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57 Cards in this Set
- Front
- Back
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What inhibitors maintain uterine quiescence during pregnancy? |
-Progesterone -Prostcyclin -Relaxin -Nitric oxide -Adenomedullan |
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What is primarily responsible for the initiation of labor? What does it cause, and where is it derived from? |
Prostaglandins are primarily responsible for the initiation of labor. It causes smooth muscle contraction, vasoconstriction, softening of the cervical tissue and modulates hormonal activity. Derived from fetus, amniotic fluid and decidua of uterus. |
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What are four signs of approaching labor? |
Bachache Bloody show Braxton Hicks (painless!) Lightening |
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What is lightening? |
Settling of fetus into maternal pelvis. |
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What are four signs of actual labor? |
-Diarrhea due to release of prostaglandins -Weight loss d/t fluid and electrolyte shifts thanks to changing estrogen and progesterone levels -Spurt of energy -SROM |
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SROM |
Membranes broke on their own. Contractions. Over 37 weeks. |
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PROM |
Water broke. Over 37 weeks but no labor is going on (breaks at least an our before contractions start). |
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AROM |
Someone has to break the bag of water - artificial |
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PPROM |
Pre-term premature rupture of membranes. Someone is less than 37 weeks. Doesn't matter if there are contractions or not. |
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Four signs of "false" or "prodromal" labor? |
-Uterine contractions without dilation -Irregular contractions -No bloody show -Labor symptoms decrease w/position changes, activity or sedation |
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Three signs of "true" or "progressive" labor? |
-Uterine contractions increase in frequency. Are rhythmic, regular, duration and intensity increase. -Contractions continue or increase with activity -Contractions are associated with pelvic pressure |
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What phase of labor can patients stay home for? |
Latent phase |
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What is the definition of latent phase? |
0-3 cm dilated |
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What is the definition of active phase? |
4-7 cm dilated |
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What is the definition of transition phase? |
8-10 cm dilated |
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What are the signs of the beginning and end of Stage 2 of labor? |
Beginning: full cervical dilation End: delivery of baby |
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What are the signs of the beginning and end of Stage 3 of labor? |
Beginning: After birth of baby End: Delivery of placenta |
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What is Stage 4 of labor? |
After deliver of placenta, this is the period of adjustment and maternal stabilization |
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What are three characteristics of the fetal head that can cause difficulty during labor? |
Size Rigidity - can make it so it doesn't mold to pelvis during delivery Encephaly - fetus is missing the top part of the skill, which can make labor more difficult |
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What is molding? |
Adaption in the size and shape of the fetal head as it passes through the maternal pelvis during labor. |
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What is fetal presentation? |
The part of the fetus that enters the birth canal first. |
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What is the difference between cephalic and breech? |
Cephalic = the head enters the birth canal first Breech = foot first |
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What is the difference between frank, footling and complete breech? |
Frank = the sacrum comes out first and the legs are completely up Complete - the legs are crossed. They get stuck and you don't want to have deliveries this way. Footling - one or two feet are coming out. |
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What are five risk factors for presentations other than vertex? |
-Placenta previa -Polyhydramnios -Multiple gestations -Uterine anomalies like masses or fibroids - create space issues -Prematurity |
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What is fetal lie? |
The relationship of the spine of the fetus to the spine of the client |
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What is the baby at higher risk for when presenting in the transverse position? |
At higher risk for a prolapsed cord. |
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What is the difference between oblique and transverse? |
Oblique is at a slight angle, and transverse is when the spines are perpendicular to each other. |
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Is flexion or extension better for fetal attitue? |
Flexion is primarily what you want - you want flexion because it is nice and compact. Extension can hinder the labor process. |
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How many stations above and below the ischial spine can the presenting part of the fetus go? |
Can go anywhere from +5 above the ischial spine to -5 below the ischial spine. This is the number of centimeters above or below the ischial spine the presenting part is located. |
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What is the purpose of the Leopold's maneuvers? |
To figure out what fetal part is presenting and where the other fetal parts are laying. |
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What are the four types of pelvises? |
Gynecoid (round) Android (heart shaped) Anthropoid (oval) Platypelloid (flat) |
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What are the two most incompatible pelvic shapes to get the fetus througH? |
Android and playpelloid. |
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What three hormones help soften the tissues in the vagina? |
Oxytocin, estrogen and progesterone |
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What is the difference between the primary and secondary powers of labor? |
Primary powers = uterine contractions. Secondary powers = maternal pushing. |
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Which is more important - uterine contractions or pushing? |
Uterine contractions |
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What are the four outcomes of uterine contractions? |
-Efface and dilate the cervix -Facilitate descent and rotation of fetus -Cause separation and expulsion of the placenta -Maintain homeostasis of uterus by compressing blood vessels |
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During what stage would maternal pushing take place? |
Stage 2 |
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What is effacement? |
Shortening and thinning of the cervix |
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What is dilation? |
Opening and enlargement of the external cervical os |
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When does effacement happen for primagravida? |
Effacement occurs before dilation |
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When does effacement happen for multigravida women? |
Dilation and effacement happen together |
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How is effacement expressed? |
As a percentage, where 1 inch thick = 0% A normal cervix is 4" thick. A woman who is about to deliver has a paper thin cervix. |
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How is dilation measured? |
Expressed in centimeters from 0-10. 1 finger is approximately 2 cm. |
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What five pieces of prenatal data do we need to collect upon admission of a pregnant woman? |
-Weight gained during pregnancy -Past/present OB history -Estimated due date -Blood type and Rh factor -GBS status |
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What is nitrazine used to indicate? |
Nitrazine is used to determine if fluids are urine or amniotic fluid when we are assessing for SROM. Amniotic fluid is alkaline, and will cause nitrazine paper to turn blue. We need to be aware of false positives due to semen, blood or vaginitis. |
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What is ferning? |
Ferning is the pattern in which amniotic fluid crystalizes on a microscope slide and is one way we can tell if fluid is amniotic. |
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What are five methods of non-pharm pain management for a woman in the 1st stage of labor? |
-Breathing techniques -Position -Touch/massage -Counterpressure/effleurage (pressing on the sacrum which relieves some of the pressure) -Hydrotherapy (getting in a bathtub) |
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How long does open glottis pushing take place, as opposed to closed glottis pushing? |
Open glottis: 6-7 seconds Closed glottis: 10 seconds |
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What is a nuchal cord? How often does it happen? |
Umbilical cord wrapped around neck of newborn - common in 30-40% of pregnancies. |
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What is shoulder dystocia and why is it a complication? |
Shoulder gets impacted against the pelvic bone while the fetal head is out - baby gets stuck while cord is compressed. |
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If a baby is breach, how would we deliver? |
C-section if we can. |
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What type of incision is necessary in order to have vaginal birth after C-section? |
Low transverse |
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When the provider is preparing to use vacuum or forceps, what should the mom also consent to? |
C-section |
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What six actions must the nurse take prior to the physician performing an assisted delivery? |
-Consent -Empty bladder -Pain mgmt -Prep for C-section -Newborn assessment -Perineal assessment |
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What is the time limit for delivering the placenta? |
30 minutes to deliver the placenta |
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What are four signs of placental separation? |
-Trickle of blood from vagina -Change in shape, size and consistency of uterus -Lengthening of umbilical cord -Contraception |
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What must we do after the placenta is delivered? |
We must assess the placenta. |
