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Exam (elaborations)

W&F Exam 3 Verified and Updated Questions and Answers (100% Correct Answers)

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W&F Exam 3 Verified and Updated Questions and Answers (100% Correct Answers)

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W&F Exam 3 Verified and Updated Questions
and Answers (100% Correct Answers)
5 Factors Affecting Labor Progress
Answer: The birth Passageway (birth canal)


The Passenger (fetus)


The physiologic forces/Power of labor


The Position of the mother


The woman's Psychosocial considerations


Not all women have the same shaped
Answer: pelvis


The Passenger
Answer: Fetal Presentation


o Vertex (head first); breech (bottom first); shoulders/transverse


Station


o Relation to the pelvis


o Ischial spines are zero station


o + = moving down and out


o - = not moving down as it should


Power: What DO We Know?
Answer: Progesterone : Relaxant; keeps uterus relaxed


Estrogen: Excites uterine response


Oxytocin and Prostaglandins: increase smooth muscle contractions

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o Effectively induce labor


♣ Indocin (an antiprostaglandin) STOPS contractions in preterm labor


Uterine Contractions: Frequency, Tachysystole
Answer: How quickly they come


o Tachysystole: occurs when there are more than 5 uterine contractions in a 10
minute period there isn't enough time for oxygen to move to baby, it won't become
oxygenated enough we have to intervene


♣ Top line is fetal HR


♣ Bottom line in mom's contractions


o Time from the beginning of one contraction to the beginning of the next


o May not be perfectly space, can give a range


♣ Ex. every 3-10 minutes


Uterine Contractions: Duration
Answer: How long they last


o Often have a range of their length


o Beginning of one contraction to the completion of that same contraction


o Often have a range of their length


o 30-40 seconds in the beginning of labor, 30-90 seconds as it progresses


Uterine Contractions: Intensity
Answer: How strong they are


o Strength of resting state to peak of contraction


o Measured by "feel" or direct measurement (little computer goes into uterus and
measures pressure of fluid)

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o Describe as mild, moderate, or strong to palpation


♣ Mild: muscle is indentable


♣ Moderate: give like the tip of your nose


♣ Strong: hard like a bone


o The chart is very subjective but the palpation is far better


Contractions cause Cervical Change
Answer: • Dilatation: opening and thinning of cervix


o 0-10 cm is how we measure


• Effacement: turning out


o Measure in terms of percentage, 0-100%


Associated Signs/Symptoms of Cervical Changes
Answer: loss of mucous plug


rupture of membranes-does not correlate with the progress of labor


o AROM


o SROM


o Loss of fluid could easily be urine


o Amnisure


o Once the membranes are ruptured we worry about bacteria getting up in the birth
canal and getting to the baby


bloody show: the cervix is very vascular so there will be a modest amount of blood
(ex. go to the bathroom and wipe and there's a little blood)

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When assessing cervical changes we'd ask our patient
Answer: did you notice any mucus? Any fluid? And little bit of blood?


Shorthand for cervical changes
Answer: dilatation/effacement/station


BBOW
Answer: bulging bag of water


During labor the presenting part should move progressively from the negative
stations to the
Answer: midpelvis at zero station and into the positive stations


Failure of the presenting part to descend in the presence of strong contractions may
be due to
Answer: disproportion between the maternal pelvis and fetal presenting part.


If the presenting part is higher than the ischial spines, a ______ number is assigned
Answer: a negative number is assigned, noting centimeters above zero station.


Power: Primary Force
Answer: maternal uterine contractions, first stage of labor (complete effacement and
dilatation)


Power: Secondary Force
Answer: abdominal muscles, second stage of labor, pushing adds to primary power
after full dilation


The cervix changes progressively from a ____,______ structure to a structure that is
________
Answer: The cervix changes progressively from a long, thick structure to a structure
that is tissue-paper thin


In primigravidas effacement usually precedes
Answer: dilatation.


AROM
Answer: artificial ROM


Once the membranes are ruptured we worry about
Answer: bacteria getting up in the birth canal and getting to the baby

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