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64 Cards in this Set

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Define molding?
cranial bones overlap under pressure of powers of labor and demands of unyielding pelvis
Define sutures of fetal skull?
membranous spaces between cranial bones
Define fontanelles?
intersections of cranial sutures
Define frontal (mitotic) suture?
located between two frontal bones; becomes anterior continuation of sagittal suture
Define sagittal suture?
located between parietal bones; divides the skull into left and right halves; runs anteroposteriorly, connecting the two fontanelles
Define coronal sutures?
located between frontal and parietal bones; extend transversely left and right from anterior fontanelle (bregma)
Define lambdoidal suture?
located between two parietal bones and occipital bone; extends transversely left and right from posterior fontanelle
Define mentum?
fetal chin
Define sinciput?
anterior area known as the brow
Define vertex?
area between anterior and posterior fontanelles
Define occiput?
areas of fetal skull occupied by occipital bone, beneath posterior fontanelle
Define fetal attitude?
relation of the fetal parts to one another

normal:
moderate flexion of head, flexion of arms onto chest, and flexion of legs onto abdomen
Changes in fetal attitude, esp. head, cause fetus to what?
present larger diameters of fetal head to maternal pelvis...this contributes to a longer, more difficult labor
Define fetal lie?
refers to relationship of cephalocaudal axis (spinal column) of fetus to cephalocaudal axis of woman
Define longitudinal lie?
occurs when the cephalocaudal axis of fetus is parallel to woman's spine
Define transverse lie?
occurs when the cephalocaudal axis of fetal spine is at right angles to woman's spine
Why does transverse lie complicate delivery?
there is shoulder presentation
Define fetal presentation?
determined by fetal lie and by body part of fetus that enters maternal pelvis first
Define presenting part?
first part of fetus to descend into pelvis
may be cephalic, breech,
or shoulder
Define malpresentations?
breech and shoulder presentations which are considered difficult during labor and do not proceed as normal
The most common presentation is?
cephalic
97% rate
Define vertex presentation of cephalic?
most common type
fetal head is completely flexed onto chest
smallest diameter of head first
Define military presentation of cephalic?
head is neithe flexed nor extended
occipitofrontal diameter first
top of head first
Define brow presentation of cephalic?
head is partially extended
occipitomental diameter, the largest anteroposterior diameter is first
Define face presentation of cephalic?
head is hyperextended
submentobregmatic diameter presents
face is presentingn part
Define breech?
presenting part is lower extremities or buttocks
3% chance in term births
classified according to attitude of hips and knees
sacrum is landmark
butt and feet first
Define frank breech?
fetal hips are flexed, knees
extended
butt first
Define footling breech?
hips and legs extended
feet first
single footling - one foot first
double footling - both feet first
Define shoulder presentation?
shoulder first
transverse lie
acromion process of scapula is landmark
Define engagement?
presenting part occurring when the largest diameter of presenting part reaches or passes through the pelvic inlet
Define station?
refers to the relationship of the presenting part to an imaginary line drawn between the ischial spines of the maternal pelvis
Define fetal position?
refers to relationship of landmark on the presenting fetal part to the anterior, posterior, or sides
What influences labor and birth?
fetal position
The most common fetal position is?
occiput anterior
Define frequency?
refers to time between beginningn of one contraction and beginning of next contraction
Define primary force?
uterine muscular contractions, which cause the changes of the first stage of labor
complete effacement and dilatation of the cervix
Define secondary force?
use of abdominal muscles to push during second stage of labor
adds to primary power after full dilatation
Contractions have what 3 phases?
increment - building up
acme - peak
decrement - letting up
Why is relaxation between contractions important?
restores uteroplacental circulation, which is important to fetal oxygenation and adequate circulation in uterine blood vessels
respite for woman
uterine muscles relax
Define duration?
measured from beginning of contraction to completeion of contraction
beginning? 30-40 seconds
later? 30-90 seconds
Define intensity?
refers to strength of uterine contraction during acme
estimated by palpating...nurse can give subjective mild, moderate, or strong by judging amount of indentability of uterine wall during acme...indented easily? mild...can't indent? strong..
contraction, but it may be measured directly with an IUC attached to monitor
Describe measurements of intensity when using an IUC?
resting tonus (between contractions): 10-12 mmHg
acme early labor: 25-40 mmHg
acme active labor: 50-70 mmHg
transition: 80-100 mmHg
second stage pushing: 100mmHg
At the beginning of labor, contractions are usually____, of _____ duration, and relatively ______
mild
short
infrequent
As labor progresses, duration and intensity _______, and frequency is every _____ to ______ minutes.
increase
2 to 3
What hormone stimulates uterine muscle contractions to permit softening, stretching, and eventual thinning of cervix.
estrogen
Define physiologic retraction ring.
the division of the uterus into two portions during true labor...upper portion which is contractile gets thicker as labor advances....lower portion, including lower uterine segment and cervix, is passive...lower portion thins out
Define effacement?
taking up of internal os and cervical canal into uterine side walls
Define brachystasis?
uterine muscle remains shorter and thicker and does not return to its original length
How does cervical dilatation occur?
as uterus elongates, longitudinal muscle fibers are pulled upward over presenting part...as well as hydrostatic pressure of fetal membranes
Define fetal axis pressure?
pressure exerted by fetus as the uterus elongates and pushes fetus down
Define lightening?
effects that occur when fetus begins to settle into pelvic inlet (engagement)..
eases mother's breathing

symptoms:
leg cramps or pains
increased pelvic pressure
increased venous stasis
leading to edema
increased urinary frequency
increased vaginal secretions
Define Braxton Hicks contractions?
prior to labor
irregular intermittent contractions...
"drawing" sensation
false labor
Define ripening?
Goodell's sign?
softening of cervix
under influence of hormonal factors
Define bloody show?
resulting pink-tinged secretions from expelling of mucus plug...
usually means labor will begin within 24 to 48 hours...
vaginal exam blood-tinged discharge may be confused with bloody show
Define mucus plug?
a barrier in cervical canal..
cervical secretions accumulate in cervical canal
How is mucus plug expelled?
softening and effacement of cervix
Define rupture of membranes (ROM)?
12% of women
80% will experience spontaneous labor within 24 hours...otherwise, labor may be induced to avoid infection if baby near term
Define spontaneous rupture of membranes?
SROM
generally occurs at height of an intense contraction with a gush of fluid out of vagina...
at risk for prolapsed cord if engagement (descent) hasn't occurrred
What is prolapsed cord?
cord is expelled with fluid before baby...mother should be checked...sometimes amniotic fluid mistaken for urine
What is amniotomy or artificial rupture of membranes?
rupture of membranes with amniohook
Signs of onset of labor might include?
lightening
Braxton Hicks
cervical changes-ripening
bloody show
ROM SROM

unknown causes:
sudden energy
weight loss 1 to 3 lbs
increased backache and
sacroiliac pressure
diarrhea
indigestion
nausea
vomiting
Define crowning?
occurs when fetal head is encircled by external opening of vagina (introitus) and means birth is imminent
Define cardinal movements?
for fetus to pass through birth canal, fetal head and body must adjust to maternal pelvis by certain positional changes
also called mechanisms of labor
List cardinal movements?
descent
flexion
internal rotation
extension
restitution
external rotation
expulsion