Nurs 2208 Ch. 15

4P's to a successful labor

Passage (pelvis is of adequate size and contour.) Passenger (fetus is of appropriate size and in an advantageous position and presentation). Powers of labor (uterine factors are adequate.) Psychological outlook is preserved, so afterward, labor can be viewed as a positive experience.

The nursing instructor is teaching a session on the birth process. During which stage does the woman's cardiac output increase 80% above the pre-labor level? A Immediately after birth B Transition stage C First stage D Pushing

A Immediately after birth

The nurse is noting a collection of blood under the scalp on a newborn being discharged to home. The nurse is correct to prepare teaching instructions of which topic?

A cephalohematoma

The new parents are spending time with their newborn. However, they are concerned with the edema and ecchymosis on the baby's scalp. How should the nurse explain this to the parents after noting the baby was ROA in labor? A The infant needs to be assessed by the health care provider. B Ecchymosis with edema on the scalp is where the infant was pushed out of the canal. C Ecchymosis indicates a blood disorder and the infant will need testing. D Edema is swelling and caused by unusual trauma; the provider must have used forceps.

B Ecchymosis with edema on the scalp is where the infant was pushed out of the canal.

A nurse is monitoring the FHR of a client in labor using an electronic fetal monitor. The reading shows a late deceleration. Which intervention should the nurse implement? A Place the client in the lithotomy position B Administer exogenous oxytocin C Encourage the Valsalva maneuver D Change maternal position to an upright or side lying position.

D Change maternal position to an upright or side lying position.

breech presentation

fetal presentation in which either the buttocks or feet are the first body parts to contact the cervix

cephalic presentation

fetal presentation in which the head is the body part that first contacts the cervix

Progesterone

a hormone produced by the corpus luteum involved in maintaining the pregnancy full term

Relaxin

a hormone that can cause backache due to influence on the pelvic joints

Which intervention would be least effective in caring for a woman who is in the transition phase of labor? a having the client breathe with contractions b encouraging the woman to ambulate c urging her to focus on one contraction at a time d providing one-to-one support

b encouraging the woman to ambulate

Amniotic fluid is alkaline and turns a Nitrazine swab

blue

molding

change in shape of the fetal skull due to uterine contractions pressing the vertex against the not-yet-dilated cervix

Fetal lie

describes the position of the fetal long axis in relation to the long axis of the mother

fetal position

relationship of the presenting part to a specific quadrant and side of a woman's pelvis

Nitrazine swabs that remain yellow to olive green suggests that the membranes are most likely

intact

A woman may present to the birthing suite at any phase of labor

it is important that the nurse immediately assess for birth imminence, fetal status, risk factors, and maternal status

Progesterone, estrogen, and relaxin are ________ produced by posterior pituitary.

not

fetal presentation

pertains to the part of the fetus that comes through the cervix and the birth canal first

cardinal movements of labor

position changes to keep the smallest diameter of the fetal head (in cephalic presentations) always presenting to the smallest diameter of the birth canal (descent, flexion, internal rotation, extension, external rotation, and expulsion)

Oxytocin hormones are ___________ by the posterior pituitary.

produced

Oxytocin

produced by the posterior pituitary, brings uterine contractions

engagement

settling of the fetal head into the pelvis during labor

fetal descent

sinking of the fetus in the birth canal just prior to birth (one of six cardinal movements of labor)

ripening

softening of the cervix with the approach of labor

crowning

the appearance of the fetal head at the perineum just before birth

attitude

the degree of head flexion a fetus assumes during labor, or the relation of the fetal parts to each other

transition

the end of the first stage of labor, just before the woman experiences pushing sensations

A face presentation

the face presents first

lie:

the relationship between the long axis of the fetus and the long axis of the mother

station

the relationship of the presenting part of the fetus to the level of the ischial spines

effacement

thinning of the cervix in labor

dilatation

widening of the opening of the cervix in labor