Fourth Stage of Labor Flashcards
describe phases of stage 1 of labor
cervical dilation:
phase 1: 0-3 cm
phase 2: 4-7 cm active
phase 3: 8-10 cm transition
describe stage 2 of labor
completely dilated
effacement= 100
ends with delivery of fetus
describe stage 3 of labor
begins with delivery
ends with placenta delivery
usually less than 20 min
what is typically the cause of stage 3 of labor lasting > 20 min
accrete- placenta is implanted in uterine muscle
describe stage 4 of labor
uterus contracts and closes open arterioles
what hormones are responsible for stage 4 of labor
decrease in progesterone and estrogen triggers oxytocin bolus
this causes contractions to get all placenta pieces out, and mother falls in love with baby
describe how to assess for uterine tone
2 handed approach (feel for firmness)
one hand above pubic bone and one on umbilicus
if uterine tone is soft…
NOT contracting
BLEEDING
massage uterus to manually manipulate contractions and dislodge clots
nursing intervention for stage 4 of labor after delivery
help pt to void!
make sure bladder is empty
why does bladder fill up after delivery
loss of placenta causes massive diuresis
fills bladder
bladder is stunned during labor so pt may not even feel urgency to go
why is an overfilled bladder during stage 4 of labor bad
bladder fills up the space where uterus needs to be
uterus will then become displaced, move upward and soften
describe pelvic floor muscles
muscles will atrophy during pregnancy due to extreme pressure (of baby) if mother did not strengthen with kegel exercises
what do kegel exercises do
with each exercise the pelvic floor muscles are able to lift a little bit more weight
what is normal blood loss for vaginal and c section (EBL)
vaginal: <500 mL EBL
c section: <1000 mL EBL
what is EBL
estimated blood loss
