Labor and Delivery Notes Review

Flashcards covering key concepts related to labor and delivery, including assessments, stages of labor, pain management, fetal circulation, and common complications, derived from lecture notes.

What are the initial assessments performed when a laboring patient is admitted to labor and delivery?

Vital signs, health history (age, DOB, allergies, PMH, surgeries, previous OB history).

What is the increasing trend in labor and delivery that gives mothers more choice in their labor experience?

Birth plans.

If a mother desires a water birth, where does the baby actually labor?

In the water.

During labor monitoring, what does the monitor placed on top of the abdomen typically track?

Baby's heart rate.

During labor monitoring, what does the monitor placed on the bottom of the abdomen typically track?

Contractions.

When membranes rupture, what three key characteristics should be assessed and documented?

Time, amount, and color of the amniotic fluid.

What is the desired color for amniotic fluid after membrane rupture?

Clear, possibly with a slight yellow or pink tinge.

What does green or brown amniotic fluid indicate?

Meconium (baby has pooped in utero).

Why is meconium in the amniotic fluid a concern?

It indicates fetal distress and poses a risk of meconium aspiration by the baby.

Why is knowing the time of membrane rupture crucial?

The longer the membranes are ruptured, the higher the risk of infection.

What is the ideal timeframe for a baby to be born after membranes rupture to minimize infection risk?

Within 24 hours.

What can a monitor with contractions reveal about the labor process besides frequency?

How intense the contractions are.

What is cervical dilation?

How much the cervix has opened, measured in centimeters (1-10 cm).

What is cervical effacement?

How much the cervix has thinned, measured in percentage (0-100%).

What must be achieved in terms of dilation and effacement before pushing can begin?

10 cm dilation and 100% effacement.

Besides dilation and effacement, what else is assessed during a cervical check?

Fetal presentation (what part of the baby is presenting first) and station.

What anatomical markers define "station zero" during a cervical check?

The ischial spines in the mom's pelvis.

What do negative station numbers (e.g., -1, -2) indicate about the baby's position?

The baby's head is higher than the ischial spines.

What do positive station numbers (e.g., +1, +2) indicate about the baby's position?

The baby's head is lower than the ischial spines and descending.

What is the definition of fetal presentation?

What part of the baby is positioned to come out first.

What is the ideal fetal presentation for a vaginal birth?

Cephalic (head down).

What is breech presentation?

When the baby's butt or feet are presenting first.

What is occiput anterior (OA) presentation?

The ideal orientation where the back of the baby's head is towards the front of the mother's pelvis.

What is occiput posterior (OP) presentation commonly referred to in labor and delivery?

"Sunny-side up," where the baby's face is coming out first.

Why are a baby's skull sutures not completely closed at birth?

To allow for passage through the birth canal and for brain growth.

What does "SROM" stand for?

Spontaneous Rupture of Membranes.

What does "AROM" stand for?

Artificial Rupture of Membranes.

What is a prolapsed umbilical cord?

When the umbilical cord comes out before the baby.

Why is a prolapsed umbilical cord considered an emergency?

It can compress blood flow to the baby, causing fetal distress or demise.

What are the typical timeframes for the first stage of labor (dilation)?

From 0 cm to 10 cm dilated.

During the active phase of labor (4-7 cm dilated), what is a key nursing intervention?

Educating and reassuring the mother about normal feelings and expectations.

What is the primary difference between an epidural and a spinal anesthetic in terms of medication delivery?

An epidural uses a catheter for continuous medicine infusion, while a spinal is typically a single injection without a catheter.

What is a common side effect of both epidurals and spinal anesthetics that nurses must monitor for?

Hypotension (drop in blood pressure).

After receiving an epidural, when is a mother typically allowed to get out of bed?

When she has regained complete feeling in her legs.

What is the second stage of labor?

The period from full dilation (10 cm) until the baby is born (pushing phase).

Why do nurses encourage mothers to push with contractions?

To increase the efficacy of contractions and help the baby descend.

What is an episiotomy?

A surgical incision made by the doctor to enlarge the vaginal opening and prevent uncontrolled tearing during birth.

What is a fourth-degree tear?

A tear that extends from the front (vagina) completely through to the back (rectum).

What is a "nuchal cord"?

When the umbilical cord is wrapped around the baby's neck.

What is the third general stage of labor?

The stage from the baby's birth until the delivery of the placenta.

What are two major risks associated with a retained placenta?

Infection and hemorrhaging.

What are the three vessels typically found in an umbilical cord?

Two arteries and one vein.

Which vessel in the umbilical cord carries oxygenated blood from the placenta to the fetus?

The umbilical vein.

Where does oxygenation of fetal blood primarily occur?

In the placenta.

Name one of the three shunts (holes) in fetal circulation.

Ductus venosus, Foramen ovale, or Ductus arteriosus.

What two structures does the foramen ovale connect in fetal circulation?

The right atrium and the left atrium.

When does fetal circulation transition to adult circulation?

After birth, as the shunts (holes) close due to pressure changes.

What is the fourth stage of labor?

The 1-4 hours immediately after birth when the mother's body begins to readjust physiologically.

What is meant by "uterine atony" and why is it a concern after birth?

It refers to a soft or boggy uterus, which increases the risk of maternal hemorrhage.

What is a common reason for inducing labor if the body doesn't progress naturally around 40-41 weeks?

To prevent risks associated with prolonged pregnancy, such as fluid loss and increased infection risk.