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If your not sure what answer should be entered, press the space bar and the next missing letter will be displayed. When you are all done, you should look back over all your answers and review the ones in red. These ones in red are the ones which you needed help on. Question: The false pelvis is the wide are between iliac crest; supports weight of enlarged uterus & what else?Answer: Guides fetus into the true Question: What pelivs is the lower part of the pelvis at the level of the linea terminalis & consist of parts?Answer: True Question: The parts of the true pelvis?Answer: Inlet-Upper border allows fetal Head 2 easily navigate through it. WIDEST DIAMETER: TRANSVERSE & NARROWEST DIAMETER:A-P. -Narrowest part which fetus must pass during birth. Outlet-Lower border, WIDEST DIAMETER; A&P & NARROWEST DIAMETER:TRANSVERSE Question: ** What is the android ?Answer: Typical male pelvis with dimensions. Heart shaped & not favorable for vaginal birth. Found in 20% of women. Question: ** What is the Anthropoid ?Answer: Narrowed from side to side & from front to back. Adequate for L&D & found in 25% of women Question: ** What is the pelvis?Answer: Typical female pelvis; adequate for vaginal delivery. in 50% of women. Question: What is the platypelloid ?Answer: Flattened(narrowed) from front to back & widened from side to side. Not for vaginal birth & found in 5% of women Question: What is ?Answer: Sutures & fontanelles allow the bones to move slightly; the shape of the fetal head so that it can adapt to the size and shape of the pelvis. Question: What are the landmarks that the head is divided into?Answer: Mentum-chin; Glabella-bridge of the nose; -brow; Bregma-anterior fontanelle; Vertex-top of head between the anterior & posterior fontanelles; Occiput-back of the head over the occipital bone. Question: **What is the lie?Answer: Relationship of the long axis(spine) of the to the long axis of the mother. Question: If the fetal lie is "Longitudinal" to mother; how is the positioned?Answer: LOng axis of the fetus to the mother is parallel; vertex or presentation. Question: If the fetal lie is "trasverse" to ; how is the fetus positioned?Answer: Long axis of fetus to the mother is perpendicular; shoulder Question: What is the attitude?Answer: relationship of the body parts (chest, chin, arms) to each other. Question: With fetal ; its said the fetus is in flexion; what does that mean?Answer: Complete state of flexion; smallest diameter of fetal head to go maternal pelvis. Question: With fetal attitude; its said the is in Extension; what does that mean?Answer: Complete state of ; largest diameter of fetal head to go through maternal pelvis; LESS LIKELY TO BE DELIVERED BY VAGINAL DELIVERY. Question: What is fetal ?Answer: (or presenting part): Part of fetus that enters the pelvic inlet first and through the birth canal during labor. Question: Fetal presentation is in categories; what are they?Answer: Vertex-Top of head, head completely flexed onto chest, OCCIPUT is presenting part; Millitary-Head nor flexed or extension, eyes straight ahead, top of head presenting; Brow-slight extension, presenting; Face-Head is hyperextended,face presenting Question: What is breech?Answer: The buttocks/feet present Question: What is considered breech?Answer: Legs are flexed at the hips, & legs are extended against the abdomen & chest busttocks is presenting parts Question: What is considered or Full" Breech?Answer: Legs are flexed up on the abdomen & knees are flexed, buttocks and feet are the presenting part. Question: What is "Single or Double Footling"?Answer: One or two legs are extended down; feet are the first Question: What is the same as Shoulder ?Answer: Transverese lie; Can NEVER be a vaginal Question: **What is the ?Answer: Measures degree of DESCENT of the presenting part of the through the birth canal. Question: How are the expressed?Answer: In terms of centimeters of the ischial spines of the maternal . Question: What is the if the baby is high in the pelvis?Answer: -5 to Question: The level 0 is at the of what?Answer: spines Question: At what is +1, +2, +3, +4?Answer: at the pelvic outlet, +5 fetal presenting below ischial Question: At what is -5, -4, -3, -2, -1?Answer: Fetal presenting part the ischial spines; -5 at the pelvic outlet Question: During labor, the presenting part should move progressively from the _______stations to the midpelvis at zero station & into the ______ stations.Answer: From negative to the stations Question: What is by "Floating or Ballottable"?Answer: Presenting part is freely movable above inlet, in false . "Like a balloon if you tap the bottom of it; it will float up" Question: What is ?Answer: The largest diameter of the part reaches or passes through the pelvic inlet. Question: is said to be engaged when the biparietal diameter of the fetal head reaches what?Answer: The level of the spines. Question: happens in a primigravida when?Answer: Often occurs approx. 2wks before labor Question: Engagement happens in a when?Answer: May not occur until labor . Question: With fetal ; what does ROA mean?Answer: Right occiput Anterior; So the occiput of babies head is against mom's side of pelvis & babies spine in relation to mom's spine is Anterior. Question: What does LOA mean?Answer: Left occiput Anterior; So the occiput of babies head is mom's left side of pelvis & babies spine in relation to mom's spine is posterior. Question: what does RMA mean?Answer: Right mentum Anterior; So the chin is against mom's right side of pelvis & chin facing anterior. Question: What does LMP mean?Answer: Left posterior; So the babies chin is against mom's left side of pelvis & chin facing posterior.(Chin facing mom's spine) Question: What does RSA mean?Answer: Its in a breech position against mom's right side of pelvis & buttocks is facing . (face of baby towards mom's spine) Question: What does LSP mean?Answer: Its in a breech position against mom's left side of pelvis & buttocks is posteriorly. (spine of baby is towards mom's spine) Question: What presentation is it if it's (O), Mentum(M), Sacrum(S), & Accordion(A)?Answer: O-Vertex, M-Face, S-Breech, A-Shoulder Question: of the fetal heart tones; best heard where?Answer: the fetal back or chest. Question: What are ?Answer: Involuntary, rhythmic,& intermittent tightening of the muscles during labor.(Primary Force) Question: What is the purpose of ?Answer: Accomplishes effacement & dilation of the cervix & facilitates descent through the pelvis. Question: What are the three phases of ?Answer: Increment-Period during which the of ctx increases; Acme-Peak:during which ctx is most intense; Decrement-Decrease in intensity as uterus relaxes Question: ** Between contractions, uterin muscles need to rest to restore UTEROPLACENTAL CIRCULATION for fetal oxygenation & adequate circulation in the uterine blood vessles. How long should it be ctx?Answer: Need to have at LEAST 60 second resting interval between ctx; resting period shorter as labor progresses Question: What is tone?Answer: The tension in the muscle during the interval between ctx Question: What is ?Answer: Time between the beginning of one ctx to the beginning of the next ctx(expressed in ) Question: What is ?Answer: Time betwen the beginning to the end of the ctx(expressed in seconds)"How long the ctx Question: What is ?Answer: Strength of ctx. (Mild, , strong) Question: What is the secondary ?Answer: Urge to Push; when the part reaches the pelvic floor---woman experiences an involuntary urge to push. Question: The secondary aids in expulsion of the fetus. The woman contracts?Answer: Her diaphragm & abdominal & pushes the baby out. Question: What is Activity?Answer: Development of the upper & lower segments. Question: Upper segment of the uterus does what and with what?Answer: Becomes active & thicker as labor progresses--exert strength to fetus downward. Question: segment of the uterus does what & helps with what?Answer: Becomes thin-walled & passive--fetus can be pushed out of uterus . Question: What is ?Answer: Softening, thinning & shortening of the cervical canal until it is assimilated in the lower uterine segment. Question: During effacement the cervix changes from____,_____ structure to one that is ____-____.Answer: Long, to paper-thin Question: How is the progress of expressed?Answer: In of percentages (0-100%). Question: What is ? Answer: of cervical opening and cervical canal from <1cm to 10cm. Question: When does E&D take concurrently?Answer: For a multigravida . Question: What happens for a in relation to E&D?Answer: E-50% befor starts; D-take longer b/c cervical tissues have not been streched before Question: The : 5/90/+1; what does that mean?Answer: Dilated-5cm, Effacement-90%, & +1 (its below the ischial spines. Question: When does the first stage of labor ?Answer: Begins with the of true labor & ends with complete dilation of cervix Question: There are three phases of ; first phase is the latent phase; describe?Answer: begins with the initiation of regular ctx & is completed when the cervix is 3 cm. Question: What is the dilation range in the phase?Answer: 0-3cm Question: How long does it take a to get to the latent & how long for a multipara?Answer: - 8.6 hours; Multipara- 5.3 hours Question: What is the , duration, & intensity of ctx in the latent phase?Answer: F- q10-30 mins & progresses to 5-7mins; D- approx. 30-40 secs; I- mild to . Question: What is the 's behavior like in the Latent phase?Answer: happy, talkative, eager to be in labor, independence by taking care of own bodily needs & seeks info Question: What are some nursing care latent phase?Answer: when mom & partner gets there greet them, them to environment; reinforce breathing & coping skills; If NO contraindications: encourage walking Question: What is the phase?Answer: @ 4cm dilation & ends at 7cm. Question: How long does it take a & multipara to reach the active phase?Answer: N- 4.6hrs; M- 2.4 Question: What is the frequency, , & intensity of ctx in the active phase?Answer: F- q2-3 mins; D- approx. 40-60 secs; I- -strong. Question: ** In the active phase what is the cervical like?Answer: -1.2cm/hr; Multipara- 1.5cm/hr Question: What is the woman's like in the active phase?Answer: May feel helpless, increase fatigue, restless, more dependent, very & anxious Question: What are some nursing care for a woman in phase?Answer: Provide general care-linen or underpad , cool washcloths, back rubs, ice chips; Encourage freq position changes(left side best)q30mins;observe bladder-void q2hrs, encourage & reassure mom, Support Question: When mom on side what does that help with?Answer: placental perfussion & helps with fetal descent. Question: The third phase is ; what does the cervix look like in this phase?Answer: Cervix is 8-10cm Question: How long does it take a & multipara to get to the transitional phase?Answer: N- 3.6hrs; M- minutes to . Question: What is the frequency, duration, & intensity of ctx in the phase?Answer: F- q1.5-2 mins; D- . 60-90 secs; I- strong. Question: ** What is the fetal descent in the phase?Answer: - 1cm/hr; Multipara- 2cm/hr Question: How is the woman's in the transitional phase?Answer: Very tired & irritable, may feel she can't keep up with labor & is out of , fear of being left alone, may fear tearing open or splitting apart with ctx, N&V r/t ^inner abdomnial pressure Question: What are some nursing care for women in the phase?Answer: Provide general comfort needs, breathing techniques, observe for signs of 2nd stage of labor: grunting, bearing down, stating "baby is coming" or need to Question: Maternal-fetal during 1st stage of labor?Answer: V/S-B/P MUST be taken between ctx, Temp is an indicator of hydration & infection-q4hrs until bag broken then q2 after; Pulse ^ is normal but >100 may indicate stess, RR may increase or decrease due to type of breating; EFM-assess duration, intensity, Question: What with GI in the 1st stage of labor?Answer: Gas motility & absorption of solid food ; gastric emptying time is prolonged Question: ** How can GBS infection be prevented?Answer: All pregnant women be screened for GBS at 35-37wks of pregnancy. Question: ** What does SROM mean?Answer: Spontaneous Rupture Of Membranes; be a gush or trickle Question: ** what does AROM mean?Answer: Artificial Rupture Of Memabranes; be a gush or trickle Question: ** Once Membranes are ruptured; what is the priority ?Answer: Check fetal heart !! Because the umbilical cord could come out & get compressed Question: What other assessment to do after the rupture of membranes?Answer: Observe color of fluid- should be clear! -green-yellowish soup looking could mean meconium is in fluid. Question: Why is meconium in a breech baby ?Answer: When is stressed- r/t relaxed anal spincter. Question: Progress of labor: as the ctx more frequent and intense, vaginal exams assess what?Answer: Dilation, , station & position Question: What is the 's Maneuvers?Answer: A systematic method of observation & abdominal palpation to determine fetal & position. Question: What does the maneuver help with?Answer: Helps determine fetal presentation. If palpate hard-head; soft & -butt Question: What does the maneuver help with?Answer: Helps determine position. Smooth, rounded-the back. Question: What does the third help with?Answer: Helps validate the part. Question: What does the maneuver help with?Answer: Helps fetal attitude. Question: What does the stage of labor begin with?Answer: Begins with complete of the cervix & ends with birth of the baby. Question: What is the freq, duration, & Intensity of ctx the second stage of labor?Answer: F-q1.5-2hrs; D-60-90secs; I-Strong & like Question: What is the time frame before giving birth for the second of labor for a nullipara & multipara?Answer: N- up to 3hours; M-<1hr. Avg 15 Question: What is cardinal of labor?Answer: For the fetus to pass through birth canal, the fetal head & body must to the passage by certain positional changes. Question: What is ?Answer: Continues downward movement of the fetus that is brought about by pressure of ctx. The head enters the inlet in occiput transverse or oblique position bc the pelvic is widest from side to side Question: Waht is ?Answer: Pressure from the pelvic causes fetal head to bend forward onto chest. Important bc it causes smalles diameter of fetal head to present to maternial pelvic. Question: What is internal ?Answer: A 45-90degree rotation of the fetal head from OT-OA or OP position. Must occur for the fetal head to pass through the narrowest transverse (biparietal) diameter of pelvis, & bring back of the neck symphysis pubis Question: What is ?Answer: As the passes under the symphsis pubis. it causes the head to exten and foremost parts of head are born. Question: What is ?Answer: Head is born in OA position & shoulders are transverse, with infants neck twisted--neck turns & realigns itself with its shoulders and spine Question: What is rotation?Answer: Fetal body rotates so that the shoulders are in A-P diameter of the maternal pelvis, which is the diameter of the outlet.Anterior shoulder is born under the symphsis pubis & posterior shoulder slides over the perineum. Question: What is ?Answer: The rest of the body is . Question: What does the third stage of labor with?Answer: Begins with the of the infant & ends with delivery of the placenta. Question: ** care during third stage of labor?Answer: ** Have pitocin prepared & administer AFTER the placenta is delivered; observe for maternal blood loss & note firm contractions Question: What is considered the the fourth stage of ?Answer: 1-4 hours after the which the physiologic readjustment of the mother's body begins. Question: **What is nursing care during the stage?Answer: Focuses on for hemorrhage & relieving discomfort. Important to assess V/S, fundus, bladder, lochia. Question: During the 4th stage: maternal pulse 7/or falling B/P; often accompanied by low or no urine output could mean what?Answer: An early sign of hypovolemia caused by excessive blood loss(visible or ). Question: A soft boggy could mean what?Answer: A poorly contracted uterus does not adquate compress large open vessels at the placental site, in hemorrhage. Question: High uterine , often displaced to one sideAnswer: Suggest a full bladder, which can with uterine contraction & result in hemorrhage. Question: Lochia exceeding one saturated perineal pad per hour 4th stage.Answer: Suggests ; however, perineal pads vary in their absorbency, and this must be considered. Question: Intense perineal or pain, poorly relieved with analgesicsAnswer: Hematoma,usually of vaginal wall or perinum; signs of hypovolemia may occur with blood loss into tissues. |
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