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67 Cards in this Set
- Front
- Back
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What are the five processes of labor?
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The 5 P's Passage, Passenger, Powers, Position, Process
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What is the mentum?
Hint: fetal skull landmark. |
the fetal chin
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WHat is the sinciput?
Hint: fetal skull landmark |
The fetal brow
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what is the bregma?
hint: fetal skull landmark |
the anterior fontanelle
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what is vertex?
hint: fetal skull landmark |
area b/w anterior and posterior fontanelles
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What fetal presentation is common in 96% of all deliveries?
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cephalic presentation
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When the area b/w anterior and posterior fontanelles, the head is completely flexed, what position is the baby in?
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the vertex position
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what presentation is the ftus in when the fetal buttocks, feet or knees present first?
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breech presentation
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When the fetus is said to be "engaged" what position is the fetus in in terms of passage?
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when lgst diameter of presenting part reaches or passes thru the pelvic inlet.
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The head to toe position of the fetus in relation to the head to toe of the mother...
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Fetal Lie
transverse or longitudinal |
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3 notations are used to describe fetal position related to the mother.... what are they?
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R or L
Presenting Part: O, M, S, SC or SA Maternal Quadrant: A, P, T |
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Name the presenting part abbrev. O, M, S, SC or SA
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Occiput, Mentum, Sacrum, Scapula, or Acromium
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When the term "fetal station" is used..... what is it describing?
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fetal station is the relation of the presenting part of the fetus to the maternal ischial spines. It determines the advancedment of the presenting part.
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THe fetal stations are above the ischial spines they are measured in...
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negative cm.
Ex: if the fetal station is above the ischial spines, it is written -1 (or above) |
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When the fetal statons are below the maternal ischial spines they are measured in...
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positive cm.
Ex: written +1 (or above) |
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When the fetal hips & knees are flexed; thighs on abd; calves on the posterior aspect of the thighs; THE BUTTOCKS & FEET PRESENT... this is WHAT kind of presentation?
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Complete Breech Presentation
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When fetal hips are flexed, knees are extended, THE BUTTOCKS PRESENTS..... this is what kind of presentation?
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Frank Breech Presentation
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WHen the fetal hips and legs are extended; feet present; may be single or double footling presentation... this is waht kind of presentation?
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Footling Breech Presentation
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what are the three phases of a contraction?
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increment, acme (peak), decrement (descent)
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What are the characteristics of a contraction?
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frewuency, duration, intensity
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what are some sign of impending labor?
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lightening(fetus drops into pelvic inlet), braxton hicks contractions, bloody show, rupture of membranes, loss of mucous plug
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When there is a spontaneous rupture of membranes... how long do you have to deliver before there is a high risk of infection?
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24 hrs.
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If there is a rupture of membranes before "engagement" what is there an increase chance of?
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prolapsed cord
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when should you assess fetal heart rate?
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before and after:
AROM, ambulation, med admin |
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The fetal heart rate is found more clearly over what part of the fetus? WHat is the maneuver done to find this?
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FHR heard more clearly over the fetus' back..... Leoppold's maneuver
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what is the baseline normally for the FHR? tachycardia? bradycardia?
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110-160 BPM
greater than 160 BPM lower than 110 BPM |
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What is the term used to describe minute fluctuations from baseline triggered by CNS control and environmental changes?
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variability
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WHat is the term used to describe the transient rise in FHR in response to fetal or uterine activity?
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accelerations
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What is the term used to describe transient decrease in FHR from baseline in response to environmental changes or stress?
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Decelerations
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WHat are some drugs used to treat pre term labor?
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Ritrodine
Terbutaline Atropine Isoxsuprine |
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What serious complication can be a cause of bradycardic FHR?
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a placental abruption
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What decelerations are not a normal part of labor?
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late decelerations.... they occur after the contraction
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what are the nursing responsibilities for a patient experiencing late decelerations?
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report to MD, Give O2, position mother on left side, good hydration, D/C oxytocin, monitor..... if condition continues a C/S is iminent
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Variable decelerations varie in timing with contractions... what should the nurse assess for when this happens?
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cord compression
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What does the first stage of labor consist of? Give the three phases within this stage.
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onset of labor to complete dialation
latent phase ( labor-3cm dilation) Active Phase (4-7cm dilation) Transition(8-10cm Dilation) |
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what is the second stage of labor?
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10cm dilation to expulsion
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what is the third stage of labor?
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from the birth to the delivery of the placenta (afterbirth)
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when does the fourth stage of labor take place? what should occur during this stage?
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1-4 hrs afterbirth
uterus should contract to control bleeding |
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when is ambulation discouraged during labor?
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when there has been a ROM when the fetus is not engaged. (cord prolapse)
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What are some nursing interventions during labor?
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encourage activity, nutrition (ice chips), encoutrage voiding ( a full bladder can impair fetal descent), reposition mother(left side)
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What are some S/S of hyperventilation?
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timgling or numbness of lips, tip of the nose, fingers or toes
dizziness, spots before the eyes, carpal pedal spasms |
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In the first stage of labor, what can contribute to pain?
Hint: first stage 1-10cm |
cervical dilation, lower uterine segment stretch, extreme pressure
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What can occur during the third stage of labor that can cause pain?
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this is the stage where a tear or an episiotomy can occur.
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what are some considerations before giving pain meds?
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try other methods first, analgesics can slow the process of labor, assess mom and baby b4 and after admin..... remember that the fetus takes longer to metabolize and excrete RX... baby can be lethargic at birth.
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When should pain meds not be given during labor????
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during the transition phase.... it's too late. Newborn will have side effects (resp depression, lethargy)
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What are the pain meds available to give to the labor pt?
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Butorphanol (stadol)
Nalbuphine (nubain) |
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What is Duncan and Schultz referring to?
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THe characteristics of the placenta
Dirty Duncan (maternal side) Shiny Schultz (fetal side) |
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If after delivery, the fundus is "boggy", what could it indicate and what should you do?
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could indicate prolonged bleeding..... the uterus should be massaged.
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what are the danger signs of post partum hemorrhage?
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hypotension, tachycardia, uterine atony, excessive bleeding, hematome in the perineal area
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At five weeks gestation, the embryo has...
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first heart beat begins, blood begins pumping, umbilical cord develops, lung and brain begin to develop, arm and leg buds appear.
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At six weeks gestation, the embryo has started to develop....
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nostrils, lenses of the ye, teeth begin to form, cartilage and bone is developed, the tongue develops, the intestines begin to form from the umbilical cord in the abdomen
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At 10 weeks gestation, the embryo develops....
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Hello Fetus! no longer an embryo, mvmnts have begun, fingerprints are evident, placenta is functioning.
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At 11 weeks gestation, the fetus has what kind of characteristics?
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the fingers and toes have separated, genitals have taken on characteristics, amniotic fluid accumulates, nearly all structures have formed and begin to function. Lanugo is present
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What is the hormone responsible for pos pregnancy test?
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HCG- Human Chorionic Gonadotropic Hormone
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What are the three trimesterz of pregnancy broken down to?
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first trimester: 1-13wks
second trimester: 14-26 wks third trimester: 27-40 wks |
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What would a pt expect her schedule to be at the doctor's office for each trimester during antepartal care?
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1st 28 wks visit once a month.
28-36 wks.... every two weeks after 36wks, weekly visits until delivery. |
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WHat is GFPAL assessing?
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G- Gravida (total pregnancies)
F- Full term pregnancies P- Premature deliveries >20wks<37wks A- Abortions/miscarriage <20wks L- Living children |
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When would a pt expect to receive an ultrasound of her fetus? What about group B strep testing?
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An U/S is performed at 6-10wks, then again at 28 wks
GBS is @ 35-37 wks |
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How would you calcualte an estimated due date of a pt that had her last menstrual period on 1-12-02
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USe the LMP 1/12 ADD 7 days then minus three months. Answer: 1/19 - 3 months
EDD= Oct 19th (+or- 10 days) |
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What is the excepted weight gain for each trimester?
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first trimester: 3-5 lbs.
second trimester: 12-15 lbs third trimester: 12-15 lbs 25-30 lbs total |
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Know what Goodall's sign is, Hegar;s sign, Chadwick's sign....
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Chadwick's Sign is the bluish discoloration of the cervix
Hegar's Sign is the softening of the lower uterine segment Goodall's sign is the softening of the cervix. |
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When does ballottement begin?
(fetal movement) |
16-18 wks.
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What does oxytocin stimulate in the pregnant woman?
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stimulates uterine contractions and the letdown reflex
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WHat is the uterine souffle? the funic souffle?
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uterine souffle is the maternal heart beat
Funic souffle is the fetal heart beat |
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What is Vena Cava Syndrome?
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when the enlarging uterus compresses the vena cava when mother lies in the supine position.
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what is diastisis recti?
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Separation of rectus abdominal muscle.
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THe letdown reflex can be stimulated by:
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infant's cry, sucking mvmnts, prescence of infant, or thought of infant.
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