T3: Nursing Care of the Family During Labor and Birth Flashcards by Spencer Aldrich-Stone

labor and birth begins with…

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

How well did you know this?

Not at all

Perfectly

diagnostics for labor

o Testing of amniotic fluid will reflect FERN PATTERN

How well did you know this?

Not at all

Perfectly

true labor

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)

How well did you know this?

Not at all

Perfectly

cervical changes are found through

a sterile vaginal exam

How well did you know this?

Not at all

Perfectly

false labor

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

How well did you know this?

Not at all

Perfectly

dilation

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

How well did you know this?

Not at all

Perfectly

effacement

thinning of the cervix during labor

How well did you know this?

Not at all

Perfectly

station

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

How well did you know this?

Not at all

Perfectly

position

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

How well did you know this?

Not at all

Perfectly

first stage of labor consists of

early/latent and active phase

How well did you know this?

Not at all

Perfectly

first stage: early/latent dilation

1-5 cm

How well did you know this?

Not at all

Perfectly

first stage: early/latent effacement

100%

How well did you know this?

Not at all

Perfectly

first stage: early/latent station

0 to -2

How well did you know this?

Not at all

Perfectly

first stage: early/latent contractions

every 5-30 minutes

How well did you know this?

Not at all

Perfectly

first stage: early/latent lasts about

6-8 hours

How well did you know this?

Not at all

Perfectly

First Stage: Active Phase dilation

6-10 cm

How well did you know this?

Not at all

Perfectly

First Stage: Active Phase contractions

every 2-3 minutes

How well did you know this?

Not at all

Perfectly

First Stage: Active Phase lasts

3-6 hours

How well did you know this?

Not at all

Perfectly

First Stage: Active Phase interventions

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

How well did you know this?

Not at all

Perfectly

at 8-10 dilation…

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

How well did you know this?

Not at all

Perfectly

second stage of labor

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

How well did you know this?

Not at all

Perfectly

third stage of labor

delivery of placenta

How well did you know this?

Not at all

Perfectly

3 signs that placenta is detached and ready to deliver

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

How well did you know this?

Not at all

Perfectly

oxytocin

given after delivery so uterus contracts

How well did you know this?

Not at all

Perfectly

fourth stage of labor

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

newborn care and assessment

-Skin to skin/warmth -APGAR SCORING

APGAR scoring tells us

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

APGAR

activity, pulse, grimace, appearance, respiration

APGAR highest score

10/10

first degree laceration

extend through skin and structures superficial to muscles

episiotomy

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

second degree laceration

extend through muscles to the perineal body

third degree laceration

extend through the anal sphincter muscle

fourth degree laceration

laceration that also involves the anterior rectal wall

5 P's of labor

Passenger passageway powers position psychological response

passenger

fetus and placenta

passageway

birth canal

4 basic types of shapes to pelvis

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

powers

contractions and maternal voluntary pushing effort

primary power

Involuntary contractions causing dilation and effacement

secondary power

voluntary urge to push

Position of Mother

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

fetal presentation

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

fetal lie

Relation of long axis of fetus to long axis of mother

fetal attitiude

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

Fetal presenting part: O

occiput (head)

Fetal presenting part: S

sacrum

Fetal presenting part: M

mentum or chin

Fetal presenting part: SC

scapula or shoulder

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

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

posterior

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

transverse

engagement

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

descent

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

how is descent assessed

through station

flexion

process of nodding of fetal head forward toward the fetal chest

internal rotation

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

extension

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

restitution

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

external rotation

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

expulsion

birth of the entire body

FETAL ADAPTATIONS TO LABOR

- 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.

Amniotomy

Artificial ROM with an amnihook