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70 Cards in this Set

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Begins with the onset of true labor and ends when the cervix is completely dilated at 10 cm.
First Stage of Labor
Begins with complete dilation and ends with the birth of the newborn.
Second stage of labor
Begins with birth of the newborn and ends with delivery of the placenta
Third stage of labor
Begins with delivery of placenta and last for 1 hour as mother's body functions stabilize.
Fourth stage of labor
3 phases of first stage of labor
latent, active & transition
starts with beginning of regular contractions with little change in dilation or descent
latent phase
characterized by more rapid dilation and presence of presenting part
active phase
characterized by increased intensity and duration of contractions and shortened intervals of contractions.
transition phase
duration of 1st stage in
primips
in multips
primips 12-14 hrs
multips 6-10 hrs
cervical dilation 0-3 cm
frequency every 10-30 min
duration 30 sec
intensity mild to moderate
latent phase
cervical dilation 4-7 cm
frequency every 2-5 min
duration 40-60 sec
intensity moderate to strong
active phase
cervical dilation 8-10 cm
frequency every 1.5-2 min
duration 60-90 sec
intensity strong
transition phase
In the fourth stage of labor, dramatic and rapid ______ _____ occurs as the uterus contracts to prevent rapid/excessive blood loss.
uterine involution
5 P's of labor
powers
passenger
passageway
position of mother
psychological factors
the mother's bony pelvis is which P of labor
Passage
Overlapping of cranial bones under pressure of the powers of labor and demands of unyielding pelvis
molding
what is the passenger in the 5 P's
the fetus & placenta
relationship of the long axis of the fetus to maternal anatomy
lie
occurs in the majority of cases & occurs when the long axis of the fetus is parallel to the maternal spine
longitudinal lie
occurs when the long axis of the fetus lies across the maternal spine
transverse lie
relationship of fetal parts to one another (flexion)
attitude
part of the fetus entering the pelvis first
presentation
relationship of the presenting part to the pelvis.
position
landmark for vertex presentation
occiput
landmark for face presentation
mentum
landmark for breech presentation
sacrum
landmark for shoulder presentation
scapula
occurs when the widest diameter of the fetal head passes through the pelvic inlet
engagement
relationship of the presenting part to an imaginary line drawn between the ischial spines
station
is station +5 inside or outside perineum
outside
involuntary powers of labor
contractions
easily indented, like chin
mild contractions
only indented with firm pressure at peak, like nose
moderate contractions
cannot be indented, like brow
strong contractions
measured from beginning of one contraction to beginning of the next
frequency or interval
measured from beginning of contraction to completion of that same contraction
duration
voluntary muscles involved in powers of labor
diaphragm, abdominal & thoracic
things influencing the personality or psychological factors of labor
past birth experiences
support system
knowledge
response of others
environment
Things to collect on admission history
presenting reason
EDC
stage of labor
when labor began
freq/duration
ROM
bleeding
color of membranes
last food intake
BP
true vs false labor
intervals of contractions
intervals between contractions
duration & intensity
pain location
activity affects on contractions
dilation & effacement
TRUE:
regular intervals
intervals gradually shorten between contractions
increase in duration & intensity
discomfort begins in back and radiates around to abdomen
intensity usually incr w/change in activity
cervical dilation & effacement are progressive
FALSE:
irregular contractions
no change in intervals between
no change in duration & intensity
discomfort in abdomen
change of activity has no effect on contraction
no change in dilation & effacement
systemic way to evaluate the woman's abdomen to determine fetal position & presentation
Leopold's Maneuver's
Order of Leopold's Maneuver's
1st-upper abdomen
2nd-sides of uterus
3rd-pelvic outlet
4th-cephalic prominence (front or back of head)
describes the effects that occur when the fetus begins to settle into the pelvic inlet (engagement)
lightening
LOA means
left occiput anterior - the posterior fontanelle (occiput bone) is in the upper left quadrant of maternal pelvis
LOP means
left occiput posterior - the posterior fontanelle is in the lower left quadrant
ROA means
right occiput anterior - the occiput is in the upper right quadrant
ROP means
right occiput posterior - the occiput is in the lower left quadrant
cardinal movements (mechanisms of labor)
descent
flexion
internal rotation
extension
restitution
external rotation
expulsion
head enters inlet of pelvis
descent
fetal chin flexes downward onto chest
flexion
rotation of the occiput, usually left to right to fit diameter of pelvic cavity
internal rotation
movement of head -- occiput, brow then face out of the vagina
extension
realigning of head and back
restitution
shoulder & body of baby are born
expulsion
when placenta separates from inside to the outer margins (fetal side presenting first)
Shultze or shiny Shultze
when placenta separates from outer margins inward, it rolls up and presents sideways (maternal surface delivered first)
Duncan or dirty Duncan
average FHR rounded to increments of 5 bpm on a 10 min strip
baseline FHR
Normal baseline FHR
110-160
causes of fetal tachycardia
early fetal hypoxia
maternal fever
maternal dehydration
amnionitis
causes of fetal bradycardia
latent/profound fetal hypoxia
maternal hypotension
prolonged umbilical cord compression
abruptio placentae
uterine rupture
changes or fluctuation in the baseline FHR over a few seconds to few minutes.
variability
causes of decreased variability
hypoxia
admin of CNS depressant drugs -- demerol, etc.
fetal sleep cycle
causes of marked variability
early mild hypoxia
fetal stimulation or activity
fetal breathing movements
gives indication of fetal oxygenation & physiological ability to compensate for stress
longterm variability
sensitive indicator of fetal oxygenation and oxygen reserve in the tissue. Needs internal heart monitor.
Beat to beat.
shortterm variability
transient increases in FHR normally caused by fetal movement
accelerations or accels
drop in FHR usually in response to contractions that occur
decelerations or decels
occurs when fetal head is compressed with the onset of contraction
early decels - no intervention required
caused by uteroplacental insufficiency resulting from decr blood flow and oxygen transfer
late decels - nonreassuring sign and requires continuous assessment
occur if umbilical cord becomes compressed, thus reducing blood flow
variable decels - requires further assessment