Labor & Delivery Flashcards
What is the definition of labor?
Progressive cervical changes in the face of regular frequent painful uterine contractions
Stages of labor
First stage
Second stage
Third Stage
Fourth Stage
First stage of labor entails?
Cervical Dilation
Lasts up to 24 hours
Dilation of cervix from 0-10cm
Has 3 PHASES (Names)
Second stage of labor entails?
Expulsion - Pushing stage
Lasts under 2 hours
Begins once cervix is fully dilated until delivery of baby
Third Stage of labor entails?
Placental delivery
Lasts no more than 1 hour (10min-1hr)
Begins from delivery of baby to placental delivery
Fourth stage of labor entails?
Maternal homeostatic stabilization
Begins after delivery of the placenta
Lasts 1-4 hours after delivery of placenta
How does one know total amount of time in labor?
Total up all four stages of labor to know total amount of time in labor
Phases of labor?
Phases have names**
Latency
Active
Transition
Latency phase lasts for how long and how much is dilated during this phase?
Prodromal
Preliminary
Early
4-24 hours
Usually cervix dilates from 0-3cm in this phase
Contractions (Freq/Duration) and attitude during latency phase?
Contractions:
Start as severe menstrual cramps, end up being much worse.
Frequency:
Starts: 20 min apart
End: 5 min apart
Duration:
Start: 10 sec each
End: 45 sec each
Attitude:
Good attitude, like she can complete labor fine.
Active phase of labor lasts for how long & how much is dilated during this phase?
About 3-5 hours
Cervix dilates about 4-7cm
Active Phase: Contractions (Duration/Freq) and attitude during this phase?
Contractions
Frequency:
3-5min apart
Duration:
60 seconds each
Attitude:
Self-absorbed
Interfocused
Transition phase of labor lasts how long and how much of the cervix dilated at this point?
Lasts about 1/2 to 2 hours
Cervix dilates about 8-10cm
Contractions (Duration/Freq) and attitude during the transition phase of labor?
Contractions:
Frequency:
2-3 min apart
Duration:
60-90 seconds each
Not much of a break in between
Attitude:
Upset
Unhappy
In pain
When are pain meds no longer an option? During what phase?
Transitional phase, too close to delivery.
You dont want her to be too numb to push
Types of pelvis
Gynecoid
Perfect for delivery
Round
Wide pelvic diameter
Anthropoid pelvis
Not ideal but more favorable than android
Long narrow and oval
Fetus usually comes out occiput posterior, sunny side up
Narrow pubic arch
Android pelvis
Male pelvis
Heart shape
Narrow diameter
Narrow pubic arch
Platypelloid pelvis
Flat wide short and oval
Transverse wide
Wide pubic arch
Cervical effacement
Happens in latent phase
Thin out the cervix before dilating
Measured 0%-100%
Occurs during dilation of 0-4cm
Which pelvic shapes can have vaginal or c-section deliveries?
Vaginal
Gynecoid - most ideal
Anthropoid
C-Section
Android
Platypelloid
Duration of contractions
Length of a single contraction
Ex: Starts at 1:00min ends at 1:01
Start to end of contraction
Frequency of contractions
Beginning of the first contraction to the beginning of the next
From start to start
How should true labor pains feel?
Should feel the contractions from front to back
The uterus is made of muscles that are horizontal which is why contractions are felt from back to front.
Occiput posterior Positioning
Nursing intervention
Most likely cause of back labor pains
Massage with a fist or tennis ball around the coccyx and sacral region, and rotate with pressure.
May try to reposition the patient, place on hands and knees and reposition.See if baby can get flipped around.
Fetal Attitude
Position of whole body of fetus
Flexion
Extension
Are they flexed or extended?
Fetal Lie
How the baby lies in relation to momma’s spine
Longitudinal - ideal
Lined up with mom’s spine
Transverse - C-Section
Perpendicular to mom
Breech
Bottom down head up
Types of breech
Frank - feet up against head
Full- flexed attitude, bottom down
Single footing - One leg down the other up
What is the biggest issue with breeched babies?
Shoulder are wider
Head may become stuck
What two types of breech babies can sometimes be delivered vaginally?
Frank breech
Full breech
Vertex presentation
Complete flexion
Ideal for delivery
May feel fontanelles and sutures to know babys position
Military presentation
Moderate flexion
Difficult to deliver
Brow presentation
Partial flexion (Extension)
Forehead presents first
Cannot do vaginal delivery
Face presentation
FULL extension
C-section cannot do vaginal delivery
