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NSG 432 - OB > T3: Nursing Care of the Family During Labor and Birth > Flashcards

T3: Nursing Care of the Family During Labor and Birth Flashcards

1
Q

labor and birth begins with…

A

first uterine contraction, continues with hard work during cervical dilation and birth, and ends as woman and family begin attachment process with infant

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1
Q

diagnostics for labor

A

o Testing of amniotic fluid will reflect FERN PATTERN

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2
Q

true labor

A

o Contractions are REGULAR
o Pain is felt in BACK RADIATING TO FRONT
o Cervical changes (DILATION!)
o Fetus engages (moves to inlet of the pelvis)
o Change of position DOES NOT MATTER/HELP
o Bloody show (cervix bleeds as it dilates)

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3
Q

cervical changes are found through

A

a sterile vaginal exam

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4
Q

false labor

A

o Contractions irregular
o Lie down or move may make labor stop
o No changes in cervical dilation, effacement, or bloody show
o Fetus not engaged often posterior

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5
Q

dilation

A

enlargement of cervical os and cervical canal during the first stage of labor

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6
Q

effacement

A

thinning of the cervix during labor

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7
Q

station

A

Relation of the presenting part of the fetus in an imaginary line drawn between the maternal ishcial spines; measured in degree of descent of the presenting part of the fetus through the birth canal
o -2,-1,0,+1,+2

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8
Q

position

A

relationship of assigned area of the presenting part or landmark to the maternal pelvis

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9
Q

first stage of labor consists of

A

early/latent and active phase

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10
Q

first stage: early/latent dilation

A

1-5 cm

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11
Q

first stage: early/latent effacement

A

100%

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12
Q

first stage: early/latent station

A

0 to -2

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13
Q

first stage: early/latent contractions

A

every 5-30 minutes

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14
Q

first stage: early/latent lasts about

A

6-8 hours

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15
Q

First Stage: Active Phase dilation

A

6-10 cm

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16
Q

First Stage: Active Phase contractions

A

every 2-3 minutes

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17
Q

First Stage: Active Phase lasts

A

3-6 hours

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18
Q

First Stage: Active Phase interventions

A
  • Change positions frequently
  • Empty bladder frequently
  • Use hydrotherapy
  • Needs encouragement
  • Don’t distract her
  • “Feel like you’re losing it”
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19
Q

at 8-10 dilation…

A

· Length, 20-40 minutes
· Contractions 2-3 minutes
· Trembling, nausea, perspiration, snap at coach
· Don’t leave alone
· Patterned breathing

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20
Q

second stage of labor

A

o 10 cm-delivery
o Latent Phase - Resting (“laboring down”)
o Active Phase - Pushing (spontaneous and “directed”-Few minutes to several hours

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21
Q

third stage of labor

A

delivery of placenta

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22
Q

3 signs that placenta is detached and ready to deliver

A

· Lengthening of the umbilical cord
· Gush of blood
· Stomach changes shape

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23
Q

oxytocin

A

given after delivery so uterus contracts

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24
Q

fourth stage of labor

A

o 1-2 hours after delivery
o Post Delivery Care
o Recovery
o Care of the family
o Family newborn relationships

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25
Q

newborn care and assessment

A

-Skin to skin/warmth
-APGAR SCORING

26
Q

APGAR scoring tells us

A

during the first minute how the baby did during labor; it is then repeated 5 minutes after to tell us how the baby is adapting to extra uterine life

27
Q

APGAR

A

activity, pulse, grimace, appearance, respiration

28
Q

APGAR highest score

A

10/10

29
Q

first degree laceration

A

extend through skin and structures superficial to muscles

30
Q

episiotomy

A

surgical incision of the perineum to enlarge the vagina and so facilitate delivery during childbirth

31
Q

second degree laceration

A

extend through muscles to the perineal body

32
Q

third degree laceration

A

extend through the anal sphincter muscle

33
Q

fourth degree laceration

A

laceration that also involves the anterior rectal wall

34
Q

5 P’s of labor

A

Passenger
passageway
powers
position
psychological response

35
Q

passenger

A

fetus and placenta

36
Q

passageway

A

birth canal

37
Q

4 basic types of shapes to pelvis

A

-Gynecoid- classic female type
-Android- resembling
- Anthropoid-resembling the pelvis of anthropoid apes
- Platypelloid-flat pelvis

38
Q

powers

A

contractions and maternal voluntary pushing effort

39
Q

primary power

A

Involuntary contractions causing dilation and effacement

40
Q

secondary power

A

voluntary urge to push

41
Q

Position of Mother

A

standing, walking, side lying, squatting, on hands and knees

42
Q

fetal presentation

A

portion of the fetus that enters the pelvic inlet first
o Vertex (96%) breech (3%) & shoulder 1(%)

43
Q

fetal lie

A

Relation of long axis of fetus to long axis of mother

44
Q

fetal attitiude

A

Relation of fetal body parts to each other e.g. flexion of chin

45
Q

Fetal presenting part: O

A

occiput (head)

46
Q

Fetal presenting part: S

A

sacrum

47
Q

Fetal presenting part: M

A

mentum or chin

48
Q

Fetal presenting part: SC

A

scapula or shoulder

49
Q

Location of presenting part in relation to a portion of maternal pelvis: A

A

anterior

50
Q

Location of presenting part in relation to a portion of maternal pelvis: P

A

posterior

51
Q

Location of presenting part in relation to a portion of maternal pelvis: T

A

transverse

52
Q

engagement

A

mechanism where fetus nestles into the pelvis; occurs when presenting part reaches the level of the ischial spines

53
Q

descent

A

process that the fetal head undergoes as it begins its journey through the pelvis

54
Q

how is descent assessed

A

through station

55
Q

flexion

A

process of nodding of fetal head forward toward the fetal chest

56
Q

internal rotation

A

occurs most commonly from occipitotransverse position, assumed at engagement into the pelvis, to the occipitoanterior position while continuously descending

57
Q

extension

A

enables the head to emerge when the fetus is in a cephalic position; begins after the head crowns; extension is complete when the head passes under the symphysis pubis and occiput, and the anterior fontanel, brow, face, and chin pass over the sacrum and coccyx and are over the perineum

58
Q

restitution

A

realignment of the fetal head with the body after the head emerges

59
Q

external rotation

A

shoulders externally rotate after the head emerges and restitution occurs, so that the shoulders are in the anteroposterior diameter of the pelvis

60
Q

expulsion

A

birth of the entire body

61
Q

FETAL ADAPTATIONS TO LABOR

A
  • Fetal lung fluid is cleared from the air passages during labor and vaginal birth;
  • Fetal oxygen pressure (PO2) decreases;
  • Fetal arterial carbon dioxide pressure increases (PCO2);
  • Fetal arterial pH decreases;
  • Fetal bicarbonate levels decrease;
  • Fetal respiratory movements decrease during labor.
62
Q

Amniotomy

A

Artificial ROM with an amnihook

NSG 432 - OB (14 decks)

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