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54 Cards in this Set

  • Front
  • Back
What are the characteristics of hypertonic labor patterns?
Occur in the latent phase
Contractions more frequent, painful.
Contractions are ineffective
Prolonged latent phase.
Definition of DYTOCIA
Dysfunctional uterine contractions that result in a prolongation of labor.
Highest indication for c-section in nulliparous.
Normal contractions with normal labor can be decribed as? Frequency and amplitude
regular-3-5 contractions per 10 minutes.
mean amplitude of 35 mmHg progressing to
contractions 4-5 in 10 minutes with amplitude of 35-40 mmHg.
Dysfunctional uterine contractions can be decribed as?
low amplitude
poor pattern of cervical dilation or arrested cervical dilation
Can be hyper or hypo tonic
The 5 P's of critical labor factors?
Definition of labor?
a series of events where the fetus, placenta, amniotic fluid, and fetal membranes are explelled from the maternal body
Causes of onset of labor?
Name 8
oxytocin stimulation
progesterone withdrawl
estrogen stimulation
fetal cortisol
gap junctions
uterine distention
calcium activation
Premonitory signs of labor?
name 6
braxton hick become stronger
bloody show= signals signs of cervical changes
weight loss= due to decreased hormone production
discomfort= pressure
GI symptoms= nausea, vomiting,
Signs of true labor?
contraction are regular
interval between contractions shortens
contractions increase in duration and intensity
discomfort begins in back and radiates to the abdomen
intesity increases with walking
cervical dilation and effacment are progressive
contractions do not decrease with rest or warm bath
Signs of false labor?
irregular contractions
interval between contractions does not change
Intesity and duration does not change
discomfort is usually begins in the abdomen
walking has no effect on the contractions
no change in cervical dilation or effacement
rest or warm bath lessen the contractions
When does stage 1 of labor begin and how many phases are in this stage?
Begins with the onset of labor and ends with complete cervical dilation.
There are 3 phases
Describe the three phases of the first stage
Phase 1= early or latent stage
Phase 2= active or acceleration
Phase 3= Transiton or deceleration
What are the characteristics of phase 1?
Begins with onset of regular contractions.
contractions start as mild progress to moderate, lasting 20-40 seconds.
Frequency every 3-30 minutes.
Average amplitude of 25-50 mmHg.
Excitment is high
Good opportunity to teach
What are the characteristics of phase 2?
Contractions are every 2-5 minutes, lasting 40-60 seconds.
moderate to stong intensity= 50-70 mmHg
Dilation 4-7 cm
Woman becomes fearful, anxious
What are the characteristics of phase 3?
COntractions are every 1 1/2 to 2 minutes.
Duration 60-90 seconds.
Strong intensity=70-90mmHg
Dilation 8-10 cm
*Mom will become inner directed*
What is a Friedman Labor curve used for?
Represents expected labor pregress: primagravida versus multigravida.
Useful in identification of dystocia.
What are characteristic of the second stage of labor?
Begins when the cervix is completely dilated.
Ends with the birth of the baby
Usually last 2 hours for primagravida or 15 miutes for the multigravida
Contactions are every 1 1/2 to 2 minutes, lasting 60-90 seconds.
Strong intensity
What are the positional changes of the fetus?
"Cardinal Movements"
Internal rotation
External rotation
What are the characteristic of the third stage of labor?
Begins after the delivery of the infant.
Ends with the delivery of the placenta.
What are signs of placenta seperation?
Can be manifested around 5 minutes after birth of infant up to 30 minutes.
Globular shaped uterus
Rise of the fundus in the abdomen.
Sudden gush or trickle of blood.
Further protrusion of the umbilical cord out of the vagina.
When is a placenta considered retained?
If more than 30 minutes have elapsed from the completion of the second stage of labor.
What is Dirty Duncan ?
Placenta separates from the outer margins inward.
It presents sideways with the maternal surface delivering first.
What is shiny Shultz?
Placenta separates from the inside to the outer margin. It presents with the shiny surface.
What is the fourth stage of labor?
One to four hours after birth.
During the fourth stage of labor, what are normal vital signs?
Due to redistribution of blood the blood pressure will decrease, pulse pressure increase,with moderate tachycardia.
Where is the normal location of the fundus during the forth stage of labor?
Midline and between the umbilicus and the pubic symphysis.
What is the true pelvis?
Divided into three sections
1. the inlet
2. pelvic cavity
3. the outlet
Represents the bony limits of the birth canal.
Measures 5cm. at its anterior, 10cm. at the posterior wall
What is the diagonal conjugate?
Extends from the subpubic angleto the middle of the sacral promontory.
Usually measures 12.5cm.
Can be measured manually during pelvic exam.
What improtance does the diagonal conjugate's measurement?
It is needed to estimate the obstetric conjugate.
What is the obstretric conjugate?
extends from the middle of the sacral promontory to an area about 1 cm. below the pubic crest.
Its lenght is an estimate by subtracting 1.5cm from the diagonal conjugate's measurement.
This is the area the fetus must pass through in order to pass through the birth canal.
What is the most common pelvis that allows vaginal delivery?
Gynecoid pelvis
What are two pelvis types that allow vaginal delivery?
Gynecoid pelvis
Anthropoid pelvis
What type of pelvis does not allow for a vaginal delivery?
Platylloid pelvis
What are four important land marks of the fetal skull?
Mentum= chin
Vertex=area between the anterior and posterior fontanelles.
Sinciput= anterior area, the brow
Occiput=occipital bone
How is fetal presentation determined?
By the fetal lie and by the body of part of the fetus that enters the pelvis= fetal presentation.
What is the smallest diameter of the fetal skull?
The suboccipitobregmatic diameter.
What are the four characteristics of the vertex presentation?
most common
fetal head is flexed onto the chest
smallest diameter is the suboccipitobregmatic presents into the maternal pelvis.
The occiput is the presenting part.
What are the four types of CEPHALIC presentation?
What are the types of presentation?
Describe MILITARY presentation?
Fetal head is neither flexed or extended.
The occipitofrontal diameter presents to the maternal pelvis.
Top of the head is the presenting part.
Three characteristics of BROW presentation?
Fetal head is partically extended
The occipitomental is the presented in the pelvis.
The siniput is the presenting part
What is the largest diameter of the fetal head?
The occipitomental diameter
What is face presentation?
Head is hyperextended
Submentobregmatic diameter presents to the maternal pelvis.
The face is the presenting part.
How are breech presentations classified?
Classifed according to the attitude of the fetus's hips and knees.
With all types the sacrum is the landmark.
What are the types of breech presentation?
What is complete breech?
fetal knees and hips are flexed.
Thighs are on the abdomen.
Calves are on the posterior aspect of the thighs.
What is a frank breech?
Fetal hips are flexed
Knees are extended
Buttocks present to the maternal pelvis
What is a footling breech?
Fetal hips and legs are extended.
Feet present to the maternal pelvis.
Can be a single or double foot.
What are causes for arrested descent?
Bladder retention
Full Bowel
What are causes fetal dystocia?
Size- CPD
Labor Dystocia, Cord COmpression, Uteroplacenta insufficiency, and preexisting fetal or maternal disease can cause?
Fetal distress
What are signs and symptoms of fetal distress?
Fetal heart rates
Acidosis <7.20
Loss of fetal movement
hypoxia-o2 sats <20-70%
What are 4 causes of fetal cord compression?
Rupture of membrane
Post dates
Nuchal cord
Prolapsed cord
After rupture of membrane what should the nurse assess for?
Prolapsed cord.