Test 2 Flashcards
length of each contraction from beginning to end
Duration
beginning of one contraction to beginning of next
Frequency
strength of contraction
intensity
Four P’s of labor
- Powers (contractions)
- Passage ( the pelvis and birth canal)
- Passenger (fetus)
- Psyche (response of woman)
Onset of regular uterine contractions and lasts until the expulsion of the placenta
Intrapartum period
descent of the fetus into the true pelvis that occurs approximately 2 weeks before term in 1st time pregnancies
Lightening (dropping)
Surge in energy
Nesting
brownish or blood-tinged cervical mucus discharge
Bloody show
shortening and thinning of the cervix
Effacement
enlargement or opening of the cervical os
Dilation
What triggers the urge to push?
Ferguson reflex-activates when the presenting part stretches the pelvic floor muscles
the relationship of fetal parts to one another
Fetal attitude or posture
complete flexion of the thighs and the legs extending over the anterior surfaces of the body
Complete breech
Complete flexion of thighs and legs
Frank breech
Extension of one or both thighs and legs so that one or both feet are presenting
footling breech
What is the ideal position of the baby to come out?
Occiput anterior
Relationship of the presenting part to the maternal ischial spines
Station-measured in cm above or below the ischial spine
begins with the onset of labor and ends with complete cervial dilation
Stage 1
begins with complete dilation of cervix and ends with delivery of baby
Stage 2
begins after delivery of baby and ends with delivery of placenta
Stage 3
begins after delivery of placenta and is completed 4 hour later
Stage 4
involves the tearing of perineal skin and vaginal mucous membrane
first-degree laceration
tear involves skin, mucous membrane, and fascia of perineal body tear
2nd degree laceration
tear involves skin, mucous membrane, and muscle of the perineal body and extends to the rectal sphincter
3rd degree laceration
rectal mucosa, and exposes the lumen of the rectum
4th degree laceration
advocates birth without fear by education and environmental control and relaxation
Dick-Read method (birthing class)
artificial rupture of membranes
amniotomy
What is noted on the external monitor tracing during a contraction if the nurse suspects umbilical cord compression?
Variable decelerations
an assessment of the cervix to assess cervical ripeness before induction?
Bishop score
A score of what is considered favorable using the Bishop score for successful induction of labor?
Greater than 6
When the greatest diameter of the fetal head passes through the pelvic inlet
Can occur late in pregnancy or early in labor
Engagement
Movement of the fetus through the birth canal during the fist and second stages of labor
descent
When the chin of the fetus moves toward the fetal chest
Occurs when the descending head meets resistance from maternal tissue
Results in the smallest fetal diameter to the maternal pelcic dimensions
Occurs in early labor
Flexion
What are the mechanisms of labor
Engagement Descent Felxion Internal rotation Extension External rotation Expulsion
When the rotation of the fetal head aligns the long axis of the fetal head with the long axis of the maternal pelvis
Occurs during second stage of labor
Internal rotation
Facilitated by resistance of the pelvic floor that causes the presenting part to pivot beneath the pubic symphysis and he head to be delivered
Occurs during second stage of labor
Extension
The sagittal suture moves to transverse diameter and the shoulders align in the anteroposterior diameter.
The sagittal suture maintains alignment with the fetal trunk as the trunk navigates through the pelvis.
External rotation
The shoulders and remainder of the body are delivered
Expulsion
Promotes psychoprophylaxis with conditioning and breathing
Lamaze
Husband coached childbirth and support by working with and managing the pain rather than being distracted from it
Bradley
what is the most important predictor of adequate fetal oxygenation and fetal reserve during labor?
variability
What is the most common reason for primary c-sections
Dystocia
abnormal labor that results from abnormalities of the power, passenger or the passage
Dystocia
Uncoordinated uterine activity
Contractions are frequent and painful but ineffective in promoting dilation and effacement
If happens in early labor its known as prodromal labor
Hypertonic uterine dysfunction
occurs when the pressure of the UC is insufficient to promote cervical dilation and effacement
Less than 25 mm HG
Hypotonic uterine dysfunction
Labor that lasts fewer than 3 hours from onset of labor to birth
Precipitous labor
Women is unable to push or bear down
Inadequate expulsive forces
COndition in which the size, shape, or position of the fetal head prevents it from passing through the lateral aspect of the maternal pelvis or when the maternal pelvis is of a size or shape that prevents the descent of the fetus through the pelvis
Cephalopelvic disproportion
Five or more UC in 10 mins over a 30 min window
or
Series of single UC lasting 2 mins or longer
or
UCs occuring w/in 1 min of each other
Tachysystole
Most concerning side effect of oxytocin
Tachysystole
artificial rupture of membranes to induce or augment labor
Amniotomy
What should you do immediately after an Amniotomy
Check FHR d/t risk of umbilical prolapse
Retraction of the fetal head against the maternal perineum after delivery of the head
Turtle SIgn
hyper flexing the birthing women’s legs onto her abdomen and simultaneously providing suprapubic pressure to assist the fetus in adducting the arms closer to body in an attempt to release the impacted shoulders
McRoberts maneuver
When the umbilical cord is palpated through the membranes but does NOT drop into the vagina
Occult prolapse
an embolus that forms when the amniotic fluid that contains fetal cells, lanugo, and vernix enters the maternal vascular system and results in cardio respiratory collapse
Anaphylactic syndrome
Maternal indications for a c-section
Previous c-section Placental abnormalities Dystocia Previous uterine surgery failure to progress through labor pre-existing or pregnancy-related maternal health factors like cardiac disease, HTN, preeclampsia, or severe diabetes mellitus
Fetal indication for c-section
Malpresentation
Category II or III FHR pattern
Multiple gestation
All hospitals should have capability of responding to obstetrical emergencies within how much time?
30 mins
Mean FHR rounded to increments of 5 beats per minute during a 10 min window, excludes acceleration or decelerations
Baseline FHR
Baseline FHR > 160 bpm lasting 10 mins or longer
Tachycardia
Baseline FHR <110 bpm lasting 10 mins or longer
Bradycardia
FLuctuations in the baseline FHR that are irregular in amplitude and frequency. The flucutuations are visually quantified as the amplitude of the peak to trough in bpm, 10 min window exlcudes accelerations and decelerations
Baseline variability
Visually apparent, abrupt increase in FHR above the baseline. The peak of the acceleration is greater than or equal to 15 bpm over the baseline FHR for greater than or equal to 15 seconds and greater than 2 mins
Accelerations
Gradual decrease in FHR below the baseline. The lowest point of the deceleration occurs at the same time as the peak of the UC
Early deceleration
Abrupt decrease in FHR below the baseline is greater than 15 bp lasting longer than 15 seconds and is less than 2 mins in duration
Variable deceleration
gradual decerase in FHR beloe the baseline. the lowest point of the deceleration occurs after the peak of the contraction
Late deceleration
