Labor & Delivery Flashcards
5 Ps
Passageway: pelvic shape
Passenger: fetus
Passageway + Passenger: presentation
Powers: contractions
Psyche: psychosocial
Signs of Impending Labor
Lightening or sense that the baby has “dropped”
Increased frequency, intensity of contractions
Gastrointestinal disturbances
Expelling the mucus plug
Feeling a burst of energy
Clinical sign;
Ripening or softening of the cervix
Effacement or thinning of the cervix
First stage of labor
Begins with onset of true labor and ends with full dilation of the cervix at 10 cm.
Latent phase(1st stage)
contractions typically five to 10 minutes apart and lasting 30 to 45 seconds with mild intensity. The cervix is dilated 1 to 3 cm, and effacement has begun. Spontaneous rupture of membranes may occur
Active phase( 1st stage)
contractions that occur every two to five minutes, lasting 45 to 60 seconds, and are of moderate to strong intensity. The cervix should dilate progressively from 4 to 8 cm with rapid effacement. Fetal descent begins
Transitional phase( 1st stage)
contractions occurring every two to three minutes, lasting 60 to 90 seconds, and of strong intensity. The uterus should relax completely between uterine contractions. Cervical examination during this time reveals dilation between 8 and 10 cm. The woman may be nauseated, vomit or report needing to have a bowel movement. There is an urge to push and bloody show
Assessment during 1st stage of labor
FHR and contractions
Labor progress
Fetal status
Maternal status
Woman’s psychosocial state
Expected outcomes in 1st stage
Woman and fetus remain free from injury
Anxiety is reduced
Pain is manageable
Woman and partner understand labor process
2nd stage of labor
Expulsion of the fetus. Enter into second stage of labor when fully dilated and effaced and ends with birth of the baby.
assessment during 2nd stage of labor
Monitor BP, P, and R every 15 to 30 minutes
Assess the contraction pattern every 15 minutes
Assess fetal status
Asses the woman’s report of an uncontrollable urge to push
Check FHR every 15 minutes for the low-risk woman, every five minutes for woman at-risk for labor complications
3rd stage of labor
Ends with delivery of the placenta.
Assessment during 3rd stage of labor
Monitor for signs of placental separation
Woman’s psychosocial state
4th stage of labor
Recovery
Assessments during 4th stage of labor
Signs of hemorrhage
Assess lochia: color and quantity
Signs of infection
Monitor for suprapubic distension
Comfort level
Woman’s psychosocial state
Assess initial bonding behaviors
Artificial Rupture of membranes
Used for induction of labor
Called an amniotomy
Monitor color of amniotic fluid and FHR
