Birth and the Family Ch 17-19
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84 terms
Terms | Definitions |
|---|---|
 Birth passage, Passenger, Presentation, Power, and client psyche | What are the factor critical factors that influcence labor in the assessment of an expectant woman and the fetuss progress in labor and birth? |
| gynecoid | this pelvis type has a rouned inlet, midpelvis with parallel side walls and adequate outlet; favorable for vaginal birth |
| android | lnlet heart shaped, with shor posterior sagittal diameter , midpelvis is reduced and outlet capacity is reduced; not favorable for vaginal birth |
| anthropoid | inlet oval in shape, with long anteroposterior diameter, midpelvis diameter adequate and outlet adequate; favorable for vaginal birth |
| playtypelloid | inlet oval in shape with long transverse diameters, midpelvis diameter reduced outlet capacity inadequate; not favorable for vaginal birth |
| gynecoid and anthropoid | which two pelvic types are favorable for vaginal delivery? |
| this is called MOLDING,when the bones of the skull are not fused togetherso that the head can adjust in shape while desending down the birth canal | A mother just had a new, born girl, she asked the nurse why her babies head is odd shaped, what should the nurse say? |
| anterior fontanelle | this fontanelle is diamond shaped and measures about 2cm by 3 cm, it remains unossified for as long as 18mths |
| posterior fontanelle | this fontanelle is shaped like a small triangle and closes with in 8-12 weeks after birth |
| fetal attitude | refers to the relation of the fetal parts to one another |
| normal attitude | when the fetus has moderate flexion of the head, flexion of the arms onto the chest and flexion of teh legs onto the abdomen. |
| fetal lie | this refers to the relationship of the cephalocaudal axis (spinal column) of the fetus the the spinal column of the mother |
| fetal presentaion | this is determined by fetal lie and the by the body part of the fetus that enters the pelvic passage first |
| cephalic, breech or shoulder | how can the fetus present |
| malpresentations | breech and shoulders presentation are associated with difficulties during labor and |
| fetal position | the relationship of the designated landmark on the presenting part to teh front, sides, or back of the maternal pelvis |
| LOA | what is the most favorable fetal position for vaginal birth |
| increment, acme, decrement | what are the three phase of the contraction |
| contraction | what is the power during labor |
| frequency, duration, intensity | How are contractions assessed? |
| frequency | Refers to the time between the eginning of one contraction and the beginning of teh next contraction |
| duration | the measurement from the beginningof a contraction to the completion of that same contraction |
| intensity | the strenght of the contraction during acme. |
| acme | The peak of the contraction |
| influences on the client psyche | the unknown, expectations, life changing event, well vs sick, and preperation |
| progesterone withdrawal and prostaglandins | What causes labor to begin |
| true labor | A women comes in with the complaint of regular, strong, long contractions that increase in intensity with walking. |
| true labor | you do a vaginal exam and notice that the cervix is progressively dilating and effaceing |
| effacement | the drawing up of the internal os and the cervical canal into the side walls of the uterus, thinning |
| false labor | contraction are irregular, with no change in cervix, not discomfort in the abd, walking has not effect or decreases contractions |
| first stage of labe | begins with the onset of true labor and ends when the cervix is completely dilated |
| second stage of labor | this stage of labor begins with complete dilation of cervix and ends with the birth of the baby |
| third stage of labor | begins with the birth of the baby until the dilivery of the placent |
| fourth stage of labor | 1-4 hours after birth of the explusion of the placenta and the mothers body is readjusting to the changes |
| first stage of labor | this stage of labor has three phases |
| latent, active and transition phase | what are the phase of the first stage of labor |
| latent | the phase that starts with the beginning of regular contractions that are mild discomfort |
| latent phase | you assess the patient and note that her contractions are every 5-7 mins lasting 30-40 sec. Cervical dilation is 0-3 cm. moter is talkative and smiling and eager to answer questions |
| 8.6 hours but not lasting more than 20 | for a nullipara the latent phase averages |
| 5.3-14hours | for a mulitpara the latent phase averages |
| active phase | you assess your laboring patient, you notice that her contractions are every 2-3 min last 60 second. Cervical dilation is 4-7cm. |
| active | you notice that your mothers behavior is showing a decreased abiltiy to cope and a sense of helplessness |
| transition phase | you assess you mother and find that her contractions are 2 mins apart and are lasting for 60-90 sec. Cervix is 8-10cm dilated |
| transition phase | you patient is showing significant anxiety she becomes acutely aware of her contractions force and intensity. She becomes restless and frequently changes position. fear of being left alone |
| stage 2 of labor | In this stage of labor the fetal head descends and the mother has the urge to push, you notice the head of the baby crowning. |
| stage 2 of labor | In this stage of labor spantaneous birth occurs and the positional changes of the fetus occurs. |
| shiny schultze | you examine the placenta and see that it has a shiny side you know that this is the side that was to the fetus |
| dull duncan | you examine the placenta and notice that it is rought and the outer margins roll inward, you know that this side of the placenta was to the mother |
| no it is normal loss | After the placenta is expelled you observe that the mother has lost 250-500ml of blood, is this cause for alarm? |
| to be expected because of the blood loss and the blood is being redistributed into the venous beds | In the fourth stage of labor, your assessing the mothers vital signs, you notice a moderate dropp in blood pressure, increase in pulse and moderate tachycardia |
| to be expected in the fourth stage of labor | you asses the fundus in the fourth stage of labor, you note midway between the symphysis pubis and umbilicus |
| to be expected in the fourth stage of labor | your mother is in the fourth stage of labor and she starts to experience shaking and chills |
| fundus, vital signs, lochia, bladder, perineum, pain | What shoud be assessed in the 4th stage of labor (early postpartum) |
| postion, presentation, activity, FHR | what is the fetal assessment during labor |
| leopolds maneuvers | a systematic way to evaluate the maternal abdomen to determine the position of the fetus |
| have to women empty her bladder and lie on her back with her feet on the bed and her knees bent | what should you have to mother do before performing the leopolds maneuvers |
| EFM (electronic fetal monitoring) | this produces a continuous trcing of the FHR |
| factors that can reduce fetal oxygentaion | maternal HTN, hypotension, hypoxia, hypertonic uterine activity, placental disruption, umbilical cord compression, fetal bradycardia and tachycardia |
| normal FHR | FHR of 110-160 |
| Fetal tachycardia | fetal heart rate over 161 |
| marked tachycarida | fetal heart rate of 180 or above |
| fetal bradycardia | a fetal heart rate less than 110 lasting 10 min or longer |
| variablity | changes in the fetal heart rate |
| baseline variability | mease of the interplay between the sympathetic and parasymphatic nervous system that over a 10 min period |
| acclerations | transient increase in the FHR normally caused by fetal movement |
| deceleration | periodic decreases in the FHR from the normal baseline |
| early decleration | decleration that occurs before the onset of the uterine contraction |
| late decleration | the onset of the deceleration occurs after the onset of the contraciton, casued by uteroplacental insufficiency resulting from decrease blood flow and oxygen transfer to the fetus during contractions |
| variable deceleration | deceleration that occurs if teh umbilical cord becomes compressed increasing peripheral resistance in teh fetal circulation causes fetal hypertension |
| change maternal position discontine oxytocin if ordered assess for prolasped cored or change in the labor process | you notice isolated or occasional moderate variable decelerations, what do you do? |
| administer O2, prepare for csection | actions for variable declerations that are severe and uncorrectable |
| administer o2, maintain hydration, moniotr maternal bp for signs of hypotension, | actions for late decelerations |
| maintaint maternal position on left side, administer o2, dc oxytocin, increase IV fluids, prepare for immediate csection | actions for late decelerations with tachycardia or decreasing variabilty |
| r/o prolapsed cored, change maternal postion, dc oxytocin, increase IV, administer toclytic if hypertonus, anticipate normal FHR recovery following deceleration if previously normal , anticipiate intervention if FHR abnormal or deceleration last long that 3 min | actions for prolonged deceleration |
| nonreassuring patters in FHR | severe variablity, late decleration of any magnitude, absence of variability, prolonged deceleration, severe bradycarida |
| reassruing FHR patterns | baseline 110-160, variablity is present, variablity is at least two cycles per minute with periodic patterns consist of accelerations with fetal movement and early deceleration may be present |
| fetal blood sampling | when teh examiner applies pressure to the fetal scalp while doing a vaginal examination |
| supportive relaxation techniques | destraction, massage, touch, effleurage (firm pressure on thelower back or sacral area to relieve back pain) |
| on vein and two arteries | when assessing the umbilical cord what is normal with the A/V |
| good condition | new born with apgar score of 7-10 |
| 1-5 min | when is the apgar scored tested |
| resuscitation | what is the course of action when the apgar score is less than 7 |
| 36-60 | normal new borns respirations |
| 36.5 c (97.8 f) | newborn body temperature |
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