Block 6 Labor and Birth Flashcards
effleurage=
a nonpharmacological pain relief measure, stroking the abdoment
Sacral pressure=
a nonpharmacological pain relief measure, firm pressure on the back
what is the first stage of breathing?
blow to avoid bearing down(when we don’t want the mom to push)
what do you have the mother do when you don’t want her to push?
breath(pant)
what is the second stage of breathing?
cleansing breath and pushing with exhaling
when is the second stage of breathing used?
when pushing
what is the advantage of pharmacological methods of pain relief for women in labor?
allows the mother to be more relaxed
what is a disadvantage of pharmacological methods of pain relief for women in labor?
it can slow the labor
what is a limitation of pharmacological methods of pain relief for women in labor?
potential impact on the condition of the fetus
when do you avoid narcotic (opioid) analgesics?
if birth is anticipated within one hour
name an adjunctive drug used during or after birth
Narcan. it reverses respiratory depression and can be given to the mother and baby
what kind of anesthesia do they use for childbirth
epidural block
when can an epidural block be given during labor?
when the cervix is at least 4 centimenters
what are the two main side effects of the epidural block?
hypotension and urinary retention
this relieves an epidural block headache
a blood patch
what are the four P’s of the birth process?
powers
passage
passenger
psyche
what are the powers during the birth process?
contractions and pushing
what is the psyche during the birth process
the mother’s emotions
What are the three phases of a contraction?
increment, peak, and decrement
increment=
when the contraction is going up
Peak=
when the contraction is at its highest
decrement=
when the contraction is going down
when should the Dr. be called regarding the contractions?
if the contraction is more than 90 seconds
how is the frequency of the contraction measured?
the beginning of one contraction to the beginning of the next
how is the duration of the contraction measure
from the beginning of one contraction to the end of it
this allows the baby’s head to change shape.
the fontanels
vertex=
head first position
breech=
feet or butt first position
name four signs of impending labor…
Braxton hicks
increased vaginal discharge
bloody show
rupture of the membranes
what is the priority if the patients membranes rupture?
fetal HR. the patient needs to go to the hospital
positive number station=
the baby is below the spine
a negative number station=
the baby is above the spine
flexion=
easiest way to go through the pelvis
when should the patient go to the hospital in relation to contractions?
when they are five minutes apart for an hour
what are the five signs that a pregnant women needs to go to the hospital?
regular contractions ruptured membranes bleeding other than bloody show decreased fetal movement any other concern
what are the three major assessments performed promptly on admission
fetal condition(HR)
maternal condition
impending birth
what should you do if the head is sticking out?
do not leave and call for help
three signs that labor is false…
contractions are irregular
bloody show usually not present
no change in effacement/dilation of the cervix
four signs that labor is NOT false
contractions develop a pattern
contractions become stronger and more effective with walking
bloody show is often present
progressive effacement and dilation of cervix
when should a fetal HR be reported to the Dr.?
when it is less than 110 or more than 160
what three things should be monitored on the fetus
HR
intermittent auscultation
continuous electronic fetal monitoring
accelerations in the fetal HR during labor are…
Good
stable fetal HR is…
Good
moderate variability in the fetal HR is…
Good
late decelerations in the fetal HR is…
the worst
what needs to be done if the fetal HR is having late decelerations?
reposition the mother onto her side
give her oxygen
increase plain IV fluids
stop the pitocin
what four things needs to be monitored on the women while in labor?
vitals
contractions
progress of labor
intake and output
how is the progress of labor determined?
dilation and effacement by a vaginal exam
how is I&O monitored during labor?
check to see if she voided
what type of test determines if fluid is amniotic fluid or urine?
nitrozene paper
what color would the nitrozene paper be if it indicated amniotic fluid?
blue
how many stages of labor is there
4
1st stage=
dilation and effacement. should be 10cm and 100% effaced
2nd stage-
expulsion of the fetus
3rd stage=
expulsion of the placenta
4th stage=
recovery
during the 4th stage of labor what needs monitored?
vitals every 15 minutes and make sure the fundus is firm
what is the last phase of the 1st stage of labor?
transition
this phase of labor the mother may curse and reject her partner
transition
transition usually occurs at how many centimeters dilated?
7 and lasts until 10
what needs done when the placenta is expelled?
need to make sure it is intact
how do you identify and prevent hemorrhage?
make sure the fundus is firm
fourth stage (recovery) nursing care needs to include these 5 things…
identify and prevent hemorrhage observe bladder function evaluate recovery from anesthesia provide initial care to the newborn infant promote bonding
this helps reduce swelling and bruising immediately after birth…
ice to perineum
these five things needs to be done during the initial care of the newborn…
maintain thermoregulation
maintain cardiorespiratory function
observing for urination and/or passage of meconium
identifying the mother, father, and newborn
performing assessment
encouraging bonding/breastfeeding
how is thermoregulation maintain in the newborn?
dry the baby
put a hat on the baby’s head
put them in the warmer
what five things are assessed in the apgar test?
HR respiratory effort muscle tone reflex to the feet skin color
what is the best apgar score?
2 points of each of the five areas (10 points)
if a baby scores an 8 or better on an apgar test what is done?
nothing just observe
if a baby scores a 4-7 on an apgar test what is done?
gentle stimulation
what does vitamin K do for the newborn?
decrease the risk of hemorrhage and assist with blood clotting
this decreases the risk of hemorrhage and assists with blood clotting in the newborn
vitamin K
