Term
| What are Premonitory signs of labor? |
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Definition
LIGHTENING
BRAXTON HICKS CONTRACTIONS
CERVICAL CHANGES
BLOODY SHOW
RUPTURE OF MEMBRANES
BURST OF ENERGY
WEIGHT LOSS-2.2-6.6 LBS.(1-3 KGS)
URINARY FREQUENCY
INCREASED BACKACHES OR SACROILIAC PRESSURE
DIARRHEA
N/V
LOSS OF MUCOUS PLUG |
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Term
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Definition
CERVICAL EFFACEMENT AND DILATION
UC-REGULAR, STRONGER, LONGER
LOCATION- BACK TO FRONT
WALKING WILL NOT LESSEN UC MAY INTENSIFY |
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Term
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Definition
NO CERVICAL CHANGES
UC- IRREGULAR AND NO CHANGE IN FREQ., INTENSITY, DURATION
POSITION CHANGE OR WALKING WILL LESSEN UC |
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Term
| What are the 5 P's of labor? |
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Definition
-Pathway
-Passenger
-Powers
-Position
-Psyche |
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Term
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Definition
REFERS TO THE MATERNAL STRUCTURES-BONES OF THE PELVIS, SACRUM AND COCCYX AND THE SOFT STRUCTURES CERVIX AND VAGINA
THE TYPE OF PELVIS AND ITS DIAMETERS CAN INFLUENCE THE DESCENT OF THE FETUS, THE PROGRESSION OF LABOR AND TYPE OF DELIVERY. |
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Term
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Definition
| SIZE, ATTITUDE (relationship of the fetal parts to one another, flexion, extension), LIE (vertex, transverse, breech), PRESENTATION (cephalic, face, brow, breech, shoulder, compound, fetal part),POSITION, ENGAGEMENT (floating, ballotable, engaged), STATION |
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Term
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Definition
Primary--Involuntary cxs (frequency, duration, intensity)effacemen (thinning and shortening of cervix, 0%-100%)t and dilation (opening of the cervix, 0-10 cm) of cervix
Secondary—voluntary use of abdominal muscles of second state of labor, results in descent and delivery of fetus/pushing. |
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Term
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Definition
| Maternal position in labor, descent of fetus, comfort of mother, uterine blood flow |
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Term
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Definition
| Psychological component of childbearing, excitement, fear, anxiety, percieved loss of control |
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Term
| What are the types of maternal pelvis? |
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Definition
GYNECOID
ANDROID
ANTHROPOID
PLATYPELLOID |
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Term
| What are the positions of the fetus? |
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Definition
LONGITUDINAL LIE- VERTEX OR BREECH
TRANVERSE LIE- LATERALLY ACROSS UTERUS.
OBLIQUE LIE –DIAGONALLY |
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Term
| What are the fetal stations? |
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Definition
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Term
| What does a 0 station mean? |
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Definition
| The baby's head is at the ischial spine aka READY TO BIRTH |
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Term
| What are the positions of the baby when being birthed? |
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Definition
-Right occipitoposterior
-Left occipitoposterior
-Right occipitotransverse
-Left occipitotransverse
-Right occipitoanterior
-Left occipitoanterior |
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Term
| What position is best for birthing a baby? |
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Definition
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Term
| What happens in the 1st stage of labor? |
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Definition
-Stage of cervical dilation
-Begins w/ onset of regular contraction and ends w/ compete dilation |
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Term
| What is the latent step of 1st stage labor? |
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Definition
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Term
| What is the active step of 1st stage labor? |
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Definition
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Term
| What is the transitional step of the 1st stage of labor? |
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Definition
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Term
| What is the 2nd stage of labor? |
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Definition
-Stage of expulsion
-Begins with complete cervical dilation and ends with delivery of fetus |
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Term
| What is the 3rd stage of labor? |
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Definition
Placental stage
Begins immediately after fetus is born and ends with the placenta being born |
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Term
| What is the 4th stage of labor? |
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Definition
Maternal Homeostatic Stabilzation
Begins after delivery of placenta and continues for 1-4 hours after delivery |
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Term
| What are the s/s of active labor? |
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Definition
Intense, regular contractions,40-60 secs, mod to stron intensity, nullips 4-5 hrs, multios 2. hrs
Serious, intense pain, doesn’t tak through cxs.
get into “the zone” or get drugs |
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Term
| What are the s/s of transitional labor? |
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Definition
1 ½-2 min frequency, 60-90 secs, strong
Very difficult, less relief with contractions, anxiety, focus only on her needs.
“I’m dying” “I can’t do this anymore”
First stage may last a few minutes or days. |
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Term
| What are the s/s of latent labor? |
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Definition
Onset of Ucs to complete effacement and dilation
Irregular, bothersome contractions
Mild to moderate in intensity
Longest phase (nullips 8-9 hrs, multips 5 hr)
Relieved that labor has started, anxious, excited, talkative |
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Term
| What are the s/s of the 2nd stage of labor? |
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Definition
Normal length—5 mins to 3 hours
UC—q 1 ½-2mins; 60-90 secs, intensity is strong
Involuntary efforts to expel fetus
Signs: grunting, bearing down, vomitting, bloody show, FHR changes, crying/screaming.
Positioning: Squating is best for progress, lateral is best for perineum, kneeling best for back labor, semi-fowlers is most common.
Renewed energy, determined, focused, unable to control pushing |
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Term
| What are the s/s of the 3rd stage of labor? |
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Definition
Relief labor is over, excited about infant, fatigue
Signs of placental separation: gust of blood, lengthening of the cord, cessation of cord pulsation.
Time: under 30 minutes (or retained).
Major risk: hemorrhage
Prevention: empty bladder, breastfeed, fundal massage, recheck H/H, T&S.
Rx: Pitocin IV or IM, Methergine IM or PO, Hemabate IM, Cytotec |
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Term
| What are the cardinal movements? |
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Definition
| THE ADAPTATIONS THE FETUS UNDERTAKES TO MANEUVER THROUGH THE PELVIS DURING LABOR AND BIRTH |
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Term
| What are the actual cardinal movements? |
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Definition
ENGAGEMENT
DESCENT
FLEXION
INTERNAL ROTATION
EXTENSION
RESTITUTION
EXTERNAL ROTATION
EXPULSION |
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Term
| What is Every Darn Fool In Rotterdam Eats Rotten Egg Rolls Everyday? |
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Definition
ENGAGEMENT
DESCENT
FLEXION
INTERNAL ROTATION
EXTENSION
RESTITUTION
EXTERNAL ROTATION
EXPULSION |
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Term
| What is the body's response to labor? |
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Definition
Cardia output—significant increase during labor
BP increased
Pulse increases during Ucs |
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Term
| What are the fetal responses to labor? |
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Definition
HEART RATE 110-160
CO2 INCREASES
PH DECREASES-SLIGHTLY ACIDITIC-7.25-7.35 |
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Term
| What are the 2 ways labor presents? |
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Definition
10% will have ruptured membranes:
Call MD/CNM
90% will have contractions:
Early labor vs. false labor
Active labor |
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Term
| How are ruptured membranes diagnosed? |
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Definition
Gross rupture with/without increased intra-abdominal pressure
Nitrazine test
Fern Test
Ultrasound |
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Term
| What is the nitrazine test? |
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Definition
pH is a measure of the acid-base balance of whatever substance is being tested.
Vaginal secretions are normally slightly acid (pH <5.0).
In testing for the presence of amniotic fluid (during pregnancy, to rule in/out ruptured membranes), the more basic amniotic fluid will turn nitrazine paper a dark blue, indicating a pH of >6.0, and confirming ruptured membranes.
In testing for the presence of bacterial vaginosis, vaginal infections with anaerobic bacteria are often associated with a pH >5.0. |
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Term
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Definition
Observe for "fern-like" crystals. Presence of crystals indicates that the fluid is amniotic fluid.
Record the results: Write your name, the date, time and findings on the patient record. |
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Term
| What is the technique involved with ferning? |
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Definition
- avoid the use of any lubricants or antiseptics
- use a sterile swab and do not touch the mucus plug
- prepare a thin smear on a glass microscope slide by spreading evenly.
Allow the slide to air dry- do not apply heat and do not coverslip the slide.
Examine the fully-dried slide microscopically, using the 10X objective |
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Term
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Definition
Stages of labor and positioning of mother and baby
Anxiety/fear
Endorphins
Culture
Support/environment |
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Term
| What are the nonpharmacologic methods of pain management of labor? |
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Definition
Positioning
Breathing Techiques
Relaxation Techiques
Gate Control Methods
Hydrotherapy |
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Term
| When is analgesia and anesthesia used? |
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Definition
| Can Be Given To Decrease Or Eliminate Pain During The Labor Process When Nonpharmacologic Methods Of Pain Management Are Ineffective |
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Term
| What is the goal of analgesia/anesthesia use? |
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Definition
| Goal Is To Maximumize Pain Relief With Minimal Risk For The Woman Or Fetus |
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Term
| What happens if A/A is given to slowly? |
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Definition
| If Given Too Early May Slow Labor Process |
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Term
| What happens if A/A is given to rapidly? |
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Definition
| If Too Much Is Given Can Effect The Neonate Respirations. |
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Term
| What are the IV opiods used in labor? |
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Definition
Agonists: Fentanyl, Demerol, Morphine
Agonist-antagonist: Stadol, Nubain
Co-drugs/Narcotic Potentiates: Phenergan, Vistaril, Reglan |
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Term
| What are the regional anesthetics used? |
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Definition
Epidural/Spinal
Pudendal nerve block
Paracervical block
Local |
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Term
| When is general anesthesia used? |
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Definition
Only For Emererncies
Watch For Bleeding
Effect Of Baby |
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Term
| How do narcotics effect the baby? |
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Definition
Easier transfer through blood-brain barrier in fetus
Longer half-life in fetus and newborn |
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Term
| What do narcotics to do the fetus respiration rate? |
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Definition
Watch for respiratory depression, delayed sucking, decreased alertness
Narcan 0.1 mg/kg IV/IM/ SC/ET q2-3 mim prn |
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Term
| What are the steps of placement of an epidural? |
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Definition
Local anesthetic (marcaine) and opioid (fentanyl)
Anesthesiologist inserts ito epidural space, into CSF if spinal
Sitting or side-lying
Insertion take 5-10-mins
Bolus given, then epid catheter is attached to a pump |
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Term
| What bloodwork is checked before epidural? |
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Definition
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Term
| What are the benefits of epidurals? |
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Definition
most effective way to alleviate or eliminate labor pain;
No change in level of consciousness
Muscular relaxation may result in labor progress
Vaginal delivery or c/s—used in both procedures |
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Term
| What are the disadvantages of an epidural? |
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Definition
Limited mobility (numbness, IV, monitoring)
Maternal hypotension
Urinary retension (catheter)
Restriction of PO intacke
Discomfort—shaking, itching, thirst/hunger
Postpartum soreness at insertion site
Longer labor
More pitocin
Increased likelyhood of vaccum/forceps delivery
Fever
Fetal distress
:bloody tap”
Spinal headache
Postpartum parastesias |
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Term
| What type of epidural is given in the 1st stage of labor |
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Definition
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Term
| What type of epidural is given in the 2nd stage of labor? |
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Definition
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