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descent into the pelvis?
lightening
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may occur 2 weeks before pregnancy with primigravida and on birth with multigravida
lightening
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when lightening happens where does it relieve pressure?
diaphram
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when lightening happens what are the symptoms on the mother?
urinary frequency, leg cramps, increased venous stasis, increased vaginal secretions
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irregular, intermittent contractions felt later in pregnancy may be regular and uncomfortable and is considered a false labor bc the cervix is not dilated
braxton hicks contractions
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this labor the contractions are irregular and the intervals remain the same and the intensity remains same?
false labor
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when starting ambulation and changing position or controlling breathing during this labor the women should know?
false labor
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True or false?
When it is false labor the cervix does not efface or dialte
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when are contractions felt above the naval?
during false labor
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in this labor contractions are regular, the intervals shorten and intensity and pain increases
true labor
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when in true labor do contractions become stronger when ambulating?
YES!
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what happens with the vagina in true labor?
the cervix softens, effaces and dilates
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when does the pregnant mother have contractions felt in the lower back and radiate to the abd
true labor
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when does the cervix "mature" or ripen?
34 weeks
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Labor begins within 24-48 hours after this?
Bloody show
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this occurs naturally when a gust of amniotic fluid rupturing
SROM
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what is AROM
artificial rupture of the membranes when the DR has to use an amniohook to rupture the membrane
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what determines the difference between urine and amniotic fluid?
nitrazine fluid
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what are some GI disturbances of a pregnant woman?
indigestion, n/v, diarrhea, may loose 1-3 lbs
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when does the sudden burst of energy for a women appear?
24-48 hrs before labor
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what kind of meals should we encourage the mother to eat?
small frequent meals
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what happens in the cardiovascular system during labor?
output increases, bp increases during 1st and 2nd trimester, hypotensive supine position
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when should we take a BP on a woman i labor?
during cotractions so it is accurate
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what are some maternal systemic responses to labor on the resp system?
o2 consumption during labor equals mod to severe exercise
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where is your bladder pushed during labor?
forward and upwrd
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What happens in the GI system during labor?
peristalsis and absorption decrease
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True or False?
does the WBC count increase during labor?
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Wha happens in the musculoskeletal system during labor?
relaxation of pelvis joints, may result in backache
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Do endorphins increase? and what does it cause?
yes and it causes a intensive affect of pain, sedative effect
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what 5 things are looked at during an ultrasound?
fetal growth, pelvic adequacy, multiple pregnancy, placenta location,fetal presentation
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What happens to the uterus during pregnancy?
the fundus becomes thicker with contractions and lower secretions
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what are the major bones of the fetus?
2 of each: temporal, frontal and parietal, occiput
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what is the ideal fetal attitude of the baby? flexion or extension?
flexion
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most commonpresenting parts during vagial birth?
vertex occiput, brow sinciput, and face to face
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what is complete breech?
hips and knees flexed on abd flexed, buttocks presenting
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frank breech?
hips flexed, knees extended, buttocks presenting
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footling breech?
hips/knees extended with foot as presenting
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how to check fetal position?
engagement, station and fetal position
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widest part of the presenting part is at or below lever of ischial spine?
engagement
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relation pf the presenting to ischial spines, measure in cm
station
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involuntary contraction of the uterus
primary power
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voluntary use of abd muscles
secondary power
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contractions begin in fundus and spread over the uterus for appx how lon?
15 sec
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3 stages of contractions
increment, acme, decrement
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decreasing intensity of contraction
decrement
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increasing intensity of contration
increment
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time from begining of one contraction to the begining of of next contraction
frequency
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length of one contraction, from the begining of increment to conclusion of decrement
duration
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how long sould contractions be?
90 sec or shorter than 60 sec
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true or falase?
the uterus should relax between contractions?
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type bearing down throughout contraction?
valsalva
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when is the spontaneous urge to bear down triggered?
when the presenting part reaches the pelvic floor
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what is the fegunson reflex?
spontaneous involuntary urge to push
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this stage of labor begins with the onset of regular contractions and ends with cervical dilation?
stage 1
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longest stage of labor?
stage 1
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stage 1 is divided into 3 stages?
latent, active, and transition
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Latent phase consist of what?
begins when 1st contractions, ends when cervix is dialted to 3, pain is mild to mod and the pt is in good humor
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what is the active stage?
stage 1 phase 2 that beings when cervix is dilated to 4 ending in 8cm, pain in mod to strong and the pt is less talkative
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phase 3 of stage 1?
transition- begins when the cervix was dilated to 8 and ends at 10cm, pain is strong, the pt is self absorbed, restless
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during this phase the client may have n/v and feel hot and perspi
stage 1 phase transition
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this stage of labor begins when fully dilated and ends with the birth, "crowning"
stage 2
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incision of the perineum to facilitate passageway of the baby
episiostomy
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head only rotates, occiput next to symphysis pubis
internal rotation
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birth of the head
extension
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head rotates back into normal growth alignment with shoulders
restitution
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shoulders rotate to an anterios/posterior position under the symphis pubis
external rotation
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the lower shoulder is delivered and then the upper shoulder followed quickly by the body
expulsion
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durign this stage is starts with the birth of a baby and ends when the palcenta is delivered
stage 3
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thsi stage shuld occur in 30 min or less
stage 3
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when some of the placenta was not expelled what can happen?
hemorrhage
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what is the 4th stage
recovery
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what is the normal blood loss?
250-500ml
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true or false?
are chills/rigor normal for recovery?
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stimulation of the uterine contractions before they begin spontaneously
induction
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stimulation of contractions after spontaneously begining, but with unsatisfactory progess
augumentation
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what must cause a forceps assisted birth?
when the cervix is dilated and membranes must be ruptured.
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what are some possibleproblems for a forceps assisted birth to he newborn?
facial bruising and edema and they risk cephalhematoma, brachial plexus palsy, retinal and intracranial hemmorhage, hyperbilirubinemi
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what are some problems to the vagina during a forceps assisted birth?
vaginal and rectal lacerations
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what are the 4 main cares of the infant?
ABC and w for warmth
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what hsould the fundus look like durng birth?
firm, size of a grapefruit, in midline and below umbillicus
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