Exam #2 Flashcards
What are the 2 sections in the first stage of labor called?
latent and active
What are characteristics of latent phase of labor?
-0-5 cm dilated
-regular, painful contractions that cause cervical change
What are characteristics of active labor?
-effacement 100%
-descent has begun
-contractions 1.5-5 mins apart last 40-90 secs and regular
When does stage 1 of labor end?
10 cm dilation
What are characteristics of stage 2 of labor?
-10 cm, 100% effaced
-ends with birth of baby
-50 mins for first time mom, 20 mins average if had kids before
-Contractions 2-3 mins apart lasting abt 90 secs
-pushing stage
When does stage 2 end?
baby delivery
Characteristics of stage 3 labor?
-ends with delivery of the placenta
-lasts 5-30 mins
What are reasons to do leopolds maneuver?
-fetal position
-where to put fhr monitor
-coming out feet or head first?
Instructions for Leopold’s maneuver?
-mom empty bladder
-fhr best heard on back
Steps of Leopold’s maneuver?
- Determine fetal lie; palpate fundus with finger tips, start at top. bottom=spony, head=firm
- Locate fetal back; run hands down each side. smooth curvature=back, knobby=legs,feet, knees
- Identify presentation; felt at mons pubis, true inlet of pelvis
- Determine attitude of head, outline head with fingertips and palms
Characteristics of true labor?
o REGULAR and predictable contractions
o Cervical CHANGE and dilation
o Felt in the lower back radiating to the lower portion of the abdomen.
What are numbers for moderate variability?
6-25 bpm over baseline
What are numbers for marked variability?
> or equal to 25 bpm
Characteristics of early decelerations?
-not pathological
-always occur with contraction
Causes of early decels?
-uterine contractions
-cephalopelvic disproportion
-persistent occiput posterior
Characteristics of late decels?
-uteroplacental deficiency
-always occur with contraction
Causes of late decels?
- hyperstimulation of the uterus from oxytocin augmentation
- supine hypotension syndrome
- hypertension – chronic or gestational; preeclampsia
- postmaturity (44-45 weeks)
- placental problems – abruptio, previa
*IUGR nadir occurs after peak of the contraction (nadir= lowest pulse rate from baby) - maternal disease – cardiac, anemia, diabetes w/vascular involvement
Characteristics of variable decels?
-umbilical chord compression
-transient and correctable
-periodic or episodic (not associated with contraction)
Causes of variable decels?
- maternal position – cord between fetus and pelvis
- nuchal cord
- short cord
- knot in cord
- prolapsed cord
What are actions to take for a prolapsed chord?
Apply firm upward pressure to raise head off cord
* Place client in knee-chest position and TURN/MOVE MOM
* O2, increase fluid intake
* Prepare for emergency CS
What is the nursing care during 1st stage of labor?
-Assess patient
-assess FHR
-manage pain
-emotional support
-encourage or assist in position changes
-assisting with interventions
-advocate for patient’s needs
Nursing care during 2nd stage of labor?
-coach for effective pushing
-assist with positioning
-offer reassurance and encouragement
-prepare for delivery
What is nursing care during 3rd stage?
-immediate infant care
-ID infant
-assign APGAR
-administer uterotonics
-emotional support
-assisting w/ interventions
Nursing care for 4th stage of labor?
-Assist with golden hour
-assist w/ feeding
-administer baby meds
-assess bp, hr, and fundus every 15 mins for first hour
-take temp every 4 hours two times and then every 8 hrs
-assess bladder
-assess lochia
-assess perineum