| A | B |
|---|
| Abruptio Placentae | (1) placenta prematurely separates from a normally implanted placenta from uterine wall before delivery of infant (2) assoc w/cocaine use, domestic abuse, abdominal trauma, fibroids, uterine overextension, age, alcohol use & high number of previous births (3) indicated by sharp fundal pain & discomfort between contractions |
| Active Phase | 2nd of 3 phases in the initial stage of labor, during which the cervix dilates from about 4 to about 7 centimeters & fetal descent is progressive |
| Acrocyanosis | (1) bluish coloration of a newborn's hands & feet caused by poor peripheral circulation (2) usually resloves 2 to 6 hrs after birth |
| Amnioinfusion | introduction of warm, sterile fluid into uterus thru an intrauterine pressure catheter in order to incr the volume of intrauterine fluid & cushion the fetus & umbilical cord from compression due to contractions |
| Amniotomy (artificial rupture of membranes) | (1) done by midwife or obstetrician (2) usually done w/an amnihook or fingercot (3) intended to (a) induce or accelerate labour (b) FHR monitoring w/elec (4) >risk of infection if birth does not occur (5) if fetal position too high procedure cancelled d/t possibility for prolapsed cord (6) limit vag exam to decrease risk of infection |
| Artificial Rupture of Membranes (AROM) | rupture of the amniotic sac during labor (a) to induce labor or augment uterine activity (b) fluid rich in prostaglandin incrs strength/frequency of contractions (c) enables scaple electrode internal fetal heartbeat monitoring (d) check fluid color/content (e) avoid fetal aspiration of contents of amniotic sac at moment of birth |
| Augmentation of Labor | process similar to induction of labor used when (a) spontaneous contractions have failed to change status of cervix or promote descent of fetus (b) when labor begins but stalls & assistance is required to achieve cervical dilation & effacement |
| Abruptio Placentae | Abruptio Placentae |
| Babinski Reflex | reflex that involves fanning or hyperextension of the toes when the lateral aspects of the foot is stroked upwards from the heel across the ball of the foot |
| Bloody Show | (1) during pregnancy, secretions accumulate in the cervical canal to form a mucous plug (2) w/softening & effacement of the cervix, the plug is often expelled (3) pinkish secretions that result when the mucous plug is expelled prior to labor & a small amount of blood is lost from the exposed cervical cavities |
| Breech Presentation | (1) any fetal presentation in which the baby is buttocks down (2) danger of prolapse cord & head entrapment d/t largest body part (head) last to deliver (3) C-section possible |
| Caput Succedaneum | (1) edema & bruising of edema of fetal scalp that occurs during labor & delivery (2) circular area under cup assoc with ventouse or vacuum extraction/suction |
| Cardinal Movements | (1) positional changes fetus makes to adjust to the maternal pelvis prior to birth (2) changes are (a) descent (b) flexion (c) internal rotation (d) extension (e) restitution (f) external rotation (g) expulsion |
| Cephalic Presentation | (1) any fetal presentation in which the baby is head down (2) most common presentation |
| Cervical Ripening | (1) cervix softening & effacement (2) prepadil & cervidil (chosen method d/t easy removal if uterus hyperstimulates) are common gels used (3) gels put in posterior position of vgina & left in place to provide slow release (3) risks: (a) hyperstimulation (b) nonreasurring fetal heart tones (c) uterine rupture (d) >incidence of postpartum hemorrhage |
| Cesarean Section | (1) surgical delivery of an infant by way of an incision in the mother’s uterus (2) incidences reduced w/ripening agents use (3) risk are 4X higher than w/vaginal birth (4) complications: (a) wound, urinry or uterine infections (b) hemorrhage, trauma to bladder & bowels, adhesions (5) 2 types of incision (a) transverse incision (longer delivery time w/decr risk of rupture in subsequent preg but can have vaginal birth) (b) classical vertical (most common) |
| C-section Bowel Sounds | usually absent until 4 hours postoperatively, when hypoactive bowel sounds may be auscultated |
| C-section Delivery | (1) placenta is removed manually (2) uterus is cleaned out |
| C-section (Post ) Delivery Fluids | (1) some vaginal drainage (2) lochia flow is lighter d/t placenta being manually removed (3) indwelling urinary catheter (a) placed before the c-section delivery (b) 2-hour postop, asssess (draining more than 30 ml/hr) (c) remains in place 24 to 48 hours after the c-delivery |
| C-section Diet | NPO until at least 4 hours postoperatively |
| C-section Uterus | uterine atone presents as large clots or large amount of vaginal bleeding |
| Compound Presentation | any fetal presentation in which there are two presenting parts, such as a hand presenting along the side of the head |
| Crowning | point during labor in which the fetal head is encircled by the external opening of the vagina, which means that birth is imminent |
| Disassociation Relaxation | technique that involves isolating and contracting one muscle group while relaxing the rest of the body |
| Ductus Arteriosus | (1) duct between the pulmonary artery & the aorta of the fetus (2) normally closes after birth as PO2 incrs & intravascular pressure in the right atrium decrs to allow blood to flow to the newborn's lungs |
| Ductus Venosus | duct that shunts blood from the umbilical vein to the inferior vena cava away from the fetal liver |
| Dystocia | (1) abnormal or difficult labour (2) distended uterus doesn’t seem to contract normally, resulting in uterine dystocia (3) problems d/t mechanical factors of fetus, pelvis or inadequate uterine or other muscular activity resulting in primary or 2ndry inertia |
| Early (Type I) Decelerations | (1) FHR decelerations that occur in response to head compression (2) decelerations begin & end when a contraction begins & ends creating a uniform pattern that looks upside down (3) no interventions are needed w/early decelerations, just monitoring (4) caused by head compression |
| Effleurage | (1) light stroking over the abdomen with the tips of the fingers to relieve mild to moderate pain during labor (2) relaxation techniques used to relieve mild to moderate pain |
| Epstein's Pearls | (1) benign small white cysts on the gums or at the junction of the hard & soft palates of the newborn (2) disappears in a few wks |
| Episiotomy | (1) surgical incision of the perineal body (2) repair done between birth or before or after expulsion of placenta (3) 2 types (a) midline (preferred if perineum is long enough d/t less blood loss & easier repair) (b) mediolateral |
| False Labor | (1) condition that occurs when Braxton-Hicks contractions become strong enough for a woman to believe she is in labor (2) toward end of pregnancy, Braxton-Hicks contractions so strong, may be confused w/true labor pains (3) does not impact the cervix even though contractions may be regular & uncomfortable (4) lying down may make false labor pains stop (5) abdominal discomfort can be a sign |
| Fetal Attitude | relation of the fetal parts to one another |
| Fetal Endocrine Theory | states that a hormone is released from the fetal brain that triggers the onset of uterine contractions |
| Fetal Heart Rate Decelerations | decreases in fetal heart rate during labor, which may indicate fetal distress |
| Fetal Lie | relation of the long axis of the fetus to that of the mother |
| Fetal Malpositions | (1) any fetal position other than occiput anterior (2) most common is persistend occiput posterior position (3) in posterior position 3rd or 4th degree perineal laceration or extension of a midline episiotomy |
| Fetal Position | placement of a fetus’s presenting part in relation to the four quadrants of the mother’s pelvis |
| Fetal Presentation | portion of the fetus that is nearest to the cervical os |
| First Period of Reactivity | the first 30 min to 1 hr period after birth during which a newborn is very alert & has a strong suck reflex making it a good time to begin breastfeeding |
| Forceps (Use risk of having an elevated bilirubin) | (1) instruments used to help provide traction on the fetal head & assist the mother while pushing (2) rotating the fetal head to a more optimal position for delivery (3) used when mother has bulging perineum, fetal scalp is visible between contractions & vertical axis of back of fetus head is at <45degrees from midline (4) used when conditions threaten mom or fetus that delivery would correct (5) may cause facial bruising or cephalohematoma which can increase the amount of bilirubin for the liver to handle |
| HypnoBirthing | (1) focuses on achieving a relaxed state in which the body will release endorphins that naturally reduce pain |
| Hypotonic Uterine Dysfunction | (1) contractions are too weak or far apart to be effective (2) unknown cause but could be genetic, age related (>25) |
| Kitzinger Method (sensory-memory) | (1) promotes home births for women who are not considered to be high risk (2) sensory memory is used to assist the woman to work with her body to prepare for birth (3) teach specific exercised to reduce pain (2) designed to provide self-help measures that can (4) (b) (a) lessen need for analgesics & anesthetics (b) eliminate fear (c) what to expect during labor & birth |
| Labor Induction | (1) stimulation of labor contractions before spontaneous labor occurs (2) incl stripping of membranes, oxytocin infusion, sexual intercourse, nipple stimulation, use of herbs & mechanical dilation |
| Lamaze (psychoprophylactic) | (1) birthing method focusing on a normal, natural, and healthy delivery; a profound experience for the expectant mother and her family (2) teach specific exercised to reduce pain (3) only method that incls disassociation relaxation (Kitzinger, Bradley and Read methods do not) (3) designed to provide self-help measures that can make the pregnancy & birth a happy experience (4) (a) lessen need for analgesics & anesthetics (b) eliminate fear (c) teach relaxation tech (d) what to expect during labor & birth (5) pattern-based breathing |
| Labor (Stage 1) | (1) from onset of regular contractions to full dilation of cervix w/effacement (thinning & ripening) (2) incl (a) latent phase (dilation of 0 to 3 cm; contractions: established, regular, >in frequency, intensity & duration) (b) active phase (4 to 7 cm, mother fatigued & helpless; fetal descent decreases) (c) transition phase (8 to 10 cm) contractions are intense; increase in frequency, duration w/mother restless("I can't take it anymore.") (3) transition is the phase of labor where clients usually complain of nausea and vomiting and increasing rectal pressure (4) laboring client usually is able to cope in the latent and active phases of labor |
| Labor (Stage 2) | (1) lasts from dilation of cervix to delivery of the fetus (2) crowning is a phase in the 2nd stage of labour when the largest segment of the fetal scalp is visible at the vaginal orifice (3) encourage ct to take short, panting breaths to avoid or control the urge to push until the time is right (4) complete cervical dilation thru birth of baby, accompanied by maternal urge to push |
| Labor (Stage 3) | lasts from delivery of the fetus to delivery of the placenta (2) birth of baby thru expulsion of placenta |
| Labor (Stage 4) | (1) lasts from delivery of placenta to 2 hrs after uterus effectively contracts to control bleeding at placental site (2) lasts about 2 hrs after birth of placenta, when homeostasis is reestablished (3) lactoferrin binds to iron & thwarts growth of pathogenic bacteria in breast milk (4) decr blood pressure & incr pulse & moderate tachycardia (5) fundus midway between symphysis & umbilicus (6) thirst, hunger & chill d/t physical exertion of labor (7) hypotonic bladder d/t trauma & anesthetics |
| Late (Type II) Decelerations | (1) FHR decelerations that start when a contraction is at its height (2) peak when the contraction is almost over (3) do not return to baseline until well after the contraction has ended (4) caused by insufficient blood flow to the placenta (5) are ominous & fetal O2 sh/be incrd (5) also resembles an upside down contraction |
| Lightening | process in which a fetus begins to settle into its mother’s pelvis, causing the woman to experience ease of breathing, increased pelvic pressure, increased urinary frequency, and increased vaginal secretions d/t congestion of vaginal mucous membranes |
| Mechanisms of Labor | positional changes made by the fetus in order to adjust to the maternal pelvis prior to birth |
| Molding | shaping of the fetal head during birth |
| Occult Cord Prolapse | phenomenon in which the umbilical cord lies beside or just ahead of the fetal head |
| Oxytocin Theory | states that oxytocin levels increase near the onset of labor |
| Placenta Accreta | (1) condition in which the chorionic villi attach directly to the muscular wall of the uterus (2) potential for abdominal hysterectomy |
| Placental Delivery | (1) expulsion of the placenta following birth (2) characterized by a decrease in fundal height |
| Placental Separation | (1) placenta detaches from uterine wall in third stage of labor (2) Signs incl (a) rise in the fundal height & sudden gush of blood from vagina of a postpartum client five minutes after birth (b) d/t decr in uterine surface (c) globular shaped uterus (d) further protrusion of umbilical cord out of vagina |
| Premature Rupture of Membranes (PROM) | (1) any rupture of sac on or before the onset of labor (2) assoc factors (a) incomplete cervix in 2nd tri (b) cervicitis (c) UTI (d) amniocentesis (e) placenta previa (f) abruptio placenta (g) maternal genital tract abnormalities (3) tx: prophylactic ABT for 48 hrs & bedrest |
| Primary Uterine Inertia | difficult labor d/t failure of cervical dilation or hypotonic uterine dysfunction when contractions are irregular or of low amplitude |
| Progesterone Deprivation Theory | (1) states that the onset of labor is triggered by decreasing progesterone levels (2) sometimes called the hormone of pregnancy |
| Progressive Relaxation | technique that involves tensing and relaxing one muscle group at a time |
| Prolapsed Cord | (1) umbilical cord precedes fetal presenting part, causing cord compression & obstruction of vessels carrying blood to & from fetus (2) no immediate physical risk to mother but enormous emotional stress d/t concern for baby (3) fetal bradycardia & deceleration & fetal may occur |
| Prostaglandin Theory | (1) states that increased secretion of prostaglandins helps trigger labor (2) dinoprostone a prostaglandin has FDA approval for use expelling fetuses that die before 28 wks gest (3) admin via 20ml suppositories inserted into the vagina (4) dose repeated q2/4hrs until max dose of 280 mg has been admin (5) contraindications: active pulmonary, hepatic, cardiac, renal or acute pelvic inflammation disease (6) oxytocin is usually admin concurrently |
| Rule of 60s | (1) rule of thumb for determining ominous cord compression, in which severe FHR decelerations drops to 60 beats per minute, decelerations lasting longer than 60 seconds, or drops to 60 beats below baseline |
| Rupture of Membranes (ROM) | (1) breaking of the amniotic sac, which typically occurs during the first stage of labor (2) fluid sh/be clear or straw-colored w/no foul smelling odor |
| Secondary Uterine Inertia | (1) direct result of dystocia (2) ongoing efforts to give birth to a malpresented fetus causes woman to stop her efforts d/t exhaustion or persistend occiput posterior position |
| Shoulder Presentation | (1) fetal presentation in which one of the baby’s shoulders is closest to the internal os (2) impossible to deliver vaginally |
| Spontaneous Rupture of Membranes (SROM) | natural rupture of the amniotic sac, which usually occurs at the height of an intense contraction with a gush of fluid out of the vagina |
| Spontaneous Vertex Birth | (1) infant’s head distends the vulva w/ea contraction, the perineum becomes thin, anus stretches & protrudes (2) after the baby’s head is born, a gentle push by the mother aids in the birth of shoulders, & body follows |
| Touch Relaxation | technique used in childbirth in which the expectant mother’s labor coach touches her, and she releases tension at the site of the touch |
| Transition Phase | last part of the first stage of labor, during which dilation of the cervix progresses from 8 centimeters to 10 centimeters, the rate of fetal descent increases, and contractions become more frequent, are longer in duration, and increase in intensity |
| True Labor | (1) condition that occurs when contractions do not subside w/activity but actually intensify w/ambulation (2) become increasingly stronger & closer together & cause cervical change (3) results in effacement & dilation of the cervix (4) assessment of cervix is necessary to differentiate between true labour & false labour (5) the pain does not go away with rest |
| Uteroplacental Insufficiency (UPI) | insufficient blood flow to the placenta |
| Variable (Type III) Decelerations | (1) decelerations in which FHR decrs sharply, stays down for a variable number of seconds, & then usually returns to baseline as sharply as it descended (2) fetus may be hypoxic & acidotic |
| Ventouse | (1) soft vacuum extraction of the fetus using a cup made of pliable plastic (2) used as an alternative to forceps during delivery |
| Vertex Presentation | (1) cephalic presentation where fetus’s head is pushing on the cervix w/ea contraction & its chin is tucked down on its chest (2) ideal type of presentation |
| Variable (Type III) Decelerations | (1) decelerations in which the FHR decreases sharply, stays down for a variable number of seconds, and then usually returns to baseline as sharply as it descended (2) caused by umbilical cord compression (3) may ve U, V or W in shape & can occur at any time during during or in abscence of contraction (4) always preceded & followed by a brief aceleration of HR |
| Ventouse | (1) soft vacuum extraction of the fetus using a cup made of pliable plastic (2) used as an alternative to forceps during delivery |
| Vertex Presentation | cephalic presentation in which the fetus’s head is pushing on the cervix with each contraction and its chin is tucked down on its chest |
| Vaginal pH Levels | (1) during childbearing years normal is 4.0-5.0 (2) environment of the vagina is acidic (3) below 4.0 is too low and above 5.0 is too high |
| Vaginal Yeast Infection | (1) during pregnancy infection is more prone to occur d/t incr in vaginal pH (2) a more alkaline environ results which is more conducive to growth of Candida albicans or yeast |
| Varicella | (1) cause of chicken pox, can have devastating effects if contracted during pregnancy (2) congenital abnormalities occurs w/exposure in 1st trimester (3) fetal mortality rate is high with contraction near time of delivery (4) varicella-zoster immune globulin (VZIG) sh/be admin to those not immune & is exposed during pregnancy |
| Vernix Caseosa | white cheeselike substance that covers the skin of the uterus while in utero & protects it from amniotic fluid |
| Varicose Veins (Varicosities) | (1) during pregnancy caused by incr congestion in lower extremeties (2) hereditary factors (3) >age & weight gain (4) Elevate legs level with hips while sitting or lying down |
| Viability | (1) 1st tri (a) factors affecting fetal growth & dev (b) eval & diagnostic testing & results (c) fundal height & FHR & movement assessed (d) viability & gest age estab (e) HCG & untrasound confirm (1) 2nd tri (a) cardiac activity (b) fetal number, presentation & anatomy verified by untrasound (c) amniotic fluid volume calcul (3) more sophisticated tech used |
| Vitamin | (1) K (thigh inject) shortly after birth to prevent possible bleeding problems d/t immature liver's inadequate production of prothrombin (2) H2O solubles & amino acids excreted in > amounts (3) glucosuria (not uncommon nor pathologic) represents kidney’s inability to reabsorb all glucose glomeruli filtered (4) newborn gut sterile at birth until feeding (5) d/t absence of intestinal flora, infants unable to synthesize Vit K (levels rise after the first week to reach adult levels by 9 mos) (6) K req for liver to activate coagulation factors |
| Venous Thrombosis (risk) | (1) incr in blood factors VII, VIII, IX & X (2) fibrin level, plasma fibrinogen, clotting time & blood factors coupled w/venous statis puts ct at incr risk |
| Variability | (1) irregularity of FH rythm sh/be closely watched (2) 6 to 10bpm is moderate & considered normal (3) lack of, when not assoc w/fetal sleep states, may reflect hypoxia (4) incr variability may be an early sign of fetal hypoxia |
