NSG 210 Exam 1 Reproduction Study Guide
Definition: The process by which human beings produce a new individual
Exemplars:
- Intrapartum
-
... [Show More] Postpartum
- Newborn Assessment
Chapter 16: Giving Birth
Physiological Responses (Maternal)
Uterus
Contraction Cycle consists of three phases
- The increment, when the contraction begins in the fundus and spreads
through the uterus
- The peak (acme) when the contraction is the most intense
- The decrement, when the intensity decreases, and the uterus relaxes
Frequency: The period from the beginning of one contraction to the beginning of
the next
Duration: The length of each contraction from beginning to end
Intensity: The strength of the contraction
Interval: The period between the end of one contraction and the beginning of the
next
Cervix
Effacement: uterus is approximately 2 cm before labor. During labor the cervix
begins to “efface”, or thin A fully thinned cervix is considered 100% effaced
Dilation: The opening of the cervix. 10 cm is considered fully dilated
Cardiovascular
Encourage mom to rest in side-lying positions between contractions to promote
blood flow to heart and placenta
Urinary
A full bladder can inhibit fetal decent and cause discomfort
Hematopoietic
Normal blood loss for a vaginal delivery is 500 mL
Normal blood loss for a cesarean section is 1000 mL
Leukocytes can average between 14,000-25,000+ mm3
Physiological Responses (Fetal)
Placenta
Exchange of oxygen, nutrients and waste occurs at the intervillous spaces.
Strong contractions cut off blood supply to the fetus for an intermittent amount of
time
Cardiovascular
The fetal heart rate is rapid, ranging from 110-160 bpm
Pulmonary
Downloaded by Simon Kamau ([email protected])
lOMoARcPSD|25111999
Fluid is expelled from the lungs during passage through the birth canal. Remaining
fluid is absorbed by pulmonary and lymphatic systems
The Four Ps of Childbirth
Powers
The two powers of labor are uterine contractions and maternal pushing efforts
Passage
The maternal pelvis and soft tissues
Passenger
The fetus, membranes, and the placenta
The attitude of the fetus is the relation of the fetal body parts together
o The normal fetal attitude is in flexion. The head is flexed towards the chest
with arms and legs over the thorax. The back is curved in a convex C shape
Psyche
Catecholamines secreted in response to anxiety and fear can inhibit uterine
contractibility and placental blood flow. Encourage mom to practice deep breathing
and provide a comfortable environment
Normal Labor
Theories of onset
- Changes in the ratio of estrogen to progesterone. Estrogen increases uterine
sensitivity and contractibility
- Prostaglandins are secreted in preparing uterus for oxytocin stimulation
- Increased secretion of oxytocin
- Fetal membranes release prostaglandins as well as cortisol possibly acting as a
uterine stimulant
Premonitory Signs
Before labor begins, women may notice warning signs that labor is near such as:
- Braxton Hicks contractions: irregular, mild contractions
- Lightening, or dropping as the fetus descends into the pelvic inlet
- Bloody show, a mixture of mucous that may occur as the cervix begins to soften,
dilate, and efface
- An energy spurt or “nesting”
- A small amount of weight loss (1-3 lb.)
*The number one indication of true labor [Show Less]