ANSWERS (GRADED A+)
Birth Trends - ANSWER-3 year decline
Mean age at first birth is 26.8 (record high)
15-29 birth rate decreasing
35-49 birth rate increasing
How much does it cost to give birth? - ANSWER-Uncomplicated vaginal birth - $10,212
Uncomplicated C/S - $16,848
How much does it cost to raise a child? - ANSWER-A sh*t ton
$234,900
CAM examples in pregnancy - ANSWER-Acupressure
Moxibustion
Massage
Hydrotherapy
Hypnosis
Herbal therapy
Aromatherapy
Visualization/guided imagery
GPTPAL - ANSWER-Gravida = # of pregnancies
Para = # of births
T = # of term babies
P = # of preterm babies
A = # of abortions
L = # of living children
Anatomy: Uterus - ANSWER-Fundus
Body
Cervix (dilation, effacement, station)
SVE - ANSWER-Charted with 3 numbers
Dilation, effacement, and station
Dilation - ANSWER-How open the cervix is (0-10)
Effacement - ANSWER-Thickness/thinness of the cervix (0%-100%)
Station - ANSWER-Where the baby's head is in relation to mom's pelvis
Higher into the abdomen = -1,-2,-3, etc
,Lower into the pelvis = +1,+2,+3, etc
TACO - ANSWER-Describes the BOW
T = time
A = amount
C = color
O = odor
Fetal doppler or US - ANSWER-Measures fetal HR/tones
Normal is 110-160
Will have variability
Accelerations are a good thing (15 beats x 15 seconds)
Decelerations are not
Stage One of Labor - ANSWER-Dilation
Stage Two of Labor - ANSWER-Pushing/Delivery
10cm-birth
~1hr to primips
~1/2hr for multips
Contractions q 2-3min, lasts 60-90sec
Stage Three of Labor - ANSWER-Placental Delivery
Placental separation 5-30mins after delivery
Assessment of Newborn - ANSWER-Done in the first 2hrs of life and then continuously
until discharge
H2T assessment (included mom's physical health, health hx, and birth hx)
Immediate Newborn Assessment - ANSWER-Within the first 2hrs of life
Assess need for resuscitation
Place with parents if stable
Gestational age assessment
Vital signs q 30min x2hrs in the immediate newborn period
Stage Four of Labor - ANSWER-Recovery
1-4hrs
Monitor blood loss (hemodynamic changes)
Uterus must remain contracted
Phases of Dilation: One - ANSWER-Early/latent
0-3cm
UCs q 5-10m
Lasts 30-40sec
~6-9hrs
,Phases of Dilation: Two - ANSWER-Active
4-7cm
UCs q 2-5min
Lasts 45-60sec
~4.5-6hrs
Phases of Dilation: Three - ANSWER-Transition
8-10cm
UCs q 1-2min
Lasts 60-90sec
~30min-1hr
Average blood loss for vaginal delivery - ANSWER-500ccs
Average blood loss for C/S - ANSWER-1000 ccs
Post-Partum Assessment: BBUBBLE-EE - ANSWER-Brain
Breast
Uterus
Bladder
Bowel
Lochia
Episiotomy/Perineum/Hemorrhoids
Extremities
Emotional
Breastfeeding Tips - ANSWER-Baby alert and rooting
Mom and baby comfortable
Grasp breast in "c-hold"
Observe latch
Watch for suck/swallow
Nose to nipple
Breastfeeding positions - ANSWER-Cradle
Football/clutch
Cross-cradle
Side-lying
APGAR Scoring System - ANSWER-How much resuscitation the baby needs at birth
Five criteria scored from 0-1
Done at 1min, 5mins, and 10mins after birth
APGAR Scoring Categories - ANSWER-Appearance
Pulse (auscultate apical HR for 1 full minute)
Grimace (reflex irritability)
, Activity (muscle tone, extent of flexion, resistance when extremities pulled away from
body)
Respiratory
APGAR: Appearance: 0 points - ANSWER-Cyanotic or pale
APGAR: Appearance: 1 point - ANSWER-Appropriate body color
Blue extremities (acrocyanosis)
APGAR: Appearance: 2 points - ANSWER-Completely appropriate color (pink on both
trunk and extremities)
APGAR: Pulse: 0 points - ANSWER-Absent
APGAR: Pulse: 1 point - ANSWER-Slow (<100bpm)
APGAR: Pulse: 2 points - ANSWER->100bpm
APGAR: Grimace: 0 points - ANSWER-No response
APGAR: Grimace: 1 point - ANSWER-Grimace or frown when irritated
APGAR: Grimace: 2 points - ANSWER-Sneeze, cough, or vigorous cry
APGAR: Activity: 0 points - ANSWER-Limp, flaccid
APGAR: Activity: 1 point - ANSWER-Some flexion
Limited resistance to extension
APGAR: Activity: 2 points - ANSWER-Tight flexion
Good resistance to extension with quick return to flexed position after extension
APGAR: Respiratory: 0 points - ANSWER-Apneic
APGAR: Respiratory: 1 point - ANSWER-Slow, regular, shallow breaths
APGAR: Respiratory: 2 points - ANSWER-Regular respirations (30-60 breaths/minute)
Strong, good cry
Normal Newborn Weight - ANSWER-5lbs 8 oz - 8lbs 14oz
2500-4000gms
Normal Newborn Length - ANSWER-17-22in
44-55cm
Normal Newborn HC - ANSWER-13-15in