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Stack #4042915
| Question | Answer |
|---|---|
| what are the Four P's of labor? | Passageway,Passenger,Powers ,Psyche |
| Passageway | The passageway consists of the woman's bony pelvis and the soft tissues of the cervix and vagina. |
| False pelvis | Flared upper portion of the bony pelvis(hips). |
| True pelvis | Bony passageway through which the fetus must pass during delivery. Consists of pelvic inlet and outlet. |
| Gynecoid Pelvis | Most favorable for vaginal birth. Rounded shape. |
| Anthropoid pelvis | Elongated in its dimensions. diameter is roomy, but narrow compared to gynecoid pelvis- can prevent vaginal delivery in some women. |
| Android Pelvis | Heart shaped- Large babies often become stuck in birth canal and must be delivered by cesarean, where as a smaller baby may be able to navigate the narrow diameters of the pelvis. |
| Platypelloid Pelvis | Least common type- flat in it's dimensions with a very narrow diameter. the shape make is extremely difficult for the fetus to pass through the bony pelvis. Must deliver the fetus by c section |
| Cervix | Firm, long and closed and measures approximately 2cm in length. Gets shorter and thinner during labor through effacement. |
| Effacement | Thinning and shortening of the cervix |
| Dilation | Opening of the cervix for the fetus to be born-measured in centimeters. Measures at 10cm when completely dilated |
| Vaginal Canal | Participates in childbirth via passive distention. |
| Passenger | Refers to the fetus. |
| Fetal Skull | Most important fetal structure because it is the largest compressible structure. Small and not completely rigid. |
| Skull molding | The cartilage between the bones allows bones to overlap during labor, elongates the fetal skull |
| Fetal Lie | Describes the position of the long axis of the fetus in relation to the long axis of the pregnant woman |
| Longitudinal | Long axis(spine) of the fetus is parallel to the long axis(spine) of the mother. Most common. Head first |
| Transverse | Long axis(spine) of the fetus is perpendicular to the long axis(spine) of the woman. Sideways |
| Oblique | In between a transverse and longitudinal lie |
| Fetal Presentation | Refers to the foremost part of the fetus that enters the pelvic inlet. |
| Cephalic presentation | Head presents- most common |
| Breech presentation | Feet or Buttocks present- occur in 3-4% of term pregnancies. |
| Shoulder presentation | Shoulder presents-least common less than 0.3%- associated with transverse lie. |
| Fetal Attitude | Relationship of the fetal parts to one another. |
| Flexion or vertex attitude | Most common attitude, and the one most favorable for a vaginal birth also called a vertex presentation. |
| Military attitude | Fetus is neither flexed or hyperextended. |
| Frontum attitude | Neck is partially extended, the brow becomes the presenting part. |
| Fetal position | Determined by the presenting part of the fetus |
| Fetal Station | Refers to the relationship of the presenting part of the fetus to the ischial spines of the pelvis. |
| Station 0 | Widest diameter of the presenting part is at the level of ischial spines. Baby is engaged |
| vertex position | Occiput presents |
| Brow position | Frontum presents |
| Face position | Mentum (chin) presents |
| Breech position | Sacrum presents |
| Shoulder Breech | Scapula (acromial process) presents |
| station -4 and higher | Baby is unengaged |
| First Designation | refers to the side of the maternal pelvis in which the presenting part is found R:Right L:Left |
| second designation | reference point on the presenting part |
| Occiput(O) | vertex and military presentations |
| Frontum or brow(Fr) | brow presentation |
| Mentum or chin(M) | face presentation |
| Sacrum(S) | breech presentation |
| Scapula(Sc) | shoulder presentation |
| Third designation | Refers to front, back, or side of maternal pelvis in which the reference point is found. |
| Anterior(A) | front of pelvis |
| Posterior(P) | back of the pelvis |
| Transverse(T) | Side of the pelvis. |
| Powers(Primary) | Primary force of labor comes from involuntary muscular contractions of the uterus. |
| Powers(Secondary) | Voluntary muscle contractions of the maternal abdomen during 2nd stage of labor. |
| Psyche | Psychological state of the laboring woman |
| Anticipatory signs of labor | Approximately 2 weeks before labor- lightening, braxton hicks, diarrhea, heartburn, nausea, vomiting, mucus plug expelled- clear or pink tinged jelly like discharge, burst of energy 24-48 hours before labor. |
| Clinical Signs of labor | Effacement of the cervix(thinning) rippening of the cervix(Softening), dilation of the cervix. |
| Cervical changes in true labor | Progresive dilation and effacement |
| Cervical changes in false labor | None |
| Membranes in true labor | May bulge or rupture spontaneously |
| membranes in false labor | remain intact |
| Bloody show in true labor | Present |
| Bloody show in false labor | Absent; may expel mucus plug, may have pinkish mucus |
| Contraction pattern in true labor | Regular(may be irregular at first) develops in which contractions become increasingly intense and more frequent |
| contraction pattern false labor | Pattern tends to be irregular, although the contractions may have a regular pattern for a time. |
| Pain in true labor | Often starts in the small of their back and radiates to lower abdomen; may begin with cramping sensation. |
| pain in false labor | May be described as a tightening sensation; usually the discomfort is confined to the abdomen |
| Effects of walking in true labor | Contractions continue and become stronger |
| Effects of walking in false labor | may decrease the frequency or eliminate the contractions all together. |
| First stage-Dilation | Onset of true labor through full dilation of cervix at 10cm |
| Early Labor-Latent phase | Contractions of true labor through dilation of cervix to 4cm frequency-5-10mins duration-30-45sec contractions may be irregular |
| Active Labor-Active phase | Cervical dilation of 4cm to 8cm frequency-3-5min duration-40-60sec contractions are regular |
| Transitional phase | Most difficult-woman must resist urge to push cervical dilation of 8cm to 10cm frequency-2-3mins duration-60-90sec |
| Second Stage-Birth | Complete cervical dilation 10cm frequency-2-5mins duration-60-90sec |
| third stage-delivery of the placenta | contractions-variable-gush of blood |
| fourth stage-recovery | afterpains-variable |
| Fetal Ph >7.25 | Reassuring associated with normal acid-base balance |
| Fetal Ph between 7.20 and 7.25 | Worrisome May be associated with metabolic acidosis |
| Fetal Ph <7.20 | Critical represents metabolic acidosis |
| <7 | Damaging Frequently associated with fetal neurologic damage |
Created by:
AlijahG7