Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

maternity nursing > process of labor and birth > Flashcards

process of labor and birth Flashcards

You may prefer our related Brainscape-certified flashcards:
Family Nurse Practitioner (FNP) flashcards NCLEX-PN® flashcards Nursing Management of Care flashcards Nursing Maternity flashcards Nursing Pharmacology flashcards NCLEX-RN® flashcards Nursing Fundamentals flashcards Nursing Adult Health flashcards Nursing Safety & Infection flashcards Nursing Mental Health flashcards
1
Q

when does the onset of labor usually occurs?

A

between the 38 and 42 weeks of pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

“P” of labor

A

Powers, passageway, passenger, passageway+passenger and their relationship(engagement, attitude, position), psychosocial influences

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

on of the factors that include the uterine contraction and the maternal pushing effort

A

POWERS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

considered as the primary force of labor

A

uterine contractions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

secondary force of labor that adds to the primary force to facilitate childbirth

A

pushing (use of maternal abdominal muscles)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

rhythmic tightening of the uterus that occurs intermittently. this action shortens the individual uterine muscle fibers and aids in the process of cervical effacement and dilation, and postpartal involution.

A

contractions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

the reduction of uterine size after birth

A

involution

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what are the 3 distinct components of contraction

A

increment, acme, decrement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

changes in uterine musculature caused by contraction

A

the upper portion of the uterus becomes thicker and more active. the lower segment becomes thinned-walled and passive.

the boundary between the upper and lower uterine segment becomes marked by a ridge on the inner uterine surface, known as “physiological retraction ring”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

the pressure exerted by the fetus

A

fetal axis pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

measured from the beginning of one contraction to the beginning of of the next contraction

A

frequency of contraction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

measured from the start on one contraction to the end of the same contraction

A

duration of contraction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

this is measure by uterine palpation and is described as mild, moderate, and strong

A

intensity of contraction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

when the uterus fundus remains soft at the acme of a contraction, the contraction intensity is describe as?

A

mild

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

when there is an inability to indent the uterus at the acme of contraction, the contraction intensity is describe as?

A

strong

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

pressure sensitive device that is used externally and applied against the uterine fundus

A

tocodynamometer

this does not give accurate data regarding the intensity of contraction because there are many variables (maternal position, obesity)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

resting pressure in the uterus between contractions

A

10-12mm Hg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

pressure of contraction during acme during early labor

A

25-40mm Hg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

pressure of contraction during active labor

A

50-70mm Hg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

pressure of contraction during transition

A

70-90mm Hg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

pressure of contraction during maternal pushing in the second stage

A

70-100mm Hg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

characteristic of uterine contraction during early labor

A

weak and irregular. they usually last for about 30 sec and occur every 5 to 7 min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what happens to maternal anus during labor and delivery

A

anus evert and the interior rectal wall is exposed as the fetal head descends forward

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

the process of shortening and thinning of the cervix

A

effacement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

is the opening and enlargement of the cervix the progressively occurs throughout the first stage of labor. it is expressed in cm

A

dilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

laboring woman usually experience this sensation when the cervix has become fully dilated

A

bearing down-assist in the expulsion of the fetus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

adverse effect of bearing down when cervix is partially dilated

A

cervical edema, adversely effect the progress of labor. Initiate pushing only when the cervix is completely dilated!!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

bony pelvis through which the fetus must pass is divided to 3 section, which are??

A

inlet, midpelvis, and outlet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

least flexible part of the fetus

A

fetal skull

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

the overlapping or overriding of the cranial bones

A

molding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

this diameter is the major transverse diameter of the fetal head

A

biparietal diameter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

the most favorable situation of the head during labor

A

when the head is fully flexed and the anteroposterior diameter is the suboccopitobregmatic, 3.7 inches

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

refers to the relationship of the long axis of the woman t to the long axis of the fetus

A

fetal lie

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

the head to tailbone axis of the fetus is the same as the woman’s , the fetus is in what lie?

A

longitudinal lie

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

what part of the fetal body enters the pelvis first in longitudinal lei

A

either fetal head or buttocks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

the head to tailbone axis of the fetus is at 90-degree angle to the woman

A

transverse or horizontal lie

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

this describes the relationship of the fetus’ body parts to one another

A

fetal attitude

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

describe fetal position

A

the fetal head is flexed so that the chin touches the chest., the arms are flexed and folded across the chest, the thighs are flexed on the abdomen, and the calves are flexed against the posterior aspects of the thighs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

fetal attitude that occurs when thee chin is not touching the chest but is in an alert, or military position. this position causes the occipital diameter to present to the birth canal.

A

moderate flexion

this usually does not interfere with the labor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

fetal attitude occurs when the brow or face of the head presents to the birth canal

A

partial extension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

refers to the fetal part that enters the pelvic inlet first and leads through the birth canal during labor

A

fetal presentation (cephalic, breech, shoulder)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

what does fetal lie and attitude determine?

A

presenting part

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

fetal presentation when the fetal head presents fully flexed. this is also the most frequent and optimal presentation because it allows the smallest suboccipitalbregmatic diameter to present

A

vertex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

the fetal head presents in a neural position, which is neither flexed nor extended. the occipitofrontal diameters presents to the maternal pelvis and the top of the head is the presenting part

A

military position

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

in this position, the fetal head is partly extended this is an unstable presentation

A

Brow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

in this position, the fetal head is fully extended and the occiput is near the fetal spine

A

face

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

breech and shoulder presentation are called??

A

malpresentations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

when does breech presentation are more likely to occur?

A

preterm birth, or in the presence of hydrocephaly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

what are the disadvantage of breech presentation?

A
  1. increase risk for umbilical prolapse.
  2. the buttocks of feet are not smooth and less effective in dilating the cervix.
  3. one the fetal body is delivered, the umbilical cord can become compressed. may cause hypoxia.
  4. No time to allow for molding
50
Q

types of breech presentation

A

frank, complete, footling

51
Q

is the most common breech position. this is when the fetal legs are completely extended up toward the fetal shoulder. the fetal buttocks presents first in the maternal pelvis

A

frank

52
Q

breech position that is the same as flexed position with the fetal buttocks presenting first. This position is a reversal of the common cephalic presentation

A

complete

53
Q

maternal abdomen appears large from side to side, rather than un and down.

A

transverse lie or shoulder presentation

54
Q

is said to have occurred when the widest diameter of the fetal presenting part has passed through the pelvic inlet. this can be determined by external palpation or by vaginal examination

A

engagement

55
Q

largest diameter in cephalic presentation

A

biparietal

56
Q

large diameter in breech presentation

A

intertrochacentric diameter

57
Q

when does engagement usually occurs?

A

in primigravidas, engagement occurs 2 weeks before the due date. in multiparas, engagement may occur many weeks before the onset of labor or it may take up during the labor

58
Q

this refer to the level of the presenting part in relation to the maternal ischial spines which is the narrowest diameter through which the fetus must pass

A

station-
landmark to identify station zero.
engagement has occurred when the presenting part is at station zero.

59
Q

at what station indicates that the presenting part is at the pelvic outlet?

A

+4cm

60
Q

This refers to the location of a fixed reference point on the fetal presenting part to a specific quadrant of the maternal pelvis

A

position

61
Q

when does the sign of impending labor occurs in primigravida woman?

A

38 weeks of gestation

62
Q

marks the beginning of engagement. the presenting part settles downward into the pelvic cavity, causing the uterus ti move downward as well.

A

lightening

“baby has dropped”

63
Q

adverse effect of lightening or downward settling of the uterus

A
  1. leg cramps of pain
  2. increase pelvic pressure
  3. increase urinary frequency
  4. increase venous stasis
  5. increase vaginal secretion
64
Q

also term as false labor because it does not lead to dilation or effacement of the cervix

A

braxton hicks

65
Q

Its presence often indicates that labor will begin within 24 to 48 hours

A

bloody show or blood tinged mucus plug-happens due to the rupture of small cervical capillaries

66
Q

how to confirm presence of amniotic fluid?

A

Nitrazine tape test, Amnisure test, fern test

67
Q

sudden increase in energy towards the end of pregnancy

A

nesting/energy spurt

68
Q

where does the pain of true labor located?

A

lower back region that radiates to the abdomen. pain intensifies with activity such as walking. contraction occur with regularity and increase in frequency, duration, and intensity.

69
Q

where does the pain of false labor located?

A

abdominal region and often stops with activities since as walking, position changes, hot showers or other comfort measure. contractions are irregular and do not change in intensity and duration

70
Q

is often referred to as stage of dilation. and it begins with the onset of regular contractions and ends with complete dilation of the cervix

A

first stage of labor-longest stage

71
Q

phases of first stage of labor

A

latent, active, transition

72
Q

Phase of labor that begins with the establishment of regular contractions. Labor pain is similar to painful menstrual cramping and are usually accompanied by low back pain

A

latent phase

73
Q

duration of contraction during latent phase

A

5 min apart, last 30 to 45 sec, and are considered to be mild. the women remain chatty and sociable during latent phase.

74
Q

this phase of labor is completed at home

A

latent phase

75
Q

phase of labor that are more frequent and last longer 60 sec

A

active phase

76
Q

is the most intense phase of labor that occur every 2 to 3 min and last 60 to 90 sec

A

transition phase

77
Q

other sensation that woman may feel during transition phase

A

rectal pressure, increase urge to bear down, increase in bloody show, spontaneous ROM

78
Q

dilation of 0-3cm

A

latent

79
Q

dilation of 4-7cm

A

active

80
Q

dilation of 8-10cm

A

transition

81
Q

four central ways to identify fetal position

A

abdominal palpation or leopold maneuvers, location of the point of auscultation of the fetal heart rate, vaginal examination and ultrasound

82
Q

suggested frequencies for FHR auscultation when no risk factor are present

A

every 60 min during the latent phase, and every 5 to 15 min during the active phase and the second stage of labor

83
Q

suggested frequencies of fetal assessment with EFM with no risk factors

A

FHR is evaluated every 30min during active phase, and every 15min during the active pushing phase of the second stage of labor

84
Q

suggested frequencies of fetal assessment with EFM with risk factors

A

15 min during active phase of the first stage of labor, 5min during the active pushing phase of the second stage of labor.

85
Q

referred to as the average FHR observed between contractions over a 10min period

A

baseline FHR

86
Q

conditions associated with fetal tachycardia

A
  1. fetal hypoxia-decrease blood flow stimulate SNS
  2. Maternal fever- temp accelerates fetal metabolism, thus increasing the FHR. seen in dehydrated women
  3. maternal medication
  4. infection
  5. fetal anemia-FHR increases in response to a decrease fetal hemoglobin
  6. Maternal hyperthyroidism
87
Q

conditions associated with fetal bradycardia

A
  1. late fetal hypoxia
  2. medications
  3. maternal hypotension
  4. Maternal or fetal hypotermia and dehydration
  5. fetal bradyarrhythmias
  6. uterine tachysystole (hyperstimulation)
  7. vagal stimulation
  8. chronic fetl head compression
88
Q

most important predictor of adequate fetal oxygenation during labor

A

baseline variability- reflective of well functioning and well-oxygenated fetal autonomic nervous system and confirms that the fetus is not experiencing metabolic acidosis.

89
Q

variability that may present fetal cerebral asphyxia

A

absent. may be normal when fetus is sleeping but should not last longer than 30min.

90
Q

variability that may be related to narcotiss, mag sulfate, cord compression, fetal sleep, anesthetic agents, prematurity

A

minimal >2-<5 bpm

91
Q

variability that indicate fetal well being

A

moderate 6-25 bpm

92
Q

variability of >25bpm

A

marked

93
Q

what to do when minimal or absent variability is detected?

A
  1. positioning,
  2. assess fetal response to fetal scalp stimulation or vibroacoustic stimulation,
  3. assess hydration-IV bolus
  4. discontinue oxytocin
  5. oxygen 8-10L
94
Q

define acceleration

A

increase of 15bpm above the fetal baseline for 15sec to less than 2min.

95
Q

define deceleration

A

any decrease in FHR below the baseline FHR

96
Q

define variable deceleration

A

abrupt decrease in FHR below the baseline of 15bpm or more, lasts at least 12 sec, and returns to the baseline in less than 2 min from the time of onset

97
Q

what may cause variable deceleration

A
  • umbilical cord compression, which triggers a vagal response that slows the FHR.
  • A sudden descent of fetal head late in the active phase of labor. This is usually non-repetitive and irregular in shape
98
Q

what may consider normal deceleration?

A

decelerations that are less than 60sec in duration, have a rapid return to the baseline, and are accompanied by a normal baseline and variability

99
Q

characteristics of abnormal deceleration

A

slow return to baseline, persistence to less than 60bpm and greater than 60sec. presence of overshoots, tachycardia, and absent variability

100
Q

is an instillation of warmed saline into the uterus via IUPC to provide fluid to cushion the umbilical cord and help lessen cord compression

A

amnioinfusion

101
Q

This type of deceleration indicate the presence of Uteroplacental insufficiency which cause a decrease in blood flow from the uterus to the placenta resulting in fetal hypoxia

A

late deceleration

102
Q

what is prolonged deceleration?

A

it is an abrupt decrease in the FHR below the baseline that is greater than or equal to 15bpm and lasts greater than or equal to 2 min but less than 10 min

103
Q

Cat 1

A

Baseline is 110-160bpm
moderate variability
early decels and accels may be present or absent
late decels absent

104
Q

Cat 2

A 
bradycardia without absent variability
tachycardia
minimal variability
absent variability without recurrent decels
marked variability
periodic or episodic deceleration
105
Q

cat 3

A

absent variability, recurrent late decels, recurrent variable decels, bradycardia

106
Q

when fetal stimulation should not be performed?

A

when decelerations or bradycardia is present. it may however perform with or without ROM with FHR is at baseline

107
Q

stage of labor that commences with full dilation of the cervix and ends with the birth of the infant

A

second stage of labor

108
Q

stimulates the urge to push as the presenting part stretches the pelvic floor muscles

A

ferguson reflex

109
Q

what are the 2 methods of pushing

A

closed and open glottis

110
Q

this is often referred to directed pushing. woman push at full cervix dilation regardless of the urge to bear down

A

closed-glottis pushing

111
Q

this is often referred to as involuntary pushing and is also recommended method of pushing

A

open glottis- the woman is encourage to hold her breath for only 5 to 6sec during pushing and to take several breaths between each bearing down effort.

112
Q

what is crowning

A

birth is imminent, occurs when the fetal head is encircled by the vaginal introitus

113
Q

degree of laceration that involve the perineal skin and vaginal mucous membrane

A

first degree

114
Q

degree of laceration that involve the perineal skin and vaginal mucous membrane and the fascia of the perineal body

A

second degree

115
Q

degree of laceration that involve the perineal skin and vaginal mucous membrane, and the muscle of the perineal body and extend to the rectal spincter

A

third degree

116
Q

degree of laceration that extend into the rectal mucosa and expose the lumen of the rectum

A

fourth degree

117
Q

when should clamping be done?

A

60 to 120sec or until cord pulsation ceases

118
Q

stage of labor that begins with the birth of the infant and ends with the delivery of the placenta

A

third stage of labor

119
Q

occurs when the placenta separates from the inside to outer margins with the shiny, fetal side presenting first

A

schulte mechanism-most common

120
Q

occurs when the placenta separates from the outer margins inward, rolls up, and presents sideways

A

duncan mechanism

maternity nursing (1 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions