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level: Level 1 of Chapter 23

Questions and Answers List

level questions: Level 1 of Chapter 23

QuestionAnswer
is difficult labor or abnormally slow progression of labordystocia
Four main components of the labor process:1. the power 2. the passenger 3. the passageway 4. the psyche (5. the placenta)
Four main components of the labor process: The force that propels the fetus (uterine contractions)The power
Four main components of the labor process: The fetusthe passenger
Four main components of the labor process: The birth canalThe passageway
Four main components of the labor process: the woman's and family's perception of the eventThe psyche
Problems with the Power: 1:Ineffective uterine force
Problems with the Power: Ineffective uterine force: is a time-honored term to denote sluggishness of contractions, or that the force of labor, is less than usual.Inertia
Problems with the Power: 2: The risk of maternal postpartal infection, hemorrhage, and infant mortality is higher in womenDysfunctional labor and associated stages of labor
Problems with the Power: 3: The number of contractions is usually low or infrequent.Hypotonic contractions
Problems with the Power: 4: increased in resting toneHypertonic contractions
Problems with the Power: can occur so closely together that they can interfere with the blood supply to the placenta.Uncoordinated contractions
Involves a prolonged latent phase, protracted active phase, prolonged deceleration phase, and secondary arrest of dilation.Dysfunction at the First Stage of Labor
Dysfunction at the First Stage of Labor: A latent phase that lasts longer than 20 hours in a nullipara or 14 hours in a multiparaProlonged latent phase
Dysfunction at the First Stage of Labor: usually associated with fetal malposition or cephalopelvic disproportion, if the active phase lasts longer than 12 hours in a primigravida or 6 hours in a multigravida.Protracted Active Phase
Dysfunction at the First Stage of Labor: When it extends beyond 3 hours in a nullipara or 1 hour in multiparaProlonged Deceleration phase
Dysfunction at the First Stage of Labor: No progress in cervical dilation for longer than 2 hours.Secondary Arrest of Dilation
Problems with power: Sourced from Google: also known as rapid labor, describes labor that's quick and short. If you have this, your baby is born within three hours of regular contractions starting. Contractions are when your uterine muscles tighten and relax to help push your baby out.Precipitate (Precipitating or precipitous) labor
Problems with power: means labor is started artificially (oxytocin or amniotomy)Induction of labor
Problems with power: refers to assisting labor that has started spontaneously but is not effective.Augmentation of labor
Problems with power: Inductions should be avoided until how many weeks unless medically indicated?39 weeks
problems with the power: a change in the cervical consistency from firm to soft, is the first change of the uterus in early labor, because, until this has happened, dilatation and coordination of uterine contractions will not occur. To determine whether the cervix is "ripe," or ready for dilatation, Bishop (1964) established criteria for scoring the cervix.Cervical ripening
Using the established criteria for scoring the cervix, (cervical ripening or dilatation and coordination of uterine contractions), using this scale, the cervix is ready for birth and should respond to induction if a woman's total score is?8 or greater
The simplest method to help a cervix "ripen" is known as ??? or separating the membranes from the lower uterine segment manually, using a gloved finger in the cervix.“stripping the membranes,”
The second method to help the cervix "ripen" is? which gradually and gently urge dilatation (laminaria technique), can be inserted. They can be held in place by gauze sponges saturated with povidone-iodine or an antifungal cream. If sponges are used, documentation of how many were placed is important so it can be documented afterward that none remain.hygroscopic suppositories
The most common method used to promote cervical ripening, however, is the? If this is put in place in the evening, cervical ripening will usually have begun by morning. It’s best if women remain in bed in a side-lying position to prevent loss or leakage of the medication.insertion of a prostaglandin such as dinoprostone (Prepidil, Cervidil) into the posterior fornix of the vagina, by the cervix (Kunzier, Park, Cioffi, et al., 2016).
Nursing responsibilities and considerations on Cervical ripening:Monitor the FHR after each application and for side effects such as vomiting, fever, diarrhea, and hypertension in the mother. Oxytocin induction can be started 12 hours after the prostaglandin dose; beginning it sooner might lead to hyperstimulation of the uterus. Even with these side effects, prostaglandins are well accepted by most women as a way to aid cervical ripening (Kunzier et al., 2016). They should be used with caution in women with asthma, renal or cardiovascular disease, glaucoma, or in those who have had past cesarean births because of the danger of side effects and hyperstimulation
Nursing responsibilities and considerations on Cervical ripening: Prostaglandins: Monitor the FHR after each application and for side effects such as?vomiting, fever, diarrhea, and hypertension in the mother.
Nursing responsibilities and considerations on Cervical ripening: Oxytocin induction can be started how many hours after the prostaglandin dose; beginning it sooner might lead to hyperstimulation of the uterus?12 hours
Nursing responsibilities and considerations on Cervical ripening: Even with these side effects, prostaglandins are well accepted by most women as a way to aid cervical ripening (Kunzier et al., 2016). They should be used with caution in women with ??? because of the danger of side effects and hyperstimulationasthma, renal or cardiovascular disease, glaucoma, or in those who have had past cesarean births
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Nursing responsibilities and considerations on Cervical ripening: Prostaglandins should be used with caution in women with asthma, renal or cardiovascular disease, glaucoma, or in those who have had past cesarean births because of?the danger of side effects and hyperstimulation
Problems with the Passage: is narrowing of the anteroposterior diameter of the pelvis to less than 11 cm. It usually is caused by rickets in early life or by an inherited small pelvis.Inlet contraction
Problems with the Passage: is a narrowing of the transverse diameterOutlet contraction
the conduction of spontaneous labor in a moderate degree of cephalopelvic disproportion, If a woman has a borderline (just adequate) inlet measurement and the fetal lie and position are good.Trial labor
Problems with the Passage: is the turning of a fetus from a breech to a cephalic position before birth. It may be done as early as 34 to 35 weeks.External cephalic version
External cephalic version may be done as early as:34 to 35 weeks
Problems with the Passage: Forceps birth: are steel instruments constructed of two blades that slide together at their shaft to form a handle.Obstetrical forceps
Problems with the Passage: Forceps birth: A forceps birth may leave?a transient erythematous mark on the newborn's cheek
Problems with the Passage: With the fetal head at the perineum, a soft, disk-shaped cup is pressed against the fetal scalp and over the posterior fontanelleVacuum extraction
Common causes of Dysfunctional Labor: 1:Primigravida status
Common causes of Dysfunctional Labor: 2:Pelvic bone contraction that has narrowed the pelvic diameter so a fetus cannot pass (cephalopelvic disproportion (CPD) such as could occur in a woman with rickets.
Common causes of Dysfunctional Labor: 3:Posterior rather than anterior fetal position or extension rather than flexion of the fetal head.
Common causes of Dysfunctional Labor: 4:Failure of the uterine muscle to contract properly or overdistention of the uterus, as with a multiple pregnancy, polyhydramnios, or an excessively oversized fetus.
Common causes of Dysfunctional Labor: 5:A nonripe cervix
Common causes of Dysfunctional Labor: 6:Presence of a full rectum or urinary bladder that impedes fetal descent
Common causes of Dysfunctional Labor: 7:A woman becoming exhausted from labor
Common causes of Dysfunctional Labor: 8:Inappropriate use of analgesia (excessive or too early administration)
Anomalies of the placenta: A.) The normal placenta weighs approximately: B.) the normal placenta is how long in diameter: C.) The normal placenta is approximately how thick: D.) Its weight is approximately how long as that of the fetus:A.) 500 g B.) 15 to 20 cm in diameter C.) 1.5 to 3.0 cm thick D.) Its weight is approximately one sixth that of the fetus
is a placenta that has one or more accessory lobes connected to the main placenta by blood vessels.Placenta Succenturiata
the fetal side of the placenta is covered to some extent with chorionPlacenta Circumvallata
the cord is inserted marginally rather than centrallyBattledore Placenta
instead of entering the placenta directly, separates into small vessels that reach the placenta by spreading across a fold of amnionVelamentous insertion of the cordd
A condition in which blood vessels within the placenta or the umbilical cord are trapped between the fetus and the opening to the birth canal. Preparation for cesarean deliveryVasa Previa
is an unusually deep attachment of the placenta to the uterine myometrium (uterine wall) Preparation for methotrexate treatment or hysterectomyPlacenta accreta
When the placenta attaches into the uterine musclePlacenta Increta
When the placenta goes completely through the uterine wall, sometimes invading nearby organs like the bladderPlacenta percreta
Instead of those three vessels, your baby's cord has only two: one vein and one artery. also known as single umbilical artery (SUA)Two-vessel cord
An unusually short umbilical cord can result in:premature separation of the placenta or an abnormal fetal lie
An unusually long cord may be easily compromised because of?its tendency to twist or knot