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BSN 346 Nrs Conc III
Labor and Birth Process
| Question | Answer |
|---|---|
| Q: What are the 4 main components of the birth process, also known as the 4Ps? | A: Power, Passage, Passenger, and Psyche. |
| Q: What does "power" refer to in the context of childbirth? | refers to uterine contractions and maternal pushing efforts during labor. |
| Q: What is the primary force that causes cervical dilation and effacement during labor? | A: Involuntary uterine contractions. |
| Q: What triggers the urge to push during labor? | A: The descending fetus puts pressure on the vaginal wall and rectum, triggering the urge to push. |
| Q: What does "passage" refer to in the birth process? | A: Passage refers to the maternal pelvis and soft tissues, including the cervix, through which the baby passes during labor. |
| Q: What happens to the cervix during labor? | A: The cervix dilates (widens) and effaces (thins) to allow the fetal head to pass through more easily. |
| Q: How is the maternal pelvis divided? | A: By the pelvic brim into the upper (false) pelvis and lower (true) pelvis. |
| Q: What are the three parts of the true pelvis? | A: The pelvic inlet (above), pelvic cavity (middle), and pelvic outlet (below). |
| Q: What is the symphysis pubis, and what hormone affects it during pregnancy? | cartilage connecting the right and left sides of the pelvis; relaxin softens it during pregnancy to widen for childbirth. |
| Q: Name the four pelvic shapes and their characteristics. | Gynecoid: wider, more open Android: narrower Anthropoid: narrow and elongated Platypelloid: wide but shallow |
| Q: What is cephalopelvic disproportion? | A: A complication where the fetal head is too large or the pelvic opening is too small, making passage difficult. |
| Q: What does "passenger" refer to in childbirth? | A: The fetus, fetal membranes, and placenta. |
| Q: What are the key fetal components that influence childbirth? | A: Fetal head, fetal lie, fetal attitude, fetal presentation, and fetal position. |
| Q: What allows the fetal skull to adapt to the maternal pelvis during birth? | A: Skull bones connected by sutures and fontanelles, allowing moulding. |
| Q: What is the typical fetal lie? | A: Longitudinal, where the fetal long axis is parallel to the maternal long axis. |
| Q: What is fetal attitude, and what is the normal attitude? | A: The relation of fetal body parts to each other; normal is flexion (head to chest, arms and legs flexed, back curved). |
| Q: What is fetal presentation? | A: The part of the fetus that first enters the maternal pelvis. |
| Q: What is the most common fetal presentation? | A: Cephalic (head first), usually in the vertex (flexed) position. |
| Q: Name the variants of cephalic presentation. | A: Vertex (flexed), military (neutral), brow (partially extended), and face (extended). |
| Q: What is breech presentation, and what are its types? | When the buttocks or legs present first. Types: Frank breech (legs extended to shoulders) Footling breech (one or both feet first) Complete breech (head, knees, hips flexed; buttocks first) |
| Q: What is fetal position? | A: The location of a fetal reference point on the presenting part in relation to the four quadrants of the maternal pelvis. |
| Q: How is fetal position described? | With three letters: First: R (right) or L (left) of maternal pelvis Second: Reference point (e.g., O for occiput in vertex presentation) Third: A (anterior), P (posterior), or T (transverse) quadrant |
| Q: What does the fetal position "LOA" stand for? | A: Left Occiput Anterior: presenting part to the left, occiput reference point, anterior quadrant. |
| Q: What does "psyche" refer to in the birth process? | A: The client’s psychological response to labor and birth. |
| Q: What factors influence the psyche during childbirth? | A: Anxiety, culture, expectations, current pregnancy experience, previous birth experiences, and available support. |
| The True Pelvis | consists of the inlet, the midpelvis, and the outlet |
| Occiput posterior refers to which component of the birth process? Powers Passenger Passage Psyche | passenger |
| Which passenger position would interfere with a safe vaginal birth? Transverse fetal lie Flexed fetal head Cephalic presentation Longitudinal fetal lie | Transverse fetal lie The fetal lie is the relationship of the long axis of the baby to the long axis of the mother. With a transverse fetal lie, there is a significant risk for fetal distress, trauma, and maternal trauma if vaginal delivery occurs. |
| The nurse knows it is important to help the woman relax through effective coaching because of which responses to stress experienced in labor? Select all that apply Fetal intolerance to labor Bradycardia related to a vagal response Release of catechol | Fetal intolerance to labor Release of catecholamines in the mother’s body Inhibited uterine contractions because of decreased blood flow to the placenta |
| Which action taken by the patient will reduce discomfort during Leopold maneuvers and make fetal presenting parts easier to feel? Standing Lying prone Emptying the bladder Pushing or bearing down with contractions | Emptying the bladder |
| A woman with an epidural is 10 cm dilated and the baby is at 0 station. There is a reassuring fetal heart pattern, although the woman does not feel the urge to push. Which are appropriate actions by the nurse? Perform another vaginal examination to check | Encourage the patient to wait to push until she feels the urge. Encourage frequent position changes while remaining in the bed. |
| What would the nurse expect when caring for a full-term primigravida who presents for a routine office visit and is not in labor? A fundal height that measures 30 cm A fetus that is engaged in the maternal pelvis A cervix that is already 3 cm dil | A fetus that is engaged in the maternal pelvis Fetal engagement often occurs before the beginning of labor in primigravidas, where with multigravidas the fetus often does not engage until labor begins. |
| A pregnant woman arrives at the emergency department, and after completing a vaginal examination the nurse midwife states that the patient is 5 cm dilated and 75% effaced and the fetus is at −3 station. Which statement is accurate regarding this assessmen | The fetus is not engaged within the maternal pelvis. |
| How is effacement measured? Select all that apply. Through digital palpation by a trained professional Using transvaginal ultrasound By estimating the stage of labor Though palpation of cervical dilation Through Leopold maneuvers | Through digital palpation by a trained professional Using transvaginal ultrasound |
| Place the feedback loop events responsible for labor contractions at term in the order of their expected occurrence. The fetal head stretches the cervix. The fetal head pushes against the cervix. Oxytocin is increasingly secreted. The fundus o | the fetal head stretches the cervix, causing the fundus of the uterus to contract, pushing the fetal head against the cervix, thus causing more pressure, which triggers more fundal contractions |
| Which premonitory labor sign becomes apparent when changing levels of estrogen and progesterone cause excretion of some of the extra interstitial fluid that accumulates in body tissue during pregnancy? “Bloody show” Braxton Hicks contractions A s | A small weight loss of 1 to 3 lb (2.2 to 6.6 kg) A small weight loss of 1 to 3 lb (2.2 to 6.6 kg) may occur because changing levels of estrogen and progesterone cause excretion of some of the extra interstitial fluid that accumulates during pregnancy. |
| Which physiological event is associated with lightening? The fetus assumes a position lower in the pelvis. The cervix begins to soften, dilate, and efface slightly. Fetal pressure causes congestion of the vaginal mucosa. The extra interstitial | The fetus assumes a position lower in the pelvis. Lightening (“dropping”) occurs as the fetus descends toward the pelvic inlet. |
Created by:
adricela55