Quiz #3 - Stages of Labor Flashcards
What are some issues for new nurses regarding labor?
Mom’s have pain that you may have never experienced! It’s unpredictable and feels very intimate which can be scary
What do intermittent labor contractions allow for?
Placental blood flow & exchange of oxygen, nutrients, and waste products
What part of the uterus contracts during labor?
Upper
What is effacement?
The gradual thinning, shortening, and drawing up of the cervix measured from 0-100%
What is dilation?
The gradual opening of the cervix measured in cm from 0-10cm
What happens to the fetus’ pulmonary system during labor?
Decreased production of fluid in lungs. Thoracic compression during labor expels additional fluid and they open!
What are the 4 components of the birthing process?
Powers, passage, passenger, psyche
What are the 2 powers of labor?
- Uterine contractions - the primary force in the first phase of labor to move fetus down
- Maternal pushing - during second phase
What is the passage of birth?
Maternal pelvis and soft tissue.
What does the hormone relaxin do?
Softens cartilage that links pelvic bones as term approaches.
What is passenger “lie”?
Either longitudinal (baby spine matches mom’s spine) or transverse (baby spine is perpendicular to mom’s spine)
What is passenger “attitude”?
Either flexion (baby chin tucked in) or extension (baby chin outwards)
What is a frank breech?
Fetus’ legs are straight up towards head, folded like V
What is a full breech?
Fetus hugging self, legs not straight
What is a single footling beech?
One leg sticking out!
What decreases a woman’s ability to cope with labor pain?
Anxiety, fear, fatigue
What is secreted in response to anxiety or fear?
Maternal catecholamines, they inhibit uterine contractility and placental blood flow. Mom needs to relax!!
What are some theories as to what onsets normal labor?
Changes in estrogen, prostaglandin secretion, increased secretion of oxytocin, more oxytocin receptors, fetal role, stretching of uterus, etc.
What are some premonitory signs of labor?
Braxton Hicks contractions, lightening, increase in clear secretions, “bloody show”, energy spurt, small weight loss
What is true labor?
Contractions that efface & dilate the cervix
What is false labor?
Irregular contractions that don’t do anything
First stage of labor?
- Latent phase 0-6cm
- Active phase 6-8cm
- Transition phase: 8-10cm
Second stage of labor?
Pushing stage
Third stage of labor?
Placenta expulsed
Fourth stage of labor?
Bonding stage
What augments the natural process of labor?
Relaxation
When should a women go to the hospital or birth center?
Increasing contractions, ruptured membranes, bleeding, decreased fetal movement, etc
SROM
Spontaneous rupture of membranes
PROM
Premature rupture of membranes
AROM
Artificial rupture of membranes
How do you assess for SROM or PROM?
With a sterile speculum exam to look for pooling (viewing amniotic fluid), ferning (swabbing secretions to test for fern pattern), or nitrazine (litmus test)
How long after ROM will labor start?
80% starts within 24 hours - look at fluid color
Why can you not vaginally exam after PROM?
No infection!
What factors change how long labor is?
Women who have never given birth, women who have given birth previously.
What are signs of impending birth?
“The baby’s coming”, grunting, bearing down, check the perineum
What responsibilities do nurses have during birth?
Preparation of sterile table, perineal cleansing preparation, initial care of newborn, administering medication
What responsibilities does the nurse have after birth with the newborn?
Promoting normal breathing patterns, keep their temperature good, identify them
What responsibilities does the nurse have after birth with the mamma?
Looking for hemorrhage, promoting more uterine contraction, promoting parent-infant attachment
Incriment of vital signs after birth
q15 min x 1 hr
q30 min x 1 hr
q hour x 2 hr
Nursing care: assessment after birth
Assess for hemorrhage & the fundus. Look at color and amount of lochia
When is the ideal time for mother-baby bonding?
First hour after birth because baby is alert and responsive
How can the nurse facilitate bonding?
Provide privacy, do the initial assessment in mom’s arms, place infant on breast
What effect does persistent contractions have on fetus?
Can reduce placental blood flow and fetal oxygen, nutrient, and waste exchange
What is the purpose of fetal surveillance?
To evaluate fetal condition during pregnancy & identify possible hypoxia. Can do intermittent auscultation or an EFM
What are the 5 required factors of adequate fetal oxygenation?
- Normal flow of oxygenated maternal blood into placenta
- Normal exchange within placenta
- Patent umbilical cord vessels
- Normal fetal circulation
- Oxygen carrying function
What are the mechanisms that regulate fetal heart rate?
Autonomic nervous system, baroreceptors, chemoreceptors, adrenal glands, CNS
Advantages of intermittent auscultation & palpation of fetus
Mom can get up and move around and atmosphere in room is more natural
Limitations of intermittent auscultation & palpation of fetus
1-1 nursing care, uterine activity is not constantly being watched, only small part of time
