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Questions and Answers
What is the main theory that suggests that stretching of a hollow muscular organ, such as the uterus, leads to contractions?
What is the main theory that suggests that stretching of a hollow muscular organ, such as the uterus, leads to contractions?
The occipitofrontal diameter is measured from the inferior aspect of the occiput to the anterior fontanel.
The occipitofrontal diameter is measured from the inferior aspect of the occiput to the anterior fontanel.
False
What does molding refer to in relation to the fetal head?
What does molding refer to in relation to the fetal head?
Molding refers to the overlapping of the fetal skull bones due to pressure during labor, which allows the head to pass through the birth canal more easily.
The ______ of a contraction refers to its strength, while the ______ refers to its duration.
The ______ of a contraction refers to its strength, while the ______ refers to its duration.
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Which of the following are TRUE statements concerning the various childbirth settings? (Select all that apply).
Which of the following are TRUE statements concerning the various childbirth settings? (Select all that apply).
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What are the five “P’s” that influence labor and birth?
What are the five “P’s” that influence labor and birth?
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A pregnant woman experiencing a contraction that is not accompanied by changes in cervical dilation or effacement is likely experiencing true labor.
A pregnant woman experiencing a contraction that is not accompanied by changes in cervical dilation or effacement is likely experiencing true labor.
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Which of the following are types of fetal presentation?
Which of the following are types of fetal presentation?
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The most favorable fetal position for vaginal delivery is left occipitoanterior, which is when the fetal head is facing the mother's left side with the back of the head (occiput) facing the front.
The most favorable fetal position for vaginal delivery is left occipitoanterior, which is when the fetal head is facing the mother's left side with the back of the head (occiput) facing the front.
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The presence of a full bladder during labor can contribute to dysfunctional labor or inefficient fetal descent.
The presence of a full bladder during labor can contribute to dysfunctional labor or inefficient fetal descent.
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The most common position for delivery is:
The most common position for delivery is:
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What is the difference between “station” and “presentation” during labor?
What is the difference between “station” and “presentation” during labor?
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The true pelvis is the wider, upper portion of the pelvis with no significant clinical impact on childbirth.
The true pelvis is the wider, upper portion of the pelvis with no significant clinical impact on childbirth.
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What is the most important transverse diameter of the fetal head that influences labor?
What is the most important transverse diameter of the fetal head that influences labor?
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The use of a side-lying position for a laboring woman in labor is considered undesirable , as it is potentially harmful.
The use of a side-lying position for a laboring woman in labor is considered undesirable , as it is potentially harmful.
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What are the characteristic differences between true labor and false labor?
What are the characteristic differences between true labor and false labor?
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Study Notes
Objectives
- Students will be able to discuss theories of labor onset
- Describe signs and symptoms of labor
- Differentiate between true and false labor
- Contrast advantages and disadvantages of different childbirth settings
- Explain the 5 Ps and how they influence labor and birth
- Differentiate the 4 stages of labor
- Identify nursing actions for each stage
- Identify common discomforts
- List 5 nursing diagnoses for childbearing women
Intrapartum
- Also known as parturition or childbirth
- Begins with contractions and ends 4 hours after delivery
- All products of conception – baby, placenta, fetal membranes – are expelled
- Intrapartum care covers labor and delivery
- Terms like toco- and toko- relate to childbirth
- Eutocia: normal labor
- Dystocia: difficult labor
Labor
- Uterine contractions expel the fetus and products of conception
- Parturient woman: woman in labor
- Puerpera: woman who has given birth
Theories of Labor Onset
- Uterine stretch theory: Hollow muscular organs contract when stretched to capacity.
- Oxytocin theory: Rising oxytocin levels stimulate contractions near term.
- Prostaglandin theory: Fetal membranes produce prostaglandins, hormones that start uterine contractions.
- Progesterone theory: Decreasing progesterone around term allows uterine contractions to occur.
- Aging placenta theory: Aging placenta produces less progesterone, leading to rising prostaglandin and estrogen levels and promoting contractions. Also includes fetal adrenal and pituitary hormones initiation of labor.
Passenger (Fetus)
- Fetal head: Major presenting part; bony and noncompliant.
- Sutures and fontanelles: Spaces between skull bones allow for molding during birth. Important landmarks include the sinciput (brow), vertex (top), and occiput (back of the head). Various diameters (biparietal, bitemporal, bimastoid) are essential to understand fetal head's relationship to pelvic dimensions.
- Fetal lie: Relationship of fetal long axis to mother's long axis. Longitudinal lie (parallel) is most common. Transverse lie (perpendicular) is unusual.
- Fetal attitude: Relationship of fetal parts to each other. Complete flexion is most favorable for vaginal birth.
- Fetal presentation: Part of fetus first entering the pelvis. Cephalic (head first) is desirable; breech or shoulder presentations are less ideal.
- Different types of presentations (Vertex, complete breech, Frank Breech, Footling breech) & their associated attitudes (attitude of flexion, extension...).
Passageway (Pelvis)
- Pelvis is the birth canal, divided into false and true pelvis.
- Important measurements include diagonal conjugate, true conjugate, obstetrical conjugate, and ischial tuberosity diameter.
- Soft tissue structures (cervix, vagina, perineum) must stretch. Progesterone and relaxin impact tissue elasticity.
- Specific pelvic shapes (gynecoid, anthropoid, platypelloid, android) influence vaginal delivery options.
Powers
- Uterine contractions: Primary power driving labor. Phases include increment, acme, and decrement; intensity is measured in millimeters of mercury (mmHg).
- Frequency: Time between the start of one contraction to the start of the next, measured in minutes.
- Duration: Length of a contraction, measured in seconds.
- Intensity: Strength of contractions, measured in mmHg.
- Hydrostatic pressure: Pressure from amniotic fluid aids in cervical dilation.
- Maternal pushing: Important in the second stage of labor.
Psyche/Psychological Response of Mother
- Psychological state, feelings experienced, coping mechanisms play a significant role during labor.
Position of Mother:
- Frequent changes in positions during labor are crucial for comfort and circulation. Upright, lateral, semi-recumbent positions are beneficial
- Positions like sitting, kneeling, squatting, walking, semi-sitting, side-lying offer support and aid in labor.
Fetal Position
- Relationship of the fetus' presenting part (e.g., occiput, sacrum) to the maternal pelvis, categorized by its relationship to the left, right, anterior, and posterior sides. e.g. Left occipital anterior (LOA)
Station
- Level of fetal presenting part relative to the ischial spine, an anatomical landmark in the mother's pelvis.
False and True Labor
- False labor (Braxton Hicks) contractions aren't progressive, aren't regular in intensity, frequency, or duration, and often diminish with activity or rest.
- True labor contractions are progressive in intensity, frequency, and duration. They are regular, typically intensify with activity, and cause cervical dilation and effacement.
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Description
Test your knowledge on the theories of labor onset and the various stages of childbirth. This quiz covers signs and symptoms of labor, nursing actions during each stage, and differentiations between true and false labor. Prepare to explore the complexities of labor and delivery in this comprehensive quiz.
