bony pelvis, soft tissue of cervix, pelvic floor, vagina & introitus
Birth Canal
Classic female type of pelvis; most common
Gynecoid
Pelvis that resembles the male pelvis
Android
Female pelvis that is oval-shaped; wider anteroposterior diameter
Anthropoid
The flat pelvis; the least common.
Platypelloid
Positions of the Mother During Birth
UPRIGHT POSITION
- Sitting on a birthing stool or cushion
“ALL FOURS” POSITION
- On all fours: putting your weight on your hands & feet or commonly on a medicine ball
LITHOTOMY POSITION
- Most common
- Supine position with buttocks on the table
- Most common in women who receive epidurals
LATERAL POSITION
- Lying on their side
Gradual enlargement or widening of the cervical opening
Dilation
Shortening & thinning of the cervix during the first stage of labor
Effacement
When the stretch receptors release oxytocin, it triggers the maternal urge to bear down. She uses secondary powers to aid in the expulsion of the baby.
Ferguson Reflex
Blue extremities
Acrocyanosis
- normal during first 24 hrs of birth
What are the signs of respiratory distress in a newborn?
Retractions
Nasal flaring
Grunting
Expected length
44-55 cm
17-22 in
Expected weight
2,500-4,000 g
5 lb, 8 oz - 8 lb, 14 oz
Head circumference
32-39 cm
14-15 in
*measure above eyebrows
Chest circumference
30-36 cm
12-14 in
*measure above nipple line
Causes of decreased temperature or heat loss
EVAPORATION - moisture from skin & lungs
CONVECTION - body heat to cooler air
CONDUCTION - body heat to a cooler surface in direct contact
RADIATION - body heat to a cooler object nearby
Post-Delivery Newborn Medications
ERYTHROMYCIN OPHTHALMIC OINTMENT (Antibiotic Ointment)
- This is given to all newborns as a prophylaxis for ophthalmia neonatorum (conjunctivitis of the newborn)
- It’s required by law in the U.S
- ROUTE: Ophthalmic
VITAMIN K
- A newborn’s gut is sterile, meaning they do not have any intestinal flora that produce vitamin K until 7 days after birth
- Vitamin K is essential for blood clotting
- Given to all newborns to prevent hemorrhage & bleeding
- ROUTE: Intramuscularly in the vastus lateralis
HEPATITIS B VACCINE
- Given to immunize against hepatitis B virus (HBV)
- ROUTE: Intramuscularly in the vastus lateralis
- Typically taken in the newborn 24 hours after birth (should be done before discharge!)
- Done to test for medical conditions such as Phenylketonuria (PKU), cystic fibrosis, sickle cell anemia, etc.
Heelstick (Heel Puncture)
Yellow discoloration of the skin, mucous membranes, and/or sclera caused by ↑ bilirubin levels. Bilirubin is caused by the breakdown of red blood cells (RBCs).
- High levels of bilirubin in the blood.
Hyperbilirubinemia (jaundice)
An abnormal jaundice that happens within the first 24 hours of life
Pathological Jaundice
- CAUSES:
Hemolytic disease
RH / ABO incompatibility
Premature infants (the liver is not fully developed)
Failure to pass meconium
Sepsis
Treatment for Pathological Jaundice
Phototherapy: fluorescent light is used to convert the bilirubin to a water-soluble substance so it can be excreted by the body via stool or urine
Complication of Pathological Jaundice
KERNICTERUS
The excess bilirubin (if untreated) can cause brain damage
REFLEX: When the bottom of the foot is stroked from the heel upward, the big toe dorsiflexes (bends back) and the other toes spread out
Babinski Reflex
(Should disappear after 1 year of age)
REFLEX: When the baby’s mouth is stroked, the baby will turn its head and open the mouth. This helps the baby fi nd the food source when feeding.
Rooting Reflex
(Should disappear after 3–4 months but can last up to a year)
REFLEX: Can be triggered by a sudden loud noise or unexpected movement. The infant will extend the arms with palms up and then move the arms back to the body.
Moro Reflex (Startle Reflex)
(Should disappear after 6 months)
REFLEX: When an infant is lying on its back and quickly turns its head to one side. The leg and arm on that side will extend, while the leg and arm on the opposite side will flex.
Tonic Neck Reflex (Fencing)
(Should disappear after 3-4 months)
When a finger is touching the inside of the infant’s palm, the hand will close.
Palmar Grasp
(Response should lessen around 3–4 months)
When a finger is placed or touching under the toes, the toes will curl
Plantar Grasp
(Response should lessen around 8 months)
