Labor and Delivery Basics Quiz

Family Nursing OB Exam 2 Blueprint Answers

• Braxton Hicks Contractions (True vs. False Labor): Contractions throughout pregnancy can become stronger and more frequent. Typically felt as a tightening in the abdomen and groin, spreading downward then relaxing. True labor contractions are often felt in the lower back and help move the cervix from a posterior to anterior position, aiding ripening and softening. They are irregular and easing by walking, voiding, eating, or changing position. Contractions last 30 seconds usually, but can last 2 minutes. As birth approaches, contractions become more intense and frequent.

• True vs. False Labor: False labor contractions are irregular uterine contractions without cervical changes. True labor's characteristics include contractions occurring at regular intervals, gradually increasing frequency, duration, and intensity, leading to progressive cervical dilation and effacement.

• Differences Between True and False Labor: A table compares these two types of labor, noting contraction regularity and strength, location of discomfort, and effect of activity on the contractions.

• Passenger (Fetus): Key factors influencing the birthing process include the fetal head (size and molding), attitude (flexion), lie (relationship of body parts), presentation (first body part), position (maternal pelvis relationship), station (location relative to pelvic inlet), and engagement.

• Fetal Head: The largest fetal structure, important in labor and birth, has variable size and diameter. Sutures (gaps between cranial bones) and fontanelles are crucial as they allow the head to mold during childbirth. Molding, and caput succedaneum (fluid collection on scalp), and cephalhematoma (blood collection) are common temporary changes.

• Fetal Attitude: Refers to the posture of joints, with most common fetal attitude at the start of labor being flexion, (body rounded, chin on chest, thighs flexed on the abdomen, and legs flexed at knees). Extension is less favorable for vaginal birth.

• Fetal Lie: The relationship of the fetus's spine to the mother's spine, important for vaginal birth. 3 possible lies are longitudinal (spine parallel), transverse (spine perpendicular), and oblique (spine at an angle).

• Fetal Presentation: The fetal body part first visible at the pelvic inlet. Cephalic (head) is most common. Breech (buttocks or feet) or shoulder are less common.

• Fetal Position: The relationship of a specific fetal landmark (like the occipital bone) to the specific quadrant of the maternal pelvis; important for labor progress; often abbreviated (e.g., LOA - Left Occiput Anterior).

• Fetal Station: Location of fetal presenting part relative to the maternal pelvic ischial spines, expressed in centimeters. Zero is at the level of the ischial spines. Positive stations are below the spines; negative are above.

• Fetal Engagement: Entrance of the largest diameter of the fetal presenting part into the maternal pelvis. Generally, this signifies the beginning of the birth process.

• Maternal/Partner Support is important for a successful childbirth experience. Support from partners, doulas, significant others, or family is valuable.

• Fetal Position: Describes the presenting part's relationship to the maternal pelvis. A landmark fetal part are assessed.

• Fetal Station: Measured in cm from the maternal ischial spine describing the position of the presenting part relative to the maternal pelvic ischial spines.

• Fetal Engagement: The largest diameter of the presenting part has entered the pelvic inlet.

• Labor Stages and Phases: The text details the characteristics of labor's three major stages: dilation, expulsion, and placental.

• Postpartum Assessment: Key areas of assessment include vital signs, pain management, skin, perineum, breasts, fundus, urinary system, and emotional status.

• Factors Affecting the Postpartum Period:

  • Medications
  • Maternal Conditions
  • Jaundice
  • Hypoglycemia

• Nursing Interventions: Various nursing interventions for the newborn and mother are detailed.

• Skin Variations: Newborn's skin variations, including common skin changes, such as vernix caseosa, stork bites (salmon patches), milia, Mongolian spots, erythema toxicum, harlequin sign, nevus flammeus, and nevus vasculosus.

• Head: Molding of the fetal head, caput succedaneum (edema), cephalhematoma (blood collection) during childbirth process. Neck: Inspect for movement/head support, assess any restricted motion. Chest: Assess for symmetry, nipple positions.

• Positioning: Importance of maternal positions is discussed. Active and directed pushing, as well as other interventions, such as applying heat or cold during labor.