MECHANISMS Flashcards
A series of processes by which the product of
conception is expelled from the maternal body
Labor
Progesterone (uterine muscle relaxant) decreases in late pregnancy
With corresponding increase in Estrogen (uterine
muscle stimulant), labor starts.
Low Progesterone Theory
Most acceptable theory
Uterine
Stretch Theory
Refers to the fetus and its ability to move through the
passageway
Passenger
- pregnant woman’s general behavior and influences
upon her also influence labor progress
Psyche
Descent of the fetus and uterus into pelvic cavity
before labor onset
Lightening
Lightening Occurs EARLIER WHEN
2-3 weeks earlier in primipara
Lightening in Multigravida happens when
a day before labor
Increases Braxton Hick’s Contractions occurs when
3 to 4 weeks before labor.
first requisite for the birth of the baby.
Descent
Associated with descent.
Internal Rotation
delivery of the fetal head in vertex presentation.
Extension
restitution
External Rotation –
incision extending from the soft tissue of the
vaginal opening into the true perineum.
Episiotomy
Episiotomy Repair is called
episiorrhaphy
Episiotomy is Done when the fetal presenting part has crowned to a diameter of about
3 to 4 cm.
incision from the vaginal opening straight down
toward but not extending into the anus.
Median Episiotomy
begins at the midline above the anus but angles to
the left or right.
Mediolateral Episiotomy
Dilation stage from the onset of the first contraction to full cervical dilation.
- Power necessary: uterine contractions
First Stage of Labor
Latent phase characteristics:
Cervix: 0 to 3 dilations; complete effacement.
Frequency over 10 minutes
Duration – average of 30 minutes
Maternal discomfort – backache, abdominal
cramps.
Nursing interventions in Latent phase
– proper positioning; side
lying; backrub, support system can include the
husband; nurse should stay with the client to
provide support.
active phase characteristics
Contraction is moderate
Frequency – 3 to 5 minutes
Duration – 45 to 60 seconds
Cervix: 4 to 7 dilations; complete effacement.
Maternal problem: Active phase
Hyperventilation
Signs – pallor, dizziness, light-headedness with
tingling sensation on the fingertips and lips.
PRIEST
Praise
Reassurance
Inform mother of the progress
encouragement
support system
touch
Transition phase characteristic:
Cervix – 8 to 10 cm dilation
strong contraction
Frequency – 2 to 3 minutes
Duration – 60 to 90 seconds
Maternal behavior in Transition phase
increased perspiration,
panicky, irritable; with N/V; may lose control
Detection of FHR – auscultation using stethoscope time
(q30 mins in early labor; q5 min in transition)
Monitoring – applied when
membranes intact.
External or Indirect
Tocodynamometer
Ultrasonic Transducer
applied when
membranes have ruptured
Internal or Direct Monitoring
intrauterine catheter
filled with water is inserted beyond presenting part; allows measurement of
frequency, duration, and intensity of
contractions
Pressure Transducer
applied to fetal
scalp; allows measurement of FHR
Internal Spiral Electrode
it is when FHR is more than 170/min
Tachycardia
deceleration (usually begins
as contraction peaks); cause by uteroplacental
insufficiency
Late deceleration
decelerations – due to umbilical cord
compression.
Variable decelerations
From fully dilated cervix to the delivery or expulsion
of the baby. From fully dilated cervix to the delivery or expulsion
of the baby.
Second Stage of Labor
stage where – progresses from irritability to
participation, eagerness, and excitement.
Second Stage of Labor
s the best time for the BOW to rupture;
early 2nd stage
first nursing action after rupture of the BOW
is to check the
FHT
the hallmark of the 2nd stage
Crowning
During the 2nd stage we Monitor FHT at intervals
midway between
contractions
Transfer To The Delivery Room: When?
Primigravida
cervix 10 cm with bulging
Transfer To The Delivery Room: When? Multigravida
– cervix 8-9 cm.
Perineal prep is at what motion
front to back motion
Clamps are placed ______inches from the fetal abdomen
8-10 inches
Proper positioning during 2nd stage
Slight Trendelenburg Position
delivery of placental with
the side closest to the baby emerging first
Schultze’s Mechanism
Assessment (REEDA):
R – Redness
E – Edema
E – Ecchymosis
D – Discharge or drainage (bleeding)
A – Approximation of wound edges.
Nursing Interventions: Fourth Stage of Labor
Monitor VS q15 mins until stable;
Palpate fundus q15 mins
May initially slow labor, have dep
Narcotics
Produce sedation and relaxation;
Tranquilizers
- Produce sedation and alter memory
Amnesics
given in 1st stage active phase;
Paracervical Block
produce rapid relief of uterine and
perineal pain; may be given in single doses or
continuously.
Peridural Blocks –
may cause maternal hypotension
Epidural
The average duration of third stage of labor
is
s 5 mins
The average duration of second stage of labor
is
50–60 mins
20–30 mins
