Rnur138 The Process Of Labor 5 P's

Front 1

what is considered the intrapartum period?

Back 1

begins with the onset of regular uterine contractions and last until the expulsion of the placenta

Front 2

what causes the relases of prostaglandins when labor begins?

Back 2

the uterine muscles are stretched to the threshold point leading to the release of prostaglandins that stimulate contractions.

Front 3

Increased pressure on the cervix stimulates the nerve plexus, causing the release of _______ by the maternal pitutary gland, which stimulates contractions.

Back 3

oxytocin

Front 4

t/f estrogen decreases stimulating a uterine response.

Back 4

f- estrogen increases stimulating a uterine response

Front 5

____________, is withdrawn allowing estrogen to stimulate contractions.

Back 5

progesterone

Front 6

how do oxytocin and prostaglandins work together to stimulate contractions?

Back 6

they work by inhibiting calcium binding in muscle cells, raising intracellular calcium levels and activating contractions.

Front 7

as the ________ ages it begins to deterioate, triggering the initiation of contractions

Back 7

placenta

Front 8

t/f fetal cortisol (produced by the fetus) rises and acts on the placenta to reduce progesterone the quiets the uterus and increases prostaglandins that stimulate the uterus to contract.

Back 8

true

Front 9

what are the 5 factors that affect labor (5 P's)

Back 9

powers (the contraction)
passage ( the pelvis/birth canal)
passanger (the fetus)
Psyche (response of mother)
Position (maternal position)

Front 10

what does powers refer to?

Back 10

both the involuntary UC of labor and the voluntary pushing or bearing down by the mother

Front 11

how many segments does the uterus have?

Back 11

2- upper and lower

Front 12

the upper segment that composes 2/3 of the uterus is responsible for?

Back 12

contracting and pushing the fetus down

Front 13

the lower segment composes the third of the uterus is responsible for what?

Back 13

it is less active, allowing the cervix to become thinner and pulled upward

Front 14

what are the 3 ways to describe a uterine contraction?

Back 14

frequency- time from the begining of one contraction to the begining of another contraction, it is recorded in mins
duration- time from the begining of a contraction to the end of the contraction, it is recorded in sec's
intensity- strength of the contraction, it is evaluated with palpation using the finger tips

Front 15

how is the intensity described

Back 15

mild: the uterine wall is easily indented during contraction
moderate: the uterine wall is resistant to indentation during a contraction
strong: the uterine wall cannot be indented during a contraction

Front 16

what are the 3 phases of the contraction?

Back 16

increment phase- build of the contraction that begins in the fundus and spreads throughout the uterus
acme phase- peak of intensity
decrement phase- descending or relaxation of the uterus

Front 17

what stage of labor does dilation and effacement occur

Back 17

during the first stage

Front 18

bearing down power

Back 18

once the cervix is fully dilated the women will involuntary push because of the ferguson reflex, the bearing down powers are enhanced when the women contracts abd muscle and pushes.

Front 19

Passage

Back 19

includes the bony pelvis and soft tissue of the cervix, pelvic floor, vagina and introitus (external opening to the vagina)

Front 20

types of pelvis's

Back 20

gynecoid
android
athropoid
platypeloid

Front 21

which pelvis is the most common?

Back 21

gynecoid

Front 22

which hormones in pregnacy is released to soften cartilage and increase elasticity of the ligaments?

Back 22

estrogen and relaxin

Front 23

________ refers to the relationship of the ischial spines to the presenting part of the fetus and assist in assessing for fetal desent during labor

Back 23

station- (-5 to +5) 0 is the narrowest diameter the fetus must pass through during a vaginal birth

Front 24

The passanger

Back 24

is the fetus and its relationship to the passageway that is the major factor in the birthing process

Front 25

the relationship between the fetus and passage way include?

Back 25

fetal skull, fetal attitude, fetal lie, fetal presentation, fetal postition and fetal size

Front 26

____is usually the accounts for the largest portion of the fetus to come throught the canal

Back 26

fetal skull

Front 27

_____is the ability of the fetal head to change shape and change to accommodate through the pelvis

Back 27

molding

Front 28

which part of the fetal head is the largest?

Back 28

biapartel (9.25cm)

Front 29

____ and ____ allows the skull bones to overlap and mold to fit through the birth canal

Back 29

sutures and fontanels

Front 30

how can a the examiner determine the postition of the head during a SVE?

Back 30

identifying the anterior fontanel in relationship to the maternal pelvis

Front 31

fetal attitude is also know as

Back 31

fetal posture- it is the relationship of fetal parts to one another, noted by flexion or extension of fetal joints

Front 32

what is the appropraite fetal attitude?

Back 32

at term- the fetus back becomes convex and the chin is to the chest arms crossed over the thorax, thighs to the abd, and legs flexed at knee

Front 33

refers to the long axis (spine) of the fetus in relationship to the long axis (spine) of the mother?

Back 33

fetal lie usually either
longitudinal lie- the axis of the fetus and mother are parallel (most common)
transverse lie- the long axis of the fetus is perpendicular to the long axis of the mother (cant delivery vaginally)

Front 34

______is determined by the part or pole of the fetus that first enters the pelvic inlet

Back 34

fetal presentation
cephalic- head first
breech- pelvis first
shoulder- shoulder first

Front 35

________is the specific fetal structure lying nearest to the cervix

Back 35

presenting part

Front 36

cephalic presentation-

Back 36

presenting part is the fetal head, 95% of all births, the degree of flexion or extension of the fetal head or neck futher classifies cephalic presentation

Front 37

vertex presentation-

Back 37

the head is sharply flexed and the chin is touching the thorax, the occiput determines this presentation(SVE)

Front 38

frontum or brow presentation

Back 38

indicates partial extension of the neck with the brow as the presenting part, the frontum determines this position(SVE)

Front 39

face presentation

Back 39

indicates that the neck is sharply extended and the back of the head (occiput) is arching to the fetal back, the chin determines this position (SVE)

Front 40

breech presentation

Back 40

the presenting part is the feet or butt

Front 41

three classifications of breech presentation include?

Back 41

complete: complete flexion of thighs and legs (Indian Style)
frank: complete flexion of teh thighs and the legs extending over the anterior surface of the body (feet to ears)
footling: extension of one or both thighs and legs so that one or both are presenting

Front 42

transverse presentation

Back 42

the presenting part is usually the shoulder

Front 43

compound presentation

Back 43

the fetus assumes a unique posture usually with one arm or hand presenting alongside the presenting part

Front 44

fetal postition is the relation of the denominator (presenting part) to the maternal pelvis and consitst of 6 positions for each presentation which include-

Back 44

right anterior
right transverse
right posterior
left anterior
left transverse
left posterior

Front 45

described and documented in three letters

Back 45

first letter- designates location of presenting part to left (L) or right (R) of the womens pelvis

Hint 45

second letter- designates the specific fetal part presenting:
O- occiput (back of head)
S- sacrum (butt)
M- mentum (chin)
A- shoulder

Front 46

the thrid letter designates the relationship of the fetal part presenting to the womens pelvis
A- anterior
P- posterior
T- transverse

Back 46

example:
RMP- fetal part presenting is facing to the maternal right, the mentum is the presenting part, and the fetal part presenting (mentum) is posterior to the maternal pelvis!

Front 47

Psyche-

Back 47

factors that influence a womens psyche is the womens coping mechanisms which include her culture, expectations, support systems, type of support during labor

Front 48

______is how the women views how the birth experience should go.

Back 48

expectations- is it precieved as a natural process or a stressful/threatening experience

Front 49

t/f past pain experience and complications of pregnancy, stongly influence a womens expectations of labor?

Back 49

true- current pregnancy experience (difficulty conceiving, unplanned, high-risk) increase anxiety

Front 50

what could help the laboring mother maintain control and is a contributing factor to control pain perception, emotions and influence decisions?

Back 50

support system
can be significant other, family, friend or doula

Front 51

the 5th "p" is?

Back 51

position- the womens position has an effect on both the anatomical and physiological adaptations to labor

Front 52

when is walking, sitting, kneeling and sqatting encouraged during labor?

Back 52

the first stage of labor

Front 53

the _____position decreases the compression of the maternal descending aorta and ascending vena cava that could result in a compromised cardiac output

Back 53

the upright position

Front 54

t/f the upright position has shown benefits in aiding the desent of the fetus with more effective contractions and shorter labor

Back 54

true

Front 55

how could you reduce fatigue, increase comfort and improve circulation to both the mother and fetus?

Back 55

frequent position changes

Front 56

what position does the US use in most births?

Back 56

lithotomy