Passenger: Fetus and Placenta Overview
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What is fetal presentation when referring to its position during delivery?

  • The travel route of the placenta
  • The position of the fetus in relation to the mother's pelvis (correct)
  • The way the baby exits the birth canal
  • The size and shape of the fetal head

    • Which of the following accurately describes fetal lie?

  • The type of contractions experienced during labor
  • The orientation of the baby's spine relative to the mother's spine (correct)
  • The position of the baby's head upon delivery
  • The sequence of labor stages

    • What is meant by fetal attitude?

  • The overall health of the fetus within the womb
  • The posture the baby assumes in utero (correct)
  • The frequency of uterine contractions
  • The type of delivery mode chosen

    • Which type of pelvis is considered the classic female shape?

    <p>Gynecoid</p> Signup and view all the answers

    What are primary powers in the context of labor?

    <p>Involuntary uterine contractions that signal labor's start</p> Signup and view all the answers

    What is the Ferguson reflex during labor?

    <p>The release of oxytocin triggered by stretch receptors</p> Signup and view all the answers

    What function do secondary powers serve during delivery?

    <p>To assist in voluntary efforts to bear down after dilation</p> Signup and view all the answers

    Which aspect does NOT affect a woman's ability to deliver vaginally?

    <p>The number of past deliveries</p> Signup and view all the answers

    What is an important consideration for a laboring mother regarding her position?

    <p>She should be encouraged to find the position that is most comfortable.</p> Signup and view all the answers

    How can a vaginal examination help determine if a woman is in true labor?

    <p>It shows whether membranes have ruptured and checks for dilation.</p> Signup and view all the answers

    What characterizes true labor contractions?

    <p>They are strong, regular, and long.</p> Signup and view all the answers

    What is a common effect of walking during true labor?

    <p>It makes contractions more intense.</p> Signup and view all the answers

    Where are true labor contractions typically felt?

    <p>In the lower back and radiating to the lower abdomen.</p> Signup and view all the answers

    What is the primary action of Pitocin in the context of labor?

    <p>To stimulate uterine smooth muscle and induce contractions.</p> Signup and view all the answers

    What effect does Pitocin have after delivery?

    <p>It is commonly administered to control postpartum bleeding.</p> Signup and view all the answers

    What is a characteristic of false labor contractions?

    <p>They can often stop with walking or a change of position.</p> Signup and view all the answers

    What is the recommended management for PPROM at less than 32 weeks?

    <p>Expectant and conservative management</p> Signup and view all the answers

    Which of the following is NOT a part of fetal surveillance for a woman with preterm PROM between 24 0/7 and 34 0/7 weeks?

    <p>Immediate cesarean section</p> Signup and view all the answers

    What defines the transition phase of the first stage of labor?

    <p>May not be easily identified by maternal behavior</p> Signup and view all the answers

    What happens during the second stage of labor?

    <p>The baby is delivered</p> Signup and view all the answers

    What is the primary focus during the fourth stage of labor?

    <p>Observing for complications after placental delivery</p> Signup and view all the answers

    Which phase occurs during the first stage of labor with a dilation of 0-6 cm?

    <p>Latent/Early Phase</p> Signup and view all the answers

    What defines fetal tachycardia?

    <p>Fetal heart rate exceeding 160 bpm for 10 minutes or longer</p> Signup and view all the answers

    Which of the following can be a cause of fetal tachycardia?

    <p>Fetal cardiac arrhythmias</p> Signup and view all the answers

    Which intervention is part of intrauterine resuscitation?

    <p>Rapid intravenous infusion of non-glucose crystalloid</p> Signup and view all the answers

    What is a common response to medications that can cause fetal tachycardia?

    <p>Caffeine consumption</p> Signup and view all the answers

    Which positioning is initially recommended during intrauterine resuscitation?

    <p>Left lateral recumbent position</p> Signup and view all the answers

    What does increased oxygen delivery aim to reverse during intrauterine resuscitation?

    <p>Fetal hypoxia and acidosis</p> Signup and view all the answers

    What is the primary characteristic of a fourth-degree perineal laceration?

    <p>Extends completely through the anal sphincters and rectal mucosa</p> Signup and view all the answers

    Which of the following interventions can help decrease perineal lacerations during labor?

    <p>Warm compresses and gentle perineal massage</p> Signup and view all the answers

    What condition occurs when the umbilical cord lies below the presenting part of the fetus?

    <p>Prolapsed cord</p> Signup and view all the answers

    What is an appropriate nursing intervention for a patient experiencing tachysystole?

    <p>Position the mother in the left lateral position</p> Signup and view all the answers

    Which factor is NOT associated with meconium-stained amniotic fluid?

    <p>Prolonged labor</p> Signup and view all the answers

    What maneuver can be used in cases of shoulder dystocia during delivery?

    <p>McRoberts maneuver</p> Signup and view all the answers

    Which statement regarding cultural differences in labor is correct?

    <p>Cultural perceptions can influence labor behavior</p> Signup and view all the answers

    What is the typical incidence rate of shoulder dystocia in vaginal births?

    <p>0.2% to 3%</p> Signup and view all the answers

    What kind of decelerations are early decelerations related to?

    <p>Fetal head compression</p> Signup and view all the answers

    Which of the following is a potential risk for the newborn during shoulder dystocia?

    <p>Brachial plexus damage</p> Signup and view all the answers

    Study Notes

    Passenger: Fetus and Placenta

    • Fetal head size influences labor process; fontanels and molding are critical to understand.
    • Fetal presentation types:
      • Cephalic/Vertex: Head down position
      • Breech: Feet or buttocks down
      • Shoulder: Sideways position.
    • Fetal lie describes the baby's spinal orientation in relation to the mother's spine:
      • Longitudinal/Vertical: Head or butt aligned with mother's spine
      • Transverse/Horizontal/Oblique: Baby positioned sideways.
    • Fetal attitude refers to the baby's posture in utero; critical head measurements affect delivery:
      • Complete flexion (chin down) yields a smaller head diameter
      • Extension (chin up) increases anteroposterior diameter.
    • Fetal position indicates how a reference point (occiput, sacrum, mentum, sinciput) aligns with maternal pelvis quadrants.

    Passageway: Birth Canal

    • Four basic pelvis shapes exist; gynecoid is the typical female shape.
    • Pelvis shape does not singularly determine a woman's ability for vaginal birth; adaptability of maternal tissues also factors in.

    Powers: Contractions

    • Primary Powers: Involuntary uterine contractions signaling labor onset.
      • Described by frequency, duration, intensity
      • Responsible for cervical effacement, dilation, and fetal descent.
      • Ferguson reflex triggers urge to bear down via oxytocin release.
    • Secondary Powers: Voluntary efforts from the mother once the cervix is fully dilated.

    Position (of Mother)

    • Encouragement for mothers to find comfortable labor positions for optimal progression and pain relief.

    Psychologic Response

    • Differentiating true labor from false labor is crucial.
    • True labor contractions: Regular, strong, and lasting; felt in the lower back and radiate to the abdomen.
    • False labor contractions: Irregular, often stop with movement, typically felt above the umbilicus.

    Medications

    • Pitocin:
      • Stimulates uterine contractions akin to spontaneous labor; has antidiuretic and vasopressor effects.
      • Administered post-delivery to manage bleeding and to augment labor.

    Fetal Tachycardia

    • Normal fetal heart rate ranges from 110-160 bpm; tachycardia is classified as >160 bpm lasting 10 minutes or more.
    • Causes include:
      • Fetal hypoxemia indicators
      • Maternal fever or fetal infection (chorioamnionitis)
      • Maternal hyperthyroidism or fetal anemia
      • Drug responses (e.g., caffeine, cocaine).

    Intrauterine Resuscitation (IUR)

    • Aimed at enhancing oxygen delivery to the placenta and umbilical blood flow.
    • Measures include:
      • Left lateral positioning, rapid IV fluids, maternal oxygen administration, and uterine contraction inhibition.

    Stages of Labor

    • First Stage: Regular contractions until full cervix dilation.
      • Latent/Early Phase: 0-6 cm
      • Active Phase: 6-10 cm; fastest dilation rate.
    • Second Stage: Fully dilated cervix to baby’s birth.
    • Third Stage: Birth to placenta delivery.
    • Fourth Stage: Placental delivery to two hours post-birth; watch for complications.

    Lacerations

    • Interventions like warm compresses and perineal massage can reduce acquisition.
    • Types of perineal lacerations:
      • First degree: Skin only
      • Second degree: Involves perineal muscles
      • Third degree: Extends to anal sphincter
      • Fourth degree: Involves anal sphincter and rectal mucosa.

    Cultural Differences in Labor

    • Women may express labor pain differently based on cultural norms; reactions range from silent endurance to vocal expressions.
    • Cultural context can shape choices regarding labor companions and father's involvement.

    Obstetric Emergencies

    • Prolapsed Cord: Cord lies below presenting fetus part; risk factors include long cords and abnormal presentations.
    • Meconium-stained Amniotic Fluid: Indicates fetal stool passage, possible normal maturation, or distress.
    • Shoulder Dystocia: Complication in 0.2-3% of vaginal births; risk of asphyxia and trauma increases for newborn and mother.
      • Management includes specific maneuvers, such as McRoberts and suprapubic pressure.

    Nursing Interventions for Tachysystole

    • Cease or reduce labor-enhancing medications.
    • Address fetal oxygen deprivation by placing the mother on her left side, providing oxygen, and escalating intravenous fluids.

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    Description

    This quiz covers vital aspects of the fetal passenger, including the size of the fetal head, fetal presentation, lie, and attitude. Understanding these concepts is crucial for maternal-fetal health professionals. Test your knowledge of these important topics in obstetrics.

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