L&B 4a/First Stage of Labor

Question 1

First stage of labor: (3) phases (ATI 125)

Answer 1

1) Latent Phase 2) Active Phase 3) Transition

Question 2

First stage of labor: Overview

1) Duration ?
2) Begins with ?
3) Ends with ?
4) Maternal characteristics (2)

Answer 2

First stage of labor: Overview

1) Duration: 12.5 hrs
2) Begins with onset of labor
3) Ends with complete dilation
4) Maternal characteristics
- Cervical dilation 1 cm/hr for pt who are primigravida
- Cervical dilation 1.5 cm/hr pt who are multigravida, on average

Question 3

First stage of labor: Latent Phase

1) Duration ?
2) Begins with ?
- Cervix
- Contractions
- Frequency
- Duration
3) Ends with ?
4) Maternal characteristics (2)

Answer 3

First stage of labor: Latent Phase

1) Duration: Primigravida 6 hrs, Multigravida 4 hrs
2) Begins with
- Cervix 0 cm
- Contractions irregular, mild to moderate
- Frequency 5 to 30 min
- Duration 30 to 45 seconds
3) Ends with cervix 3 cm
4) Maternal characteristics
- Some dilation and effacement
- Talkative and eager

Question 4

First stage of labor: Active Phase

1) Duration ?
2) Begins with ?
- Cervix
- Contractions
- Frequency
- Duration
3) Ends with ?
4) Maternal characteristics (4)

Answer 4

First stage of labor: Active Phase

1) Duration: Primigravida 3 hrs, Multigravida 2 hrs
2) Begins with
- Cervix 4 cm
- Contractions more regular, moderate to strong
- Frequency 3 to 5 min
- Duration 40 to 70 seconds
3) Ends with cervix 7 cm dilated
4) Maternal characteristics
- Rapid D and E
- Some fetal descent
- Feeling of helplessness
- Anxiety and restlessness increase as contractions become stronger

Question 5

First stage of labor: Transition

1) Duration ?
2) Begins with ?
- Cervix
- Contractions
- Frequency
- Duration
3) Ends with ?
4) Maternal characteristics (5)

Answer 5

First stage of labor: Transition

1) Duration: Primigravida & Multigravida 20-40 min
2) Begins with
- Cervix 8 cm
- Contractions strong to very strong
- Frequency 2 to 3 min
- Duration 45 to 90 seconds
3) Ends with complete dilation at 10 cm
4) Maternal characteristics
- Tired, restless and irritable
- Feeling out of control, client often states “cannot continue”
- May have N/V -Urge to push
- Increase rectal pressure and feelings of needing to have a BM -Increased bloody show
- Most difficult part of labor

Question 6

Second stage of labor:

1) Duration ?
2) Begins with ?
- Cervix
- Contractions
- Frequency
- Duration
3) Ends with ?
4) Maternal characteristics (4)

Answer 6

Second stage of labor:

1) Duration: Primigravida 30 mins to 2 hrs, Multigravida 5 to 30 min
2) Begins with
- Cervix full dilation
- Contractions progresses to intense contractions every 1 to 2 min
3) Ends with birth
4) Maternal characteristics
- Pushing results in birth of fetus

Question 7

Second stage of labor:

1. Primigravida
2. Multigravida
3. Assessment of perineal laceration

Answer 7

Second stage of labor: from outline

Primigravida

Multigravida
Assessment of perineal laceration

Question 8

Third stage of labor:

1) Duration ?
2) Begins with ?
- Cervix
- Contractions
- Frequency
- Duration
3) Ends with ?
4) Maternal characteristics (3)

Answer 8

Third stage of labor:

1) Duration: Primigravida & Multigravida
2) Begins with delivery of the neonate
3) Ends with delivery of placenta
4) Maternal characteristics
- Placental separation and expulsion
- Schultze presentation: shiny fetal surface of placenta emerges first
- Duncan presentation: dull maternal surface of placenta emerges first

Question 9

Third stage of labor

1. Vital signs
2. Fundus
3. Signs of placental separation

Answer 9

Third stage of labor from outline

Vital signs
Fundus
Signs of placental separation

Question 10

Fourth stage of labor:

1) Duration ?
2) Begins with ?
- Cervix
- Contractions
- Frequency
- Duration
3) Ends with ?
4) Maternal characteristics (2)

Answer 10

Fourth stage of labor:

1) Duration: Primigravida & Multigravida 1-4 hrs
2) Begins with delivery of placenta
3) Ends with maternal stabilization of VS
4) Maternal characteristics
- Achievement of VS homeostasis
- Lochia scant to moderate rubra

Question 11

Fourth stage of labor

1. Placental exam
2. Inspection and clamping of the cord “AVA”
3. Assessment of episiotomy “REEDA”
4. Lochia
5. Maternal infant bonding

Answer 11

Fourth stage of labor: from Outline

Placental exam
Inspection and clamping of the cord “AVA”
Assessment of episiotomy “REEDA”
Lochia
Maternal infant bonding