INDUCTION OF LABOR AND PROPER ASSESSMENTS

Question 1

what are nursing interventions during the first stage of active labor?

Answer 1

1. teach patient and partner what to expect
2. effleurage
3. frequent fetal patient monitoring
4. position changes
5. non pharm and pharm pain relief as prescribed

Question 2

what is effleurage?

Answer 2

gentle circular stroking of abdomen in rhythm with breathing during contraction

Question 3

what are nursing interventions during the first stage of transitional labor?

Answer 3

1. monitor and support the fetus
2. discourage pushing until cervix is fully dilated
3. listen for patient saying they need to have a bowel movement–> finding of complete dilation and fetal descent
4. observe for perineal bulging and crowning
5. encourage bearing down with contractions once cervix is fully dilated

Question 4

what are nursing interventions to provide in general during the first stage of labor?

Answer 4

1. perform leopold’s maneuvers
2. perform vaginal exams to allow provider to see whether patient is in true labor and if membranes have ruptured
3. monitor dilation, effacement, station, presentation
4. perform bladder palpitation to prevent bladder distention
5. take temperature every 4 hours

Question 5

how long does the second stage of labor last?

Answer 5

lasts from time cervix is fully dilated to birth of the fetus

Question 6

what are nursing interventions to perform during the second stage of labor?

Answer 6

1. promote rest between contractions

2. prepare for care of neonate by haveing resuscitation equipment and a trained nurse for resuscitation present

Question 7

how long does the third stage of labor last?

Answer 7

lasts from birth of fetus until placenta is delivered

Question 8

what are nursing interventions to perform during the third stage of labor?

Answer 8

1. check BP, HR, and RR every 15 minutes
2. APGAR at 1 and then 5 minutes after birth
3. promote bonding which will increase release of oxytocin

Question 9

what is the 4th stage of labor look like?

Answer 9

begins with delivery of placenta and includes 2 hours after birth

Question 10

what are nursing interventions for the 4th stage of labor?

Answer 10

1. assess maternal BP every 15 minutes for first 2 hours–> every 4 hours for first 8 hours after birth–> every 8 hours
2. assess fundus and lochia every 15 minutes for the first hour and then according to facility rules
3. massage fundus or give oxytocin to maintain uterine tone and prevent hemorrhage

Question 11

what is induction of labor?

Answer 11

deliberate initiation of uterine contractions to stimulate labor before spontaneous onset to being about the birth by chemical means

Question 12

what are medications for induction of labor?

Answer 12

IV oxytocin

Question 13

when should oxytocin be disontinued?

Answer 13

if uterine hyperstimulation occurs where contraction frequency more than every 2 minutes, contraction duration longer than 90 seconds, no relaxation of uterus between contractions–> this is bad because baby is not getting enough oxygen during when contractions are long

Question 14

what is the bishop score?

Answer 14

used to determine maternal readiness for labor by evaluating whether the cervix is favorable by rating:

1. dilation
2. effacement
3. cervical consistency (firm, soft)
4. cervical position (posterior, anterior)
5. station of presenting part