Labor Flashcards
cervical change and contractions increase in frequency and duration
true labor
no cervical change and no contraction pattern
false labor
what do you do when membranes rupture (water breaks)
you first listen to the fetal heart tones to assess for a change. Many times the cord may become compressed after ROM which may cause cord compression and hence, fetal hypoxia will result in fetal bradycardia (<110 beats per minute). Next, evaluate the color. Should be clear or straw colored with white flecks. If green or brown, this is meconium staining because of fetal hypoxia.
what to assess for during membrane rupture
COLOR- want clear/straw color
ODOR- want no odor
AMOUNT- varies depending on how the head is applied to the cervix
TIME- do not want a term patient to go more than 18-24 hours ruptured due to risk for infection
At what are the critical hours regarding ruptured membranes
Do not want a term mom to go more than 18-24 hours with ruptured membranes because this allows an increase in the risk for infection. 18 hours after the patient’s membranes have ruptured, give her antibiotics to decrease the risk of infection.
What is the sequella for mom and baby for prolonged ruptured membranes without antibiotics?
without antibiotics include: fetal tachycardia due to infection (amnionitis), chorioamnionitis which may induce maternal fever, maternal and fetal tachycardia, uterine tenderness, and foul odor of amniotic fluid.
nursing interventions after water breaks
temperature q1hr and antibiotics after 18 hrs
general hygeine, nutrient/fluid intake, elimination every 2 hrs, cath, bowel elimination
what fetal positions make a c section necessary
Complete breech, single footling breech, shoulder presentation, or if cord between head and external OS
what fetal station do you want baby at
≥ 0
the contracting of the uterus back down
occurs in 4th stage of labor
uterine involution
do not like to show any signs of weakness, women are extremely stoic during childbirth
somalia
natural childbirth methods practiced; may labor silently; may not eat during labor; father may be present
japan
Stoic response to pain; father usually not present; side-lying position is preferred for labor and birth because this position is thought to reduce infant trauma.
china
natural childbirth methods preferred; father not usually present; female relatives usually present
india
father not present; female support and female caregivers preferred
iran
may be stoic about comfort until the second stage, and may then request pain relief; father and female relatives may be present
mexico
may use squatting position for birth; father may or may not be present; female attendants preferred
laos
Normal labor pattern called a partogram or Friedman’s graph
Friedman’s curve just addresses the trees/rocks or the highway. The primigravida graph is longer (trees, scrubs bushes) than the multipara graph (paved highway). First-time mom- it will be slower, if you’re are a multip, it is faster. The graph is important because if you are not laboring in the expected timeline, the baby may be too big or malpositioned. This may indicate a need for surgical intervention.
breathing techniques can promote relaxation of the abdominal muscles and increase the size of the abdominal cavity which helps with discomfort
first stage breathing
breathing is used to increase abdominal pressure and thereby assist in expelling the fetus
second stage breathing
most associated with prepared childbirth and includes slow-paced, modified-paced, and patterned-paced (pant-blow) breathing techniques
paced breathing
how many breaths per min
6-8 breaths per minute
shallow and faster than her normal rate of breathing, but should not exceed twice her resting respiratory rate
modified paced breathing
It is performed at the same rate as modified-paced breathing and consists of panting breaths combined with soft blowing breaths at regular intervals
Patterned-paced (pant-blow) breathing
Undesirable reaction to pattern-paced breathing is
HYPERVENTILATION which can cause RESPIRATORY ALKALOSIS
Symptoms of respiratory alkalosis
Lightheadedness, dizziness, tingling of the fingers, circumoral numbness
Relaxed breath in through nose and out through mouth. Used at the beginning and end of each contraction
cleansing breath
(Approximately 6 to 8 Breaths per Minute): Performed at approximately half the normal breathing rate (number of breaths per minute divided by 2);
slow paced breathing
