Module 4 - Normal Labor and Birth Questions and Answers with Complete Solutions | 100% pass

what are the 5 P's affecting labor and short description? - 1) power - primary: uterine ctx - 2ndary: maternal bearing-down 2) passage - maternal anatomy: mother's bony pelvis; tissues of the cervix; pelvic floor; vagina; introitus 3) position - position changes mom's anatomic and physiologic adaptation to labor 4) psychology 5) passenger - descent through the birth canal is determined by the fetal head size, lie, presentation, attitude, and position theories of labor onset - maternal factors? - - oxytocin release: stimulating nipples can cause oxytocin release and labor/ctx - cervix - uterine muscle: dehydration can make it cramp; over-distension leads to contractions - progesterone decrease: leads to a less relaxed uterus/ctx which leads to delivery - progesterone keeps you pregnant; it relaxes muscles and ligaments theories of labor onset - fetal-placenta factors? - - prostaglandin production: prod by fetal membranes and decidua which leads to uterine ctx - cortisol release: causes decreased progesterone release and increased prostaglandin release - placental aging - ROM - can begin the laborsigns of impending labor? - - lightening - inc vaginal discharge - inc energy - GI sx: period-y GI sx such as cramps, bloating, diarrhea - bloody show - ROM - lower back pain - wt loss - uterine ctx good things to ask mom about preparedness for birth and psychological responses? - - ask mom and involve family about what mom wants from her birth experience - breastfeeding/skin-to-skin - delayed cord clamping - who she wants in the room - what do you know about the induction process - pain management; when to get epidural - goals for the day what is fetal lie? - - relationship of the long axis/spine of the fetus to the long axis of the mom - longitudinal or transverse; oblique is rare - with transverse lie, there is a high risk of umbilical cord coming out - transverse lie can happen with an overdistended uterus from several previous births different fetal positions: cephalic and breech? - 1) cephalic - occiput or vertex: flexed head allows smallest diameter of head to pass through pelvis; best and most common - sinciput: head not flexed or extended; largest diameter- brow: largest diameter; head extended - face: head hyperextended with face presenting - brow and face normally do not come out vaginally 2) breech - frank: most common; both feet up by head; completely flexed hips - complete: both feet up, but not all the way flexed - footling: one foot down; worry about foot falling through cervix; more common in early gestation d/t extra space in uterus 3) shoulder - won't be able to feel a presenting part fetal attitude? - - relationship of fetal parts to each other and degree of flexion or extension of fetal head - normal attitude: moderate flexion with chin flexed onto the chest and extremities flexed onto the abdomen fetal position? - - relationship b/w fetal presenting part and four quadrants of mother's pelvis; feel for fontanels to determine - occiput anterior (LOA/ROA) is most common and best; back of babies head is in the front of mom (triangle fontanel is in front) - occiput posterior (OP); can deliver in this position; back of head is pressing on mom's sacrum and gives mom more back pain; push longer; position to help get them into OA; diamond fontanel in front - occiput transverse (OT); hard to deliver; usually c/s; doc may try to manually rotate the head - determine by feeling fontanels (triangle or diamond) and direction of suture line (oblique- OA or OP or transverse- OT) how to determine fetal station? - - during SVE - using the inside flat part of the fingers, starting posterior, smoothly move fingers to the anterior side along vaginal sidewall - as fingers pass over the ischial spine, palpate for a small protrusion under the tissue - be gentle - this is a tender spot and the pt may fi