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VSNG 1230 Unit 3 BP

1230 OB Test 3 Blueprint

What are the Four Ps of Labor? Passageway, Passenger, Powers, psyche
Problem in any area of the Four Ps influences labor negatively
Passageway consists of bony pelvis and soft tissue
The pelvic shape most favorable for vaginal birth2 gynecoid
Birth Canal is the soft tissue of the cervix and vagina
Effacement occurs first then dilation (thinning and opening of cervix
Passenger ingludes Fetal skull and the fetal accomodation to the passageway.
The fetal accomodation to the passageway is how their spine is in conjunction with the mothers spine.
Longitudinal Lie the Long axis of the fetus is parallel to the long axis of the mother
Oblique Lie In between longitudinal and traverse lie
traverse lie the Long axis of the fetus is perpindicular to the long axis of the woman
Presentation foremost part of the fetus that enters the pelvic inlet
Cephalic presentation head
breech presentation feet or buttocks
shoulder presentation shoulder... (duh)
Attitude relationship of fetal parts to one another: ovoid, military, brow, or face
Position the relationship of the reference point on the presenting part to the quadrants of the maternal pelvis
Zero Station Presenting part is at the level of iscial spines (at the door)
Minus Station Presenting part is above the ischial spines (up in the body)
Plus station presenting part is below the iscial spines (coming out)
Powers Phases of involuntary uterine contraction
Parts of the contraction: Increment building up of the contraction - longest phase
Parts of the contraction: Acme Peak
Parts of the contraction: Decrement letting up phase
Parts of the contraction: Relaxation Rest period in between contraction
Psyche Factors impacting the psyche of laboring woman Including: current prgnancy experienc, previous birth experiences, expectations, prep for birth, and process of labor
Cardinal Movements of Labor Engagement - Descent - Flexion - Internal rotation - extension - external rotation - expulsion
When to go to a hospital When the mother not only FEELS the baby coming but MENTALLY knows the baby is coming and even contraction
Early Stage of labor Activity Excited and Talkative
During active labor activity more introverted - focusing energies in coping with the stress of contraction
Spiral electrode is attached to the presenting part just under the skina dn records a graphic representation of FHR. Easier to obtain consistent tracing. Increases risk of maternal and fetal infection and injury.
Baseline Fetal Heart Rate measured between uterin econtractions during a 10 minute period.
Normally accepted baseline rate is between 110 bpm and 160 bpm
Fluctuations of the baseline rate are normal if greater than 6bpm amnd less than 25bpm
Periodic changes are variations in the FHR pattern that occur in conjuctions with the uterine contractions
Episodic changes are variations in the FHR pattern not associated with uterine contractions
Prodromal Labor increase in braxton hicks contractions without cervical changes - can be uncomfotable
True Labor progressive dilation and effacement of cervix
Early decelerations are benign periodic changes.
Late decelerations indicate uteroplacental insufficiency
variable decelerations indicate some type of acute imbilical cord compression
Decelerations are changes of the FHR below the baseline
The nurses role to help with decelerations ongoing assessment of uterine contractions and FHR
Stages of Labor: First STage: Dilation - Early, Active, Trasition. SEcond Stage: Birth. Third Stage: Delivery of Placenta. Fourth Stage: Recover.
Lightening Sense that the baby has "dropped"
Assessment during the start of labor FHR and contractions at least once every hour, maternal status, status of fetal membranes, the womans psychosocial state.
Ineffective breathing pattern: hyperventilation related to anxiety and/or inappropriate application of breathing techniques.
Narcotics too late Blast phase/trasition of labor - too late!
Bishop Scale cervix is ripened or not and ready for inducement
Cesarean Section Surgical delivery of fetus through incisions in the mother's abdomen and uterus
VBAC Contraindications Previous classic Csection uterine scar, placenta previa, history of previous uterine rupture, lack of facitilites or equipment to perform immediate Csection
Indications of Cesarean History of previous cesarean, labor dystocia, non-reassuring fetal status, fetal malpresentation
Nonpharmacologic Intervention for pain relief: Continuous labor support Helped with a trained nurse or doula (trained layperson who coaches) increases the coping ability of the laboring woman. Fewer requests for pain meds. lower rate of Csections.
Nonpharmacologic Intervention for pain relief: Comfort Measures Lip balm, ice chips, lollipops, clear liquids, Changing soiled linens, Warm perineal care
Nonpharmacologic Intervention for pain relief: Relaxation Techniques These include: patterned breathing, attention focusing, movement and positioning, touch and massage, water therapy, hypnosis
Pharmacologic Interventions for pain relief: Analgesia and sedation Opioids, help to tolerate labor contractions by causing relaxation and sleep between contractions.
Narcan antidote for opidoids
Pharmacologic Interventions for pain relief: Anesthesia Local, Regional, and general. Local numbs perineum just before birth. Regional pain relief during labor and birth (preferred for nonemergent cesarean), General for emergencies
Magnesium sulfate and brethine Stops premature labor
Meconium aspiration is respiratory distress due to poop aspiration
Two types of labor dystocia: Disorder of Protraction and disorder of arrest protraction: abnormally slow progression of labor; arrest: total lack of progress
Diagnosis of labor dystocia is made after two hours of no change in either dilation or descent
Nursing care for Hypotonic uterin dysfonction Carefully assess fetal lie, presentation, and position. assess contraction pattern every 30 minutes. fetal response to uterin econtractions. thorough pain assess every hour. plot cervical changes. determine if woman might benefit from pain relief.
Nitrazine Paper To test vaginal pH during late pregnancy to determine the breakage of the amniotic sac. While vaginal pH is normally acidic, a pH above 7.0 can indicate that the amniotic sac has ruptured.
Bloody SHow the passage of a small amount of blood or blood-tinged mucus through the vagina near the end of pregnancy. It can occur just before labor or in early labor as the cevix changes shape. Freeing mucus and blood that occupied the cervix.
Rupture of Membranes (ROM) rupture of amniotic sac. "spontaneously" occurs at full term at the onset of, or during, labor. aka breaking water. Production of the hormone prostaglandin increases speeding up contractions.
Umbilical Cord Prolapse when the UC slips down in front of the presenting part. It occurs rarely in vertex presentations. Immediate Csection is treatment.
Shoulder dystocia treatments Mcroberts maneuver (tried first) two nurses holding the leg up. Suprapubic manuever - Mcroberts plus applying pressure.
Created by: christinego