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MATERNAL > Week 7 > Flashcards

Week 7 Flashcards

1
Q

Labor normally begins when a fetus is ———to cope with extrauterine life yet not too large to cause __________with birth.

A

sufficiently mature

mechanical difficulty

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2
Q

results in release of prostaglandins

A

Uterine muscle stretching

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3
Q

which stimulates the release of oxytocin from the posterior pituitary

A

Pressure on the cervix

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4
Q

which works together with prostaglandins to initiate contractions

A

Oxytocin stimulation

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5
Q

(increasing estrogen in relation to progesterone, which is interpreted as progesterone withdrawal)

A

Change in the ratio of estrogen to progesterone

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6
Q

which triggers contractions at a set point

A

Placental age,

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7
Q

which reduces progesterone formation and increases prostaglandin formation

A

Rising fetal cortisol levels,

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8
Q

which stimulates contraction

A

Fetal membrane production of prostaglandin

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9
Q

woman often experiences subtle signs that signal labor is imminent. It is important to review these with women during the last trimester of pregnancy so they can more easily recognize beginning signs.

A

PRELIMINARY SIGNS OF LABOR

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10
Q

lightening, or descent of the fetal presenting part into the pelvis, occurs approximately 10 to 14 days before labor begins.

A

primiparas

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11
Q

related to an increase in epinephrine release initiated by a decrease in progesterone produced by the placenta. This additional epinephrine prepares a woman’s body for the work of labor ahead.

A

Increase in Level of Activity

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12
Q

As___________ level falls, body fluid is more easily excreted from the body. This increase in urine production can lead to a weight loss between 1 and 3 pounds.

A

progesterone

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13
Q

the cervix becomes still softer (described as “butter-soft”), and it tips forward.

A

Ripening of the cervix

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14
Q

an internal announcement that labor is very close at hand.

A

Ripening of the cervix

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15
Q

Signs of true labor involve_____ and______ changes.

A

uterine

cervical

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16
Q

The surest sign that labor has begun

involuntary and come without warning, their intensity can be frightening in early labor

A

Uterine Contraction

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17
Q

Helping a woman appreciate that she can predict when her next one will occur and therefore can control the degree of discomfort she feels by using ____________________offers her a sense of well-being.

A

breathing exercises

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18
Q

As the cervix softens and ripens, the mucus plug that filled the cervical canal during pregnancy(operculum) is expelled.

A

Show

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19
Q

This blood, mixed with mucus, takes on a pink tinge and is referred to as

A

show or bloody show.

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20
Q

Labor may begin with_____________________, experienced either as a sudden gush or as scanty, slow seeping of clear fluid from the vagina.

A

rupture of the membranes

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21
Q

Two risks associated with ruptured membranes are

which could cut off the oxygen supply to the fetus

A

intrauterine infection and prolapse of the umbilical cord

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22
Q

successful labor depends on four integrated concepts:

A

Passage
Passenger
Power
Psychological

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23
Q

the passage

A

woman’s pelvis

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24
Q

passenger

A

fetus

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25
Q

The powers of labor

A

uterine factors

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26
Q

psychological outlook

A

positive experience.

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27
Q

refers to the route a fetus
must travel from the uterus through the cervix and vagina to the external perineum.

A

passage

28
Q

Two pelvic measurements are important to determine the adequacy of the pelvic size:

A

diagonal conjugate

transverse diameter

29
Q

part least likely to be able to pass through the pelvic ring.

A

head

30
Q

change in the shape of the fetal skull produced by the force of uterine contractions pressing the vertex of the head against the not-yet-dilated cervix.

A

Molding

31
Q

refers to the settling of the presenting part of a fetus far enough into the pelvis to be at the level of the ischial spines, a midpoint of the pelvis.

A

Engagement

32
Q

refers to the relationship of the presenting part of a fetus to the level of the ischial spines.

A

Station

33
Q

When the presenting fetal part is at the level of the___ spines, it is at a 0 station

A

ischial

34
Q

If the presenting part is above the spines, the distance is measured and described as_________ stations, which range from 1 to 4 cm.

A

minus

35
Q

If the presenting part is below the ischial spines, the distance is stated as______ stations (+1 to +4)

A

plus

36
Q

describes the degree of flexion a fetus assumes during labor or the relation of the fetal parts to each other

A

Fetal Attitude

37
Q

A fetus in good attitude is in(1):

the spinal column is bowed (2)

, the head is flexed forward so much that the chin touches the(3)

, the arms are flexed and folded on the chest, the thighs are flexed onto the abdomen, and the calves are pressed against the (4) aspect of the thighs.

A
  1. complete flexion
  2. forward
  3. sternum
  4. posterior
38
Q

This normal “fetal position” is advantageous for birth because it helps a fetus present the smallest anteroposterior diameter of the skull to the pelvis and also because it puts the whole body into an____________ shape, occupying the smallest space possible.

A

ovoid

39
Q

A fetus is in moderate flexion if the chin is not touching the chest but is in an alert

A

military position”.

40
Q

means that the widest part of the fetus (the biparietal diameter in a cephalic presentation; the intertrochanteric diameter in a breech presentation) has passed through the pelvis inlet or the pelvic inlet has been proved adequate for birth.

A

Descent

41
Q

the relationship between the long (cephalocaudal) axis of the fetal body and the long (cephalocaudal) axis of a woman’s body; in other words, whether the fetus is lying in a horizontal (transverse) or a vertical (longitudinal) position

A

Fetal Lie

42
Q

the most frequent type of presentation, occurring as often as 95% of the time. With this type of presentation, the fetal head is the body part that will first contact the cervix

A

Cephalic Presentation

43
Q

The four types of cephalic presentation

A

vertex, brow, face, and mentum

44
Q

The four types of cephalic presentation

A

vertex, brow, face, and mentum

45
Q

means that either the buttocks or the feet are the first body parts that will contact the cervix

occur in approximately 3% of births and are affected by fetal attitude.

A

Breech Presentation

46
Q

Three types of breech presentation

A

complete, frank, and footling

47
Q

In a transverse lie, a fetus lies horizontally in the pelvis so that the longest fetal axis is perpendicular to that of the mother.

A

Shoulder Presentation

48
Q

Leg folded with feet at the level of the baby’s bottom

A

Complete breech

49
Q

One or both feet point down so the legs would emerge first

A

Footling breech

50
Q

Legs point up with feet by the baby’s head so the bottom emerges first

A

Frank breech

51
Q

Position is the relationship of the presenting part to a specific quadrant of a woman’s pelvis.

A

FETAL POSITION

52
Q

Passage of a fetus through the birth canal involves several different position changes to keep the smallest diameter of the fetal head (in cephalic presentations) always presenting to the smallest diameter of the pelvis.

A

MECHANISM OF LABOR

53
Q

Passage of a fetus through the birth canal involves several different position changes to keep the smallest diameter of the fetal head (in cephalic presentations) always presenting to the smallest diameter of the pelvis.

A

MECHANISM OF LABOR

54
Q

These position changes are termed the cardinal movements of labor:

A

descent, flexion, internal rotation, extension, external rotation, and expulsion.

55
Q

the downward movement of the
biparietal diameter of the fetal head to within the pelvic inlet.

occurs when the fetal head extrudes beyond the dilated cervix and touches the posterior vaginal floor.

occurs because of pressure on the fetus by the uterine fundus. The pressure of the fetal head on the sacral nerves at the pelvic floor causes the mother to experience a pushing sensation.

may be aided by abdominal muscle contraction as the woman pushes.

A

Descent

56
Q

As descent occurs and the fetal head
reaches the pelvic floor, the head bends forward onto the chest, making the smallest anteroposterior diameter (the suboccipitobregmatic diameter) present to the birth canal.

A

Flexion

57
Q

During descent, the head enters the pelvis
with the fetal anteroposterior head diameter (suboccipitobregmatic, occipitomental, or occipitofrontal, depending on the amount of flexion) in a diagonal or transverse position. The head flexes as it touches the pelvic floor, and the occiput rotates to bring the head into the best relationship to the outlet of the pelvis (the anteroposterior diameter is now in the anteroposterior plane of the pelvis). This movement brings the shoulders, coming next, into the optimal position to enter the inlet, putting the widest diameter of the shoulders,

A

Internal Rotation

58
Q

As the occiput is born, the back of the neck stops beneath the pubic arch and acts as a pivot for the rest of the head.

A

Extension

59
Q

almost immediately after the head of the infant is born, the head rotates (from the anteroposterior position it is assumed to enter the outlet) back to the diagonal or transverse position of the early part of labor. This brings the aftercoming shoulders into an anteroposterior position, which is best for entering the outlet. The anterior shoulder is born first, assisted perhaps by downward flexion of the infant’s head.

A

External Rotation

60
Q

Once the shoulders are born, the rest of the baby is born easily and smoothly because of its smaller size. This movement,

A

Expulsion

61
Q

This is the force supplied by the fundus of the uterus, implemented by uterine contractions, a natural process that causes cervical dilatation and then expulsion of the fetus from the uterus. After full dilatation of the cervix, the primary power is supplemented by use of the abdominal muscles. It is important for women to understand they should not bear down with their abdominal muscles until the cervix is fully dilated. Doing so impedes the primary force and could cause fetal and cervical damage

A

effective powers of labor

62
Q

A contraction consists of three phases:

A

increment, when the intensity of the contraction increases;

the acme, when the contraction is at its strongest;

and the decrement, when the intensity decreases

63
Q

Even more marked than the changes in the body of the uterus are two changes that occur in the cervix: effacement and dilatation

A

Cervical Changes

64
Q

is shortening and thinning of the cervical canal. Normally, the canal is approximately 1 to 2 cm long. With effacement, the canal virtually disappears.

A

Effacement

65
Q

refers to the enlargement or widening of the cervical canal from an opening a few millimeters wide to one large enough (approximately 10 cm) to permit passage of a fetus.

A

Dilatation

66
Q

psychological state or feelings that a woman brings into labor. For many women, this is a feeling of apprehension or fright. For almost everyone, it includes a sense of excitement or awe.

A

PSYCHE

MATERNAL (9 decks)

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