labor phase/ stages Flashcards
Premonitory signs of labor/ Signs of Impending labor
Lightening Braxton Hicks contractions Increased energy level (nesting) Cervical softening and effacement Rupture of membranes Increased vaginal discharge Weight loss
Name of First stage
Dilation
Acronym for first stage
FLAT
3 phases of the first stage
Latent
Active
Transitional
Latent phase
The latent phase is the beginning of labor contractions and the cervix may be dilated 0 to 3 centimeters.
mild contractions lasting 20 to 40 seconds with a frequency of 3 to 30 minutes.
woman may be relieved that labor has finally started
woman feels able to cope with the discomfort.
woman is often talkative and smiling and is eager to talk about herself and answer questions
Active phase
the cervix dilates from about 4 to 7 cm.
her anxiety tends to increase as she senses the intensification of contractions and pain.
Transition phase
begins with 8 cm to 10 cm of dilation
contractions have a frequency of 1 1/2 to 2 minutes, a duration of 60 to 90 seconds, and are strong in intensity
When the woman enters the transition phase, she may demonstrate significant anxiety.
She becomes acutely aware of the increasing force and intensity of the contractions.
She may become restless, frequently changing position
Name of Second labor stage
Pushing
When does the second stage of labor occur?
begins when the cervix is fully dilated and ends with the birth of the baby.
Second stage — expulsion of fetus (30 minutes to 2 hours)
Phases of the second/pushing stage
Latent phase
Active phase
Latent phase
Fetal station 0 to +2
Passive fetal descent
Urge to bear down is not string and may only occur at the peak of contractions
Maternal behavior: relaxed. May sleep or rest in between contractions
Active (pushing) phase:
Fetus descends +2 to +4. The Ferguson reflex is activated when the fetus descends, causing the urge to push.
Strong contraction every 1 to 3 minutes
Maternal behaviors: sense of urgency, may push voluntarily or involuntarily. Vocalizations may change form quite to loud with coinciding contractions
Third stage of labor name
Placental Expulsion ( 5 to 30 minutes)
Third Stage of labor
begins with the birth of the baby and ends with the complete expulsion of the placenta
uterine inversion occurs during the third stage of labor.
Fourth stage of labor name
Restorative
Fourth Stage: Restorative
begins with the complete expulsion of the placenta and ends when the woman is hemodynamically stable
crucial period for family bonding, breastfeeding, and attachment, and the nurse
most important nursing intervention during the fourth stage of labor assess for signs of hemorrhage
Lighetning
descent of the fetal presenting part into the pelvis ( occurs @ 10 to 14 days) before labor begins.
Lightening s/s
shooting leg pains from increase pressure on sciatic nerve, incr. Vaginal disch; urinary frequency
Lightening gives her a relief from the diaphragmatic pressure and she states, “ I am able to breath better!” (There is no shortness of breath anymore)
“Lightening to their load.”
True labor vs. false labor
The main difference between true labor and false labor is contraction and cervical dilation which is seen in true labor
The conclusive distinction between true and false labor is that contractions of true labor cause progressive change in the cervix (cervical dilation and effacement). True labor contractions occur regularly, becoming stronger, lasting longer, and occurring closer together. They may become more intense during walking and continue despite comfort measures As the cervix begins to soften, dilate, and efface, expulsion of the mucous plug that sealed the cervix during pregnancy occurs. This causes rupture of small cervical capillaries = bloody show.
Bloody show can occur before true labor. Fetal descent can occur before true labor.
False labor may have contractions that occur this frequently; however, this is usually inconsistent. False labor pains can be relieved with walking or position changes.
A pregnant client is making her first antepartum visit at 4-weeks gestation. She has 2 years old twin sons born at 40 weeks, a 5 y/o daughter born at 38 weeks, and a 8 y/o twin daughters born at 28 weeks. She had a spontaneous abortion 3-years ago at ten weeks. She had two elective abortions as a teenager at eight weeks and ten weeks gestation.
G7 T2 P1 A3 L5 M2
Find out G and L first and remeber to count current pregnancy for G but not for L
A pregnant client is making her first Antepartum visit at 18 weeks gestation. She has a two-year-old born at 40 weeks, an 8-year-old daughter born at 38 weeks, and 7-year-old twin daughters born at 35 weeks. She had a spontaneous abortion three years ago at ten weeks. Use the GTPAL format to calculate her gravida and para.
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A pregnant client is making her first Antepartum visit. She has a two-year old son born at 40 weeks, a 5 year old daughter born at 38 weeks , and 7 y/o triplets daughters born at 35 weeks. She had a miscarriage three years ago at ten weeks and a stillbirth at 39 weeks. Use the GTPALM form to calculate.
What happens in the first stage of labor?
dilation and effacement (can last 4 to 6 hours)
