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Maternity Ch6 CCC105
Maternity Chapter 6 CCC PN 105
| Question | Answer |
|---|---|
| settings for childbirth | hospitals, freestanding birth centers, home |
| effect of contractions on cervix | efface (thinning) and dilate (opening) |
| phase of contractions | increment, peak, decrement |
| increment | period of increasing contraction strength |
| peak | period of greatest contraction strength |
| decrement | period of decreasing contraction strength |
| contraction frequency | time from beginning of one contraction until the beginning of the next contraction |
| contraction duration | time from the beginning of one contraction until the end of the same contraction |
| contraction intensity | approximate strength of the contraction |
| interval contraction | amount of time that uterus relaxes between contractions |
| mild contraction | fundus easily indented with fingertips |
| moderate contractions | fundus can be indented with fingertips but with difficulty |
| firm contractions | fundus cannot be readily indented with fingertips |
| contractions occurring more often than every ________ should be reported | 2 minutes |
| contractions longer than ____________ should be reported | 90 seconds |
| contraction intervals shorter than ____________ should be reported | 60 seconds |
| maternal pushing | occur in stage 2 labor to propel fetus downward through pelvis |
| Breech birth | baby exit mother feet first |
| Braxton Hicks contractions | false labor; irregular contractions relieved by walking or changing positions |
| signs of coming labor | Braxton hicks contractins, increased vaginal discharge, bloody show, rupture of membranes, energy spurt, weight loss |
| mechanisms of labor | descent, engagement, flexion, internal rotatin, extension, external rotation, expulsion |
| descent | level of presenting part of fetus in pelvis, described in stations |
| engagement | presenting part of fetus reaches level of ischial spines of maternal pelvis - occurs before onset of labor |
| flexion | fetal head flexed to pass most easily through pelvis, contractions increase fetal head flexion |
| internal rotation | as fetus is pushed down by contractions, shape of pelvis causes head to turn |
| extension | to properly naviate pelvis curve, fetal head pivots from flexion to extension until born |
| external rotation | head is born, and must realign with shoulders during birth; shoulders rotate within pelvis until aligned with maternal anteroposterior pelvis |
| expulsion | anterior shoulder and posterior shoulder born, quickly followed by remainder of body |
| true labor | refular contractions gradually developing into a regular pattern becoming more frequent and stronger causing effacement and dilation of cervix |
| when to go to hospital | contractions increasing in frequency/duration/intensity (every 5 min for 1 hr), ruptured membranes (water broke), bleeding (other than bloody show), decreased fetal movement, any other concern |
| fetal heart rate | 110-160 bpm |
| first stage of labor | dilation and effacement (4-6 hrs) |
| second stage of labor | expulsion of fetus (30 min-2 hrs) |
| third stage of labor | expulsion of placenta (5-30 min) |
| fourth stage of labor | recovery |
| nursing care after birth | observe for hemorrhage, promote comfort |
| why straight cath during labor | to prevent hemmorhage - full bladder can push uterus and interfere with contractions |
| first phase of infant care | first to 1 hour - in delivery room |
| second phase of infant care | 1-3 hrs - in transition nursery or postpartum unit |
| third phase of infant care | 2-12 hours - in postpartum unit or with mother |
| infant care phase one includes | maintain thermoregulation, maintain cardiorespiratory function, observe for urination/mecomium, identify parents, perform brief abnormality assessment, encourage breasfeeding |
| apgar scoring includes | heart rate, respiratory efford, muscle tone, reflex response, skin color |
| total apgar points | 2 each category, 10 total |
| average apgar score | done 1-5 min after birth, 8-9 is good, 10 is perfect; no special action required |
| apgar score 4-7 | infant needs gentle stimulation such as rubbing the back |
| apgar score 3 and under | infant needs active resuscitation and additional scoring sheet is added |
| newborn eye medications | arithromycin in eye; state law; prevents complications/blindness from gonorrhea and chlamydia |
| newborn vitamin k (aquamephyton) | help infant blood clotting immediately following birth |
Created by:
cmp12345
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