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52 Cards in this Set

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5 P's that affect the process of labor and birth:
Passenger
Passageway
Powers
Position of the Mother
Psychologic Response
Passenger:
Fetus and Placenta
Passenger: Movement through the birth canal affected by -
Size of Head
Fetal Presentation
Fetal Lie
Fetal Attitude
Fetal Position
Passenger: Molding -
Overlapping of cranial bones or shaping of the fetal head to accommodate and conform to the bony and soft parts of the mother's birth canal during labor.
Passenger: Presentation -
The part of the fetus that enters the pelvic inlet 1st and leads through the birth canal during labor.
Passenger: 3 Main Presentations -
Cephalic (head 1st)
Breech (buttocks or feet 1st)
Shoulder
Passenger: Vertex -
When the presenting part is the occiput (back part of the head or skull).
Passenger: Fetal Lie -
The relation of the long axis (spine) of the fetus to the long axis (spine) of the mother.
Passenger: Fetal Attitude -
The relation of the fetal body parts to each other.
Passenger: Fetal Position -
The relation of the presenting part to the 4 quadrants of the mother's pelvis.
Passenger: Station -
The relation of the presenting part of the fetus to an imaginary line draw between the maternal ischial spines and is a measure of the degree of descent of the presenting part of the fetus through the birth canal. -5 to +5.
Passenger: Engagement -
The term used to indicate that the largest transverse diameter of the presenting part has passed through the maternal pelvic brim or inlet into the true pelvis and usually corresponds to station O.
Passageway:
Composed of the mother's rigid bony pelvis and the soft tissue of the cervix, pelvic floor, vagina, and the introitus (external opening to the vagina)
Passageway: 4 types of Pelvis -
Gynecoid
Android
Anthropoid
Platypelloid
Passageway: Gynecoid Pelvis -
Classic female pelvis
Passageway: Android Pelvis -
Resembles the male pelvis
Passageway: Anthropoid Pelvis -
Resembles the pelvis of anthropoid apes
Passageway: Platypelloid Pelvis -
Flat pelvis
Powers:
Involuntary and voluntary powers that combine to expel the fetus and the placenta from the uterus.
Powers: Primary -
Involuntary contractions, described in terms of frequency, duration and intensity, which result in effacement and dilation of the cervix.
Primary Powers: Frequency -
Time from the beginning of one contraction to the beginning of the next.
Primary Powers: Duration -
Length of the contraction
Primary Powers: Intensity -
Strength of the contraction
Primary Powers: Effacement -
The shortening and thinning of the cervix during the 1st stage of labor.
Primary Powers: Dilation -
The enlargement and widening of the cervical opening and cervical canal that occurs once labor has begun.
Ferguson Reflex:
Occurs when the presenting part of the fetus reaches the perineal floor resulting in the release of endogenous oxytocin and the urge to bear down.
Powers: Secondary -
Voluntary efforts (bearing down) that aid in the expulsion of the fetus.
Stages of Labor: 1st Stage -
Last from the onset of regular uterine contractions to full dilation of the cervix.
Stages of Labor: 2nd Stage -
Last from the time the cervix is fully dilated to the birth of the fetus.
Stages of Labor: 3rd Stage -
Last from the birth of the fetus until the placenta is delivered.
Stages of Labor: 4th Stage -
Lasts about 2 hours after the delivery of the placenta.
Mechanism of Labor:
Turns and other adjustments made in the birth process.
Mechanism of Labor: 7 Cardinal Movements -
Engagement
Descent
Flexion
Internal Rotation
Extension
External Rotation
Birth by Expulsion
Mechanism of Labor: Engagement -
When the bipartal diameter of the head passes the pelvic inlet.
Mechanism of Labor: Descent -
Refers to the progress of the presenting part through the pelvis.
Mechanism of Labor: 4 forces of Descent -
Pressure exerted by amniotic fluid
Direct pressure exerted by the contracting fundus on the fetus
Force of the contraction of the maternal diaphragm and abdominal muscles in the 2nd stage of labor
Extension of the straightening of the fetal body
Mechanism of Labor: Flexion -
As soon as the head meets resistance from the cervix, pelvic wall, or pelvic floor it normally flexes so the chin is brought into closer contact w/ the fetal chest.
Mechanism of Labor: Internal Rotation -
The fetal head rotation that occurs between the maternal inlet and the true pelvis.
Mechanism of Labor: Extension -
The occiput appears 1st, then the face and finally the chin.
Mechanism of Labor: External Rotation -
After the birth of the head it briefly rotates to the position it occupied when it was engaged in the inlet.
Mechanism of Labor: Expulsion -
After the birth of the shoulders the head and shoulders are lifted towards the mother's pubic bone and the trunk of the baby is born by flexing it latterly in the direction of the symphysis pubis.
Fetal Decelerations: Early -
Begins early in contraction
Returns to baseline before completion of contraction
Caused by fetal head compression
Fetal Decelerations: Early, Treatment -
Observe for any signs of fetal intolerance
Fetal Decelerations: Late -
Begins 30 seconds or more after onset of contraction
Returns to baseline after contraction is over
Caused by Uteroplacental Insufficiency (inadequate uterine/placental oxygen exchange that is aggravated by uterine contraction resulting in fetal hypoxia)
Fetal Decelerations: Late, Treatment -
Left side
O2 (6-7 l/min)
D/C Oxytocin
^ IV fluids
Notify MD of pattern
Continue observation
Fetal Decelerations: Variable -
Begins anytime
Returns to baseline anytime
Caused by cord compression resulting in fetal hypoxemia
Fetal Decelerations: Variable, Treatment -
Position change
O2 (6-7 l/min)
D/C Oxytocin
^ IV fluids
Vaginal exam to detect cord prolapse
Notify MD of pattern
Close observation
1st Stage of Labor: Phases -
Latent
Active
Transitional
1st Stage of Labor: Latent -
Nullipara - 8.5hrs
Multipara - 5hrs
Dilation - 0-3 or 4cm
Contraction:
Freq. - Every 10-20 mins. increasing to every 5-7 mins.
Duration - 15-30 secs. progressing to 30-40 secs.
Intensity - mild and progress to mod.
Misc.:
Little to no fetal decent
Talking/Smiling
1st Stage of Labor: Active -
Nullipara - 6hrs
Multipara - 4.5hrs
Dilation - 4-8cm
Contraction:
Freq. - Every 2-3 mins.
Durations - 60 secs.
Intensity - Begin mod. progress to strong
Misc.:
Fetal descent
Epidural given
Uncomfortable
^ fear/anxiety
1st Stage of Labor: Transitional -
Nullipara - 3hrs
Multipara - 1hr
Dilation - 8-10cm
Contraction:
Freq. - Every 1.5-2 mins.
Duration - 60-90 secs.
Intensity - Strong
Misc.:
^ Fetal descent
^ 2hrs if epidural
Inner directed
Tired
Helpless
2nd Stage of Labor:
Nullipara - 1 hr
Multipara - 15 mins.
Contractions:
Freq. - Every 1.5-2 mins.
Durations - 60-90 secs.
Intensity - Strong
Misc.:
Episiotomy
Pushing
Crowing
Control
Birth