Labor
The factors that affect the process of labor and birth, known commonly as the five Ps, include all IN ANSWER!
PASSENGERS (fetus and placenta)
PASSAGEWAY (pelvis, birth canal)
POWERS (contractions)
POSITION (maternal)
PSYCHOLOGICAL RESPONSE
APGAR score range that requires no immediate nursing intervention and is considered normal
8-10
What is involution
uterus returns to pre-pregnancy state
What is an acceleration?
Short increases in the FHR above the baseline that meets the 15x15 rule
What is the hormone that stimulates milk production and the hormone that causes milk ejection?
Prolactin; Oxytocin
Regular timed contractions that increase in intensity and frequency and have cervical changes vs. irregular contractions that do not change in intensity or frequency and do not have cervical changes
true vs false labor
The small white bumps on baby's nose and cheeks that will resolve in 1-2 weeks
Milia
What is the primary nursing intervention if you assess a boggy uterus?
continual fundal massage
What is the beat to beat fluctuation of the fetal heart rate?
Variability
What is the name of the disorder that causes anxiety, irritability, mood swings, tearfulness, fatigue, and increases sensitivity that peaks at 4-5 days and resolved by d10 without the use of medications?
how to determine the frequency of contractions
time from the start of one contraction to the start of another contraction
Name the two fontanelles (shape and location) and what is the expected assessment
Anterior (top of head; diamond)
Posterior (occipital; triangle)
flat, not depressed or bulging
Where should you find the location of the uterus when doing an assessment 24 hours after delivery and how should it feel?
midline, about the height of the umbilicus, firm
What is the primary nursing intervention for a fetus having a variable decel?
change maternal position
What are the 4 "T"s of PPH? (causes)
Tissue
Trauma
Tone
Thrombin
What is the first stage of labor? Include the two phases
from 0-10 cm dilation and has the latent (0-6cm) and active (6-10cm) phases.
The nurse is assessing the reflexes of a newborn. The nurse strokes the outer edge of the newborn's foot. This is an example of what reflex? What would the expected outcome be?
Babinski
Toes flare/fan out (positive Babinski)
What is the amount of blood loss during delivery to be considered a PPH for both vaginal and c/s?
Vaginal 500mL or greater
C/S 1000mL or greater
What nursing interventions (5) need to be done for a fetus having late decelerations?
Stop pitocin
Start O2
increase fluids
reposition patient
call physician
What are (in order) the 3 maternal psychological adaptations and meaning? (Reva Rubin's phases)
Taking-in: immediately after birth; needs others; 24-48 hrs
Taking-hold: dependent (2-3d PP-weeks) and independent (autonomy with new changes but needs assurance)
Letting-go: re-establishes relationships with others; motherhood as a new role
Epidural (regional)
Breathing exercises
Stadol
Ambulation
Attention focusing/imagery
Acupuncture
Hydrotherapy
What is the normal ranges for a newborn RR, HR, Temp? How long should you count for a rate vs how long to listen to lungs and heart?
RR 30-60
HR 110-160
Temp 36.5-37.5
count for 15 sec x 4; always still listen for 1 minute for any abnormals
What are the three stages of lochia, color, and when do they occur?
Rubra; bright red; 1-4 days
Serosa; pinkish/brown; 3-10 days
Alba; whitish/yellow/lt. brown; 10-3 to 6 weeks
V variable decel Cord compression
E early decel Head compression
A acceleration Ok!
L late decel Placental Insufficiency
What are the 4 mechanisms of thermoregulation of the newborn and each meaning?
Conduction: transfer of heat form object to object
Convection: flow of heat from body surface to cooler air
Evaporation: loss of heat when liquid is converted to vapor
Radiation: loss of body heat without direct contact