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Maternity Ch6 CCC105

Maternity Chapter 6 CCC PN 105

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