Labor and Delivery Process Overview

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Questions and Answers

What characterizes the active phase of labor?

  • Contractions are irregular and mild.
  • Frequency of contractions is 3 to 5 minutes. (correct)
  • Maternal discharge is usually bright red and heavy.
  • Cervical dilation from 0 cm to 5 cm.

Which of the following describes a typical maternal characteristic during the latent phase of labor?

  • Talkative or calm with ability to follow directions. (correct)
  • Very focused and serious demeanor.
  • Exhibiting signs of distress and agitation.
  • Need for constant reassurance and support without breaks.

What is the primary focus of the five P's of labor?

  • Assessment of maternal nutritional needs.
  • Monitoring changes in fetal heart rate.
  • The role of paternal involvement during delivery.
  • Factors that affect the labor process and delivery. (correct)

What indicates a potential issue immediately after the rupture of membranes?

<p>Assessing fetal heart rate for abrupt decelerations. (D)</p> Signup and view all the answers

During which stage of labor does cervical dilation occur from 6 cm to 10 cm?

<p>Active phase. (B)</p> Signup and view all the answers

What is a common physiological change experienced before labor begins?

<p>Lightening, or fetal head descent into the pelvis. (C)</p> Signup and view all the answers

What does the amniotic fluid typically look like when healthy?

<p>Watery, clear with a slight yellow tinge. (B)</p> Signup and view all the answers

What is typically observed in contractions during the transition phase of labor?

<p>Strong and occur every 2 to 3 minutes. (C)</p> Signup and view all the answers

What is a common maternal characteristic during the transition phase of labor?

<p>Severe pain and feelings of helplessness (C)</p> Signup and view all the answers

Which of the following describes the second stage of labor?

<p>The period of pushing and fetal descent (B)</p> Signup and view all the answers

What is one of the presentations that can occur during the delivery of the placenta?

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

Which of the following describes the 'lie' of a fetus in labor?

<p>The orientation of the fetal head relative to the mother's pelvis (C)</p> Signup and view all the answers

What key characteristic might a mother exhibit during the complete dilation phase of labor?

<p>Irritability and doubt about her ability to continue (B)</p> Signup and view all the answers

Which element is NOT one of the Five P's of Labor?

<p>Psychological state (A)</p> Signup and view all the answers

What is typically experienced during the fourth stage of labor?

<p>Immediate vital sign stabilization for the mother (C)</p> Signup and view all the answers

In terms of fetal position, what does it mean when a fetus is described as being in the left occipito-anterior position?

<p>Fetal head facing the mother’s left side with the back of the head towards the front (D)</p> Signup and view all the answers

What is the primary characteristic of the contraction during the active phase of labor?

<p>Contractions have a longer duration and increased frequency. (B)</p> Signup and view all the answers

Which of the following factors most impacts maternal positioning during the second stage of labor?

<p>Maternal preference and fetal condition (D)</p> Signup and view all the answers

What commonly occurs during the transition phase of labor?

<p>Women may experience extreme fatigue and anxiety. (B)</p> Signup and view all the answers

Which parameter is NOT a characteristic of true labor?

<p>Decreased contraction frequency (D)</p> Signup and view all the answers

During the first stage of labor, which process must occur for successful childbirth?

<p>Thinning and shortening of the cervix (A)</p> Signup and view all the answers

What role does gravity play during labor?

<p>It aids fetal descent in certain upright positions. (D)</p> Signup and view all the answers

Which symptom indicates a woman is experiencing true labor as opposed to false labor?

<p>Increased pain across the entire belly. (B)</p> Signup and view all the answers

What is the primary focus of nursing care during the pre-procedure phase of labor?

<p>Performing Leopold maneuvers to assess fetal position. (D)</p> Signup and view all the answers

Flashcards

Complete Dilation

The cervix is fully open, allowing the baby to pass through the birth canal.

Second Stage of Labor

The stage of labor after complete dilation, where the baby is pushed out of mother's body.

Third Stage of Labor

Placenta is delivered.

Schultze Presentation

Placenta presentation with shiny fetal surface.

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Duncan Presentation

Placenta presentation with dull maternal surface facing outwards.

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Fetal Lie

Relationship between the fetal body's long axis and mother's long axis.

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Fetal Attitude

The degree of flexion or extension the baby's body parts have.

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Fetal Station

Measurement of fetal descent in relation to maternal ischial spines (-,0,+).

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Birth canal

The passageway through which the baby travels during delivery, composed of the bony pelvis, cervix, pelvic floor, vagina, and introitus.

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Cervix

The lower part of the uterus that opens during labor, allowing the baby to pass through.

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Contractions

Muscular tightening of the uterus that helps to dilate the cervix and push the baby down the birth canal.

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First stage of labor

The stage of labor characterized by the dilation and effacement of the cervix.

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Duration of a contraction

The length of time from the start to the finish of a contraction.

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Frequency of contractions

The time interval between the beginnings of two consecutive contractions.

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Intensity of a contraction

The strength of a contraction at its peak.

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Lightening

The fetal head descends into the true pelvis about 14 days before labor, making breathing easier but causing more pressure on the bladder.

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Bloody Show

Increased vaginal discharge with a tinge of blood, often a sign of cervical dilation.

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Nesting

A sudden burst of energy before labor, often accompanied by a strong desire to prepare for the baby.

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Cervical Ripening

The cervix becomes softer, thinner, and begins to open in preparation for labor.

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Amniotic Fluid pH

Amniotic fluid is alkaline with a pH of 6.5 to 7.5, unlike urine which is slightly acidic.

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Contractions in Latent Phase

Contractions are irregular, mild to moderate, and last 30 to 45 seconds, occurring every 5 to 30 minutes.

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Contractions in Active Phase

Contractions become more regular, stronger, and last 40 to 90 seconds, occurring every 3 to 5 minutes.

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Maternal Characteristics in Latent Phase

The mother may be talkative, calm, and able to walk through most contractions.

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Study Notes

Labor and Delivery Process

  • Labor and delivery process: Assessment of mother, fetus, and the family
  • Premonitory signs (Physiological changes before labor):
    • Back pain (constant, low, dull backache caused by pelvic muscle relaxation)
    • Weight loss (1-3.5 lbs)
    • Lightening (fetal head descends into the true pelvis about 14 days before labor)
  • Contractions:
    • Irregular uterine contractions (Braxton Hicks) that progress in strength and regularity
    • Increased vaginal discharge or bloody show
    • Energy bursts (nesting)
    • Gastrointestinal changes (less common; nausea and vomiting, indigestion)
    • Cervical ripening (soft, opens, and partially effaced; can begin to dilate)
  • Rupture of membranes:
    • Labor often occurs within 24 hours of rupture
    • Prolonged rupture (>24 hours) can lead to infection
    • Assess fetal heart rate (FHR) for decelerations after rupture to rule out cord prolapse
  • Monitoring during labor:
    • Assess amniotic fluid (watery, clear, slightly yellow tinge; 700-1000 mL) for presence; check pH (6.5-7.5, alkaline) to confirm amniotic fluid
    • Monitor physiological factors, progress of labor, and cultural considerations
    • Amniotic fluid is alkaline (pH 6.5 to 7.5) while urine is slightly acidic.

First Stage of Labor

  • Latent phase (0-5 cm):
    • Contractions are irregular, mild to moderate
    • Frequency: 5 to 30 minutes

Second Stage of Labor

  • Full dilation
  • Pushing and fetal descent (estimated 30-60 minutes).
  • Birth of the newborn.
  • Note the maternal characteristics during this time.

Third Stage of Labor

  • Delivery of the placenta.
  • Maternal characteristics:
    • Placental separation and expulsion (Schultze presentation: shiny fetal surface first; Duncan presentation: dull maternal surface first).

Fourth Stage of Labor

  • Post-procedure:
    • Fundal assessment and massage
    • Lochia assessment (vaginal bleeding, assess every 15 minutes for the first hour)
    • Continue to monitor vital signs and fetal heart rate

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