OB Word Scramble
|
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Question | Answer |
Essential components of labor (4) | 4P's - passageway, passenger, powers, pshyche |
passageway pelvic structures (2) and def | false pelvis - upper flare part - not part of bony pelvis; true pelvis - below linea terminalis - bony passage fetus must pass thru during delivery |
4 pelvic shapes | gynecoid, anthropoid, android, platypelloid |
Gynecoid def | most favorable vaginal birth - 50% of moms have it and allows fetus to pass thru |
Anthropoid def | elongated in shape, usually allows vaginal birth. anthropoid diameter is generous but transverse diameter is narrow. 25% of moms have it usually can delivery vaginally |
android def | heart shaped, looks like male pelvis, not favorable for vaginal delivery - most likely c-section |
platypelloid def | flat in dimension, narrow anthropoid diameter with generous transverse diameter. usually requires c-section |
pelvic measurements | calculate the likelihood of delivering vaginally includes the obstetric conjugate and diagonal conjugate |
obstetric conjugate | measures the smallest diameter of the inlet through which the fetus must pass. determined by subtracting 1.5 from the diagonal conjugate. A measurement of 11 is considered adequate |
diagonal conjugate | symphisis pubis to sacral promontory |
mid pelvis | distance between the ischial spines |
angle of pubic arch | at least 90 degrees |
birth canal | soft tissues making up the "passageway" includes the cervix and vagina |
what are the 2 processes making up the cervix? | effacement - cervix gets shorter and thinner in % - 100% is complete thinning of membranes; dilation is from 1cm up to 10cm dilated |
fetal adaptations to delivery (2) | skull bones have cartilage between them which can overlap to decrease the diameter of the skull and helps adjust to the shape of the pelvis; molding - skull can elongate via pressure from the vaginal walls to decrease the diameter of the skull (cone head) |
fetal orientation (3) | fetal lie,fetal presentation, fetal attitude |
fetal lie | relationship to long axis of the mother (longitudinal - up & down, transverse - side to side and oblique - at an angle) |
fetal presentation | 1st part of the body entering pelvic inlet (cephalic, breech, and shoulder) |
fetal attitude | position of the head in a cephalic presentation including vertex (chin into chest), military (chin - no flex at all or extension - wider dilation), brow (partially extended back - cone out bruised face), face (head fully extended - extremely bruised face |
fetal position | position of presenting in relation to quadrants of maternal pelvis. |
3 designations | 1st designation which side the presenting part is facing (left or right), 2nd designation - reference pt on presenting part, 3rd designation front, back, or side of the maternal pelvis in which the reference is found |
what is the most favorable fetal position? | LOA - left occipital anterior |
fetal station | describes the position of the widest part of the presenting part in relation to the level of the ischial spines - "floating" - ballottable - bounce |
To what degree is the baby "engaged" or drops | 0 also known as lightening - baby is at the level of the ischial spine |
Powers - describe contractions | frequency - interval of time from beginning of one to the beginning of another, duration - how long they last, strength/intensity - strength of contraction; involuntary - uterus, voluntary - abdominal muscles |
Psyche | mental state of the laboring woman including current pregnancy experience, previous birth experiences, expectations, preparation, support system, culture |
signs that labor may begin soon (4) | lightening, braxton-hicks contractions, loss of mucous plug, nesting behavior |
lightening def | presenting part sets in pelvic cavity at zero station - baby drops - easier for lungs to expand, can eat larger meals and increase urination |
braxton-hicks contractions def | false/irregular labor pain - practice contractions getting ready for labor - toward end more intense |
loss of mucous plug | prevents bacteria from entering uterus, some women have huge chunk come out; can come out 1 week before labor |
nesting behavior | burst of energy before labor - important to conserve for labor and delivery |
clinical signs of labor (3) | cervical ripening or softening, cervical effacement, dilation |
3 components of vaginal exam | dilation, effacement, fetal station |
how many stages of labor are there? | 4 |
1st stage of labor and components (3) | aka dilation stage - begins w/ the onset of true labor and ends when pt is fully dilated - 3 phases - early/latent, active phase & transition stage |
early/latent phase | contractions mild to moderate, more frequent - early labor. |
active phrase | contractions are moderate to strong - baby drops to pelvis |
transition | most intensive usually fastest - contractions very strong - strong urge to push - if not 10 cm DONT push b/c can cause cervical edema and laceration - get very discouraged and want to quit |
2nd stage | begins when pt is fully dilated and ends with delivery of infant - most common position is dorsal recumbent |
dorsal recumbent def | most common position for L & D, laying on back with head at 45 degree angle and legs held w/support |
3rd stage | begins once fetus is expelled and ends when placenta is delivered - placental separation |
signs of placental detachment | blood discharge from vagina & uterus takes on globular shape - important to inspect placenta to make sure intact and nothing left b/c it could lead to infection |
4th stage | begins when placenta is delivered and continues for 4 hours |
how many hours recovery is for a vaginal delivery? c-section delivery? | vaginal - 1 hour; c-section - 4 hours |
factors influencing pain mgmt (8) | amt of support, age, level of inexperience, other parities/babies, length of labor, fear, amt of anxiety, culture |
definitions r/t pain mgmt (3) | unique - normal physiologic process, increasing intensity is desirable and positive, predictable; threshold - amt of pain necessary to perceive pain, pain will last 60-90 seconds then rest; tolerance - ability to withstand pain once recognized |
paint mgmt techniques - pharmacologic | analgesic - reduce sensation of pain - dont give too early because could cause respir distress in baby; anesthesia - block sensation; |
paint mgmt techniques - non-pharmacologic (9) | labor support, comfort measures, relaxation techniques, breathing, attention focusing, movement & positioning, apply counter pressure, hypnosis, water injections |
priorities of fetal monitoring | establish a baseline heart rate (110-160), assess variability (fluctation of FHR), variability results from the interplay between the sns and psns - shows goog oxygenation - LPN must know difference between reassure and nonreassuring interplay |
periodic FHR changes | accelerations - an increase of at least 15 beats above baseline for 15 seconds or more. If acceleration lasts longer than 10 min then it is considered a change of baseline. Accelerations are a reassuring sign which indicate that the fetus is doing well |
benign changes | early decels - have U shaped appearance and begin at the start of ctx and end at the end of the ctx. Must hit its lowest pt at the peak of a ctx. results from head compression during ctx. continue to monitor as long as baseline and variability are WNL |
benign changes | closer to delivery - when d-cells are at lowest pt, its at the highest part of contractions |
nonreassuring changes | variable decels - may occur any time during a monitoring pd. variables have a jagged appearance & be described as U,V, or W shaped. indication of cord compression. if variables resolve quickly & arent severe, NI is minimal - aimed at relieving compression |
late decels | appear smooth and U shaped but are offset from the ctx. they begin after the onset of ctx and dont resolve until ctx ends. later decels result from a prob w/ BF from uterus to placenta. non-reassuring sign. NI aimed @ improving utero-placental perfusion |
NI of late decels | uterus relax, ocygen on face, increase IV fluids |
reasons for induction | post-dats (2wks after due date), premature rupture of membranes (PROM), fetal indication (IUGR, defect), maternal indication (HTN), elective. Usually arent allowed to induce prior to 39 weeks |
methods of induction (3) | cervical ripening - med which is vaginal suppository for 12hrs which softens the cervix; AROM - artifical rupture of membranes; Pitocin - synthetic form of oxytocin which stimulates uterine ctx |
assisted delivery methods (4) | episotomy, vacuum, forceps, cesarian section |
episotomy | surgical cut into the perineum to allow room for delivery of fetus; high risk for infection - not acceptable anymore unless distress; most times allow them to tear on their own |
vacuum delivery | suction applied to fetal head to assist in delivery |
forceps delivery | metal tongs applied to either side of baby's head to assist in delivery; high risk for injury; nurse is responsible for pumping up pressure |
cesarean section | baby is delivered through an incision in the lower abdomen' roughly 25% of births in the USA; high risk |
common indications for c-section | hx of c-section, labor dystocia (not moving/progressing - cant get passed 4cm), fetal distress, malpresentation - breech/shoulder showing, previa, abruption, cephalopelvic disproportion - pelvis isnt big enough to deliver head, herpes lesion, DM, HTN |
Created by:
breinard
Popular Nursing sets