Exam (elaborations)
PN131 EXAM 2 LATEST UPDATED
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PN131 EXAM 2 LATEST UPDATED...
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fetal head during labor - ANSWER composed of several bonesseparated by strong connective tissue called sutures
suture lines, fontanelles, molding
how do you determine how the fetus is laying during labor - ANSWER
orientation of fetus to the moms spine
can be longitudinal (preferred), transverse, or oblique
how do you determine the fetal attitude during labor - ANSWER
relationship of fetal parts to one another
flexion (preferred)- the chin is tucked
extension- head is tilted back
how do you determine the fetal presentation during labor - ANSWER
part of the fetus that enters the pelvis first
cephalic (preferred)- vertex, military, brow, face
breech- complete/full, frank, footing
shoulder
how do you determine the fetal position during labor - ANSWER
relationship of fetal part to 4 quadrants of maternal pelvis
,what are the factors influencing labor during the passage stage -
ANSWER passage includes mothers bony pelvis and soft tissues
(cervix, muscles, ligaments and fascia)
pelvis
- shape: gynecoid pelvis (most favorable)
soft tissues: (primipara vs. multipara)
- cervix
- dilation- how open ("closed" or 0-10 cm)
- effacement- how thin ("thick" or 0-100%)
- station- how low (zero station= fetal head at level of ischial spine)-
negative numbers (still further up in the pelvis), positive numbers
(starting to come out of pelvis)
- documentation example- 4/80/0 (4 cm dilated, 80% effaced, 0 station)
- muscles, ligaments, and fascia
what are the factors influencing labor during the primary powers (uterine
contractions) stage - ANSWER involuntary
wavelike pattern
phases of contraction (increment, peak, decrement)
frequency
duration
relaxation- the baby getting oxygen back to itself
intensity
- measured by palpation, external monitor (measures when contraction
are happening, and internal monitor (measures how strong the
contractions are
cause cervical change
,what are the factors influencing labor during the secondary powers
(maternal pushing efforts) stage - ANSWER added once the cervix is
fully dilated
should NOT push prior to full dilation
helps to propel the fetus through the pelvis
can be impacted by exhaustion and an epidural
if a pregnant women is having contractions, when do you report them to
the RN - ANSWER any contractions that occur MORE FREQUENTLY
than every 2 minutes, LAST LONGER than 90 seconds, or have
INTERVALS SHORTER than 60 seconds
what are the factors influencing labor during the maternal position stage
- ANSWER examples of favorable labor positions:
- upright- improved descent, improved blood flow
- squat- opens up pelvis
- hands and knees- great for OP baby and opens pelvis
- side lying- improved blood flow, allows for rest
*key point- encourage frequent position changes while laboring
what are the factors influencing labor during psyche stage - ANSWER
goal
- provide the woman as much control over situation as possible
factors
- accomplishment of tasks of pregnancy
- preparation for childbirth
- past experiences
- support systems
support systems
- who are they
- evidence based practice
- decreased pain
, - decreased interventions
- decreased complications
- better outcomes
- increased satisfaction
other considerations
- anxiety
- environment
- culture
what are sings on impending labor - ANSWER braxton hicks
contractions
lightning (baby dropping) and increased vaginal discharge
bloody show
rupture of the membranes (water breaking)
energy spurt
weight loss
what do uterine contractions look like during true labor - ANSWER
regular and strong
what do uterine contractions look like during false labor - ANSWER
irregular and does not increase frequency
what does discomfort feel like during true labor - ANSWER contractions
are felt in the back and the front
what does discomfort feel like during false labor - ANSWER contractions
are felt in the front only
what does the cervix do during true labor - ANSWER dilate and efface
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