L&D/First Stage of Labor/Separate deck Flashcards
First stage of labor: (3) phases
ATI 125
1) Latent Phase 2) Active Phase 3) Transition
First stage of labor: Overview1) Duration ?2) Begins with ?3) Ends with ?4) Maternal characteristics (2)
First stage of labor: Overview1) Duration: 12.5 hrs2) Begins with onset of labor3) Ends with complete dilation4) Maternal characteristics-Cervical dilation 1 cm/hr for pt who are primigravida-Cervical dilation 1.5 cm/hr pt who are multigravida, on average
First stage of labor: Latent Phase
1) Duration ?
2) Begins with ?-Cervix-Contractions-Frequency-Duration
3) Ends with ?
4) Maternal characteristics (2)
First stage of labor: Latent Phase1) Duration: Primigravida 6 hrs, Multigravida 4 hrs2) Begins with-Cervix 0 cm-Contractions irregular, mild to moderate-Frequency 5 to 30 min-Duration 30 to 45 seconds3) Ends with cervix 3 cm4) Maternal characteristics-Some dilation and effacement-Talkative and eager
First stage of labor: Active Phase
1) Duration ?
2) Begins with ?-Cervix-Contractions-Frequency-Duration
3) Ends with ?
4) Maternal characteristics (4)
First stage of labor: Active Phase1) Duration: Primigravida 3 hrs, Multigravida 2 hrs2) Begins with-Cervix 4 cm-Contractions more regular, moderate to strong -Frequency 3 to 5 min-Duration 40 to 70 seconds3) Ends with cervix 7 cm dilated4) Maternal characteristics-Rapid D and E-Some fetal descent-Feeling of helplessness-Anxiety and restlessness increase as contractions become stronger
First stage of labor: Transition
1) Duration ?
2) Begins with ?-Cervix-Contractions-Frequency-Duration
3) Ends with ?
4) Maternal characteristics (5)
First stage of labor: Transition1) Duration: Primigravida & Multigravida 20-40 min2) Begins with-Cervix 8 cm-Contractions strong to very strong-Frequency 2 to 3 min-Duration 45 to 90 seconds3) Ends with complete dilation at 10 cm4) 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
Second stage of labor:
1) Duration ?
2) Begins with ?-Cervix-Contractions-Frequency-Duration
3) Ends with ?
4) Maternal characteristics (4)
Second stage of labor:1) Duration: Primigravida 30 mins to 2 hrs, Multigravida 5 to 30 min2) Begins with-Cervix full dilation-Contractions progresses to intense contractions every 1 to 2 min3) Ends with birth4) Maternal characteristics-Pushing results in birth of fetus
Second stage of labor:
- Primigravida
- Multigravida
- Assessment of perineal laceration
Second stage of labor: from outlinePrimigravidaMultigravidaAssessment of perineal laceration
Third stage of labor:
1) Duration ?
2) Begins with ?-Cervix-Contractions-Frequency-Duration
3) Ends with ?
4) Maternal characteristics (3)
Third stage of labor:1) Duration: Primigravida & Multigravida2) Begins with delivery of the neonate3) Ends with delivery of placenta4) Maternal characteristics-Placental separation and expulsion-Schultze presentation: shiny fetal surface of placenta emerges first-Duncan presentation: dull maternal surface of placenta emerges first
Fourth stage of labor:
1) Duration ?
2) Begins with ?-Cervix-Contractions-Frequency-Duration
3) Ends with ?
4) Maternal characteristics (2)
Fourth stage of labor:1) Duration: Primigravida & Multigravida 1-4 hrs2) Begins with delivery of placenta3) Ends with maternal stabilization of VS4) Maternal characteristics-Achievement of VS homeostasis-Lochia scant to moderate rubra
Fourth stage of labor
- Placental exam
- Inspection and clamping of the cord “AVA”
- Assessment of episiotomy “REEDA”
- Lochia
- Maternal infant bonding
Fourth stage of labor: from OutlinePlacental examInspection and clamping of the cord “AVA”
Assessment of episiotomy “REEDA”LochiaMaternal infant bonding
Opioids can be administered during this phases
Active phase