Spontaneous Labor - Chapter 12

Questions and Answers

What is indicated by the 5-1-1 rule in labor?

Contractions every 5 minutes, lasting 1 minute, for 1 hour. (correct)

Contractions lasting 5 minutes with no specific frequency requirement.

Contractions occurring once every 5 minutes for a full hour.

Contractions that start 5 minutes apart, lasting 1 hour each.

What characteristic of contractions describes the time from the beginning of one contraction to the beginning of the next?

Frequency (correct)

Pattern

Duration

Intensity

What is the maximum acceptable blood loss during a normal vaginal delivery?

500 ml (correct)

300 ml

700 ml

1000 ml

What does the term 'Lightening' refer to during labor?

The baby's head descending into the pelvic cavity. Signup and view all the answers

Which factor is NOT part of the '4 Ps' that influence the duration of labor?

Position Signup and view all the answers

How is Spontaneous Rupture of Membranes (SROM) confirmed clinically?

Nitrazine test with a cotton swab. Signup and view all the answers

What is the name given to the ability of the cervix to dilate with pressure from the head during labor?

Primigravida Signup and view all the answers

What procedure is typically performed to assess dilation, effacement, and station during labor?

Cervical exam Signup and view all the answers

What defines the true pelvis in relation to the bony pelvis?

It is the area below the linea terminalis. Signup and view all the answers

Which fetal presentation is characterized by the fetal head being the first part to enter the pelvis?

Cephalic presentation Signup and view all the answers

What term describes the mother's psychological state affecting labor?

Psyche Signup and view all the answers

Which of the following bones is located at the back of the fetal head?

Occipital bone Signup and view all the answers

What is the primary force that moves the fetus through the maternal pelvis during labor?

Uterine contractions Signup and view all the answers

Which fontanelle is shaped like a diamond?

Anterior fontanelle Signup and view all the answers

Which maternal condition is described as contractions becoming more regular during labor?

Uterine contractions Signup and view all the answers

In fetal lies, what is the most common orientation of the fetus to the mother's body?

Longitudinal Signup and view all the answers

What is the primary indicator of true labor?

Cervical dilation and effacement Signup and view all the answers

Which labor mechanism involves the fetus pressing down and compressing the bladder?

Descent Signup and view all the answers

During false labor, how do contractions behave?

They are irregular and inconsistent Signup and view all the answers

At what dilation measurement are first-time moms required to be to deliver?

10 CM Signup and view all the answers

What characterizes cervical effacement in labor?

Thinning and shortening of the cervix Signup and view all the answers

Which of the following statements about the signs of true labor is incorrect?

Water breaking is unrelated to cervical dilation Signup and view all the answers

What does a fetal station of +3 indicate?

The fetus is crowning Signup and view all the answers

During which phase does the presenting part of the fetus reach 0 station?

Engagement Signup and view all the answers

Which action is NOT appropriate for a nurse assisting in vaginal delivery?

Delivering the placenta if no HCP is available Signup and view all the answers

What is the primary monitoring concern during the immediate postpartum period?

Quantified blood loss from the placenta Signup and view all the answers

What characteristic defines a third degree perineal tear?

Involves the anal sphincter and perineal muscles Signup and view all the answers

During the delivery process, what stimulates the fetal ejection reflex?

Baby hitting a certain nerve Signup and view all the answers

When should a nurse typically monitor the mother after delivery?

Every 15 minutes for the first hour and then every 30 minutes Signup and view all the answers

What are important signs to assess during the newborn's transition after birth at 1 minute?

Respiration rate, crying, and grunting Signup and view all the answers

What is the expected duration for vaginal healing post-delivery?

Up to 6 weeks Signup and view all the answers

What is an important action to take for the newborn immediately after delivery?

Keeping the baby warm and evaluating their transition Signup and view all the answers

What is the primary purpose of using a peanut ball during labor?

To help open the pelvis and shift pelvic tightness Signup and view all the answers

In which stage of labor does full dilation of the cervix occur?

Stage 1 - Active Signup and view all the answers

What is a common effect of hyperventilation during labor?

Numbness and tingling in hands and feet Signup and view all the answers

Which position is NOT recommended for a laboring woman to avoid supine hypotension?

Laying flat on the back Signup and view all the answers

What medication is recommended to prevent postpartum hemorrhage after the placenta delivery?

Pitocin Signup and view all the answers

During the transition phase of labor, how often do contractions typically occur?

Every 2-3 minutes Signup and view all the answers

What is a key role of the RN during the administration of an epidural anesthesia?

Position the patient side to side post-administration Signup and view all the answers

Which of the following is NOT a characteristic of the first stage of labor?

Fetal positioning is less critical than in later stages Signup and view all the answers

Study Notes

Reproductive System Characteristics

Contractions' frequency is measured from the onset of one contraction to the next.
Duration of contractions is measured from the onset to the conclusion of the same contraction.
In primigravida, the pressure of the fetal head allows cervical dilation; subsequent births result in faster modulation of the cervix.

Blood Loss During Labor

Normal blood loss during childbirth is 500 ml; 800-1000 ml can occur with a C-section, while over 1000 ml is concerning.

Signs of Labor

Defined by regular uterine contractions (CTX) and cervical changes.
Spontaneous Rupture of Membranes (SROM) represents a significant stage, often accompanied by a bloody show indicating dilation.

Lightening and Contraction Timing

Lightening refers to the baby dropping into the pelvis.
Follow the 5-1-1 rule: contractions every 5 minutes or less lasting 1 minute for at least 1 hour.

Admission and Monitoring

Upon arrival to Labor & Delivery (L&D), bring prenatal paperwork for assessment.
Includes fetal monitoring and cervical exams to measure dilation, effacement, and station.

Four Ps of Labor

Passage: Birth passage details, including the size and shape of the true pelvis.
Passenger: Fetal presentation and positioning; optimal position involves the fetal head in the occiput anterior position.
Powers: The strength, frequency, and quality of uterine contractions that assist in fetal descent.
Psyche: The mother's mental state toward labor influences progress and experience.

Normal Labor Signs

Braxton Hicks contractions, increasing vaginal mucus, cervical softening, and possible bloody show indicate impending labor.
Distinguish true labor from false labor by evaluating contraction regularity, intensity, and cervical change.

Cervical Change and Stations

Cervical dilation ranges from 0 cm (closed) to 10 cm (fully dilated), and effacement measures the thinning of the cervix from 0% to 100%.
The fetal station indicates the position of the fetal head in relation to the ischial spines, with -3 being high in the pelvis and +3 indicating crowning.

Stages of Labor

Stage 1: Dilation of cervix, divided into:
- Latent phase (0-6 cm): Contractions mild and spaced.
- Active phase (6-10 cm): Contractions moderate and closer together.
- Transition phase (8-10 cm): Strong contractions every 2-3 minutes.
Stage 2: Pushing stage; active efforts to deliver the baby begin at full dilation.
Stage 3: Delivery of the placenta occurs within 5-30 minutes after birth; monitor for signs of complications.
Stage 4: Initial bonding time between mother and baby; postpartum monitoring for potential complications.

Maternal and Fetal Considerations

Maternal cardiovascular changes include fluctuating blood flow to the placenta and increased blood volume.
Respiratory changes involve deeper and faster breathing; hyperventilation can cause dizziness and numbness—play a role in calming the mother during contractions.
A full bladder during labor can obstruct fetal descent and may need to be managed.

Pain Management and Comfort Measures

Positioning is crucial; avoid supine positions to prevent supine hypotension.
Non-pharmacological options include hot showers or baths.
Epidurals require IV hydration and specific procedures; sufficient pain relief may be achieved with medications including nabufine and fentanyl.
Monitor maternal well-being rigorously post-delivery for signs of excessive blood loss or complications.

Types of Vaginal Tears

First-degree: Involves only the labia.
Second-degree: Extends to perineal muscles, near the anal sphincter.
Third-degree: Involves the anal sphincter and perineal muscles.
Fourth-degree: Extends through the vagina to the anus; requires surgical repair.

Newborn Transition and Bonding

Post-birth, the newborn undergoes a transition evaluated by the APGAR score to ensure physical stability.
Encourage immediate bonding between mother and child if both are stable.

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Description

This quiz covers Chapter 12 on the process of spontaneous labor, focusing on the characteristics of uterine contractions and the factors affecting birth. Key topics include the frequency and duration of contractions, the effects of pressure during dilation, and blood loss during delivery. Test your understanding of these critical aspects of the reproductive system and labor process.