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120 Cards in this Set
- Front
- Back
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"Table 8-1
True Labor Versus False Labor Contractions" |
"True: Regular contractions that ↑ in frequency, intensity, and duration.
False: Irregular or regular mild contractions with no increase in frequency, intensity, and duration." |
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"Table 8-1
True Labor Versus False Labor Discomfort" |
"True: Begins in the back and radiates to the lower abdomen and the front.
False: Felt in the middle of the abdomen or groin area. Can be mentally and physically tiring." |
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"Table 8-1
True Labor Versus False Labor Cervical Changes" |
"True: Progressive cervical dilation and effacement
False: Little or no cervical change" |
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"Table 8-1
True Labor Versus False Labor Bloody Show" |
"True: Usually present and ↑ with cervical change.
False: None present" |
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"Table 8-1
True Labor Versus False Labor Activity" |
"True: Activity such as walking may ↑ intensity of conractions.
False: Activity or position change often lessens contractions." |
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"Supportive Activities and Comfort Measures in Labor
Emotional Support" |
"Sustaining physical presence, eye contact.
Verbal encouragement, reassurance, and praise. Listen to woman and family." |
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"Supportive Activities and Comfort Measures in Labor
Physical Support" |
"Comfort measures such as ice chips, fluids, food, and pain medications.
Hygiene including mouth care, pericare, and changing soiled linens. Assistance with position changes and ambulation. Reassuring touch, massage. Application of heat and cold. Hydrotherapy in shower and tub, if no ROM Calm environment" |
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"Supportive Activities and Comfort Measures in Labor
Informational Support" |
"Provide information on the progess of labor.
Explain all procedures. Communicate in lay terms." |
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"Supportive Activities and Comfort Measures in Labor
Advocacy" |
"Support decisions made by the woman and her family.
Ensure respect for the woman's decision. Manage the environment, which include visitors." |
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"Supportive Activities and Comfort Measures in Labor
Support of the Partner and Family" |
"Offer support and praise.
Role model therapeutic behaviours. Assist the partner with food and rest. Provide breaks if desired or needed." |
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"Table 8-2
First Stage of Labor LATENT PHASE Dilation:" |
0-3 cm
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"Table 8-2
First Stage of Labor LATENT PHASE Effacement:" |
0%-40%
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"Table 8-2
First Stage of Labor LATENT PHASE Length of phase:" |
6-24 hrs
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"Table 8-2
First Stage of Labor LATENT PHASE Contraction Frequency:" |
Every 5-30 minutes
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"Table 8-2
First Stage of Labor LATENT PHASE Contraction Strength:" |
"Mild to moderate
25-40 mm Hg by IUPC" |
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"Table 8-2
First Stage of Labor LATENT PHASE Contraction Duration:" |
30-45 seconds
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"Table 8-2
First Stage of Labor LATENT PHASE Contraction Pattern:" |
Irregular
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"Table 8-2
First Stage of Labor LATENT PHASE Show Amount & Color:" |
"Scant
Mucoid, blood-tinged" |
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"Table 8-2
First Stage of Labor LATENT PHASE Descent of the Fetus, Nullipara" |
0 Station
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"Table 8-2
First Stage of Labor LATENT PHASE Descent of the Fetus, Multipara" |
negative 3 to 0 station
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"Table 8-2
First Stage of Labor LATENT PHASE Summary of Maternal Behaviors" |
Excited, talkative; pain is well-controlled; open to suggesions and follows directions easily.
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"Table 8-2
First Stage of Labor ACTIVE PHASE Dilation:" |
4-7 cm
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"Table 8-2
First Stage of Labor ACTIVE PHASE Effacement:" |
40%-80%
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"Table 8-2
First Stage of Labor ACTIVE PHASE Length of phase:" |
3-6 hours
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"Table 8-2
First Stage of Labor ACTIVE PHASE Contraction Frequency:" |
Every 2-5 minutes
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"Table 8-2
First Stage of Labor ACTIVE PHASE Contraction Strength:" |
"Moderate to strong
50-70 mm Hg by IUPC" |
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"Table 8-2
First Stage of Labor ACTIVE PHASE Contraction Duration:" |
45-70 seconds
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"Table 8-2
First Stage of Labor ACTIVE PHASE Contraction Pattern:" |
Regular
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"Table 8-2
First Stage of Labor ACTIVE PHASE Show Amount & Color:" |
"Scant to moderate
Mucoid, bloody" |
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"Table 8-2
First Stage of Labor ACTIVE PHASE Descent of the Fetus, Nullipara" |
negative 2 to 0/plus 1/plus 2
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"Table 8-2
First Stage of Labor ACTIVE PHASE Descent of the Fetus, Multipara" |
negative 2 to plus 1, plus 2
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"Table 8-2
First Stage of Labor ACTIVE PHASE Summary of Maternal Behaviors" |
More serious and inner-directed; doubtful of her ability to control pain; desiring companionship and encouragement; has difficulty following directions.
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"Table 8-2
First Stage of Labor TRANSITION PHASE Dilation:" |
8-10 cm
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"Table 8-2
First Stage of Labor TRANSITION PHASE Effacement:" |
80%-100%
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"Table 8-2
First Stage of Labor TRANSITION PHASE Length of phase:" |
20-60 minutes
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"Table 8-2
First Stage of Labor TRANSITION PHASE Contraction Frequency:" |
Every 2-3 minutes
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"Table 8-2
First Stage of Labor TRANSITION PHASE Contraction Strength:" |
"Strong
70-90 mm Hg by IUPC" |
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"Table 8-2
First Stage of Labor TRANSITION PHASE Contraction Duration:" |
45-90 seconds
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"Table 8-2
First Stage of Labor TRANSITION PHASE Contraction Pattern:" |
Regular
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"Table 8-2
First Stage of Labor TRANSITION PHASE Show Amount & Color:" |
"Moderate to heavy
Bloody" |
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"Table 8-2
First Stage of Labor TRANSITION PHASE Descent of the Fetus, Nullipara" |
0 to plus 2/3
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"Table 8-2
First Stage of Labor TRANSITION PHASE Descent of the Fetus, Multipara" |
negative 1 to plus 2/3
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"Table 8-2
First Stage of Labor TRANSITION PHASE Summary of Maternal Behaviors" |
Describes pain as severe; fears loss of control; is irritable; has difficulty communicating; may have n/v; perspires; may shake or tremble and feel the need to push
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"Table 8-2
Second Stage of Labor Dilation:" |
10 cm to delivery
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"Table 8-2
Second Stage of Labor Effacement:" |
100%
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"Table 8-2
Second Stage of Labor Length of phase:" |
10 minutes to several hours
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"Table 8-2
Second Stage of Labor Contraction Frequency:" |
Every 1-3 minutes
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"Table 8-2
Second Stage of Labor Contraction Strength:" |
"Strong, increase to expulsive
80-100 mm Hg by IUPC" |
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"Table 8-2
Second Stage of Labor Contraction Duration:" |
60-90 seconds
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"Table 8-2
Second Stage of Labor Contraction Pattern:" |
Minimal rest between Ucs
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"Table 8-2
Second Stage of Labor Show Amount & Color:" |
Increase bloody show
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"Table 8-2
Second Stage of Labor Descent of the Fetus, Nullipara" |
0 to plus 3 to birth of baby
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"Table 8-2
Second Stage of Labor Descent of the Fetus, Multipara" |
0 to plus 3 to birth of baby
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"Table 8-2
Second Stage of Labor Summary of Maternal Behaviors" |
May be fatigued or sleepy initially, the urge to bear down, grunting, may be swearing or screaming, loses ability to focus or concentrate, irritable, may feel burning with crowning of fetal head.
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"Table 8-2
Third Stage of Labor Dilation:" |
From birth of baby until expulsion of the placenta
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"Table 8-2
Third Stage of Labor Length of phase:" |
5-7 minutes, up to 20 minutes
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"Table 8-2
Third Stage of Labor Contraction Frequency:" |
Irregular
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"Table 8-2
Third Stage of Labor Contraction Strength:" |
Mild
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"Table 8-2
Third Stage of Labor Contraction Duration:" |
30-60 seconds
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"Table 8-2
Third Stage of Labor Contraction Pattern:" |
Irregular
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"Table 8-2
Third Stage of Labor Show Amount & Color:" |
Gush of blood with placental separation
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"Table 8-2
Third Stage of Labor Summary of Maternal Behaviors" |
Relief with completion of birth, laughing, crying, talking interest in fetus.
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"Table 8-2
Fourth Stage of Labor Dilation:" |
Immediate postpartum period
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"Table 8-2
Fourth Stage of Labor Length of phase:" |
Immediate postpartum period; 4 hours
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"Table 8-2
Fourth Stage of Labor Summary of Maternal Behaviors" |
Excited, talkative, hungry and thirsty, holds and inspects newborn
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Episiotomy
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An incision in the perineum to provide more space for the presenting part at delivery. Routine use no longer typical
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Median or Midline Episiotomy
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At the midline and tends to heal more quickly with less discomfort.
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Medilateral Episiotomy
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A cut at a 45-degree angle to the left or right and may be used for a large infant. It tends to heal more slowly, causes greater blood loss, and is more painful.
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Lacerations
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Tears in the perineum that may occur at delivery.
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First degree laceration
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Involves the perineal skin and vaginal mucous membrane.
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Second degree laceration
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Involves skin, mucous membrane, and fascia of the perineal body.
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Third degree laceration
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Involves skin, mucous membrane, and muscle of the perineal body and extends to the rectal sphincter.
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Fourth degree laceration
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Laceration extends into the rectal mucosa and exposes the lumen of the rectum.
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"Analgesic Medications in Labor
Table 8-5 Morphine Dosage:" |
"5 mg - 10 mg IM
2 mg - 5 mg IV" |
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"Analgesic Medications in Labor
Table 8-5 Morphine Class:" |
Opiod
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"Analgesic Medications in Labor
Table 8-5 Morphine Side Effects:" |
"CNS depression
Neonatal respiratory depression" |
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"Analgesic Medications in Labor
Table 8-5 Morphine Nursing Interventions:" |
Avoid use when close to delivery time (about 1 hr)
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"Analgesic Medications in Labor
Table 8-5 Butorphanol (Stadol) Dosage:" |
"2 mg - 4 mg IM
0.5 mg - 2 mg IV" |
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"Analgesic Medications in Labor
Table 8-5 Butorphanol (Stadol) Class:" |
Opiod agonist-antagonist
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"Analgesic Medications in Labor
Table 8-5 Butorphanol (Stadol) Side Effects:" |
No respiratory depression in woman or neonate
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"Analgesic Medications in Labor
Table 8-5 Butorphanol (Stadol) Nursing Interventions:" |
"Check maternal hx for drug abuse.
Do not give to drug dependent woman due to possible precipitation of sudden withdrawal response in woman and baby. Monitor effective response." |
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"Analgesic Medications in Labor
Table 8-5 Nalbuphine (Nubian) Dosage:" |
10 mg IM or IV
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"Analgesic Medications in Labor
Table 8-5 Nalbuphine (Nubian) Class:" |
Opiod agonist-antagonist
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"Analgesic Medications in Labor
Table 8-5 Nalbuphine (Nubian) Side Effects:" |
No respiratory depression in woman or neonate
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"Analgesic Medications in Labor
Table 8-5 Nalbuphine (Nubian) Nursing Interventions:" |
"Check maternal hx for drug abuse.
Do not give to drug dependent woman due to possible precipitation of sudden withdrawal response in woman and baby. Monitor effective response." |
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"Analgesic Medications in Labor
Table 8-5 Sublimaze (Fentanyl)" |
May be use in conjunction with regional anesthesia
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"Analgesic Medications in Labor
Table 8-5 Sublimaze (Fentanyl) Class:" |
"Short acting opiod antagonist.
Crosses the placenta rapidly" |
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"Analgesic Medications in Labor
Table 8-5 Sublimaze (Fentanyl) Side Effects:" |
"FHR changes.
Hypotension. Maternal/fetal/neonatal CNS depression. Respiratory depression." |
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"Analgesic Medications in Labor
Table 8-5 Sublimaze (Fentanyl) Nursing Interventions:" |
"Monitor for side effects such as sedation, n/v, itching.
Monitor respiratory rate and effort." |
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"Analgesic Medications in Labor
Table 8-5 Promethazine (Phenergran) Dosage:" |
"25 mg - 75 mg IM
25-50 mg IV" |
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"Analgesic Medications in Labor
Table 8-5 Promethazine (Phenergran) Class:" |
Ataractics
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"Analgesic Medications in Labor
Table 8-5 Promethazine (Phenergran) Side Effects:" |
"Drowsiness
Agonist effect of narcotics" |
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"Analgesic Medications in Labor
Table 8-5 Promethazine (Phenergran) Nursing Interventions:" |
"Monitor effective response.
Potentiates narcotic effect." |
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"Analgesic Medications in Labor
Table 8-5 Hydroxyzine (Vistaril) Dosage:" |
25-100 mg IM or Z tract
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"Analgesic Medications in Labor
Table 8-5 Hydroxyzine (Vistaril) Class:" |
Ataractics
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"Analgesic Medications in Labor
Table 8-5 Hydroxyzine (Vistaril) Side Effects:" |
"Drowsiness
Agonist effect of narcotics" |
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"Analgesic Medications in Labor
Table 8-5 Hydroxyzine (Vistaril) Nursing Interventions:" |
"Monitor effective response.
Potentiates narcotic effect." |
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"Analgesic Medications in Labor
Table 8-5 Naloxone (Narcan) Class:" |
"Antagonist- used to reverse narcotic effect.
May be used to relieve maternal itching and respiratory depression." |
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"Analgesic Medications in Labor
Table 8-5 Naloxone (Narcan) Nursing Interventions:" |
Review appropriate dosing for adult vs. newborn.
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"Anesthesia in Labor and Delivery
Table 8-6 Local Define:" |
Anesthetic injected into perineum at episiotomy site.
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"Anesthesia in Labor and Delivery
Table 8-6 Local Time Given and Effects:" |
"Second stage of labor, immediately before delivery.
Anesthetizes local tissue for episiotomy and repair." |
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"Anesthesia in Labor and Delivery
Table 8-6 Local Adverse Effects" |
"Risk of hematoma.
Risk of infection." |
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"Anesthesia in Labor and Delivery
Table 8-6 Local Nursing Implications:" |
"Monitor for:
Return of sensation to area Increased swelling at site of injection" |
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"Anesthesia in Labor and Delivery
Table 8-6 Regional: Pudendal Block Define:" |
Anesthetic injected in the pudendal nerve (close to the ischial spines) via needle guide known as "trumpet".
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"Anesthesia in Labor and Delivery
Table 8-6 Regional: Pudendal Block Time Given and Effects:" |
"Second stage of labor, prior to time of delivery.
Anesthetizes vulva, lower vaginal and part of perineum for episiotomy and use of low forceps." |
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"Anesthesia in Labor and Delivery
Table 8-6 Regional: Pudendal Block Adverse Effects" |
"Risk of local anesthetic toxicity.
Risk of hematoma. Risk of infection." |
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"Anesthesia in Labor and Delivery
Table 8-6 Regional: Pudendal Block Nursing Implications:" |
"Monitor for:
Return of sensation to area Increased swelling S/S of infection Urinary retention" |
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"Anesthesia in Labor and Delivery
Table 8-6 Regional: Epidural Block Define:" |
Anesthetic injected in the epidural space: located outside the dura mater between the dura and spinal canal via an epidural catheter.
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"Anesthesia in Labor and Delivery
Table 8-6 Regional: Epidural Block Time Given and Effects:" |
"First stage and/or second stage of labor.
Can be used for both vaginal and c-section. Has the potential of 100% blockage of pain. Can be used with opiods such as Sublimaze (Fentanyl) to allow walking during first stage of labor and effective pushing in second stage." |
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"Anesthesia in Labor and Delivery
Table 8-6 Regional: Epidural Block Adverse Effects" |
"Most common complication is hypotension.
Other side effects include n/v, pruritis, respiratory depression, alterations in FHR." |
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"Anesthesia in Labor and Delivery
Table 8-6 Regional: Epidural Block Nursing Implications: Pre-anesthesia care" |
"Obtain Consent.
Check lab values - especially for bleeding or clotting abnormalities, platelet count. IV fluid bolus with normal saline or lactated Ringer's. Ensure emergency equipment is available." |
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"Anesthesia in Labor and Delivery
Table 8-6 Regional: Epidural Block Nursing Implications: Post-anesthesia care" |
"Monitor maternal v/s and FHR q5 mins initially and after every re-bolus then every 15 mins and manage hypotension or altercations in FHR.
Urinary retention is comman and catheterization may be needed. Assess pain and level of sensation and motor loss. Position woman as needed (on side to prevent inferior vena cava syndrome). Assess for itching, n/v, HA, and administer medication PRN. When catheter d/c'd, note intact tip when removed." |
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"Anesthesia in Labor and Delivery
Table 8-6 Regional: Spinal Block Define:" |
Anesthetic injected in the subarachnoid space
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"Anesthesia in Labor and Delivery
Table 8-6 Regional: Spinal Block Time Given and Effects:" |
"Second stage of labor or in use for c-section.
Rapid acting with 100% blockage of sensation and motor functioning. Can last up to 3 hours." |
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"Anesthesia in Labor and Delivery
Table 8-6 Regional: Spinal Block Adverse Effects" |
"Similar to epidural with the addition of a spinal headache.
A blood patch often provides relief." |
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"Anesthesia in Labor and Delivery
Table 8-6 Regional: Spinal Block Nursing Implications:" |
"Interventions are same as epidural.
Monitor site for leakage of spinal fluid or formation of hematoma. Observe for HA" |
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"Anesthesia in Labor and Delivery
Table 8-6 General Anetsthesia Define:" |
Use of IV injection and/or inhalation of anesthetic agents that render the woman unconscious.
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"Anesthesia in Labor and Delivery
Table 8-6 General Anetsthesia Time Given and Effects:" |
Used mainly in emergency c-section
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"Anesthesia in Labor and Delivery
Table 8-6 General Anetsthesia Adverse Effects" |
"Risk for fetal depression.
Risk for uterine relaxation. Risk for maternal vomiting and aspiration." |
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"Anesthesia in Labor and Delivery
Table 8-6 General Anetsthesia Nursing Implications:" |
"Obtain Consent.
Ensure woman is NPO. IV with large-bore needle. Place Foley. Administer meds to decrease gastric acidity as ordered such as Bicitra or Protonix. Place wedge to hip to prevent vena cava syndrome. Assist with supportive care of newborn." |
