Nursing 209

N209: Reproductive Health Study Guide

Third stage: o Delivery of the baby until delivery of the placenta

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True labor vs. false labor: o Braxton-Hicks contractions: Irregular contractions that do not cause cervical changes o True labor: Contractions that come in regular intervals, increase in intensity and frequency, and cause cervical changes o Lightening: Baby “dropping” into pelvis o Mucous plug: Mucous that forms at the cervix during pregnancy • Fetal evaluation: o Leopold’s maneuver: Determines fetal presenting part by palpation • Fetal heart rate monitoring: o Auscultation: Periodic evaluation of FHR with fetoscope or Doppler o Electronic fetal monitoring  Measures fetal heart rate in response to uterine contractions  Can be internal, external, or a combination  Two devices are applied to maternal abdomen  Tocodynamometer: Measures tension across the abdomen (contractions)  Ultrasound transducer: Records FHR • Internal fetal monitor: o Scalp electrode: Applied to fetal scalp closest to cervix o Intrauterine Pressure Catheter (IUPC): Inserted into amniotic space to measure contraction strength • Fetal heart rate: o Baseline: Average FHR rounded to increments of 5 bpm over a 10-minute period; normal baseline 110-160 bpm o Tachycardia: Mean FHR >160 bpm o Bradycardia: Mean FHR <110 bpm (must distinguish from maternal HR) o Baseline change: An increase or decrease in FHR for longer than 10 minutes o Variability: Variation in FHR reflects status of CNS and is only accurate when fetal scalp electrode is utilized  Minimal variability: Less than 5 bpm  Moderate variability: 6-25 bpm  Marked variability: Greater than 25 bpm

4.2 Process of Labor •

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