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Intrapartum:
Labor and birth processes, pain management
| Question | Answer |
|---|---|
| What is passenger? | fetus and placenta |
| What is passenger lie? | relationship of maternal spine to fetal spine (can be transverse or parallel). |
| What is fetal attitude? | relationship of fetal body parts to one another (can be flexion or extension). |
| What is fetal presentation? | the fetal part entering the pelvic first (can be occiput, mentum, scapula, or sacrum). |
| What is the most favorable fetal position for delivery? | LOA |
| What is fetal station? | measurement of fetal decent in cm. |
| What is passageway? | the birth canal |
| What is powers? | forces of labor: uterine contractions (leading to effacement and dilation), urge to push, bearing down |
| What is a tocotransducer? | Transducer on abdomen over fundus to measure contractions. |
| What is IUPC? | Intrauterine pressure catheter: vaginally inserted in dilated cervix and ROM to monitor contraction pressure. |
| What are assessments for contractions? | frequency, duration, intensity, and resting tone of contractions. |
| What are characteristics of true labor contractions? | - regular frequency - stronger, last longer, more frequent - felt in lower back, radiating to abd. - walking can increase contraction intensity |
| What are characteristics of false labor contractions? | - painless, irregular frequency, intermittent - decrease with walking or position change - felt in lower back, upper abdomen |
| What are cervical changes during labor? | - effacement and dilation - moves to anterior position - bloody show |
| What are physio changes preceding labor? | Lightening, backache, contractions, bloody show, weight loss, energy burst, GI changes, ROM |
| What are assessments for amniotic fluid? | color, clarity, odor, volume |
| What does nitrazine paper test for? | Test for amniotic fluid: blue is positive. |
| What is fetal engagement? | When presenting part is at level of ischial spine: station 0 |
| What are three phases of first stage of labor? | 1. Latent 2. Active 3. Transition |
| Describe latent phase. | - cervix 0-3 cm dilated - irregular, mild-mod. contractions - frequency 5-30 min, 30-45 sec. duration - mother is talkative and eager |
| Describe active phase. | - cervix 4-7 cm dilated - regular, mod-strong contractions - frequency 3-5 min, 40-70 sec. duration - anxiety and restlessness |
| Describe transition phase. | - cervix 8-10 cm dilated - strong-very strong contractions - frequency 2-3 min, 45-90 sec. duration - tired, restless, irritable - most difficult part of labor |
| Describe second stage of labor. | - full dilation - intense contractions q 1-2 min - pushing results in fetus birth |
| Describe third stage of labor. | - delivery of placenta |
| Describe fourth stage of labor. | - 1-4 hr postpartum - maternal stabilization of VS |
| What is gate-control theory of pain? | concept that the sensory never pathways that pain sensations use to travel to the brain will only allow a limited # of sensations to travel at any given time. |
| When are sedatives used during labor? | Can only be used during early or latent phase of labor to relieve anxiety and induce sleep. |
| What is pudendal block? | Local anesthesia to perineum. |
| What is epidural block? | Local anesthesia into epidural space that blocks sensation from umbilicus to thigh. Given in active labor with > 3 cm dilation. |
| What is spinal block? | Local anesthesia into subarachnoid space that blocks sensation from nipples to feet. Usually for c-section. |
| What are the interventions to relieve postpartum headache from cerebrospinal fluid leak from spinal anesthesia? | pt in supine position, bedrest, pain management, fluids. |
| What is the most important nursing intervention to monitor for pt in labor with an epidural? | maternal hypotension |
Created by:
odbal24
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