introduction to Maternity & Pediatric
Nursing
what are the 4 variations of cephalic presentation - -vertex
-military
-brow
-face
vertex presentation - fetal head is fully flexed
most favored; because of smallest possible diameter of the head enters the pelvis
military presentation - the fetal head is neither flexed nor extended
brow presentation - fetal head is partly extended
longest diameter of fetal head is presenting
unstable; either converts to vertex or face
face presentation - the head is fully extended and the face presents
what are the 3 breech types - -frank breech
-full or complete breech
-footling breech
frank breech - -buttocks presents at the cervix
-legs are flexed at the hips and extended toward the shoulders
full or complete breech - reversal of cephalic presentation
both feet and the buttocks present at the cervix
footling breech - one or both feet are present first at cervix
what does position refer to - reference point on the fetal presenting part is oriented
within the mothers pelvis
what is occiput - used to describe how the head is oriented is in a cephalic vertex
presentation
what is sacrum used to describe - how a fetus in breech presentation is oriented within
the pelvis
, factors that may play part in the start of labor - stretching of uterine muscles
hormonal changes
placental aging
increased sensitivity to oxytocin
what are some signs of impending labor - braxton hicks contractions
increased vaginal discharge
bloody show
rupture of the membranes
energy spurt
weight loss
what are braxton hicks contractions - "false" labor
painful irregular contractions
pain can decrease with interventions
-prepares the cervix to dilate and adjust the fetal position within the uterus
what causes increased vaginal discharge during start of labor - fetal pressure causes
increase in clear nonirritating vaginal secretions
-itching or irritating should be reported because it is a sign of infection
what causes "the bloody show" - -when the time of birth approaches, the cervix softens,
effaces, and dilates slightly. The mucous plug is dislodged for cervix tearing small
capillaries in the process
-few days before labor
-pink or dark brown blood
what may be a problem if the membranes rupture - -infection is likely to happen if hours
have passed since the rupture
-fetal umbilical cord may slip down and might become compressed between moms
pelvis and fetal presenting part
-cant go more than 24 hours or r/f infection is extreme
when to go to the hospital for labor - -when the contractions have a pattern and no
interventions can take pain away
-ruptured membranes
-bleeding other than bloody show. free flow blood not mixed with mucous
-decreased fetal movement
-any other concern
what are 3 major assessments performed promptly on admission - fetal condition,
maternal condition, and impending birth
how is the fetal condition assessed - fetal heart rate with fetoscope, hand held doppler,
external fetal monitor. when the membranes rupture, the amount, color and odor of fluid
are assessed
Nursing
what are the 4 variations of cephalic presentation - -vertex
-military
-brow
-face
vertex presentation - fetal head is fully flexed
most favored; because of smallest possible diameter of the head enters the pelvis
military presentation - the fetal head is neither flexed nor extended
brow presentation - fetal head is partly extended
longest diameter of fetal head is presenting
unstable; either converts to vertex or face
face presentation - the head is fully extended and the face presents
what are the 3 breech types - -frank breech
-full or complete breech
-footling breech
frank breech - -buttocks presents at the cervix
-legs are flexed at the hips and extended toward the shoulders
full or complete breech - reversal of cephalic presentation
both feet and the buttocks present at the cervix
footling breech - one or both feet are present first at cervix
what does position refer to - reference point on the fetal presenting part is oriented
within the mothers pelvis
what is occiput - used to describe how the head is oriented is in a cephalic vertex
presentation
what is sacrum used to describe - how a fetus in breech presentation is oriented within
the pelvis
, factors that may play part in the start of labor - stretching of uterine muscles
hormonal changes
placental aging
increased sensitivity to oxytocin
what are some signs of impending labor - braxton hicks contractions
increased vaginal discharge
bloody show
rupture of the membranes
energy spurt
weight loss
what are braxton hicks contractions - "false" labor
painful irregular contractions
pain can decrease with interventions
-prepares the cervix to dilate and adjust the fetal position within the uterus
what causes increased vaginal discharge during start of labor - fetal pressure causes
increase in clear nonirritating vaginal secretions
-itching or irritating should be reported because it is a sign of infection
what causes "the bloody show" - -when the time of birth approaches, the cervix softens,
effaces, and dilates slightly. The mucous plug is dislodged for cervix tearing small
capillaries in the process
-few days before labor
-pink or dark brown blood
what may be a problem if the membranes rupture - -infection is likely to happen if hours
have passed since the rupture
-fetal umbilical cord may slip down and might become compressed between moms
pelvis and fetal presenting part
-cant go more than 24 hours or r/f infection is extreme
when to go to the hospital for labor - -when the contractions have a pattern and no
interventions can take pain away
-ruptured membranes
-bleeding other than bloody show. free flow blood not mixed with mucous
-decreased fetal movement
-any other concern
what are 3 major assessments performed promptly on admission - fetal condition,
maternal condition, and impending birth
how is the fetal condition assessed - fetal heart rate with fetoscope, hand held doppler,
external fetal monitor. when the membranes rupture, the amount, color and odor of fluid
are assessed
