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IntrapartumCare
MCH Test 3 SFC
| Question | Answer |
|---|---|
| Progesterone is produced by the | placenta |
| What are the maternal factors that assist in labor? | Progesterone, Estrogen, Prostaglandins, Oxytocin |
| What are the fetal factors that assist in labor? | adenocorticotropic hormones |
| How does prosgesterone assist in labor? | relaxes myometrium during pregnancy therefore it prevents contractions. availability decreases at term |
| What hormone has an inverse relationship with progesterone? | Estrogen |
| How does Estrogen assist in labor? | facilitates coordinated uterine contractions and myometrial stretching, stimulates prostaglandin production, increases myometrial sensitivity to oxytocin |
| Where is prostaglandins produced? | myometrium, cervix, fetal membranes and cervix |
| How does prostaglandins assist in labor? | stimulates myometrium to contract, stimulates connective tissue of cervix to soften, efface, and dilate |
| Where is oxytocin produced? | posterior pituitary in increasing amts as pregnancy progresses |
| How does Oxytocin assist in labor? | oxytocin receptors in uterus increases as gestation approaches term and causes uterine contractions |
| How does fetal adrenocorticotropic hormones assist in labor? | rise at term and increase uterine sensitivity to oxytocin prostaglandins |
| An increase in fetal glucocorticord and androgen production causes an decrease in | progesterone and prostaglandins |
| The types of pelvics include | gynecoid, android, anthropoid, platypelloid |
| The most commmon type of pelvis is | gynecoid and is shaped like a circle |
| The inlets widest diameter in a gynecoid is | transverse midplane |
| The oulets widest diameter in a gynecoid is the | anterior posterior |
| The narrowist part of spine is the | ischial pelvis |
| Station is the relationship between the | ischial spines and the presenting part of the fetus |
| Engagement indicates the | largest diameter of the presenting part has passed through the inlet into the true pelvis |
| Engagement corresponds with what station? | Station 0; even with ischial spine |
| If the fetus is at +4 station what is the s/s? | see babys head |
| At a +5 station what is the s/s | head bulging out |
| In a prenip engagement usually occurs | 2 weeks prior to labor |
| In multips engagement usually occurs | anytime before or after labor |
| When measuring station, above the ischial spine is indicated as | negative |
| when measuring station, below the ischial spine is indicated as | postive |
| The pelvic floor is described as | a muscular layter that seperates pelvic cavity above the perineal space |
| How does the pelvic floor assist with delivery? | helps the fetus rotate as it passes through the birth canal |
| Effacement is described as | the thinning of the cervix |
| When cervix is prepared to go into labor it feels like | earlobe |
| When cervix is not read to go into labor it feels like | nose |
| 50% effacement is | 1cm long cervix |
| 100% effacement is | same thickness as lower uterine segment |
| Completely effaced is | one os |
| Dilation is described as | the opening of the cervix |
| Complete dilation is described as when | you can no longer feel the cervix |
| Prenips usually _______ before they ________ | efface, dialate |
| Soft tissue changes of a multip include | effacement and dilation simutaneously |
| Prior to labor the position of the cervix is | pointing towards the coccyx |
| During labor the cevix points anterior d/t | the pressure of baby's head |
| The bones of the fetal head involved in birth includes | Two frontal bones, two parietal bones, occipital bone |
| A fontanel is defined as | the wider spaces at intersections of the sutures |
| The anterior fontanel is characterized as | diamond shaped, formed by intersection of 4 sutures: coronal, frontal, and sagittal |
| The anterior fontanel connects which bones | 2 frontal and parietal bones |
| The posterior fontanel is characterized as | trianglar shaped, formed by intersection of 3 sutures |
| The posterior fontanel connects which bones | 2 parietal and occipital bone |
| Fetal presentation is determined by | fetal lie and body part of fetus that enters pelvic passage first: known as presenting part |
| Fetal presentations include | vertex, shoulder or transverse, breech |
| A cephalic presentation consists of the fetus in a | longituidal lie and head enters the pelvis first |
| Types of cephalic presentaion include | vertex, military, brow, face |
| The most common type of cephalic presentation includes the | vertex position where the head is flexed and the occiput leads the way |
| When does the fetus settle into thier presentation? | 36-37 weeks gestation |
| A shoulder or transverse presentation is defined as | the fetus's spine perpindicular to mothers spine |
| A shoulder or transverse presentation may be d/t | contracted pelvis, uteran tumor, large head (hydrocephalis), tumor on back, or twins |
| Breech presentations are associated with | preterm births, placenta previa, polyhydramnios, multiple gestation, uterine anomalies, fetal anomalies |
| An increased risk of prolapsed cord in an incomplete breech presentation is d/t | the availibilty of space between the cervix and presenting part |
| Risks for breech presentations include | higher morbidity and mortality rates, increased risk of prolapsed cord, increased risked of cervical spinal cord injuries, increased risk of birth trauma |
| Types of breech's include | Frank, footling, & complete |
| A frank breech is defined as | the babys bottom sits over the woman's cervix, their hips are flexed and the legs are extended (straight) |
| The most common and most favorable type of breech is | frank breech |
| A footling breech is characterized as | the baby's foot (or feet) sit over the womans cervix leading the way |
| A complete breech is characterized as | everything being in the right position but the baby is upside down |
| Fetal lie is defined as | the relationship of the spine of the mother to the spine of the fetus |
| Types of fetal lie inlcudes | longitudinal or vertical; transverse, horizontal, or oblique |
| A longitudinal or vertical lie is characterized by | long axis of the fetus is parallel with long axis of mother |
| A transverse, horizontal or oblique lie is characterized as | long axis of fetus is at a right angle to the long axis of the mother |
| Fetal attitude is defined as | relationship of the fetal body parts to one another |
| A normal fetal attitude is characterized by | head flexed onto chest, arms and legs flexed against the chest, and back bowed out. Occiput presents first |
| Asynclitic attitude is characterized as | head titled to side which increases diameter of head and causes a more difficult delivery |
| Fetal position is defined as | the relationship of the fetal presenting part to the left or ride side of the maternal pelvis. position is indicated by a 3 letter abbreviation |
| First letter of fetal position is defined as | the location of the presenting part in the R or L side of maternal pelvis |
| Second letter of fetal position is defined as | the specific presenting part of the fetus 0: occiput S: sacrum M: mentum |
| Third letter of fetal position is defined as | the location of the presenting pare in relation to anterior, posterior, or transvers protion of maternal pelvis |
| The steps of leopolds maneuvar includes | First maneuvar: Determine which part of the fetus is in the fundus Second maneuvar: Where is the back? move hand downward over each side of the abdomen Third maneuvar: determine fetal position by placing hand over symphysis pubis |
| Primary powers are defined as | involuntary contractions originating at pacemaker points in upper uterine segment: move downward over uterus in waves, seperated by short rest periods |
| Primary powers are responsible for | dilation and effacement |
| Duration of a contraction is measured | from beginining of one contraction to the completion of the same contraction |
| Duration is measured in | seconds and is typically 60 sec to 1 min long |
| Intensity of a contraction is defined as | the strength of contraction |
| The three phases of intensity of a contraction are | Increment: building up Acme: strongest point Decrement: lessening |
| Intensity of a contraction is measured by | the indentiblity of uterine wall during acme |
| intensity of a contraction is measured as | Mild: easy to indent with fingertip (nose) Moderate: difficult to indent (chin) Strong: Rigid, almost impossible to indent (forehead) |
| With an intrauterine pressure monitor the strength of contraction is usually ____ during each phase | Resting tone: 10-20 mm Hg Early Labor: 20-40 mm Hg Active Labor: 50-70 mm Hg Transition: 70-90 mm Hg Pushing: 70-100 mm Hg |
| During resting tone the strength of a contraction with an intrauterine pressure monitoring is | 10-12 mm Hg |
| During Early labor the strenght of a contraction with an intrauterine pressure monitor is | 25-40 mm Hg |
| During active labor the intensity of a contraction with an intrauterine pressure monitor is typically | 50-70 mm Hg |
| During transition the intensity of a contraction with an intrauterine pressure monitor is typically | 70-90 mm Hg |
| During pushing the intensity of a contraction with an intrauterine pressure monitor is typically | 70-100 mm Hg |
| Frequency of a contraction is defined as | the time between the beginning of one contraction to the next |
| Frequency of a contractions in active labor is typically | 2-3 minutes |
| Period of relaxation between contraction is important d/t | restoration of uteroplacental circulation, allows uterine walls to rest, rest for mom, important for fetal circulation and adequate circulation in the uterine blood vessels |
| Secondary powers of labor are defined as | presenting pare of fetus descends to pelvic floor, and stretch receptors in posterior vagina cause release of exogenous oxytocin that triggers maternal urge to bear down |
| Secondary powers of labor cause | involuntary urge ot bear down and push |
| If a mother during labor is expreiencing severe back pain the cause probably from | the infant being occiput posterior (sunny side up) |
| Lightening is defined as | the movement of presenting part into true pelvis, same as engagement |
| S/S of include | increased pelvic pressure and congestion,improved breathing d/t pressure on diaphragm is decreased, increased urinary frequency, increased vaginal secretions, neuropathic pain d/t pressure on pelvis nerves, LE edema d/t impaired venous congestion |
| S/S of impending labor include | lightening, cervical changes, bloddy show or mucus plug, ROM |
| Cevical changes such as dilation and effacement is d/t which hormones | prostaglandins |
| Cervical changes in prenip typically are seen as | effacement occurs prior to dilation |
| Cervical changes in multip typically seen are | concurrent (effacement and dilation) |
| Braxton-Hicks contractions are typically felt in | anterior abdomen |
| Braxton-Hicks contractions will decrese with | activity |
| Braxton-Hicks contractions are defined as | painless irregular contractions that do not result in cervical change |
| Functions of amniotic fluid include | allows for fetal limb extension and chest expansion, prevents fetus form tangling with amnion, helps maintain fetal temperture, provides buffer from trauma |
| Characteristics of amniotic fluid include | opaque, translucent; may have vernix; sterile; composition changes and amount increases as pregnancy progresses; 800-1000 ml |
| Oligohydramnios is defined as | < 300 ml |
| Oligohyramnios may be caused from | rupture of membranes, fetal renal agenesis, urinary malformation |
| Polyhydraminos is defined as | > 2000 ml |
| Polyhydraminos may be caused from | fetal GI malformations, maternal glucose elevations |
| SROM | spontaneous rupture of membrane |
| AROM | artifical rupture of membrane |
| PROM | premature; atleast one hr to onset of labor |
| PPROM | preterm premature |
| MSF | meconium staind fluid |
| Amniotic fluids pH is typically | > 6.5; turns pH paper blue |
| Characteristics of real contractions inlcude | regular intervals, intervals shorten, duration and intensity increase, begin in back and radiates to abdomen, walking increases intensity, rest does not decrease DIF, cervical effacment and dilation occur |
| Start of labor is defined as contractions | 5 minutes apart and regular |
Created by:
stilsl
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