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40 Cards in this Set
- Front
- Back
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In labor, estrogen stimulates uterine muscle what?
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uterine contractions
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In labor, connective tissue loosens, which causes what?
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softening, thinning, and opening of the cervix
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In labor, muscles of the upper uterine segment shorten which causes?
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thinning, flattening and forward movement of the cervix
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In labor, progesterone causes?
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Relaxation of smooth muscle
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In labor, pressure of the fetal head causes what?
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Cervical dilation
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What are some maternal systemic responses to labor?
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Increased BP, Increased oxygen demand (often causing mild resp acidosis), kidneys increase renin, often edema at base of bladder d/t pressure of fetal head, decreased gastric mobility, increased WBCs, decreased blood glucose, pain
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What are some fetal responses to labor?
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Often no adverse effects, FHR decreases as head pushes on cervix, pH in fetus decreases d/t decreased blood flow during contractions, feta hypoxia can occur
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What is lightening "dropping"?
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Moving of the fetus and uterus downward into the pelvic cavity. Usually occurs 2-3wks before but may occur during active labor
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What are Braxton Hicks contractions?
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Intermittent painless contractions of the uterus that may occur every 10 to 20 minutes. They occur more frequently toward the end of pregnancy and are sometimes mistaken for true labor signs.
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When should expectant mother go to the hospital?
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Regular UCs q5mins or closer
Gush or leakage of water Bright red vaginal bleeding No fetal movement |
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What are the four stages of labor?
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1- Dilation
2- Delivery 3- Delivery of placenta 4- Recovery |
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When does the dilation stage start and end?
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It begins with onset of true labor and ends with complete dilation (10cm) & 100% effacement
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How long does the dilation stage last?
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normal: 6-18 hours for primip
can be 4 to more than 24hrs multip: 2-10 hours or more |
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In dilation, when does the latent phase begin and end? what is fetal station at?
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Begins at onset of labor until 3cm dilation. Fetal station is -5 to 0
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In the active phase of dilation, how often do contractions occur? How long do they last? How strong are they?
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q3-4 mins, lasting 45-60 seconds, and moderate to strong
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In latent phase of dilation, what are UCs like?
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mild like menstrual cramps, infrequent but increasing to every 5mins with a duration of 15-30 seconds
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In latent phase of dilation, what is the women like?
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sociable, excited, and cooperative, may feel some apprehension
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In dilation, when does the active phase begin and end? what effacement is it? what is fetal station?
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begins at 4cm ends at 7cm. phase is 75% effacement. fetal station is 0
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During the dilation stage of labor, the transition stage begins and ends when? During this stage effacement is what? Fetal station is what?
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begins at 8cm and ends when dilation is complete. effacement is complete. fetal station is +1 to +2
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During the transition phase of dilation, UCs occur how often? How long do they last? How intense are they?
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occur q 2mins, last 60-90 sec long, and are intensely painful
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When can ROM occur?
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At any time up until actual delivery
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SROM? AROM? Prom? PPROM?
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spontaneous ROM, Artificial ROM (also known as an amniotomy), Premature ROM (is high risk for infection after 24hrs and higher risk for cord compression or prolapse), PPROM- occurs before 38weeks
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What are nursing interventions after ROM?
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IMMEDIATELY assess FHR and again 5 mins later
Note color and odor of fluid If questionable check w/ nitrazine or ferning test Record time, color, and odor of fluid Notify PCP if meconium present Monitor temp q 1-2hrs Limit vaginal examinations |
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The second stage of labor begins and ends when? How long does it last?
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begins with complete dilation and effacement and ends with delivery of neonate.
Lasts 5-60mins for multip, up to 2hrs for primip. Avg lasts 20mins multip & 50 mins for primip |
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During delivery, as head emerges, which do you suction first.. mouth or nose?
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suction mouth THEN nose
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During delivery, check for a _____ cord, and wipe face with sterile gauze..
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nuchal
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When is APGAR score taken?
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When infant is born and 5 mins after
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3rd stage of labor begins and ends when? How long does it last?
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Begins after delivery of neonate, ends when placenta is out. Last 5-30mins, if over 30mins intervention needed.
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What happens during stage 3 of labor?
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small gush of blood precedes expulsion of placenta, cord lengthens, abdomen takes on an oval shape, 1 push usually expels the placenta.
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Administer what immediately after placenta is expelled?
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Pitocin, an oxytocin drug that vasoconstricts. if unavailable, put baby on breast for natural oxytocin
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The 4th stage of labor, recovery, lasts how long?
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1-4hrs
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What are nursing interventions in 4th stage of delivery?
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VS & fundal massage q15mins x 4, q30mins x 2, q1hr x 2 (more if pt is doing bad such as bleeding out), monitor blood loss, cleanse perineum & apply pads, give clean, dry gown, profile food & beverage
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What are the 4 S/S of the placenta coming?
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Fundus pulls forward against abdomen
Abdominal wall changing to a ovoid shape Gush of blood Cord lengthens |
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Retained placenta can lead to uterine _____ so be sure all of it is out.
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atony
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In emergency, when delivering baby, pull ___ to deliver the anterior shoulder and ___ to deliver posterior shoulder.
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down, up
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What is lie? What are the different types? The most common types?
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It's the orientation mother's spine. Longitudinal, oblique, transverse. 99% are longitudinal.
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What is attitude?
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Degree of flexion
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What are types of fetal presentations?
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Vertex: head first (most common)
Transverse lie: almost always CS Complete breech: buttocks first, legs crossed, mostly CS Frank breech: buttocks first, body doubled Footling breech: foot/feet first, always CS |
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What is Leopold's maneuver?
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A series of four maneuvers designed to provide a systematic approach whereby the examiner may determine fetal presentation and position.
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What are steps to perform Leopold's maneuver?
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Locate fundus
Palpate down each side Palpate at symphysis pubis Palpate for chin/neck |
