Test 2 - Process of Labor

Question 1

What are the passenger assessments during labor?

Answer 1

Fetal head
Fetal lie
Fetal presentation
Fetal attitude
Fetal position
Station

Question 2

What are the 5 P’s

Answer 2

Passenger  fetus and placenta 
Passageway  birth canal
Powers (Voluntary/ involuntary UC) 
Position of the mother
Psychologic responses

Question 3

Are fetal skull bones fused?

Answer 3

No. United by membranous sutures

Question 4

What is BPD?

What does it measure?

Answer 4

Biparietal diameter

Largest transverse diameter of the head

Question 5

Body part of fetus that first enters the pelvic inlet

Answer 5

Fetal presentation

Question 6

3 major presentations:

Answer 6

• Cephalic or Vertex (head)
• Breech (buttocks or feet)
• Shoulder

Question 7

Most favorable fetal presentation?

Can a shoulder presentation be delivered?

Answer 7

Cephalic

No

Question 8

Relation of spine of baby to Mom’s spine (long axis)

Answer 8

Fetal Lie

Question 9

Two types of fetal lie:

Answer 9

Longitudinal or Vertical - spines are parallel as in cephalic or breech

Transverse – baby spine at right angle to Mom (as in shoulder presentation)

Question 10

Relation of fetal parts to one another

Answer 10

Fetal attitude

Question 11

3 types of fetal attitude

Answer 11

–General flexion head flexed with arms folded onto chest, legs onto abdomen, back curved in shape of C.
Examiner palpates posterior fontanel
–Extended - presents wider part of skull to inlet.
–Examiner’s finger would palpate the mentum (chin) or brow

Question 12

To determine fetal position

Answer 12

Identify the presenting part

Identify the maternal quadrant the presenting part is facing

Question 13

he degree of descent of presenting part above/below ischial spines

Answer 13

Fetal Station

Question 14

presenting part at ischial spines.

Answer 14

engagement

Question 15

Most favorable pelvic shape

Answer 15

gynecoid

Question 16

What are primary powers?

Answer 16

Involuntary uterine contractions which cause effacement and dilation

Question 17

What are secondary powers

Answer 17

voluntary bearing down

Question 18

Effacement usually precedes dilation in the ________ woman.

Answer 18

nulliparous

Question 19

thinning and shortening of cervix

Answer 19

effacement

Question 20

widening of cervical canal to accommodate head of baby

Answer 20

dilation

Question 21

maternal urge to bear down:

Answer 21

ferguson reflex

Question 22

premonitory signs of labor

Answer 22

Braxton Hicks – strong.  
Lightening 
Energy increased
Ripening of cervix 
Mucus plug expelled
Bloody show

Question 23

What is the purpose of cardinal movements:

Answer 23

To present the smallest diameter of head

Question 24

7 movements in vertex presentation

Answer 24

-Engagement – BPD at pelvic inlet
-Descent – measured by station + numbers … lower than ischial spines
-Flexion – head flexes toward chest
-Internal rotation – head rotates to occiput anterior
-Extension – occiput passes under symphysis pubis and head … first the occiput
–External rotation (restitution) – realignment of infant head to back/shoulders (back to original position)
Expulsion (birth) – anterior shoulder under symphysis pubis posterior shoulder and body completely emerges