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NUR 106 Test 2 CH13
NUR 106
| Question | Answer |
|---|---|
| Another word for labor.. | parturition |
| How many stages are there in labor? name them. | 4; stages I, II, II, IV |
| when does stage I start and end? | onset of labor and continues until full cervical dilation occurs |
| when does stage II start and end? | at the point of COMPLETE DILATION of the cervix. complete when the fetus is expelled |
| how long does stage I usually last? | typically lasting 12hrs for primigravidas; 8hrs for multigravidas |
| how long does stage II usually last? | usually lasts 50 mins - 2hrs for primigravidas; 20mins multigravidas |
| when does stage III begin and end? | with the delivery of the fetus and ends with delivery of the placenta AND membranes |
| how long does stage III usually last? | within 8-10 mins of delivery of the neonate |
| when does stage IV begin and end? | begins when placenta and membranes are delivered and is complete 4 HOURS LATER!!!! |
| factors that effect the onset of labor are.. | progesterone withdrawal or binding, increased estrogen levels, prostaglandins, and oxytocin sensitivity |
| fetal factors that are believed to have a part in onset of labor | cortisol levels |
| what are the primary hormones involved in initiation of labor (4) | estrogen, progesterone, prostaglandins, and oxytocin |
| what hormone is believed to relax the myometrium | progesterone |
| what hormone is believed to stimulate myometrial contractions? | estrogen |
| what gland produces oxytocin? | posterior pituitary |
| what hormone plays a role in the onset and maintenance of labor? | oxytocin |
| t/f oxytocin receptors in the utuerus increase creating increased sensitivity to oxytocis | TRUE |
| the most common type of female pelvis is the __________ pelvis. | gynecoid; found in 50% women |
| the least commmon type of female pelvis is which type? | platypelloid (3%) |
| which two pelvis shapes increase the likelihood of forceps and cesarean deliveries? | android and anthropoid (narrow arches) |
| What are the 5 P's of labor? | passageway, passanger, powers, position, psychologic response |
| which fontanel is diamond shaped? | anterior |
| which fontanel is triangular shaped? | posterior |
| when does the anterior fontanel close? | 18 months of age to allow brain growth |
| when does the posterior fontanel close? | 6-8 weeks after birth |
| what is the term used to describe overlapping of the fetal skull? | molding |
| what does molding help with during labor? | helps the fetal head to apadt to the size and shape of the maternal pelvis. (usually effects of molding of head usually resolve completely in 3 days) |
| station refers to the relationship btw what two things? | ischial spines in PASSAGE and the presenting part of the FETUS |
| what fetal factors ease the passage thru the pelvis? | head size, presentation, lie and position |
| what is fetal presentation? | anatomical part of the fetus that is either in or closest to the birth canal |
| how do you determine fetal presentation? | by performing a vaginal examination and feeling the part through the cervix |
| what are the three major presentations? | cephalic/fetal head (leads to vag birth), breech or buttock (3% of births), shoulder presentation (1%) |
| what is fetal lie? | describes the relationship of the fetal long (head to foot) axis to that of the maternal long axis/spinal cord. |
| what is the lie in breech or cephalic presentation.. | lie is longitudinal |
| what is the lie in shoulder presentation.. | lie is transverse (vag birth unlikely) |
| head presentation comes in what three ways? | vertex, sinciput, and brow. easiest to pass is vertex (mostly flexed) |
| what is the relationship of fetal body parts to one another? | fetal attitude. |
| sinciput and brow presentation present as a ____ diameter to pass through the maternal pelvis and thus increases the difficulty of labor and delivery | larger. |
| this refers to the relationship of the fetal presenting part to the left or right side of the maternal pelvis | fetal position |
| how do you determine presentation and position of the fetus? | leopold's maneuver or thru vaginal examination. |
| primary powers are... | the involuntary uterine contractions |
| secondary powers are... | the mother's intentional efforts to push out the fetus |
| uterine contractions are measured by __, __, and___. | frequency, duration, and intensity |
| frequency of a contraction is measured from ... | the beginning of one contraction to the beginning of the next contraction. |
| the duration/length of the contraction is... | how long it lasts in seconds |
| the intensity is evaluated, how? | by external palpation of the firmness of the uterus and the level of pain perceived by the client. |
| define effacement. | shortening and thinning of the cervix |
| define cervical dilation. | widening of the cervical opening |
| what is the most comfortable position and best for the fetal well-being particularly during the first stage of labor? | lateral recumbent position |
| the process by which a woman acquires knowledge of maternal behavior that aids in transforming her maternal identity | maternal role attainment |
| what do you call the movement of the presenting part of the fetus into the true pelvis? | lightening |
| lightening usually occurs about ___ weeks before the onset of labor, in primigravidas | two |
| Where are braxton hicks contractions usually felt? | in front of the abdomen. true labor pain is felt in the lower back. |
| What is the correct term for the mucous plug? | bloody show. . . labor usually ensues within 24 to 48 hours of expelling the mucous plug |
| what are the three phases in the first stage of labor? | latent, active, and transition |
| describe latent phase | contractions mild to moderate every 15-20 mins apart progressing to 5-7 mins, 15-20 secs progressing to 30-40 secs. dilation 0-3 cm. lasts 8-10hr (primig) or 5hr (multigr) |
| describe active phase | contractions moderate to strong every 2-3 min, lasting up to 60 secs. dilation 4-7 cm. 6hr (primig) or 4hr (multig) |
| describe transition phase | contractions every 2-3 mins, lasting 60-90 secs, dilation 8-10 cm. 2hr (primig) or 1hr (multig). at this stage the nurse must prepare the woman for second stage of labor!! |
| describe the second stage of labor.. | the "pushing stage" when the cervix is completely dilated and effaced, ends when fetus is expelled. influences: maternal parity, fetal size, uterine contractile force, presentation, position, pelvic size, method of anesthesia, & maternal expulsive effort |
| define crowning | point at which the fetal head is visible at the vulvar opening |
| the most common position for labor | lithotomy. |
| Name the cardinal movements or mechanism of labor | Engagement Descent Flexion Internal Rotation Extension External Rotation Expulsion |
| Signs of placental separation: | a. The uterus becomes globular in shape and firmer. b. The uterus rises in the abdomen. c. The umbilical cord descends three (3) inches or more further out of the vagina. d. Sudden gush of blood. |
| what hormone produces milk? | prolactin |
| in the fourth stage, what occurs to the woman's vital signs? | bc of the blood loss and return of a more normal adbominal anatormy as the uterus returns to a normal size (involution) -- there is a decrease in blood pressure and slight tachycardia. fundus midline and level at umbilicus. |
| reasons for labor induction.. | postterm gestation, PIH, diabetes mellitus, intrauterine growth restriction, intrauterine fetal demise, and other. some women chose this for convenience. |
| when would you NOT induce labor? | placenta previa, transverse fetal lie, prolapsed umbilical cord, previous classical uterine incision scar, and active herpes |
| why is amniotomy (artificial rupture of membranes) often used in conjuction with oxytocin? | bc the longer the membranes have been ruptured, the greater the possibility of INFECTION |
| indications for a cesarean section | dystocia (failure of labor to progress), repeat c section, breech presentation, and fetal distress. risk for uterine rupture increases dramatically after vertical uterine incision so contraindicated for vag delivery |
| hemoglobin values: nonpreg versus preg | from 12-16 g/dl to 11-14 g/dl (lowers while preg) |
| hematocrit values: nonpreg versus preg | from 37-47% to 32-42% (lowers) |
| lnterventions when the fetus is intolerant of labor.. | repositoin the client to side-lying position, turn off oxytocin infusion, increase mainline IV, admin. o2 per facemask at 8-10 L/min, performing a vag exam to evaluate for umbilical cord prolapse, notify care provider,prepare 2 admin. terbutaline (brethin |
Created by:
Sarahmarie001
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