Stages of Labor and Childbirth
54 Questions
6 Views

Choose a study mode

Play Quiz
Study Flashcards
Spaced Repetition
Chat to lesson

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What is the McRobert Maneuver used for in labor and delivery?

  • Laying flat on back, pushing knees back, and applying pressure to the abdomen to facilitate shoulder fitting and baby delivery (correct)
  • Performing Leopold maneuvers to determine fetal positioning
  • Feeling for the fetal head and flexed areas to assess engagement
  • Adjusting the angle of the pelvis to aid in fetal descent
  • What is the characteristic feature of hypertonic uterine dysfunction?

  • No progression in cervical dilation in 2 hours
  • Uterus never fully relaxes between contractions (correct)
  • Contractions quality decreases and fails to dilate & efface cervix
  • Contractions are not as effective or coordinated
  • In which condition does labor progress too quickly, completing in less than 3 hours?

  • Precipitated labor (correct)
  • Arrest disorder
  • Dystocia
  • Hypotonic uterine dysfunction
  • What is the main concern associated with meconium-stained amniotic fluid?

    <p>Decreased oxygen to the baby</p> Signup and view all the answers

    What is the primary purpose of performing Leopold maneuvers during labor and delivery?

    <p>To determine the presenting part of the fetus</p> Signup and view all the answers

    What does the term 'dystocia' refer to in the context of labor and delivery?

    <p>Problems with power during labor</p> Signup and view all the answers

    Which condition is characterized by no progression in cervical dilation in 2 hours despite initial progress?

    <p>Arrest disorder</p> Signup and view all the answers

    What is the primary risk associated with hypotonic uterine dysfunction during labor?

    <p>Decreased contraction strength and duration</p> Signup and view all the answers

    'Meconium aspiration syndrome' occurs when a baby:

    <p>Breathes in meconium during delivery</p> Signup and view all the answers

    During which stage of labor does the maternal urge to push occur?

    <p>Second stage</p> Signup and view all the answers

    Which obstetric emergency is characterized by sudden painless bleeding?

    <p>Placenta previa</p> Signup and view all the answers

    What type of pain management in labor may increase the second stage of labor?

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

    Which type of analgesia/anesthesia may cause hypotension and fetal distress as complications?

    <p>Combined spinal/ epidural</p> Signup and view all the answers

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

    <p>Monitoring for hemorrhage</p> Signup and view all the answers

    What is the most common symptom of placental abruption?

    <p>Vaginal bleeding</p> Signup and view all the answers

    Which factor affecting the labor process relates to the fetal and placental position?

    <p>Passenger (fetus and placenta)</p> Signup and view all the answers

    Which type of analgesia/anesthesia may cause CNS depression in both mother and newborn?

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

    Which obstetric emergency is characterized by tearing of the uterus at the site of a previous scar into the abdominal cavity?

    <p>Uterine rupture</p> Signup and view all the answers

    What is the most likely consequence of umbilical cord prolapse in cases of premature birth?

    <p>Fetal bradycardia</p> Signup and view all the answers

    What is the typical and most favorable fetal attitude during labor?

    <p>Flexed position with rounded back</p> Signup and view all the answers

    Which fetal lie is the only possible lie for vaginal delivery?

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

    What is considered engaged when the fetus is at 0 station?

    <p>At ischial spine</p> Signup and view all the answers

    Which of the following is characteristic of true labor?

    <p>Vaginal pressure felt with contractions</p> Signup and view all the answers

    What information can a vaginal exam provide about labor progress?

    <p>Dilation, effacement, and station</p> Signup and view all the answers

    In Stage 1 labor, which fetal heart rate pattern is predictive of normal acid-base balance?

    <p>Baseline FHR 110-160 with moderate baseline variability</p> Signup and view all the answers

    Which category of fetal heart rate tracings requires interventions such as notifying the MD and increasing IV fluids?

    <p>Category 3</p> Signup and view all the answers

    What intervention is required for fetal tachycardia in Stage 2 labor?

    <ul> <li>Baseline FHR &gt;160 for &gt;10 minutes</li> </ul> Signup and view all the answers

    What is a characteristic maternal physiological response to labor?

    <ul> <li>Increased basal metabolic rate</li> </ul> Signup and view all the answers

    What physiologic response is characteristic of the fetus during labor?

    <ul> <li>Periodic FHR decelerations</li> </ul> Signup and view all the answers

    What is the function of Braxton Hicks contractions?

    <p>To help move the cervix from a posterior position to an anterior position</p> Signup and view all the answers

    What is the significance of the 'bloody show' in the premonitory signs of labor?

    <p>It is a sign that the body is preparing for labor</p> Signup and view all the answers

    What occurs when the fetal presenting part descends into the pelvis?

    <p>The shape of the abdomen changes</p> Signup and view all the answers

    What is the purpose of nesting in the premonitory signs of labor?

    <p>To prepare for the arrival of the baby</p> Signup and view all the answers

    What is the role of intra-abdominal pressure during pushing in labor?

    <p>To coordinate pushing</p> Signup and view all the answers

    What is effacement in relation to labor?

    <p>The thickness of the cervix</p> Signup and view all the answers

    What are the functions of contractions during labor?

    <p>Voluntary (actively pushing) &amp; involuntary (contractions)</p> Signup and view all the answers

    What does lightening refer to in relation to labor?

    <p>The fetal presenting part descending into the pelvis</p> Signup and view all the answers

    'Platypelloid' is associated with which type of pelvis?

    <p>Pelvic shapes - gynecoid= female pelvis</p> Signup and view all the answers

    What is the primary complication associated with precipitated labor?

    <p>Maternal injury</p> Signup and view all the answers

    What is the purpose of performing Leopold maneuvers during labor and delivery?

    <p>To identify the presenting part of the fetus</p> Signup and view all the answers

    What is the characteristic feature of hypertonic uterine dysfunction?

    <p>Uterus failing to fully relax</p> Signup and view all the answers

    What is the McRobert Maneuver used for in labor and delivery?

    <p>Assisting in fetal head engagement</p> Signup and view all the answers

    What results from meconium-stained amniotic fluid?

    <p>Potential meconium aspiration syndrome for the baby</p> Signup and view all the answers

    What is the primary risk associated with hypotonic uterine dysfunction during labor?

    <p>Fetal distress</p> Signup and view all the answers

    What fetal lie is determined through Leopold Maneuver 2?

    <p>Longitudinal lie</p> Signup and view all the answers

    What is characteristic of hypotonic uterine dysfunction?

    <p>Failure to fully relax between contractions</p> Signup and view all the answers

    What is the primary concern associated with IUGR (Intrauterine growth restriction) in relation to labor?

    <p>Fetal malpresentation</p> Signup and view all the answers

    What is the primary consequence of cord compression during labor?

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

    Which condition is characterized by no progression in cervical dilation in 2 hours despite initial progress?

    <p>Arrest disorder</p> Signup and view all the answers

    What is the primary risk associated with hypotonic uterine dysfunction during labor?

    <p>Postpartum hemorrhage</p> Signup and view all the answers

    What is the purpose of performing Leopold maneuvers during labor and delivery?

    <p>Determining the fetal presentation and position</p> Signup and view all the answers

    What is the primary consequence of hypertonic uterine dysfunction during labor?

    <p>Excessive tone and ineffective contractions</p> Signup and view all the answers

    What is the primary risk associated with precipitated labor?

    <p>Maternal injury due to hard contractions</p> Signup and view all the answers

    What is the purpose of the McRobert Maneuver in labor and delivery?

    <p>Laying flat on the back and pushing knees back to make space for the baby to come out</p> Signup and view all the answers

    Study Notes

    Pelvic Shapes and Functions

    • Pelvic shapes: gynecoid (female pelvis), platypelloid, anthropoid, android (male pelvis)
    • Functions of contractions:
      • Voluntary (actively pushing) and involuntary (use of intra-abdominal pressure)
      • Rhythmic, intermittent, can be altered with deflation, pain medication, illness, anxiety
    • Effacement (softness of the cervix): 2cm thick cervix = 0% effaced, 1cm = 50% effaced, paper thin = 100% effaced

    Premonitory Signs of Labor

    • Cervical changes: softening of the cervix and possible dilation, effacement and dilation only possible once the cervix is soft
    • Lightening: fetal presenting part descends into the pelvis, shape of abdomen changes, baby "dropped"
    • Nesting: extra energy, typically 24-48 hours before labor, focused on getting ready for baby
    • Bloody show: mucous plug expelled due to increased pressure and softening of the cervix, prevents bacteria from coming in
    • Braxton Hicks: becomes stronger and more frequent, helps move the cervix from a posterior position to an anterior position, improves with walking, change in position, water, rest, voiding, and eating
    • SROM: prelabor rupture of membranes, water breaks prior to onset of labor, must go to the hospital, note color, odor, amount, and time

    Fetal Attitude, Lie, and Position

    • Fetal attitude: amount of flexion, flexed is the typical and most favorable, want all joints flexed with rounded back, chin on chest, thighs on abdomen, legs flexed at the knees
    • Fetal lie: relationship of the fetal spine to the maternal spine, longitudinal, only possible lie for vaginal delivery
    • Fetal position: presenting part of the fetus to a designated point of the maternal pelvis, identify the presenting part, want occipital anterior position
    • Fetal station: relationship of the presenting part with the maternal ischial spines, considered engaged when fetus is at 0 station, floating means the presenting part is above the pelvic inlet and is freely movable

    True vs. False Labor

    • True labor: regular, becomes closer together, usually 4-6 minutes apart, lasts 30-60 seconds, becomes stronger with time, vaginal pressure felt, starts in the back and radiates around toward the front of the abdomen
    • False labor: irregular, not occurring close together, frequently weak, not getting stronger with time, usually felt in the front of the abdomen, contractions may stop or slow down with walking or making a position change

    Vaginal Exams and Labor Progress

    • Vaginal exams: way to assess labor progress, tells you dilation, effacement, station, presentation, position, attitude, and membrane status
    • Dilation, effacement, station: measurements of labor progress

    Labor Management

    • Category 1: normal, predictive of normal acid-base balance, baseline FHR 110-160, moderate baseline variability, present or absent accelerations, present or absent decelerations, no late or variable decelerations, safe to monitor fetus intermittently, requires no interventions
    • Category 2: intermediate, not predictive of abnormal fetus acid-base status, requires evaluation and continued surveillance, can include fetal tachycardia, fetal bradycardia, absent baseline variability, minimal or marked variability, recurrent late deceleration, and recurrent variable deceleration
    • Category 3: abnormal, predictive of abnormal fetus acid-base status, requires intervention, includes fetal bradycardia, recurrent late decelerations, recurrent variable decelerations, and sinusoidal pattern

    Maternal and Fetal Physiologic Responses to Labor

    • Maternal:
      • Increased heart rate, cardiac output, and blood pressure
      • Increased WBC, respiratory rate, and oxygen consumption
      • Decreased gastric emptying and gastric pH
      • Slight temperature elevation
      • Muscle aches/cramps
      • Increased basal metabolic rate
      • Decreased blood glucose levels
    • Fetal:
      • Periodic FHR accelerations and slight decelerations
      • Decrease in circulation and perfusion
      • Increase in arterial carbon dioxide pressure
      • Decrease in fetal breathing movements
      • Decrease in fetal oxygen pressure and partial pressure of oxygen

    Stages of Labor

    • First stage: longest stage, from 0-10cm, latent, active, and transitional phases
    • Second stage: from complete dilation until birth of baby, latent and active phases
    • Third stage: begins at the birth of the newborn and ends at the separation and birth of the placenta
    • Fourth stage: begins after the delivery of the placenta, focuses on monitoring for hemorrhage, bladder distension, and venous thrombosis

    Obstetric Emergencies

    • Uterine rupture: tearing of the uterus at the site of a previous scar, symptoms include sudden fetal bradycardia, acute and continuous abdominal pain, vaginal bleeding, hematuria, and loss of fetal station
    • Placental abruption: detachment of the placenta, symptoms include partial separation, concealed hemorrhage, and complete separation
    • Placental previa: placenta partially or fully covering the internal os of the cervix, symptoms include sudden painless bleeding
    • Umbilical cord prolapse: umbilical cord goes through the cervix and around the baby's neck, increased risk factors include breech, premature birth, and hydramnios

    Pain Management in Labor

    • Pharmacologic measures:
      • Regional analgesia/anesthesia
      • Pain relief without loss of consciousness
      • Obstetrical referring to loss of pain sensation
      • Epidural, combined spinal/epidural, and local infiltration
    • Systemic analgesia:
      • Given PO, IM, or IV
      • Need to avoid giving before delivery due to CNS depression in the newborn
      • Opioids, antiemetics, and benzodiazepines
    • Nonpharmacologic measures:
      • Continuous labor support
      • Hydrotherapy
      • Ambulation
      • Maternal position changes
      • Attention focusing and imagery
      • Therapeutic touch and massage
      • Gate control theory
      • Application of heat and cold
      • Breathing techniques

    Dystocia

    • Definition: abnormal progression of labor
    • Causes: issues with powers, passenger, and passageway
    • Types: failure to progress, including arrest in dilation and failure to descend

    10 P's Factors Affecting Labor Process

    • Passageway (birth canal)

    • Passenger (fetus and placenta)

    • Powers (contractions)

    • Position (maternal)

    • Psychological response

    • Philosophy (low-tech/high touch)

    • Partners (support)

    • Patience (natural timing)

    • Patient (client-childbirth knowledge base)

    • Pelvic shapes### Labor Stages

    • First stage: from 0-10cm dilation, divided into latent, active, and transitional phases

      • Latent phase: 0-4/6cm dilation, contractions q5-10 minutes, lasting 30-35 seconds, mild
      • Active phase: 6-10cm dilation, contractions q2-5 minutes, lasting 45-60 seconds, moderate
      • Transitional phase: 8-10cm dilation, faster progression, feels everything
    • Second stage: from complete dilation to birth of baby, contractions q2-3 minutes, lasting 60-90 seconds

    • Third stage: from birth of newborn to separation and birth of placenta, placental separation, uterus continues to contract

    • Fourth stage: after delivery of placenta, beginning of postpartum period, monitoring vital signs, lochia, and for hemorrhage, bladder distension, and venous thrombosis

    Obstetric Emergencies

    • Uterine rupture: tearing of uterus at previous scar site, sudden fetal bradycardia, acute and continuous abdominal pain, vaginal bleeding, hematuria, loss of fetal station, hypovolemic shock
    • Placental abruption: placenta detaches, partial or complete separation, concealed or apparent hemorrhage
    • Placenta previa: placenta partially or fully covers internal os of cervix, sudden painless bleeding
    • Umbilical cord prolapse: cord goes through cervix and around baby's neck, increased risk with breech, premature, and hydramnios

    Pain Management

    • Pharmacologic measures: regional analgesia/anesthesia, pain relief without loss of consciousness
    • Epidural: may increase second stage labor, doesn't slow down labor, complications: hypotension, fetal distress, N/V, fever, pruritus, respiratory depression
    • Combined spinal/epidural: rapid onset, limited duration, injection of anesthetic agent in subarachnoid space
    • Local infiltration: pudendal block, provides long-lasting perineal analgesia, pain relief to lower vagina
    • Systemic analgesia: given PO, IM, IV, need to avoid before delivery due to CNS depression in newborn
    • Nonpharmacologic measures: continuous labor support, hydrotherapy, ambulation, maternal position changes, attention focusing and imagery, therapeutic touch and massage, gate control theory, application of heat and cold, breathing techniques

    Signs of Shock

    • Hypotension
    • Increase HR/pulse
    • Rapid respiration
    • Hnh increase
    • Peripheral cyanosis
    • Hypovolemia
    • Altered mental state
    • Decreased urine output
    • Weakness

    Dystocia

    • Definition: abnormal progression of labor, can be an issue with powers, passenger, or passageway
    • Failure to progress: arrest in dilation, failure to descend, baby will be OP, eyes looking up and head facing mother's butt

    Factors Affecting Labor Process

    • Passageway (birth canal): bony pelvis is important, relaxin and estrogen work on soft tissue and ligaments for flexibility
    • Passenger (fetus and placenta)
    • Powers (contractions)
    • Position (maternal)
    • Psychological response
    • Philosophy (low-tech/high touch)
    • Partners (support)
    • Patience (natural timing)
    • Patient (client-childbirth knowledge base)
    • Pelvic shapes: gynecoid, platypelloid, anthropoid, android

    Studying That Suits You

    Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

    Quiz Team

    Related Documents

    NURS 307 Exam 2 PDF

    Description

    Learn about the different stages of labor and childbirth, including the latent, active, transitional, and second stages. Understand the progression, contractions, and experiences associated with each stage.

    More Like This

    Use Quizgecko on...
    Browser
    Browser