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NURS 6700 Exam 3 with complete solution 2024_2025
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NURS 6700 Exam 3 with complete solution 2024_2025
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NURS 6700 Exam 3 with completesolution 2024/2025
passengers (fetus and placenta)
passageway (birth canal)
powers (contractions)
position of the mother
psychological response. - ANSWER-What are the five Ps that affect the process
of labor and birth?
Passenger - ANSWER-The way the ?, or fetus, moves through the birth canal is
determined by several interacting factors: the size of the fetal head, fetal
presentation, fetal lie, fetal attitude, and fetal position. Because the placenta also
must pass through the birth canal, it can be considered a ? along with the fetus;
however, the placenta rarely interferes with the process of labor in a normal
vaginal birth.
Presentation - ANSWER-The part of the fetus that enters the pelvic inlet first and
leads through the birth canal during labor at term. Is the part of the fetus that lies
closest to the internal os of the cervix. It is the part of the fetal body first felt by
the examining finger during a vaginal examination. Factors determining this
include fetal lie, fetal attitude, and extension or flexion of the fetal head.
cephalic presentation-often feel the occiput noted as vertex
Shoulder- feel the scapula
Breech- you feel the sacrum - ANSWER-Three types of presentation?
?-head first
?-shoulder first
?-breech
Lie - ANSWER-The relation of the long axis (spine) of the fetus to the long axis
(spine) of the mother. The two primary ? are longitudinal, or vertical, in which the
,long axis of the fetus is parallel with the long axis of the mother; and transverse,
horizontal, or oblique, in which the long axis of the fetus is at a right angle
diagonal to the long axis of the mother
Longitudinal
Transverse
oblique - ANSWER-? lies are either cephalic or breech presentations, depending
on the fetal structure that first enters the mother's pelvis.
Vaginal birth cannot occur when the fetus stays in a ? lie.
An ? lie, one in which the long axis of the fetus is lying at an angle to the long
axis of the mother, is less common and usually converts to a longitudinal or
transverse lie during labor
Attitude - ANSWER-Is the relation of the fetal body parts to one another. The fetus
assumes a characteristic posture (attitude) in utero partly because of the mode of
fetal growth and partly because of the way the fetus conforms to the shape of the
uterine cavity. Normally the back of the fetus is rounded so that the chin is flexed
on the chest, the thighs are flexed on the abdomen, and the legs are flexed at the
knees. The arms are crossed over the thorax, and the umbilical cord lies between
the arms and the legs. This attitude is termed general flexion.
Position - ANSWER-Indicates that portion of the fetus that overlies the pelvic
inlet. Position is the relationship of a reference point on the presenting part
(occiput, sacrum, mentum [chin], or sinciput [deflexed vertex]) to the four
quadrants of the mother's pelvis. Position is denoted by a three-part abbreviation.
The first letter of the abbreviation denotes the location of the presenting part in
the right (R) or left (L) side of the mother's pelvis. The middle letter stands for the
specific presenting part of the fetus (O for occiput, S for sacrum, M for mentum
[chin], and Sc for scapula [shoulder]). The final letter stands for the location of
the presenting part in relation to the anterior (A), posterior (P), or transverse (T)
portion of the maternal pelvis. For example,
that the occiput is the presenting part and is located in the right anterior quadrant
of the maternal pelvis - ANSWER-ROA means what with position?
Station - ANSWER-Is the relationship of the presenting fetal part to an imaginary
line drawn between the maternal ischial spines and is a measure of the degree of
descent of the presenting part of the fetus through the birth canal. The placement
,of the presenting part is measured in centimeters above or below the ischial
spine
Engagement - ANSWER-The largest transverse diameter of the presenting part
(usually the biparietal diameter) has passed through the maternal pelvic brim or
inlet into the true pelvis and usually corresponds to station 0.
passageway, or birth canal - ANSWER-The ? , is composed of the mother's rigid
bony pelvis and the soft tissues of the cervix, the pelvic floor, the vagina, and the
introitus (the external opening to the vagina).
false - ANSWER-The ? pelvis is the part above the brim and plays no part in
childbearing. Lies above this imaginary line; the true pelvis lies below it (linea
terminalis).
true - ANSWER-The ? pelvis is the bony passageway through which the fetus
must travel. It is made up of three planes: the inlet, the mid-pelvis (cavity), and
the outlet.
The pelvic inlet is wider in the transverse aspect (sideways) than it is from front
to back
• The mid-pelvis (cavity) occupies the space between the inlet and outlet. It is
through this snug, curved space that the fetus must travel to reach the outside.
As the fetus passes through this small area, its chest is compressed, causing
lung fluid and mucus to be expelled.•
For the fetus to pass through the pelvis, the outlet must be large enough
vaginal birth - ANSWER-The diameters at the plane of the pelvic inlet, midpelvis,
and outlet, plus the axis of the birth canal, determine whether ? birth is possible
and the manner by which the fetus may pass down the birth canal. The subpubic
angle, which determines the type of pubic arch, together with the length of the
pubic rami and the intertuberous diameter, is of great importance. Because the
fetus must first pass beneath the pubic arch, a narrow subpubic angle is less
accommodating than a rounded wide arch.
Station Relationship of the presenting fetal part to an imaginary line drawn
between the ischial spines of the pelvis. It is a measure of the degree of descent
of the presenting part of the fetus through the birth canal. When your baby's head
is level with the ischial spines, the fetal station is zero. Once your baby's head
, fills the vaginal opening, just before birth, the fetal station is +5. Each change in
number usually means your baby has descended another centimeter into your
pelvis. However, assigning a number is an estimate. - ANSWER-How does ischial
spine relate to station?
1. Gynecoid (the classic female type)
2. Android (resembling the male pelvis)
3. Anthropoid (oval shaped, with a wider anteroposterior diameter)
4. Platypelloid (the flat pelvis - ANSWER-What are the 4 pelvic types:
Involuntary and voluntary powers combine to expel the fetus and placenta from
the uterus - ANSWER-What is meant by Power?
Primary powers - ANSWER-Involuntary uterine contractions signal the beginning
of labor. Responsible for the effacement and dilation of the cervix and descent of
the fetus. Effacement of the cervix means the shortening and thinning of the
cervix during the first stage of labor. Only a thin edge of the cervix can be
palpated by an examiner when effacement is complete. The involuntary
contractions originate at certain pacemaker points in the thickened muscle layers
of the upper uterine segment. From the pacemaker points, contractions move
downward over the uterus in waves, separated by short rest periods.
secondary powers - ANSWER-Once the cervix has dilated, voluntary bearing-
down efforts by the woman which starts the force of involuntary contractions. As
soon as the presenting part reaches the pelvic floor, the contractions change in
character and become expulsive. The laboring woman experiences an involuntary
urge to push. She uses ? powers (bearing-down efforts) to aid in expulsion of the
fetus as she contracts her diaphragm and abdominal muscles and pushes. These
bearing-down efforts result in increased intraabdominal pressure that
compresses the uterus on all sides and adds to the power of the expulsive forces.
The ? powers have no effect on cervical dilation, but they are of considerable
importance in the expulsion of the infant from the uterus and vagina after the
cervix is fully dilated
Types of involuntary contractions:
Frequency-
Duration-
Intensity- - ANSWER-?: (the time from the beginning of one contraction to the
beginning of the next)
?: (length of contraction)
?: (strength of contraction at its peak).
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