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M&B test 3
| Question | Answer |
|---|---|
| Physiologic primary force of labor is | uterine muscular contractions. |
| Physiologic secondary force of labor is | use of abdominal muscles to push during second stage of labor. |
| When pushing...Dont to soon can risk | ripping of cervix (if not complete), more swelling, and exhaustion! |
| Progesterone causes | relaxation of smooth muscle tissue |
| Estrogen causes | stimulation of uterine muscle contradiction. |
| connective tissue loosens | and permits softening, thinning, opening of cervix |
| Psychosocial considerations for a woman giving birth | Understanding and preparing for childbirth experience, Amount of support from others, present emotional status, Beliefs and values. |
| Physical things to look at from stress of labor (Mom) | Respiratory Alkalosis from hyperventillating |
| Physical things to look at from stress of labor (baby) | acidotic less than plt 7.25. |
| The more times you check mom | more risk of infection |
| Thinning of Cervix is called | Effacement |
| Effacement | Muscles of upper uterine segment shorten and cause cervix to thin and flatten. Fetal body straightened as uterus elongates with each contraction. |
| If cervix is thick, long and hard | not going to deliver. |
| Contraction | Pressure of fetal head causes cervical dilation and thin out cervix, rectum and vagina are drawn upward and forward with each contraction, During second stage, anus everts |
| lightening | Fetus descends into pelvic inlet |
| Braxton hicks contractions | Irregular, intermittent contractions that occur during pregnancy, cause more discomfort closer to onset of labor. |
| cervical changes | cervix begins to soften and weaken (ripening) |
| Bloody show | loss of cervical mucous plug, cause blood-tinged discharge (never dismiss it! look at volume and circumstance surrounding) |
| Check for rupture | nitrozene paper - turns blue (amnionic fluid), Best test Speculum test, Fern test, Diffinative slide test shows ferning under microscope |
| nesting | Sudden burst of energy, usually occurs 24-48 hours before onset of labor. |
| Rupture of membranes | If rupture prior to onset of labor, good chance labor will begin within 24 hours. ( risk of infection or preterm labor and or/ delivery) |
| Premonitory signs of labor | loss of 1 to 3 pounds, Diarrhea, indigestion, nausea, vomiting may occur prior to onset of labor. |
| True labor characterized by | Contractions at regular intervals- increase in duration and intensity |
| Cardinal Movements in Delivery | Decent, flexion, Internal Rotation, Extension, Restitution, Expulsion |
| Decent | The head enters the pelvic inlet in the occiput, transverse or oblique position because the inlet is widest from side to side. |
| In Decent...present in 3 ways | Occiput, transverse, oblique |
| Four forces affecting decent | 1, pressure of amniotic fluid, 2, direct pressure of the uterine fundus on the breech, 3, contraction of abdominal muscles, 4, extennsion and strengthening of the fetal body. |
| Flexion | fetal chin flexes downward onto the chest |
| Internal Rotation | Head rotates inside the pelvic cavity from left to right. |
| Extension | The occiput, then brow and face emerge from the vagina |
| Restitution | Shoulders enter pelvic inlet obliquely and remain oblique when the head rotates to the anteroposterior diameter thru internal rotation. |
| restitution | turning the head to one side, and aligns with position of the back in the birth canal. |
| Expulsion | The anterior shoulder quickly born before the posterior and the body quickly follows engagement. |
| Engagement | Presenting part occurs when largest diameter of presenting part reaches or passes thru pelvic inlet. |
| Engagement | can be determined by a sterile vaginal exam (to see if baby is blottable) |
| Engagement | Confirms adequacy of pelvic inlet (does not indicate whether the mid pelvis and outlet are adequate) |
| Engagement | Usually occurs a couple weeks before term. |
| Once head is engaged | there is a less chance of cord prolapse. |
| station | relationship of presenting part to an imaginary line drawn between the ischial spines of the maternal pelvis, the ischial spines are 0 station, if presenting part is higher -, if below + number. |
| fetal postiion | Refers to the relationship of a designated landmark on the presenting fetal part to the front, sides or back of the maternal pelvis. |
| Lightening | moving of the fetus and uterus downward into the pelvic cavity |
| hyperventalation | numbness tingling in fingers or lips give paper bag to breathing. Imbalance o2 and co2...too much 02, shallow breaths, slow breathing, count out loud.. need more co2 in |
| Pushing | Woman uses intra-abdominal pressure, Perineum begins to bulge, flatten and move anteriorally, bloody show may increase, labia begin to part with each contraction. |
| Crowning | fetal head is encircled by the external opening of the vagina, birth is imminent |
| Frequency (Contraction) | The time between the beginning of one contraction to the beginning of the next contraction |
| Duration (Contraction) | The beginning of a contraction to the completion of that same contraction. |
| if cervix is not completely dilated (10cm), bearing down (pushing) can cause | cervical edema, possible tearing and bruising of the cervix and maternal exhaustion |
| Intensity (contraction) | Refers to the strength of the contraction during acme. |
| Acme | Peak of contraction |
| Intensity can be estimated | by palpating the uterine fundus during a contraction.by judging the amount of indentablility of the uterine wall during acme of a contraction. |
| intensity can be measured | by an intrauterine catherter. |
| Fetal response to labor | heart rate may decrease as head pushes against cervix |
| Fetal response to labor | Decrease in pH due to decreased blood flow at peak of each contraction |
| Fetal response to labor | Further decrease of ph occurs during pushing due to woman holding her breathe. |
| Fetal postition | Refers to the relationship of a designed landmark on the presenting fetal part to the front, sides or back of the maternal pelvis. |
| 1st postition | right or left of the maternal pelvis |
| 2nd position | Fetal presenting part: Occiput (O), mentum(M) which is the face, and sacrum (S), acromion process (A) |
| 3rd position | Anterior (A), posterior (P) or transverse (T) (front, back or side of the pelvis) |
| Most common position.. safe for delivery | LOA, ROA |
| If baby position is posterior | really hard to get out (c-section) |
| Fetal lie | Relationship of spine of baby...want longitudinal lie (up & down) or transverse lie (side ways)...move baby or c-section. |
| effacement | thinning of the cervix based on a subjective percentage determined with a sterile vag exam. 100% fully effaced. |
| First Stage | Begins with onset of true labor and ends when the cervix is dialated to 10cm, |
Created by:
CHARLIA
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