Nsg 220 - Labor & Delivery

Front 1

Begins with the onset of true labor and ends when the cervix is completely dilated at 10 cm.

Back 1

First Stage of Labor

Front 2

Begins with complete dilation and ends with the birth of the newborn.

Back 2

Second stage of labor

Front 3

Begins with birth of the newborn and ends with delivery of the placenta

Back 3

Third stage of labor

Front 4

Begins with delivery of placenta and last for 1 hour as mother's body functions stabilize.

Back 4

Fourth stage of labor

Front 5

3 phases of first stage of labor

Back 5

latent, active & transition

Front 6

starts with beginning of regular contractions with little change in dilation or descent

Back 6

latent phase

Front 7

characterized by more rapid dilation and presence of presenting part

Back 7

active phase

Front 8

characterized by increased intensity and duration of contractions and shortened intervals of contractions.

Back 8

transition phase

Front 9

duration of 1st stage in
primips
in multips

Back 9

primips 12-14 hrs
multips 6-10 hrs

Front 10

cervical dilation 0-3 cm
frequency every 10-30 min
duration 30 sec
intensity mild to moderate

Back 10

latent phase

Front 11

cervical dilation 4-7 cm
frequency every 2-5 min
duration 40-60 sec
intensity moderate to strong

Back 11

active phase

Front 12

cervical dilation 8-10 cm
frequency every 1.5-2 min
duration 60-90 sec
intensity strong

Back 12

transition phase

Front 13

In the fourth stage of labor, dramatic and rapid ______ _____ occurs as the uterus contracts to prevent rapid/excessive blood loss.

Back 13

uterine involution

Front 14

5 P's of labor

Back 14

powers
passenger
passageway
position of mother
psychological factors

Front 15

the mother's bony pelvis is which P of labor

Back 15

Passage

Front 16

Overlapping of cranial bones under pressure of the powers of labor and demands of unyielding pelvis

Back 16

molding

Front 17

what is the passenger in the 5 P's

Back 17

the fetus & placenta

Front 18

relationship of the long axis of the fetus to maternal anatomy

Back 18

lie

Front 19

occurs in the majority of cases & occurs when the long axis of the fetus is parallel to the maternal spine

Back 19

longitudinal lie

Front 20

occurs when the long axis of the fetus lies across the maternal spine

Back 20

transverse lie

Front 21

relationship of fetal parts to one another (flexion)

Back 21

attitude

Front 22

part of the fetus entering the pelvis first

Back 22

presentation

Front 23

relationship of the presenting part to the pelvis.

Back 23

position

Front 24

landmark for vertex presentation

Back 24

occiput

Front 25

landmark for face presentation

Back 25

mentum

Front 26

landmark for breech presentation

Back 26

sacrum

Front 27

landmark for shoulder presentation

Back 27

scapula

Front 28

occurs when the widest diameter of the fetal head passes through the pelvic inlet

Back 28

engagement

Front 29

relationship of the presenting part to an imaginary line drawn between the ischial spines

Back 29

station

Front 30

is station +5 inside or outside perineum

Back 30

outside

Front 31

involuntary powers of labor

Back 31

contractions

Front 32

easily indented, like chin

Back 32

mild contractions

Front 33

only indented with firm pressure at peak, like nose

Back 33

moderate contractions

Front 34

cannot be indented, like brow

Back 34

strong contractions

Front 35

measured from beginning of one contraction to beginning of the next

Back 35

frequency or interval

Front 36

measured from beginning of contraction to completion of that same contraction

Back 36

duration

Front 37

voluntary muscles involved in powers of labor

Back 37

diaphragm, abdominal & thoracic

Front 38

things influencing the personality or psychological factors of labor

Back 38

past birth experiences
support system
knowledge
response of others
environment

Front 39

Things to collect on admission history

Back 39

presenting reason
EDC
stage of labor
when labor began
freq/duration
ROM
bleeding
color of membranes
last food intake
BP

Front 40

true vs false labor
intervals of contractions
intervals between contractions
duration & intensity
pain location
activity affects on contractions
dilation & effacement

Back 40

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

Front 41

systemic way to evaluate the woman's abdomen to determine fetal position & presentation

Back 41

Leopold's Maneuver's

Front 42

Order of Leopold's Maneuver's

Back 42

1st-upper abdomen
2nd-sides of uterus
3rd-pelvic outlet
4th-cephalic prominence (front or back of head)

Front 43

describes the effects that occur when the fetus begins to settle into the pelvic inlet (engagement)

Back 43

lightening

Front 44

LOA means

Back 44

left occiput anterior - the posterior fontanelle (occiput bone) is in the upper left quadrant of maternal pelvis

Front 45

LOP means

Back 45

left occiput posterior - the posterior fontanelle is in the lower left quadrant

Front 46

ROA means

Back 46

right occiput anterior - the occiput is in the upper right quadrant

Front 47

ROP means

Back 47

right occiput posterior - the occiput is in the lower left quadrant

Front 48

cardinal movements (mechanisms of labor)

Back 48

descent
flexion
internal rotation
extension
restitution
external rotation
expulsion

Front 49

head enters inlet of pelvis

Back 49

descent

Front 50

fetal chin flexes downward onto chest

Back 50

flexion

Front 51

rotation of the occiput, usually left to right to fit diameter of pelvic cavity

Back 51

internal rotation

Front 52

movement of head -- occiput, brow then face out of the vagina

Back 52

extension

Front 53

realigning of head and back

Back 53

restitution

Front 54

shoulder & body of baby are born

Back 54

expulsion

Front 55

when placenta separates from inside to the outer margins (fetal side presenting first)

Back 55

Shultze or shiny Shultze

Front 56

when placenta separates from outer margins inward, it rolls up and presents sideways (maternal surface delivered first)

Back 56

Duncan or dirty Duncan

Front 57

average FHR rounded to increments of 5 bpm on a 10 min strip

Back 57

baseline FHR

Front 58

Normal baseline FHR

Back 58

110-160

Front 59

causes of fetal tachycardia

Back 59

early fetal hypoxia
maternal fever
maternal dehydration
amnionitis

Front 60

causes of fetal bradycardia

Back 60

latent/profound fetal hypoxia
maternal hypotension
prolonged umbilical cord compression
abruptio placentae
uterine rupture

Front 61

changes or fluctuation in the baseline FHR over a few seconds to few minutes.

Back 61

variability

Front 62

causes of decreased variability

Back 62

hypoxia
admin of CNS depressant drugs -- demerol, etc.
fetal sleep cycle

Front 63

causes of marked variability

Back 63

early mild hypoxia
fetal stimulation or activity
fetal breathing movements

Front 64

gives indication of fetal oxygenation & physiological ability to compensate for stress

Back 64

longterm variability

Front 65

sensitive indicator of fetal oxygenation and oxygen reserve in the tissue. Needs internal heart monitor.
Beat to beat.

Back 65

shortterm variability

Front 66

transient increases in FHR normally caused by fetal movement

Back 66

accelerations or accels

Front 67

drop in FHR usually in response to contractions that occur

Back 67

decelerations or decels

Front 68

occurs when fetal head is compressed with the onset of contraction

Back 68

early decels - no intervention required

Front 69

caused by uteroplacental insufficiency resulting from decr blood flow and oxygen transfer

Back 69

late decels - nonreassuring sign and requires continuous assessment

Front 70

occur if umbilical cord becomes compressed, thus reducing blood flow

Back 70

variable decels - requires further assessment