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HCC Intrapartum

QuestionAnswer
Passageway The birth canal.
Passenger Fetus.
Fetal Skull Parts The face, the base of the skull(cranium), and the vault of the cranium(roof).
Molding When the cranial bones overlap under the pressure of labor.
Sutures The membranous joints that unite the cranial bones.
Frontal Suture (Mitotic) Located between the two frontal bones.
Sagittal Suture Located between the parietal bones, divides the skull into left and right halves.
Coronal Sutures Located between the frontal and parietal bones.
Lambdoidal Suture Located between the two parietal bones and the occipital bone.
Fetal Attitude The relation of the fetal body parts to one another.
Flexion Normal fetal attitude, chin flexed to chest. This position is the smallest diameter of presentation.
Fetal Lie The relationship of the spinal column of the fetus to that of the mother. Longitudinal or transverse.
Fetal Presentation The body part of the fetus that enters the maternal pelvis.
Malpresentations Breech and shoulder presentations.
Cephalic presentation The fetal head presents to the birth passage in approx. 97% of term births.
Vertex Presentations When the presenting part is the occiput. Most common. The head completely flexed to chest.
Sinciput Presentation The fetal head is partially flexed. The TOP of the head is the presenting part.
Brow Presentation The fetal head is partially extended. The largest anteroposterior diameter.
Face Presentation The fetal head is hyperextended(complete extension). The face is the presenting part.
Breech Presentation The presenting part is the lower extremities or the buttocks.
Complete Breech The fetal knees and hips are both flexed, and the buttocks and feet are the presenting parts.
Frank Breech The fetal hips are flexed and the knees are extended. The buttocks is the presenting part.
Footling Breech The fetal hips and legs are extended. The feet are the presenting part(s)
Shoulder Presentation The fetal shoulder is the presenting part.
Engagement When the presenting part reaches or passes through the pelvic inlet.
Station The relationship of the presenting part to an imaginary line drawn between the ischial spines of the maternal pelvis. -1 to -5 above ischial spines, +1 to +5 below spines. 0 is equal to spines.
Fetal Position The relationship of the landmark on the presenting fetal part to the anterior, posterior, or sides of the maternal pelvis.
ROA Right-occiput-anterior. Vertex presentation.
ROT Right-occiput-transverse. Vertex presentation.
ROP Right-occiput-posterior. Vertex presentation.
LOA Left-occiput-anterior. Vertex presentation.
LOT Left-occiput-transvers. Vertex presentation.
LOP Left-occiput-posterior. Vertex presentation.
Fontanelle In the fetus, an unossified space, or soft spot, consisting of a strong band of connective tissue lying between the cranial bones of the skull.
Contractions Rhythmic tightenings and shortenings of the uterine muscles during labor.
Three Phases of a Contraction 1. Increment-building up(longest phase). 2. Acme-peak of contraction. 3. Decrement-letting up.
Frequency The time between the beginning of one contraction and the beginning of the next contraction.
Duration Measured from the beginning of the contraction to the completion of the contraction.
Intensity The strength of the uterine contraction during acme. Inesity is estimated by palpating the contraction.
Bearing Down Once the cervix is completely dilated the maternal abdominal musculature contracts as the woman pushes.
Effacement The taking up of the internal os and the cervical canal into the uterine side walls. The cervix changes from long thick structure to tissue-paper thin.
Cervical Dilatation The cervical os and canal widen from less than 1 cm to approx 10 cm, allowing birth of the fetus.
Lightening The effects that occur when the fetus begins to settle into the pelvic inlet(engagement).
Braxton Hicks Contractions Irregular, intermittent contractions that occur throughout the pregnancy-may become uncomfortable.
Bloody Show Pink-tinged secretions after the mucous plug is expelled.
ROM Rupture Of Membranes. The rupture of the amniotic membranes.
SROM Spontaneous Rupture Of Membranes generally occurs at the height of the intense contraction with a gush of the fluid out of the vagina.
Latent Phase(First Stage) 0-3cm. Begins with the onset of regular contractions. As the cervix begins to dilate it also efaces, little or no fetal descent.
Active Phase(First Stage) 4-7cm. Anxiety tends to increase with intensification of contractions and pain.
Transition Phase(First Stage) 8-10cm. Last phase of first stage. Significant anxiety.
True Labor Contractions @ reg intervals, intervals grad shorten, contracts increase duration & intensity, discomfort @ back radiates around abd, intensity increase c walking, dilate & efface progress, contracts don't decrease c rest.
False Labor Contractions irregular c no change, discomfort usually in abd, walking does not help, no change in dilate or efface, rest & warm baths decrease contracts.
Nullipara 1st Preg. Latent 8.6hrs, Active 4.6hrs, Transition 3.6hrs. 2nd stage up to 3hrs.
Multipara Latent 5.3hrs, Active 2.4hrs, Transition varies. 2nd stage 0-30min.
Latent Phase Contractions Frequency q3-30min, Duration 20-40sec, Intensity mild progress to mod; 25-40 mmHg
Active Phase Contractions Frequency q2-5min, Duration 40-60sec, Intensity mod to strong 50-70 mmHg.
Transition Phase Contractions Frequency q1.5-2min, Duration 60-90sec, Intensity strong 70-90 mmHg.
Second Stage Begins when the cervix is completely dilated to 10 cm and ends with birth of the infant.
Crowning When the fetal head is encircled by the external opening of the vagina(introitus) and means birth is imminent.
Cardinal Movements Positional changes by the fetal head and body that promote passage through the birth canal.
Descent The head enters the inlet in the occiput transverse or oblique position.
Flexion The fetal chin flexes downward onto the chest.
Extension Extension of the fetal head as it passes under the symphysis pubis, the occiput, then brow and face emerge from the vagina.
Restitution Twisting of the neck, then once the head is free the neck untwists-restitution.
External Rotation As the shoulders rotate to the anteroposterior position in the pelvis, the head is turned farther to one side.
Expulsion The anterior shoulder meets the undersurface of the symphysis pubis and slips under it. The anterior shoulder is born first, then posterior. The body follows quickly.
Fourth Stage The time from 1-4hrs after birth in which physiologic readjustment of the mother's body begins.
Blood Loss 250-500 mL.
EFM Electronic Fetal Monitoring.
FHT Fetal Heart Tones.
UC Uterine Contractions.
Leopold's Maneuvers A systemic way to evaluate the maternal abdomen. After she has emptied her bladder.
First Leopold's Maneuver The nurse palpates the upper abdomen with both hands. To determine shape, size, consistency, and mobility. Head or buttocks occupies the fundus?
Second Leopold's Maneuver Determine the location of the fetal back.
Third Leopold's Maneuver Determine what fetal part is lying above the inlet by gently grasping the lower portion of the abdomen just above the symphysis pubis c the thumb and fingers of the R hand.
Fourth Leopold's Maneuver Face the mom's feet, fingers of both hands are moved gently down the sides of the uterus toward the pubis to find the cephalic prominence(brow).
FHR Fetal Heart Rate. Under 110 = bradycardia. Over 160 = tachycardia.
Decelerations (decels) Decreases in FHR below the BL.
Early Decelerations Occurs at the same time as the peak of the contraction. Result of vagal nerve stim caused by fetal head compression that occurs during UCs.
Late Decelerations Due to uteroplacental insufficiency and are a result of decreased blood flow and/or oxygen transfer to fetus during contractions.
Assessment of Uterine Contraction Pattern Frequency? Duration? Intensity?
APGAR Score Newborn is rated at 1 and 5 minutes after birth. A score 7-10 indicates a newborn in good condition.
APGAR Heart Rate Above 100 scores 2. Slow-below 100 scores 1. Absent scores 0.
APGAR Respiratory Effort Good crying scores 2. Slow irregular breathing scores 1. Absent breathing scores 0.
APGAR Muscle Tone Active motion scores 2. Some flexion of extremities scores 1. Flaccid scores 0.
APGAR Reflex Irritability Vigorous cry is a score of 2. A grimace is a score of 1. No response is 0.
APGAR Skin Color Completely pink scores 2. Blue extremities and rest of body is ping scores 1(acrocyanosis). Totally cyanotic, pale scores 0.
Initial Newborn Assessment Resp. 30-60 irregular. Pulse 110-160 somewhat irregular. Skin Temp above 97.8F(36.5C). Color pink c bluish extrem.
Umbilical Cord Two arteries and one vein.
GTPAL Gravida, Term, Preterm, Abortions, Living
Gravida Number of Pregnancies
Term Number of pregnancies to term. 38-42 weeks gestation.
Preterm Number of pregnancies 20-37 weeks gestation.
Abortions Number of pregnancies ending in either spontaneous or therapeutic abortion.
Living Number of currently living children to whom the woman has given birth.
Precipitous Labor and Birth Labor lasting less than 3 hours.
Dystocia Long, difficult, or abnormal labor.
Primary Powers Effacement(the effacement is the cause of dystocia)
Secondary Powers Descent (the descent is the cause of dystocia)
Hypertonic Labor Patterns Frequent contractions that are painful and ineffective in dilating and effacing the cervix.
Hypotonic Labor Patterns Longer frequencies of contractions
Created by: mande747
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