Nursing 223 - Exam 2
Theories of onset of labor - answer What causes someone to go into labor?
Maternal factors:
-increased secretion of Oxytocin via moms pituitary gland
-decreased secretion of progesterone (make uterus irritated)
Fetal factors:
-fetal adrenal gland secretes hormones that could stimulate labor.
Distention theory: When uterus is dilated to certain point it stimulates labor.
Factors contributing to length of labor - answer1st time mom vs. multiple time
Many factors contribute to the length of any labor:
-Passage: looks at pelvis, baby passes through outlet (notes inlet and outlet to
determine if baby can pass through easily)
-Passenger: Position, size of baby, how its coming down, vertex (head down, chin to
chests is ideal to get widest area through first.)
-Power: Uterine contractions (longer, stronger, closer together? coordinated?, not
effective?)
-Position (upright, side-lying, walking aids in process. comfortable position of relaxation)
-Psyche & perception (prepared for labor, tours, support person. preparation classes
known to decrease labor time)
-Parity (impacts length of labor; 2-3rd labors tend to be shorter)
-placenta (where is it located? typically in posterior uterine wall well protected.
Active phase inertia - answerwoman gets so many cm dilated then contractions stop.
brain telling body labor wont work
Uterine Dystocia - answer-related to ineffective uterine activity.
Most common is uncoordinated UC's that prolong labor or dilation stops
-defined as hypertonic or hypotonic UC's
, Signs to educate patient to help her identify labor - answer-Increasing Braxton Hicks
contractions
-engagement
-wt. loss that is typically fluids. (1-2 lbs prior to labor)
-spurt of energy/adrenaline
-bloody show is blood tinged mucus that signs cervix dilation
-loose stool/diarrhea is body cleansing before labor.
Braxton Hicks Contractions - answer(irregular, cramping contractions (multipara
mothers experience this more)
-if woman increases activity, true labor will get stronger, braxton hicks go away with
activity.
-suddenly changing body temperature, braxton hicks go away, true labor wont change.
Engagement - answermeans baby's presenting part is at level of ischial spines
-predictable in primipara (1-2 weeks before labor)
-multipara this would occur during labor
-engagement symptoms: - easier breathing, more pelvic pressure (worse hemorrhoids,
vericose veins) , leg cramps, increased urinary frequency, lower edema, increased
vaginal secretions.
1st stage of labor - answerStage of dilation: 0-10cm (dilation and effacement = thinning.
2cm is normal cervical length)
About 12 hours for primipara and 8 for multipara
Early / Latent Phase
Active phase
Transition phase
Early / Latent phase of 1st stage labor - answerAbout 8 hrs primi / 4 for para:
-contractions 30-5 minutes apart and lasting 30 sec
-0-3cm dilation
-encouraged to rest, eat light, drink clear liquids at home
-Women may start to dilate prior to labor contractions r/t braxton hicks contractions
-Rupture of membranes usually facilitates labor progression
-Vital signs, BP, FHR
-patient may be ambulating, intermittent FHR
Active Phase of 1st stage labor - answerAbout 4 hrs primipara / 2-3 hrs multipara
Theories of onset of labor - answer What causes someone to go into labor?
Maternal factors:
-increased secretion of Oxytocin via moms pituitary gland
-decreased secretion of progesterone (make uterus irritated)
Fetal factors:
-fetal adrenal gland secretes hormones that could stimulate labor.
Distention theory: When uterus is dilated to certain point it stimulates labor.
Factors contributing to length of labor - answer1st time mom vs. multiple time
Many factors contribute to the length of any labor:
-Passage: looks at pelvis, baby passes through outlet (notes inlet and outlet to
determine if baby can pass through easily)
-Passenger: Position, size of baby, how its coming down, vertex (head down, chin to
chests is ideal to get widest area through first.)
-Power: Uterine contractions (longer, stronger, closer together? coordinated?, not
effective?)
-Position (upright, side-lying, walking aids in process. comfortable position of relaxation)
-Psyche & perception (prepared for labor, tours, support person. preparation classes
known to decrease labor time)
-Parity (impacts length of labor; 2-3rd labors tend to be shorter)
-placenta (where is it located? typically in posterior uterine wall well protected.
Active phase inertia - answerwoman gets so many cm dilated then contractions stop.
brain telling body labor wont work
Uterine Dystocia - answer-related to ineffective uterine activity.
Most common is uncoordinated UC's that prolong labor or dilation stops
-defined as hypertonic or hypotonic UC's
, Signs to educate patient to help her identify labor - answer-Increasing Braxton Hicks
contractions
-engagement
-wt. loss that is typically fluids. (1-2 lbs prior to labor)
-spurt of energy/adrenaline
-bloody show is blood tinged mucus that signs cervix dilation
-loose stool/diarrhea is body cleansing before labor.
Braxton Hicks Contractions - answer(irregular, cramping contractions (multipara
mothers experience this more)
-if woman increases activity, true labor will get stronger, braxton hicks go away with
activity.
-suddenly changing body temperature, braxton hicks go away, true labor wont change.
Engagement - answermeans baby's presenting part is at level of ischial spines
-predictable in primipara (1-2 weeks before labor)
-multipara this would occur during labor
-engagement symptoms: - easier breathing, more pelvic pressure (worse hemorrhoids,
vericose veins) , leg cramps, increased urinary frequency, lower edema, increased
vaginal secretions.
1st stage of labor - answerStage of dilation: 0-10cm (dilation and effacement = thinning.
2cm is normal cervical length)
About 12 hours for primipara and 8 for multipara
Early / Latent Phase
Active phase
Transition phase
Early / Latent phase of 1st stage labor - answerAbout 8 hrs primi / 4 for para:
-contractions 30-5 minutes apart and lasting 30 sec
-0-3cm dilation
-encouraged to rest, eat light, drink clear liquids at home
-Women may start to dilate prior to labor contractions r/t braxton hicks contractions
-Rupture of membranes usually facilitates labor progression
-Vital signs, BP, FHR
-patient may be ambulating, intermittent FHR
Active Phase of 1st stage labor - answerAbout 4 hrs primipara / 2-3 hrs multipara
