Labour and delivery Flashcards
What are the 4 stages of labor?
1st: onset of reg contractions to full dilation
2nd: full dilation until birth of baby
3rd: birth of baby until delivery of baby
4th: first 1-4 hours after birth
What is the average length of time for a primigrivada (primip) for each
1st: latent 8.6 hrs active 4.6 hrs transition 3 hrs 2nd: 2hrs 3rd: 5 mins
What is the average length of time for a multigrivada (multip) for each phase?
1st: latent 5.3 hrs active 2.4 hrs transition <1 hrf 2nd: 1 hr 3rd: 5 mins
Describe what happens in each stage of labour.
1st: decent, flexion
2nd: decent and flexion, internal rotation, extension, restitution, external rotation and expulsion
3rd: expulsion of the placenta.
4th: close monitoring and time to start breast feeding
What are the two sides of the placenta called?
gray side : dirty or Duncan
codyledon side : shiny or schultz
What does nursing care just after admission for labor look like?
assessing status of mother: contractions (length, strength, frequency)
history
change and get comfortable
physiological assessment
vag exam (dilation, effacement, presentation, station), urine test and swabs
What does nursing care in the first stage of labor look like?
regular assessments (15-30 mins) assess contractions (str, length, freq) offer fluids and ice chips mobilize/change positions frequently comfort measures/distraction assess BP and temp
What does nursing care in the second stage of labor look like?
contact MD
provide comfort measures (ice chips, assist breathing, relaxation, focal point)
encourage not to push until the active part of this stage.
assess contraction and fetal heartrate every 5 mins
instruct how to push
note time of birth
What does nursing care in the third stage of labour look like?
administration of synthetic oxytocin assist in immediate care of the newborn assess blood flow and contraction of uterus obtain fetal blood from cord assist with delivery of placenta Perform apgar on baby
what does nursing care look like in the 4th stage of labour?
assess general state of mother assess BP, pulse, flow, fundus every 15 mins assess temp APGAR performed on the baby assist breast feeding clean up allow family time
what are the three ways a baby can present?
cephalic - head
breech - feet
shoulder
What does fetal lie refer to?
the position of the baby’s spine in relation to it’s mothers
Longitudinal - parallel to mom
transverse - perpendicular to mom
What is the fetal attitude?
The relation of the fetal parts to one another
ideal is head slightly down thighs on abdomen and calves on thighs with arms tucked between legs
What does station mean?
the relationship of the presenting part to the ischial spines
What is engagement?
when the presenting part reaches or passes the pelvic inlet