First Stage of Labor Quiz
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Questions and Answers

What characterizes the active phase of the first stage of labor?

  • Dilatation of 0-3 cm with mild intensity contractions
  • Dilatation of 8-10 cm with strong contractions
  • Contractions occurring every 10-15 minutes
  • Dilatation of 4-7 cm with moderate intensity contractions (correct)

At what dilatation level is the mother considered fully dilated?

  • 100% (correct)
  • 50%
  • 75%
  • 25%

During which phase of labor might a mother experience hyperesthesia?

  • Transitional Phase (correct)
  • Active Phase
  • Latent Phase
  • Postpartum Phase

What indicates that the presenting part is engaged during labor?

<p>0 station (B)</p> Signup and view all the answers

What is the purpose of sacral pressure during the transitional phase of labor?

<p>To manage discomfort (A)</p> Signup and view all the answers

What is the primary purpose of monitoring vital signs during the first stage of labor?

<p>To assess maternal and fetal well-being (C)</p> Signup and view all the answers

In which position should a laboring mother rest to prevent supine vena cava syndrome?

<p>Left side lying position (A)</p> Signup and view all the answers

What is the contraindication for administering DEMEROL during the latent phase of labor?

<p>It may cause respiratory depression (A)</p> Signup and view all the answers

What does the term 'lightening' refer to in the context of labor?

<p>The fetus engaging in the pelvis (B)</p> Signup and view all the answers

Which stage of labor includes the delivery of the head in vertex presentation?

<p>Extension (D)</p> Signup and view all the answers

What is the primary risk associated with a median episiotomy?

<p>Possibility of extending to the anal sphincter (A)</p> Signup and view all the answers

What is the first requisite for the birth of the baby during labor?

<p>Descent (D)</p> Signup and view all the answers

What occurs during the external rotation phase of labor?

<p>Turning of the back of the baby’s head (C)</p> Signup and view all the answers

What is typically done to address hypotension caused by epidural anesthesia?

<p>Elevate the mother's legs (C)</p> Signup and view all the answers

Which of the following describes the mechanism of engagement during labor?

<p>The fetal head passes through the pelvic inlet (B)</p> Signup and view all the answers

Flashcards

First Stage of Labor

The first stage of labor begins when true labor contractions start and lasts until the cervix is fully dilated and effaced. This stage lasts from 12 hours to complete.

Effacement

Effacement refers to shortening and thinning of the cervix during labor. It's expressed as a percentage from 0% to 100%.

Dilatation

Dilatation refers to the opening of the cervix during labor, measured in centimeters (cm). A fully dilated cervix is 10 cm.

Station (Labor)

Station refers to the relationship of the baby's head to the ischial spine, a bony landmark in the pelvis. It is used to track the baby's descent through the birth canal.

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Active Phase (Labor)

The active phase of labor is when cervical dilation increases from 4-7 cm. This stage is characterized by more frequent uterine contractions, moderate intensity and lasting approximately 40-60 secs which happen every 3-5 mins..

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Fetal Position During Labor

Describes the location of the fetus's head in relation to the mother's pelvis.

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Engagement (Labor)

Fetal head passing through pelvic inlet, crucial for labor.

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Descent (Labor)

The movement of the fetus into the birth canal.

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Flexion (Labor)

Fetal chin tilting to chest to allow smaller birth passage.

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Internal Rotation (Labor)

Fetal head turning to face the mother's pubic bone.

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Extension (Labor)

Fetal head emerging from the birth canal.

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External Rotation (Restitution)

Fetal head turns to align with baby's body.

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Expulsion (Labor)

Complete delivery of the baby.

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Episiotomy

Surgical incision of the perineum during delivery, to prevent tearing.

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Supine Hypotension

Low blood pressure that can occur when a pregnant person lies on their back.

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Study Notes

First Stage of Labor

  • Duration: 12 hours
  • Definition: Onset of true labor contractions to full dilatation and effacement of the cervix

Stages of Effacement & Dilatation

  • Latent Phase:
    • Cervical dilation: 0-3 cm
    • Contraction frequency: 5-10 minutes, duration: 20-40 seconds
    • Contraction intensity: Mild
  • Active Phase:
    • Cervical dilation: 4-7 cm
    • Contraction frequency: every 3-5 minutes, duration: 40-60 seconds
    • Contraction intensity: Moderate
  • Transitional Phase:
    • Cervical dilation: 8-10 cm
    • Contraction frequency: every 2-3 minutes, duration: 60-70 seconds
    • Contraction intensity: Strong
    • Duration: Primi (1 hour), Multi (30 minutes)
    • Emotional and sensory changes: Increased sensitivity (hyperesthesia)
    • Management: Sacral pressure, cold compress
    • Nursing care: Provide emotional support, encourage relaxation techniques, monitor discomfort
    • Pelvic Exams:
      • Effacement: Shortening of the cervical canal. Measured as a percentage (e.g., 25%, 50%, 75%, 100%).
      • Dilatation: Opening of the cervical canal. Measured in centimeters (e.g., 1 cm, 2 cm, etc.). 100% means complete dilation.
      • Station: Relationship of the presenting part to the ischial spine (-4 to -1 = above the spine, 0 = at the spine, +1 to +4 = below the spine)

Nursing Considerations during First Stage of Labor

  • Hygiene: Bath recommended
  • Vital Signs: Monitor blood pressure; elevated BP requires physician notification
  • Nutrition: Light meal
  • Urinary Function: Encourage voiding
  • Perineal Preparation: Perineal care (rule of 7)
  • Positioning: Left lateral recumbent position to prevent supine hypotension syndrome
  • Amniotomy: If membranes haven't ruptured, amniotomy may be required
  • Fetal Distress: Monitor for fetal distress

Pain Management

  • Systemic Analgesics:
    • Demerol (Meperidine HCl): Narcotic and antispasmodic. Avoid in latent phase. Used at 6-8 cm dilation. Watch for respiratory depression.
    • Epidural Anesthesia: Watch for hypotension risk. Pre-hydrate the patient. In case of hypotension, elevate legs, increase IV fluids.

Second Stage of Labor (Fetal Stage)

  • Definition: From complete dilation and effacement to birth
  • Characteristics: Crowning, lithotomy position

Fetal Descent

  • Engagement: Fetal head passing through pelvic inlet.
  • Descent: Moving through the pelvis.
  • Flexion: Fetal chin to chest
  • Internal Rotation: Head turns towards the pubic bone.
  • Extension: Head emerges from vaginal opening
  • External Rotation: Restitution- return to original position.
  • Expulsion: Complete birth of baby.

Episiotomy

  • Surgical incision of the perineum.
  • Types:
    • Median episiotomy: Common, midline incision, easier to repair.
    • Mediolateral episiotomy: Incision starts midline & extends towards the anus.

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Description

Test your knowledge on the first stage of labor, including the phases of effacement and dilation. This quiz covers key aspects such as contraction frequency, intensity, and nursing care during labor. Ideal for nursing students and healthcare professionals.

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