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Maternity-Exam II
Lowedermilk, Perry, & Cashion/ Labor/birth;Management of Discomfort;Fetal Assemnt in Labor; RN care of family during birth/Labor; Labor/Birth AT RISK
49
Nursing
Undergraduate 1
07/14/2011

Additional Nursing Flashcards

 


 

Cards

Term

  Name the Five Factors that affect Labor; 

The 5 P's

 

 Beginning of Chapt. 9

Definition
  1. Passenger (Fetus & Placenta)
  2. Passageway (Birth Canal) {Fetal head, Attitude, Lie, Presentation, Position of fetus}
  3. Powers (Contractions)
  4. Position of mother
  5. Psychologic response of Mother
Term
What is the largest part of the fetus/ or passenger to come through the canal?
Definition

 

The fetal Head

Term
List the six bones of the fetal skull
Definition

 

2 Parietal Bones

2 Temporal Bones

1 Occipital Bone

1 Frontal Bone

Term
 What are these fetal skull bones united by?
Definition

 

 Membranous Sutures

Term
Name the four membranous sutures that the fetal skull is united by
Definition
  1. Sagittal
  2. Lambdoidal
  3. Coronal
  4. Frontal 
Term

 What are Fontanels?

 

Where are they located?

Definition

 Membrane-filled spaces

 

Located where the sutures intersect

Term

During labor, after ROM's,

 palpation of fontanels and sutures during vaginal examination reveals what about the fetus?

Definition
  • Fetal Presentation
  • Fetal Position
  • Fetal Attitude 
Term
What are the two most important fontanels?
Definition
  1. The Anterior fontanel
  2. The Posterior fontanel
     
Term

Describe the shape of the anterior &

posterior fontanels

 
Definition
  1. Anterior Fontanel- Larger of these; Diamond shaped approx. 3cm by 2cm
  2. Posterior Fontanel- Triangular approx. 1cm by 2cm
Term
What suture line does each fontanel lie at?
Definition
  1.  Anterior- Lies at the junction of the sagittal, coronal, and frontal sutures (soft spot; top of head).
  2. Posterior- Lies at the junction of the sutures of the two parietal bones & the occipital bone (back of head). 
Term
 When does the Anterior & Posterior fontanels close after birth?
Definition

Anterior fontanel closes by 18 months

 

Posterior fontanel closes 6-8 weeks

after birth

Term
 (Blank) & (Blank) make the skull flexible to accomodate the infant brain?
Definition

Sutures & Fontanels 

Term
  • What is molding?
  • How does it accomodate the fetal skull during labor?
  • When does the newborn assume their normal shape of the head
Definition
  1. Molding is the slight overlapping of the bones that occurs during labor
  2. The capacity of the bones to slide over one another permits adaptation to the various diameters of the maternal pelvis
  3. Within 3 days after birth 
Term
What does the Fetal Presentation refer to?
Definition

Part of the fetus that enters

 the pelvic inlet first

Term

 What are the three main presentations?

 

Definition
  1. Cephalic presentation (Occiput--Head first)
  2. Breech presentation (Sacrum--buttocks or feet first)
  3. Shoulder presentation (Scapula--Shoulder first; transverse lie- C/S required

C/S= Cesarean Section

Term
 What is the Presenting Part?
Definition

 Part of the fetal body first felt by the

examiner (Dr. or RN), during a vaginal exam

Term
When the presentating part is the occiput, the presentation is noted as?
Definition

  

Vertex

Term
 Three factors that determine the presenting part are?
Definition
  1. Fetal Lie
  2. Fetal Attitude
  3. Extension or Flexion of the fetal head 
Term
 Define fetal Lie
Definition
 The relation of the long axis (spine) of the fetus to the long axis (spine) of the mother
Term
  1. What are the two primary lies?
  2. Where is the long axis of the fetus positioned r/t the mothers long axis?
Definition
  1. Longitudinal or Vertical--Fetus' long axis is parallel with the long axis of the mother 
  2. Transverse, Horizontal, or Oblique---Fetus'long axis is at a right angle diagonal to the long axis of the mother
Term
  1. Longitudinal lies are what two types of presentations?
  2. What type of delivery does a transverse lie require?
Definition
  1. Cephalic or Breech presentations
  2. C/S b/c vaginal birth cannot occur when the fetus stays in a transverse lie.  Oblique lie, is uncommon and fetus usually coverts to the longitudinal or transverse lie during labor. 
Term
What is fetal Attitude?
Definition

The relationship of the fetal body parts to each other/or relationship of the presenting part

Term

What is the following attitude known as:

The back of the fetus is rounded so that the chin is flexed on the chest, the thighs are flexed on the abdomen, and the legs are flexed at the knees.  The arms are crossed over the thorax, and the umbilical cord lies between the arms and the legs.

Definition
General Flexion
Term

What is approx. 9.25 cm at term,

Is the largest transverse diameter, and

Is an important indicator of fetal head size called?

Definition

Biparietal Diameter

In a well-flexed cephalic presentation, the biparietal diameter will be the widest part of the head entering the pelvic inlet.

Term
The relationship of the presenting part (occiput, sacrum, mentum, or sinciput (deflexed vertex--head more straight down) to the four quadrants of the mother's pelvis is known as the ?
Definition
Fetal Position
Term
  • Position is denoted by a three-letter abbreviation.  (ie. ROA, LOA,RSA, ect)
  • Explain what each letter stands for 
Definition

First Letter = Location of the presenting part in the right (R) or left (L) side of the mothers' pelvis.

The middle letter = The specific presentation part of the fetus----Point of reference (O for occiput, S for sacrum, M for mentum (chin), and Sc for scapula (shoulder).

The 3rd letter = Location of the presenting part in relation to the anterior (A), posterior (P), or transverse (T) portion of the maternal pelvis.

Term

If the occiput is the presenting part and is located in the right anterior quadrant of the maternal pelvis....then list the abbreviation

Definition
ROA
Term

If the sacrum is the presenting part and is located in the left posterior quadrant of the maternal pelvis....then list its abbreviation

Definition
LSP
Term

--The relationship of the presenting part of the fetus to an imaginmary line drawn between the maternal ischial spines

--Is a measure of the degree of descent of the presenting part of the fetus through the birth canal....Is known as?

 
Definition

Station

The placement of the presenting part is measured in cm above or below the ischial spines.

(ie. When the lowermost portion of the presenting part is 1cm above the  the spines = station is -1.  At the level of the spines =  station is 0.  When the presenting part is 1cm below the spines = station is +1.

Birth is imminent when at +4 or +5cm

Station should be determined when labor begins so you can measure fetus' rate of descent during labor.

Term

What term indicates that the largest transverse diameter of the presenting part of the fetus has passed through the maternal pelvic inlet into the true pelvis and corresponds to station zero (0)

Definition
Engagement
Term

The passageway/ or birth canal is composed of what?

Definition

---The mothers rigid bony pelvis

The soft tissues of the:

            Cervix

            Pelvic floor muscles

            Vagina

            Inroitus (external opening to the vagina)

 

Term
Point of the Ischial spine is what?
Definition
True Pelvis
Term
If -3 or above the babies head is what?
Definition
Ballotable
Term

If babies presenting part is +3 what is occuring?

Definition

The infant's presenting part is crowning and delivery is imminent

Term

If the soft tissues contribute to vaginal birth of the fetus, espescially the musclualr layers of the pelvic floor, then what is the maternal pelvis' role?

Definition

Maternal pelvis plays a far greater role in the labor process b/c the fetus must successfully accommodate itself to this rigid passageway.  Thus, the size and shape of the pelvis need to be determined befor labor begins

Term

What is the bony pelvis separated by?

 

What two parts is the pelvis divided into

Definition
  • Brim or inlet
  1. True pelvis- Involved in birth, divided into 3 planes (the inlet or brim; the midpelvis, or cavity; and the outlet)
  2. False pelvis- Part above the brim; plays no part in childbearing.

 

Term
The pelvic outlet is the?
Definition
Lower border of the true pelvis
Term
The subpubic angle determines what?
Definition
The type of pubic arch
Term
Why is the subpubic angle so important?
Definition

Because the fetus must first pass beneath the pubic arch, a narrow subpubic angle will be less accommodating than a rounded wide arch.

Term
What is the classic type of the female pelvis?
Definition

Gynecoid---50% of all women

Brim = slightly ovoid or transversely rounded

Shape =  Round

Depth = Moderate

Ischial Spines = Blunt, somewhat widely separated

Scrum = Deep, curved

Subpubic arch = Wide

Usual mode of birth = Vaginal, Sponatneous, Occipitoanterior position

 

Term

The contractions  of the uterine body exert downward pressure on the fetus, pushing it against the cervix.  What does this cause the cervix to do?

Definition

The cervix effaces (thins), and dilates (opens) sufficiently to allow the first fetal portion to descend into the vagina. 

 

Term
What is the Primary Powers
Definition

Involuntary contractions

Primay powers are responsible for:

          -Effacement of cervix= shortening/ thinning normally 2-3cm long and 1cm thick

          -Dilation of cervix= widening of the cervical opening

* When cervix is fully dilated it can no longer be palpated

* Full dilation marks the end of the first stage of labor

Term
Maternal urge to bear down is AKA?
Definition
Ferguson's Reflex
Term
What are secondary powers
Definition

--The urge to bear down

--Have no effect on cervical dilation

--Valsalva Maneuver is discouraged b/c it cuts off oxygen to the baby.

Term

What are the benefits of frequent position changes during labor for woman

Definition

--Relieves fatigue

--Increase comfort

--Improve circulation

Term
What are the signs preceding labor?
Definition

Lightening-Dropping

Low back pain

Bloody show

Weight loss of 0.5-1.5kg

Surge of energy= Nesting

 

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