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OB - Spring 2016 > Labor & Delivery - Unit 2 (Class) > Flashcards

Labor & Delivery - Unit 2 (Class) Flashcards

1
Q

Contractions - coordinated (def)

A

contracts all at once.

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2
Q

Contractions - involuntary (def)

A

we can’t make it do it - we can’y say contract now, mother fucker!

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3
Q

How do we measure frequency of contractions?

A

You start from the beginning of one contraction to the beginning of the second contraction.

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4
Q

Contractions - measured in hours. T/F?

A

FALSE - minutes minutes minutes minutes MINUTES!

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5
Q

Duration - how do we measure duration of contractions?

A

From start to finish. IN SECONDS

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6
Q

Contraction cycle - Increment - Top - Decrement - Interval -

A

Increment - going up! Top - peak (aka acme) Decrement - going down! Interval - space between contractions.

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7
Q

Intensity - what do mild, moderate, and strong feel like?

A

Mild = soft like nose. Moderate = chin. Strong = forehead.

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8
Q

Contractions - can tell intensity from monitor. T/F?

A

FALSE, UNLESS there is an internal monitor.

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9
Q

Cervix is usually as thick as pinky is long. T/F?

A

True

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10
Q

Effacement = what?

A

Thinning - the cervix becomes very thin, like paper - it almost disappears. You can feel the babies head when it’s 100%

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11
Q

Dilation = what?

A

The cervix becomes open. It is in cm. Complete = 10. A cheerio = finger tip cervix.

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12
Q

What happens to the cardiovascular system during labor?

A

Increased BP with contractions, increased blood volume, decreased pulse during contraction.

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13
Q

What happens to the respiratory system during labor?

A

Increased RR, increased O2 demand, watch for hyperventilation.

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14
Q

What happens to the GI system during labor?

A

Slows down! just tell the pt to act like they are having a big shit…that’ll help!

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15
Q

What happens to the urinary system during labor?

A

You lose bladder sensation - it’s easy for the mom to get a full bladder/distended bladder and she might not even realize she has to pee!

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16
Q

Full bladder won’t allow for baby to descend. T/F?

A

True

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17
Q

If the mom has to pee, check the dilation/cervix/ first. T/F?

A

TRUE - or you could have a baby on your hands.

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18
Q

What happens to the blood during labor?

A

BV increased about 1.5 liters from the start of pregnancy. Total loss = 500 m. late stage = a hypercoaguable state, meaning we are aware of risk for DVT. Clotting factors are increased.

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19
Q

When uterus clamps down, circulation is decreased to little one. T/F?

A

True

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20
Q

Can babies go a minute/minute and a half without oxygen when the cord is clamped during a contraction?

A

Yes

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21
Q

Cord is cut - what happens with the ductus arteriosus, foramen ovale, and ductous venosus?

A

They close!

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22
Q

What are 4 components of the birth process?

A

Powers (making it happen!), Passage (pelvis), Passenger (bambino!) and Psyche (mental part of it!)

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23
Q

Passage - what is the difference between the false pelvic and true pelvis?

A

False = top of pelvis and has nothing to do with birth process. True = lower porition, including inlet (upper pelvic opening, midpelvis (pelvic cavity) and outlet (lower pelvic opening).

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24
Q

Cartilage in pelvis will start to relax due to the hormone relaxin. T/F?

A

True

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25
Q

Babies head bones aren’t fused. T?F?

A

True - makes it easy for them to be pushed through.

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26
Q

Flexion - moderate poor full

A

Mod (Military) = kind of flexed but not really. Poor (Brow) - almost how we look. Full extension (Face)- you’ll feel the face!

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27
Q

What’s the vertex presentation?

A

Complete flexion - chin to chest.

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28
Q

Cephalic down position = the worst. T/F?

A

FALSE - it’s the best.

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29
Q

Transverse = what angle?

A

90 degree

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30
Q

Look at babies head and where it touches- that determines position. T/F?

A

True

31
Q

We want the baby to be born OA = what does that mean?

A

Occipital anterio.

32
Q

What’s OP?

A

Occipital posterior - like ellie was born!

33
Q

Right or left = babies right or left. T/F?

A

FALSE - it’s mom’s.

34
Q

Posterior - risk for back labor/pain. T/F?

A

True

35
Q

Name the positions!

A

Just look at the other!

36
Q

Psyche - what does it include?

A

Aniety, fear - they can stall labor. Help patient & talk to them. Get up in that pudenda!

37
Q

Braxton Hicks - has a pattern. T/F?

A

FALSE - it does not.

38
Q

In order to be in labor, you have to have contractions, discomfort, and cervical dilation. T/F?

A

True

39
Q

What is descent?

A

Going down (baby) - pretty much the same as lightening.

40
Q

What is Engagment?

A

In pelvis.

41
Q

What is internal rotation?

A

Coming down and rotating (baby)

42
Q

Extension - as babies head comes out, it’s going to look up and be like “hey bitches!” T/F?

A

True (just minus the words)

43
Q

External rotation - as the baby moves out, what happens with shoulders?

A

They move out, shoulders come one at a time.

44
Q

Babies are nose breathers, so clean their mouth out first. T/F?

A

True - that way it won’t go back down in their throat.

45
Q

What are the 3 parts of the first stage of labor?

A

Latent, active, transition

46
Q

What happens during the latent stage?

A

From close to 3cm. It can be quite long. Mom may not know she’s in labor. Longer for 1st time mom. Contractions gradually increase. Contractions are 20-40 seconds long and are 5 minutes apart.

47
Q

What are moms like during the latent stage?

A

Sociable, happy, yay!

48
Q

What occurs during active?

A

4-7 cm. Completely effaced, Fetus descends in pelvis, rotates, etc.

49
Q

What are contractions like during the active stage?

A

2-5 minutes apart, 30-60 seconds in length. More uncomfortable.

50
Q

What’s the mom like during the active stage?

A

Anxious, uncomfortable - “oh boy, we are having a baby. This is real!”

51
Q

Transition - length? Info?

A

SHORT and INTENSE. COntractions and everything are moving right along 1-1.5 minutes apart, 60-90 seconds in length. Not much rest in between.

52
Q

What is mom like during transition phase?

A

CRAZY. MIGHT LOSE CONTROL. N/V, shaking, etc. Vomiting can cause baby to come out.

53
Q

What occurs during the second stage of labor?

A

You’re 100% effaced, and contractions can subside for a bit. Best thing for mom is to “labor down” - baby is coming so let mom have a few. She might say “i feel better, have a new sense of purpose, I’ve come this far!”

54
Q

What happens with the third stage?

A

Starts with birth of baby and goes until the placenta comes out. Once baby comes out, the cavity gets smaller and the placenta seperates away.

55
Q

It’s okay to pull on the cord to get the placenta out. T/F?

A

FALSE - never ever ever ever do that.

56
Q

When is the 4th stage?

A

1-4 hours after. 2 hour checks common. Check for bleeding, fundal height, vital signs, etc.

57
Q

Fundal check - it should feel hard after birth. T/F?

A

True

58
Q

If the fundus is too soft, what do we do?

A

Massage it - hold on to the ligaments (so it doesn’t fall out and massage!)

59
Q

What is lochia?

A

The bleeding post partum. A little bit is okay, but nothign crazy!

60
Q

Should we ask questions about home meds and such?

A

YES. Be detailed.

61
Q

What’s the litmus paper for?

A

Shows pg - if it changes colors, yeah, you’ve ruptured. If not, you just wet yourself.

62
Q

When calling provider, what should we provide?

A

All sorts of stuff - gravida, para, EDC, etc.

63
Q

Fetal fibrinectin test - what do it do?

A

Shows , within a good amount of reason, that you’re going to give birth soon!

64
Q

If they say they want EXCLUSIVE breast feeding, we need an order for formula. If they say they don’t care, we don’t need an order.

T/F?

A

True

65
Q

Bishop score - what is it?

A

How ready the cervix is for labor.

66
Q

Vitals/contraction assessments - ever 30 minutes until active, then every 15 minutes. T/F?

A

True

67
Q

If uterus doesn’t constrict, what can happen?

A

BLEEDING

68
Q

Apgar’s - 1 minute and then 5 minutes - repeat every 5 minutes if under 7. T/F?

A

True

69
Q

Apgar - activity -

0 =

1 =

2 =

A

0 = Absent

1 = Arms and legs flexed

2 = Active movment

70
Q

apgar - pulse

0 =

1 =

2 =

A

0 = absent

1 = below 100

2 = above 100

71
Q

Apgar - grimace (reflex irritability)

0 =

1 =

2 =

A

0 = flaccid

1 = some flexion of extremities

2 = active motion, cough, pull away, sneeze

72
Q

apgar - appearance (color)

0 =

1 =

2 =

A

0 = blue, pale

1 = body pink, extremities blue

2 = completely pink

73
Q

apgar - respirations

0 =

1 =

2 =

A

0 = absent

1 = slow, irregular

2 = vigorous cry

74
Q
A

OB - Spring 2016 (18 decks)

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