Labor & birth Theories why labor begins - dec progesterone - inc prostaglandins [cervix release] - uterine muscle stretches - fetus presses on cervix - release of oxytocin - placenta
Birth - coordinated effort - depending on 5 interrelated factors - abnormalities in an y of the 5 can alter or prev...
NUR 335 Quiz 3 Questions and Correct
Answers
Labor & birth
Theories why labor begins ✅- dec progesterone
- inc prostaglandins [cervix release]
- uterine muscle stretches
- fetus presses on cervix - release of oxytocin
- placenta
Birth ✅- coordinated effort
- depending on 5 interrelated factors
- abnormalities in an y of the 5 can alter or prevent labor progress, putting mother and
baby at risk
5 ps of birth
- p brith canal
- p fetus
- p contractions
- p mental state
- p mother ✅- passage through birth canal
- passenger (fetus)
- powers (contractions)
- psyche (psychological state)
- position of the mother
Best fetal positions for labor ✅roa or loa
Shoulder/transverse presentation
- requires what? ✅- immediate c section
Fetal station ✅location of the presenting part in relation to the midpelvis or ischial
spines; expressed as cm above or below the spines; station 0 is engaged, station -2 is 2
cm above the ischial spines
- +4 - baby crowning
- 0 - baby locked in pelvis
- -#s - baby is floating
Cardinal movements of labor
- des
- fle
- in ro
- exten
- exter ro
Frequency of uterine contractions ✅- from the beginning of one contraction to the
beginning of the other
- duration: from the beginning of the contraction to the end of the contraction
* only push during contraction
Cervical changes during labor ✅- effacement
- dilation
Effacement ✅- thinning of the cervix
Dilation cervix ✅10 begin labor [should be fully dilated before pushing]
Uterine contractions at labor
- where do they state
- where will the baby move down ..... And out of ... . ✅- uterine muscles contraction
starting at the to pf the muscle (fundus)
- contractions will move baby down pelvis and out of the cervical opening into the
vagina and birth canal
Signs of true labor
- what contraction
- what is showing
- rupture of what
- changes of what ✅- uterine contractions
- show
- rupture of membranes
- cervical changes
First stage of labor
- what begins regularly
- what dilates
- what phases [late, act,trans] ✅the initial stage of childbirth in which regular
contractions begin and the cervix dilates
- latent phase, active phase, transition phase [difficult but the shorters]
,Second stage of labor
- dilation is
- cervical ef
- bir ✅full dilation, cervical effacement
Intense contractions
Birth!!
Third stage of labor
- what is delivered [sep - exp] ✅delivery of placenta
- placental separation
- placental expulsion
Maternal response to labor
- what in increases in response to pain
- wbcs
- o2
- emotional distress d/t fa and fea ✅- increases up to 50%
- bp inc - response to pain
- increase in wbcs
- o2 needs increase
- emotional distress r/t fear fatigue and fear
Fetal response to labor ✅- neuro system: pressure on head r/t contractions
- cv system - fhr variation are normal
- resp system
Maternal danger signs during labor ✅- abnormal pulse
- abnormal bp
- inadequate or prolonged contractions
Fetal danger signs of labor
- what kind of staining
- hyperactivity could be a s/sx of
- normal o2 sat in utero ✅- hr
- meconium staining
- hyperactivity - might be a s/sx of hypozia
- low o2 sat [40-7o%]
Assessment of fhr
- how often during early labor
- how oftern during active labor
- how often during 2nd stage of labor ✅- assess q 30 miin during early labor
- q 15 min during active labor
- q5 during 2nd stage of labor
, Late decelerations
- when does it happen in relation to contractions
- what is the rn intervention for fetus ✅- after contraction begins (peak
- nursing intervention to improve blood & oxygen supply
Rn intervention for late deceleration ✅- immediately improving placental blood flow
- oxygenation
Prolonged deceleration
- what might the baby be doing
- rn intervention [position, o2, what to admin, what exam to perform] ✅-lasts longer
- baby might be lying on the cord
- ** change mothers position, give o2, ivf, and perform a vaginal exam
Variable decelerations
- good or bad
- what does it mean according to the cord
- mom position [what to do, head ] ✅hr up or down, cord compression = very bad
Prolapsed cord= push head up, change mom position
Variable decelrations rn interventions
- what to d/c
- mom position
- what to admin
- what to assess in mom
- who to notify
- what to assist with if prx ✅- d/c oxytocin
- change mother position
- admin o2
- assess mom vs
- notify hcp
- assist with amnioinfusion if prx
Early decelerations ✅head pressed on. This is ok.
Sinuisoidal pattern
- can be caused by what
- what to do if you do not know what is happening ✅- caused by a narcotic
- call provider if they do not know what it is causing it
Rn interventions for fetal decelerations
- what to prepapre for if it does not return to normal ✅- change maternal position
- ivf
- o2
- continue to monitor
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