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Matern-Child - WK3&4
Care of women during delivery and labor
| Question | Answer |
|---|---|
| Overdistention theory of onset of labor | enlarged uterus; prostaglandin increased to promote labor |
| Hormonal theory of onset of labor | prostaglandin increased |
| Lightening | the baby drops down in the ribcage; You can breathe easier |
| Braxton Hicks contractions | false contractions; more in the front than in the back; irregular; don't affect the cervix |
| Effacement | thinning of the cervix; measured in a %; when it's paper thin, it's 100% |
| Dilatation | measure the cervix opening in cm. |
| Bloody show | occurs when there is cervical change; blood vessels break and it's called “bloody show” |
| SROM | “Spontaneous rupture of membranes” |
| PROM | “Premature rupture of membranes” - 36 wks and under |
| PPROM | “prolonged premature rupture of membranes”; bed rest and antibiotics |
| AROM | “artificial rupture of membranes” - doc pops membrane w/ a hook |
| nesting | sudden burst of energy |
| contractions | sign of "true labor" - begin irregularly but become regular and Predictable; felt in lower back and sweep to abdomen; continue increase in duration, frequency, and intensity cervical dilation is achieved |
| 5 “P’s” (both maternal and fetal characteristics) | Passage Passenger Powers Position Psyche |
| CPD | Cephalopelvic Disproportion – head or shoulders too big for the passage (pelvis) – Csection (last resort) |
| Station | where the presenting part of the baby is in relation to the ischeal spine (the bony part) – the ischeal spine is “0” - above that are -numbers, below the ischeal are +numbers. |
| Passage | Cervix, Vagina, Perineum |
| Fontanelles | the soft spots on baby's head |
| Molding | the baby has open spots on their skull so they can cross over for passage – the head can mold thru the pelvis |
| Fetal attitude | relationship of the fetal parts to eachother – flexion or extension – expect a normal baby to have an attitude of flexion |
| Fetal lie | relationship of the long axis of the baby to the long axis of the mom |
| Passenger | the baby |
| Longitudinal lie | long axis of fetus is parallel to long axis of mother |
| Transverse lie | long axis of fetus is at a right angle to long axis of mother |
| Fetal presentation | determined by the part presenting into pelvis(cephalic, breech, shoulder)- The body part of the fetus that is closest to the cervix |
| Cephalic presentation | head is presented |
| Vertex | occiput (crown of head) first; head is in complete flexion |
| Face (mentum) | face first; head is in full hyperextension |
| Brow | sinciput (forehead or brow) first; head neither extended not flexed |
| Complete breech | Hips and knees flexed on abdomen, buttocks first |
| Frank breech | Hips flexed, knees extended (pike position); buttocks first |
| Footling breech | One or both of the hips are extended; with foot (feet) first |
| Ischial Spine | the bony prominence of the pelvis |
| Fetal Position | Relationship of the presenting part to the four quadrants of the maternal pelvis |
| Fetal landmarks identified in right or left, anterior or posterior quadrants | First letter refers to mother’s right or left side Second letter refers to the fetal landmark Third letter refers to mother’s anterior or posterior quadrant |
| Anterior Fontanel | baby born "looking at the ceiling" |
| Posterior Fontanel | baby born "looking at the floor" |
| Powers: Primary Contractions | Contractions – primary powers are the contractions Frequency – how long from start of 1 contraction to the start of another contr. Duration – how long contraction from beginning to end Intensity – how strong of a contraction – can read by a monitor – I |
| mild contraction | feels like the tip of nose |
| moderate contraction | feels like touching your chin |
| strong contraction | feels like touching your forehead |
| Powers: Secondary Contractions | Ferguson’s reflex – when presenting part of baby passes a plexus of nerves – unbelieveable urge to push – will not be able to stop pushing – involuntary reflex |
| Contractions | begin in the fundus; result of shortening of the muscle fibers; ontract and relax in rhythmic pattern; during relaxation, circulation is restored to placenta Contracted uterine muscle fibers remain shortened – gradual decrease in size of uterine cavity |
| Frequency of contractions | time from the onset of one contraction to the onset of the next contraction |
| Duration of contractions | time from the onset of a contraction to the end of that contraction |
| Intensity of contractions | the strength of the contraction at its peak |
| Secondary power | Mother actively pushing Ferguson’s reflex - the spontaneous urge to push occurs when the presenting part reaches the pelvic floor may occur without full cervical dilation stretch receptors in the vagina trigger release of oxytocin, intensifying contr |
| Psyche | Emotional status (Past experiences; Expectations; Culture- birth rituals differ widely) Fear and anxiety (Stimulate “fight-or-flight” response; Constricts blood vessels - restricting placental circulation; Decreases effectiveness of contractions; T |
| Position | May need frequent position changes throughout labor Relieves muscle tension Supports different areas of the body Provides some distraction No single “right” position for labor |
| best position for deliver | squatting - gravity helps get the baby out |
| Pain In Labor | Focus shifts as labor progresses May cause anxiety and fear, but is also associated with excitement and anticipation May begin as mild ache; builds to great intensity in short period of time Relieved abruptly and rapidly after birth |
| Nonpharmacologic Pain Relief during labor | Light activity Walking, changing position, bathing, rocking Relaxation techniques Guided imagery, light massage Counterpressure Sacral massage Natural childbirth Breathing and relaxation |
| Progressive relaxation | relaxing each muscle as you go down the body |
| Touch relaxation | when touch body part have them relax it |
| Effleurage | light fingertip massage on the back or belly – circular movements |
Created by:
MarieG
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