Birth Flashcards
certain rituals and taboos by the male to signify the transition to fatherhood
couvade
The Five Stressors That Affect the Labor Process
Passenger, Passageway, Powers (contractions), Position of the Mother, Psych
Which type of fetus lie is ideal for a vaginal birth?
longitudinal lie. Cephalic is ideal for delivery as opposed to breech
What is the most common fetal position?
LOA- The occiput of the infant’s head is in the Left Anterior of the mother’s pelvis
Cephalopelvic Disproportion (CPD)
When the head is larger than the pelvic opening. C-section rationale
refers to the amount of time from the beginning of one contraction to the beginning of the next contraction
Frequency
is measured from the beginning of one contraction to the end of that same contraction.
Duration
is measured, when using a monitor, by the rise in intrauterine pressure above normal resting tone of uterus (0 to 15mmHg). It is estimate when monitor is not used, by pressing hand on the fundus and rating contraction as mild, moderate or strong.
Intensity
What is Secondary Power?
Voluntary Bearing Down - Pushing
Mother helps in expelling the infant & placenta by contracting her abdominal muscles
If she pushed before complete dilatation - cervical edema – retards dilatation & exhausts mother. Can also cause tearing and bruising of cervix
Effective pushing can cut pushing time in half
Which position of the mother causes the contractions to be stronger and more efficient?
upright position
How to tell if contractions are Braxton Hicks?
Change positions and they will go away.
Test for anmiotic fluid
alkalinity with nitrazine paper
begins with true labor and ends with complete cervical dilatation. It is divided into three phases.
1st stage of Labor
begins with complete dilatation of the
cervix and ends with delivery of the baby (pelvic phase or expulsive stage)
2nd stage
begins with the delivery of the infant and
ends with delivery of the placenta.
3rd stage
Latent Phase
0-4cm. Contractions are mild. 10-20 minutes apart lasting 15-20 seconds
Active Phase
4-8 cms. Contractions are 3-5 minutes apart lasting 30-60 seconds
Transitional Phase
8-10cms. Contractions are 1.5-2 minutets apart and lasting 50-90 seconds
Cardinal Movements of Labor
Descent Flexion Internal Rotation Extension External Rotation
During labor and delivery nursing focus is mainly on careful assessment of mother, giving care and support, and knowing what actions to take in emergency situations.
Secondary Prevention
Nursing Care during Admission
*Assess if delivery is imminent!
* Many hospitals have paper work from health care provider ahead of
admission with pregnancy history, etc.
*Anxiety of coming to hospital- orient, rapport
*Aware of cultural, age, etc
*Are they in labor? Assess signs
*Vaginal exam for effacement and dilation
*Vital signs
*Maternal weight
*Urine sample
*Lab work
Nursing Care during 1st Stage of Labor
*Assess mother’s need for information and teach necessary breathing techniques, effleurage, etc. as needed. Respect techniques learned in classes and
support them during labor.
*Monitor maternal status - TPR & BP. Assess fetal status, usually with a monitor.
*Promote elimination and hydration
*Promote comfort by changing maternal position frequently, rub back,
providing socks for cold feet, change gown, etc.
*Watch for hyperventilation
* Minimize risk of infection and injury by keeping perineum
clean & dry, change pad under mother frequently, do pelvic exams
only when necessary and use sterile gloves
*Assess for signs of second stage - desire to push or move bowels. Do not push until fully dilated.
Nursing Care during 2nd stage of Labor
- Coach pushing how to push and how to use squat bars if available
- Promote comfort, wash cloth, support legs or back during pushing.
- Prepare room for delivery
- Clean perineum and drape
- BP and FHR frequently
- Note and record, the time of delivery and type of episiotomy or laceration.