Unit 1 - Reproduction Flashcards
Factors Affecting Labor: 5 P’s
- passenger (fetus)
- passageway (fetus)
- powers (physiological focus of labor)
- position (relation between fetus and passage)
- psychological considerations
True Labor:
- _____ interval for contractions
- _____ in intensity and frequency
- _____ with rest
- regular interval for contractions
- increase in intensity and frequency
- unrelieved with rest
False Labor:
- _____ intervals for contractions
- _____ _____ in durations and frequency
- contractions _____ with rest
- irregular intervals for contractions
- no change in durations and frequency
- contractions relieved with rest
nulliparas
contractions 5 min. apart x 1 hour
multiparas
contractions 6-8 min. apart x 1 hour
contractions: duration
how long
- beginning of 1 contractions to the end of same contraction
contractions: frequency
how often
- beginning of one contractions to beginning of next contraction
acme
top line of contraction monitor
increment
increase of line of contraction monitor
decrement
decrease of line of contraction monitor
Stages of Labor:
onset of contractions to complete cervical dilation
Stage 1
3 phases of stage 1
latent
active
transitional
Stages of Labor:
frequent monitoring of pt. & labor progression
Stage 1
Stages of Labor:
complete cervical dilation to birth
Stage 2
Pushing stage
Stage 2
Stages of Labor:
birth to delivery of placenta
Stage 3
Stages of Labor:
placenta is guided out as expelled
Stage 3
What should you watch for in Stage 3
hemorrhage
Stages of Labor:
initial recovery
stage 4
Stages of Labor:
monitor VS as scheduled & lacerations degrees
Stage 4
Stages of Labor:
will have slight decrease in BP, slight increase in HR, uterus will be midline & firm = normal (uterus will be palpable midline between symphysis pubis & umbilicus)
Stage 4
Stage 4:
- slight _____ in BP
- slight _____ in HR
- uterus will be _____ & _____ = normal
- slight decrease in BP
- slight increase in HR
- uterus will be midline & firm = normal
Maternal Physiological Responses to Labor and Delivery:
- cardiac output _____
- _____ distribution during a contraction
- BP _____
- BP can _____ due to supine hypotensive crisis, hypovolemia, hemorrhage, dehydration, metabolic acidosis, narcotics, and _____
- temperature _____
- respirations _____
- diaphoresis
- metabolic acidosis _____ by respiratory alkalosis
- metabolic acidosis quickly reverse to normal in the _____ stage because of change in/increased _____ rate
- renal activity _____
- cardiac output increases
- fluid distribution during a contraction
- BP increases
- BP can decrease due to supine hypotensive crisis, hypovolemia, hemorrhage, dehydration, metabolic acidosis, narcotics, and EPIDURALS
- temperature increases
- respirations increase
- diaphoresis
- metabolic acidosis uncompensated by respiratory alkalosis
- metabolic acidosis quickly reverse to normal in the 4th stage because of change in/increased respiratory rate
- renal activity increases
What type of pain control is a epidural
regional
Pain Control - Analgesia:
short acting, one injection directly into spinal fluid, can last up to 2 hours
spinal block
Pain Control - Analgesia:
longer acting, catheter inserted into epidural space to allow continuous anesthesia
Epidural
Pain Control - Analgesia:
Uses local anesthetic (lidocaine or bupivacaine), opioid analgesic injection for immediate relief into spinal fluid, and insertion of epidural catheter into epidural space for continuous anesthesia, may be controlled by PCA
*most common
CSE (Combined Spinal/Epidural)
Pain Control - Analgesia:
Only for emergencies or if epidural contraindicated
General
Normal FHR baseline should be…
110-160 bpm
Need at least _____ minutes of monitoring and _____ minutes of consistent baseline tracing to determine baseline
10
2
_____ tracing is gold standard for determining if baby is well oxygenated. This is when FHR has normal baseline with moderate variability and 2 or more accelerations in a 20 minute period.
“Reactive”
Minimum timeframe for FHR monitoring is _____ minutes if tracing is reactive. Longer if there are alterations in tracings.
20
Labor that progresses so rapidly (typically less than 3 hours from onset to delivery)
Precipitous Delivery
Head delivers but not the shoulders; can be related to the size of the fetus but does occur in normal-sized fetus. Signs of impending _____ _____ include the slowing of progress or increasing formation of caput succedaneum; treatment is McRobert’s maneuver.
Shoulder dystocia
Treatment for Shoulder dystocia
McRobert’s maneuver
