MCN 3F Flashcards
Labor that has started spontaneously but not effective
Augmentation of Labor
Labor is starting artificially
Induction of Labor
Artificial rupturing of membranes during labor if they do not rupture spontaneously
Amniotomy
Sluggishness of contractions, or that the force. of labor that is less than usual
Dysfunctional Labor
Highest peak of contraction
Acme
Building up phase
Increment
Letting up phase
Decrement
Normal labor
Eutocia
Difficult labor
Dystocia
Given to mothers who have undergone cesarean section
Trial of Labor / TOLAC
Reliefs from diaphragmatic pressure, sinking of fetal
Lightening
changes in ratio of estrogen to progesterone occurs, increasing estrogen in relation to progesterone; interpreted as progesterone withdrawal
Progesterone Deprivation
stretches from increasing size of fetus, release in prostaglandin; increase estrogen decrease progesterone
Uterine Stretch Theory
Fetus presses on cervix, stimulates release of oxytocin from posterior pituitary; stimulates prostaglandin to initiate contractions
Oxytocin Theory
Placenta reaches set age, triggers contractions
Placental Degeneration
Rising fetal cortisol levels reduce progesterone formation and prostaglandin formation
Fetal Endocrine Control Theory or Adrenal Theory
fetal membrane begins to produce prostaglandins to stimulate contractions
Prostaglandin Theory
Premonitory Signs of Labor
Lightening
Slight Loss of Weight
Excess Energy
Backache
Braxton Hick’s Contraction
Ripening of the Cervix
Show
Rupture of Membranes
Uterine Contractions
Begins at onset of regularly perceived uterine contractions
Latent Phase
Mild and Short Contractions; 20-40s
Latent Phase
Analgesia may be given if too early, it may prolong stage
Assist mother to prepare psychologically
Teach breathing exercises
Encourage nonpharmacologic measures
Provide Ice chips
Pain Management: Latent
Uncomfortable phase for the mother
Stronger contractions 40-60s
Bloody show and spontaneous rupture
Active Phase
Frequent perineal care
Encourage to keep active and assume most comfortable position except flat on back
Anticipate mood swings
Upright
Left side lying
Nursing Care: Active Phase
Peak contractions
60-70s
Full cervical dilatation and effacement
ROM may occur at full cervical dilation
Strong urge to push
Transition Phase
Experience intense discomfort
Help direct maternal focus to birthing of baby
Provide support
Stay with mother
Nursing Care: Transition Phase
Complete cervical dilatation to delivery of the neonate
Fetus moved along the birth canal by mechanism of labor
Second Stage of Labor
Assist with second stage pushing
Prepare birthing area
Assist in birthing position
Ready for episiotomy
Assist with delivery
Nursing Care: Second Stage
Begins with the birth of the infant and ends with the delivery
Third Stage
Placenta detaches from uterine wall
Placental Separation
Lengthening of the umbilical cord
Sudden gush of blood
Placenta is visible at vaginal opening
Uterus contracts and feels firm
Schultz & Duncan
Signs of Placental Separation
Placenta is delivered through natural bearing down/gentle pressure (Crede’s Maneuver)
No pressure on noncontracted uterus - causes uterine version and hemorrhage
Note time
Inspect intactness
Placental Expulsion
Vaginal mucous membrane and skin of the perineum fourchette
First Degree Laceration
Vagina, perineal skin, fascia, levator and muscle, and perineal body
Second Degree Laceration
Entire perineum, extending to reach the external sphincter of the rectum
Third Degree Laceration
Entire perineum, rectal sphincter, and some of the mucous membrane of the rectum
Fourth Degree Laceration
First hour after delivery
Beginning postpartum
6 weeks postpartum period
High risk for hemorrhage
Fourth Stage
Assess lochia, consistency and position of the fundus, episiotomy site
Obtain vitals every 15mins
Nursing Care: Fourth Stage
