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22 Cards in this Set
- Front
- Back
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beginning of first stage of labor
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onset of regular contractions (increase in frequency, duration, intensity), ends with full cervical dilation/effacement
bloody show SROM |
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first stage of labor phases
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latent (1-3 cm dilation)
active (4-7 cm dilation) transition (8-10 cm dilation) |
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admission data
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prenatal data (age, preg. hx, current preg. info)
primary complaint (ROM/bloody show) psychosocial factors (appearance, behavior, sex. abuse, stress in labor, cultural factors) physical assessment |
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assessment of labor
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true vs. false labor (walk - contractions increase in true labor)
immediate attention if OM, bleeding, change in fetal movements education - relaxation/diversionary activities |
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physical exam - admission data
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vitals
leopold's maneuvers (fetal presentation/position, PMI |
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clinical eval of labor status - FHR
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FHR and pattern -
variations assess FHR after ROM, any change in contraction pattern, before/after medications/procedures |
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clinical eval of labor status assessment of UC
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regular activity?
women's subjective description effect on effacement/dilation |
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clinical eval of labor status - vaginal exam
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cervical effacement/dilation/station/amniotic membranes/fluid
performed: on admission, change in UA, urge to bear down, ROM, variable decelerations of FHR |
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lab and diagnostic test results
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urine specimen - hydration status, nutritional status, infection, preeclampsia
blood tests - Hct, CBC, blood type, Rh factor assess amniotic membranes and fluid infection (temp/vaginal discharge) |
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ROM
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may be SROM or AROM
Timinig amount color odor nitrazine test/ferning test |
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second stage of labor
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full effacement and dilation of cervix, ends with birth of baby
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phases of second stage of labor
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latent (rest)
descent (urge to bear down, best for pushing, strong UC, release of oxytocin from posterior pituitary transition - presenting part on perineum, bearing down most effective |
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factors affecting duration of second stage of labor
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effectiveness of primary and secondary powers of labor
type/amount analgesia/anesthesia physical/emotional condition position/activity level parity/pelvic adequacy size/presentation/position of fetus nature/source of support |
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signs suggesting onset of second stage of labor
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objective - cannot feel cervix
sweat on upper lip vomiting increased blood show shaking of extremities increases restlessness, verbalization involuntary bearing-down efforts premature urge to bear down |
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bearing down
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involuntary response to Ferguson reflex - presenting part pressing on stretch receptors
breathing important - open-glottis pushing, breathe between bearing down, do not hold breath controlled bearing down |
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vertex presentation mechanisms of birth
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crowning - widest part of head distends vulva
ritgen maneuver - upward pressure from coccygeal region to protect perineum nuchal cord- cord around neck |
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prevent meconium aspiration
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suction head and mouth before first breath is taken
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immediate newborn assessment
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record time of birth
umbilical cord stabililze newborn apgar |
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priorities in newborn care
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patent airway
support respirations prevent cold stress |
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perineal trauma r/t childbirth
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immediate repair to promote healing, limit damage
1st degree - skin, superficial to muscles 2nd degree - thru muscles 3rd - thru anal sphincter muscle 4th - anterior rectal wall |
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third stage of labor
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placental separation and expulsion
firmly contracted uterus, change in uterus shape to ovoid, sudden gush of blood, umbilical cord lengthens, vaginal fullness |
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care of mother third stage
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cardiac output increases, BP variable, pulse slows
risk of hemorrhage lacerations/episiotomy clean peri area, ice reposition, change gown and linens |
