LABOR AND DELIVERY 2
Terms
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- NAME 5 TERMS USED WHEN REFERRING TO THE "CLIMAX" OF PREGNANCY.
- LABOR & DELIVERY; INTRAPARTEM; ACCOUCHMENT; PARTUITION; CONFINEMENT
- CONFINEMENT
- WOMEN USED TO BE CONFINED TO BED DURING L&D.
- WHY DID CONFINEMENT OF WOMEN DURING L&D CHANGE?
- RISK FOR BLOOD CLOTS
- WHAT DOES EDC STAND FOR?
-
ESTIMATED DATE OF CONFINEMENT
EXPECTED DELIVERY DATE - DOULA DEFINITION
- SUPPORTIVE COMPANION, LABOR COACH, ADVOCATE FOR PT. DURING LABOR.
- LABOR DEFINITION
-
RHYTHMIC UTERINE MUSCLE CONTRACTIONS THAT LEAD TO:
PROGRESSIVE EFFACEMENT (THINNING) AND DILITATION OF THE CERVIX; THE DECENT OF THE PRESENTING BABY PART; EVENTUAL EXPULSION OF THE BABY AND OTHER PRODUCTS OF CONCEPTION. - DELIVERY DEFINITION
- OCCURS DURING THE 2ND STAGE OF LABOR AND IS THE ACTUAL BIRTH OF THE BABY.
- HOW MANY STAGES OF LABOR ARE THERE?
- 4
- WHAT IS STAGE 1? HOW MANY PHASES ARE THERE?
- DILATATION PHASE; THERE ARE 3 PHASES
- WHAT IS THE 1ST PHASE OF STAGE 1?
- PHASE I: CERVIX 0-4 CM; SOMETIMES CALLED EARLY PHASE, LATENT PHASE; EFFACEMENT PHASE.
- WHAT IS THE 2ND PHASE OF STAGE 1?
- PHASE II: CERVIX 4-8 CM; ACTIVE PHASE OR DILATATION PHASE.
- WHAT IS THE 3RD PHASE OF STAGE 1?
- PHASE 3: CERVIX 8-10 SM. TRANSITION PHASE OR ACTIVE DECELERATION.
-
WHICH PHASE OF STAGE 1 OF L&D IS THE LONGEST?
WHICH HAS THE STRONGEST CONTRACTIONS LASTING THE LONGEST AND IS THE MOST EFFECTIVE PHASE? -
LONGEST - PHASE 1
STRONGEST - PHASE 3 - WHAT IS STAGE II OF L&D?
- EXPULSION STAGE: STAGE OF DELIVERY OF BABY. BEGINS WHEN CERVIX IS 10 CM AND ENDS WITH BIRTH OF BABY.
- WHAT IS STAGE III OF L&D?
- PLACENTAL STAGE; FROM BIRTH OF BABY THROUGH DELIVERY OF PLACENTA. BEGINS AFTER BIRTH OF BABY AND ENDS WITH DELIVERY OF PLACENTA
- WHAT IS STAGE IV OF L&D?
- RECOVERY STAGE: IST HOUR AFTER DELIVERY OF PLACENTA OR UNTIL MOTHER IS PHYSIOLOGICALLY SAFE; ENDS WHEN SHE IS STABLE.
- WHAT IS A PRIMIP (PRIMIPARA)AND WHAT IS THE AVERAGE TIME LENGTH OF L&D?
-
1ST BABY
13-14 HOURS - SECUNDA?
- A WOMAN HAVING HER 2ND BABY.
- MULTIP?(MULTIPARA)
- A WOMAN HAVING HER 3RD OR GREATER BABY.
- ELDERLY GRAVIDA
- OVER AGE 35; MORE CAREFUL, EXTRA TESTS
- AT TERM
- GESTATIONAL AGE FROM 37-42 WEEKS
- PREMATURE
- FROM THE PERIOD OF VIABILITY TO 37 WEEKS.
- ABORTION
- REFERRING TO SPONTANEOUS MISCARRIAGE. BEFORE 20 WEEKS GESTATION. AFTER 20 WEEEKS - STILLBORN, PREEMIE
- POSTMATURE
- 42 WEEKS AND GREATER.
- AGA
- AVERAGE FOR GESTATIONAL AGE OF THAT BABY, NOT NECESSARILY FULL TERM
- SGA
- SMALL FOR GESTATIONAL AGE OF THAT BABY. POSSIBLE CAUSES: MOM SMOKED, SMALL PARENTS, POOR NUTRITION.
- LGA
- LARGE FOR GESTATIONAL AGE OF THAT BABY. POSSIBLE CAUSES: DIABETES, LARGE PARENTS.
- ATTITUDE
- THE RELATIONSHIP OF FETAL PARTS TO FETAL PARTS. FLEXION AND EXTENSION IS HOW YOU ACCOMPLISH ATTITUDE.
- LIE
- THE RELATIONSHIP OF THE LONG AXIS (SPINE) OF THE FETUS TO THE LONG AXIS OF MOTHER.
- LONGITUDINAL LIE
- CONSIDERED NORMAL- 99% LONG AXIS OF FETUS SAME DIRECTION AS MOTHER'S.
- TRANSVERSE LIE
- CONSIDERED ABNORMAL - BABY WILL NOT DELIVER AS IS. MOTHER IS PERPENDICULAR TO BABY (BABY SIDEWAYS)
- PRESENTATION
- THE PART OF THE FETUS WHICH IS LOWERMOST, WHICH CAN BE FELT BY VAGINAL EXAM.
- WHAT ARE THE 3 PRESENTATIONS?
-
CEPHALIC: HEAD IS LOWERMOST - NORMAL, 95%.
BREECH: BUTTOCKS ARE LOWERMOST - 3-4%
SHOULDER: PRESENTS WITH TRANSVERSE LIE - 1% - WHAT DETERMINES THE CEPHALIC ATTITUDES?
- THE DEGREE OF FLEXION OR EXTENSION OF THE HEAD
- WHAT ARE THE CEPHALIC ATTITUDES?
-
VERTEX - 95%
FACE - 5%
BROW - WILL NOT DELIVER AS IS - BREECH ATTITUDES
-
3.5%
FULL OR COMPLETE BREECH: HIPS AND KNEES FLEXED LIKE AN INDIAN.
INCOMPLETE OR FOOTING: ONE OR BOTH (FOOT AND LEG) DROPS DOWN. SINGLE OR DOUBLE FOOTING.
FRANK BREECH: HIPS FLEXED AND LEGS EXTENDED TO SHOULDERS. - POINT OF REFERENCE:
- AN ARBITRARY PLACE ON THE PRESENTING PART USED TO DETERMINE POSITION. EACH ATTITUDE HAS A POR.
- CEPHALIC PRESENTATION
-
VERTEX - WITH POINT OF REFERENCE - OCCIPUT:BABY'S HEAD FLEXED TO CHEST
FACE - WITH POINT OF REFERENCE - MENTUM: HYPEREXTENSION, WOULD FEEL FACE.
BROW - NO FLEXION OR EXTENSION. WILL NOT DELIVER VAGINALLY UNLESS PUSHED FACE OR VERTEX - WHAT ARE THE POSSIBLE ATTITUDES AND POINT OF REFERENCES WITH A BREECH PRESENTATION
-
COMPLETE - FULL
INCOMPLETE
FRANK
POINT OF REFERENCE FOR ALL 3 IS SACRUM - wHAT IS THE ATTITUDE AND POINT OF REFERENCE FOR A SHOULDER PRESENTATION?
-
SCAPULA - Sc - OLD METHOD
ACROMION PROCESS - A - NEW METHOD - WHAT ARE THE 3 PRESENTATION POSSIBILITIES?
-
CEPHALIC
BREECH
SHOULDER - WHAT ARE THE POSSIBLE ATTITUDES?
- VERTEX, BROW, FACE, COMPLETE, INCOMPLETE, FRANK
- WHAT ARE THE POINT OF REFERENCE POSSIBILITIES?
- OCCIPUT, MENTUM, SACRUM, SCAPULA, ACROMION PROCESS
- WHICH ATTITUDE WILL NOT DELIVER VAGINALLY?
- BROW
- WHICH BREECH PRESENTATION IS THE SAFEST TO DELIVER? LEAST SAFE?
-
SAFEST - FRANK
LEAST SAFE - INCOMPLETE - 1 LEG UP ONE LEG DOWN. - POSITION
- THE RELATIONSHIP OF THE POINT OF REFERENCE OF THE PRESENTING PART TO THE FOUR QUADRANTS OF THE MATERNAL PELVIS.
- LIGHTENING
- THE DESCENT DOWNWARD AND FORWARD OF THE UTERUS. - "THE BABT HAS DROPPED?
- ENGAGEMENT
- WHEN THE LARGEST TRANSVERSE DIAMETER OF THE FETAL HEAD (BIPARIETAL DIAMETER) HAS DESCENDED INTO THE TRUE PELVIS OR IS AT THE LEVEL OF LINEA TERMINALUS
- WHEN DOES ENGAGEMENT USUALLY OCCUR IN THE PRIMIPARA? MULTIPARA?
-
PRIMIPARA - OFTEN 2 WEEKS BEFORE LABOR
MULTIPARA - COMMON DURING LABOR - STATION
- A MEASURE OF DESCENT OF THE LOWERMOST PART OF THE FETUS IN RELATION TO THE ISCHIAL SPINES - ALSO AN ESTIMATE OF ENGAGEMENT
- ZERO STATION
- AT THE LEVEL OF THE ISCHIAL SPINES
- MINUS STATIONS
- ABOVE THE SPINES
- PLUS STATIONS
- BELOW THE SPINES
- STATIONS ARE MEASURED IN
- CENTIMETERS
- -1 STATION
- PRESENTING PART IS MOVEABLE
- -2 STATION
- BOBBING OR DIPPING
- -3 STATION
- FLOATING
- 0 STATION
- AT THE LEVEL OF SPINES
- +4 STATION
- ON THE PERINEUM - ON THE PELVIC FLOOR, BUT CAN'T SEE FROM OUTSIDE WHEN NOT PUSHING
- +5 STATION
- CROWNING - YOU CAN SEE IT BETWEEN CONTRACTIONS
- EFFACEMENT
- PROCESS IN WHICH THE CERVICAL CANAL IS PROGRESSIVELY SHORTENED AND THINNED UNTIL IT BECOMES A PART OF LOWER UTERINE SEGMENT.
- WHEN DOES EFFACEMENT OCCUR IN THE PRIMIP? MULTIP?
-
PRIMIP - EFFACEMENT PRECEDES DILATATION
MULTIPS - EFFACE AND DILATE AT SAME TIME. - DILATATION
- PROCESS BY WHICH THE EXTERNAL OS OF CERVIX ENLARGES FROM APPROX 0-10CM (COMPLETE DILATATION)
- WHAT FACTORS AFFECT THE RATE OF DILATATION
- UTERINE CONTRACTIONS, PRESENTING PARTS (AREA OF HEAD-VERTEX IS BEST FORCE), AMNIOTIC FLUID-FOREWATER - HYDROSTATIC PRESSURE WITH INTACT MEMBRANES ACTING AS DILATOR.
- AMNIOTOMY
- ARTIFICIAL RUPTURE OF MEMBRABANES
- WHAT ARE NURSES RESPONSIBILITY REGARDING AMNIOTOMY?
- RECORD FHR BEFORE & AFTER PROCEDURE; RECORD AMT AND COLOR OF FLUID; RECORD PROCEDURE TIME;ASSESS FOR PROLAPSED CORD; ASSESS FOR PROGRESS OF LABOR.
- WHAT ARE SOME POSSIBLE COLORS OF THE AMNIOTIC FLUID AND THE CAUSES?
- SLIGHTLY YELLOW-MECONIUM: HYPOXIA CAUSES ANAL SPHINCTER TO RELAX. WINE COLOR-BLOOD;COCA COLA COLOR -FETAL DEMISE. WATCH FOR PROLAPSED CORD. CAN BE OVERT - OUT OF VAGINA OR COMPRESSED WITH CONTRACTIONS
- RIPE CERVIX
- SOFT, SHORT, MOVES TO ANTERIOR POSITION (READY FOR LABOR)
- GREEN CERVIX
- LONG, FIRM AND POSTERIOR
- STRIP THE MEMBRANES
- PULL THE MEMBRANE AWAY FROM CERVIX-CAUSES CHANGE-PERSON WILL GO INTO LABOR WITHIN 48 HOURS.
- BOW
- BAG OF WATER (AMNIOTIC FLUID), MEMBRANES - RUPTURED OR INTACT?
- PROM
- PREMATURE RUPTURE OF MEMBRANES
- PROLONGED RUPTURE OF MEMBRANES LEADS TO WHAT RISK?
- RUPTURED FOR 24 HOURS - INCREASED RISK FOR INFECTION.
- WHAT ARE THE CHARACTERISTICS OF TRUE LABOR?
-
-PROGRESSIVE CERVICAL CHANGES
-CONTRACTIONS ARE REGULAR, GRADUALLY GET STRONGER, LAST LONGER, BECOME MORE FREQUENT
-DISCOMFORT BEGINS IN BACK AND RADIATES DOWN OVER BODY OF UTERUS
-WALKING USUALLY INCREASES FREQ. INTENSITY, AND DURATION - WHAT ARE THE CHARACTERISTICS OF FALSE LABOR?
-
-NO SIGNIFICANT CERVICAL CHANGES
-MIMIC REGULAR CONTRACTIONS BUT DO NOT GRADUALLY INCR. IN FREQ., INTENSITY, AND DURATION.
-DISCOMFORT IS USUALLY FELT IN LOWER ABDOMEN AND GROIN
-WALKING HAS NO EFFECT ON. MAY DECREASE CONTRACTIONS - CPD - CEPHALOPELVIC DISPROPORTION
- DISPARITY IN SIZE BETWEEN THE BIRTH CANAL AND FETUS
- FUNIS
- UMBILICAL CORD
- SHOW
- BLOOD FROM THE RUPTURE OF TINY CAPILLARIES IN THE CERVIX AS IT DILATES
- PRECIPITOUS - RAPID - DYSFUNCTIONAL
-
-LABOR LASTING 3 HOURS OR LESS
- MAY BE REFERRED TO AS PRECIPITOUS WHEN THERE IS NO PHYSICIAN IN ATTENDANCE OR PATIENT "PRECIPITATES" IN BED - SPONTANEOUS
- OCCURRING NATURALLY, WITHOUT ASSISTANCE.
- SVD
- SPONTANEOUS VAGINAL DELIVERY WITHOUT FORCEPS.
- SROM
- SPONTANEOUS RUPTURE OF MEMBRANES
- INDUCED
- CAUSING OR INITIATING LABOR
- STIMULATE OR AUGMENT
- TO INCREASE THE RATE OF LABOR
- ELECTED OR ELECTIVE
- PERFORMED BY CHOICE. IS NOT ESSENTIAL -DECISION BETWEEN PT. AND DR.
- DYSTOCIA
- DIFFICULT AND/OR PROLONGED LABOR - 60-90 SECONDS CONTRACTIONS
- TETANIC CONTRACTION
- A CONTRACTION IN WHICH DURATION LASTS TWO MINUTES OR MORE - MORE RISK FOR BABY, MORE TIME WITHOUT O2
- CROWNING
- SIGHT OF THE PRESENTING PART AT THE VAGINAL ORIFICE BETWEEN CONTRACTIONS.
- VBAC
- VAGINAL BIRTH AFTER CESAREAN