Intrapartum Flashcards
Premonitory Signs of Labor
Cervical Changes Lightening Increased Energy Level Bloody Show Braxton Hicks Contractions Spontaneous Rupture of Membranes Premature Rupture of Membranes True vs. False Labor
Factors Affecting Labor
At least five factors affect process of labor and birth. Five P’s: Passenger (fetus and placenta) Passageway (birth canal) Powers (contractions) Position of mother Psychologic response
Phases of Labor During First Stage
Latency (0 to 3 cm) Prodromal, early, preliminary 4- 24 hours Active (4 to 7 cm) 3 to 5 hours Transition (8 to 10 cm) ½ to 2 hours
Physiologic Forces of Labor
DIF: Duration, Intensity, Frequency
Effectiveness of pushing
Uterine Contractions
Palpation Timing Frequency Duration strength
Birth Passage
Size of maternal pelvis
Type of maternal pelvis
Ability of cervix to dilate
Ability of vaginal canal to distend
EMTALA
Emergency Medical Treatment and Active Labor Act
Federal regulation enacted to ensure that woman receives emergency treatment or labor care
Nurses must be familiar with their responsibilities
Agencies must have policies and procedures in place to ensure compliance
Admission to Labor Suite
History Contractions When they last ate Vital signs Ultrasound Examination
Membranes Rupture
600 to 800 cc Color Odor Consistency Nitrazine Paper
External fetal monitoring
Two belts Uterine contractions Fetal heart monitoring benefits negatives
Maternal Responses to labor
Cardio, B/P Respiratory GI/Renal Immune/blood Psychosocial Pain
Pain During Labor and Birth
Neurologic origins
Visceral pain: From cervical changes, distention of lower uterine segment, and uterine ischemia
Located over lower portion of abdomen
Referred pain: Originates in uterus, radiates to abdominal wall, lumbosacral area of back, iliac crests, gluteal area, and down thighs
Somatic pain: Pain described as intense, sharp, burning, and localized
Stretching and distention of perineal tissues and pelvic floor to allow passage of fetus from distention and traction on peritoneum and uterocervical supports during contractions and lacerations of soft tissue
Factors Influencing Pain Response
Physiologic factors Culture Anxiety Previous experience Gate-control theory of pain Comfort Support Environment
Nonpharmacologic Pain Management
Nonpharmacologic measures often simple, safe, few adverse reactions, and inexpensive
Provide sense of control over childbirth
Methods require practice for best results
Try variety of methods and seek alternatives, including pharmacologic methods, if measure used is not effective
Breathing Methods
Basic principles Comfortable position Chest breathing Focal point Verbal and non-verbal cues Cleansing breath Rhythmic chest Shallow chest Pant-blow Exhalation pushing
