NCMA 217 RLE (LABOR AND DELIVERY) Flashcards
PRELIMINARY SIGNS OF LABOR
- LIGHTENING
- SUDDEN WEIGHT LOSS
- INCREASE ACTIVITY LEVEL
- BRAXTON HICK’S CONTRACTION
- RIPENING OF THE CERVIX
- SHOW/BLOOD SHOW
- RUPTURE OF MEMBRANE
TRUE LABOR AND FALSE LABOR
Frequency of contractions Irregular
FALSE LABOR
TRUE LABOR AND FALSE LABOR
Frequency of contractions Regular
TRUE LABOR
TRUE LABOR AND FALSE LABOR
Intensity of contractions
no increase
FALSE LABOR
Intensity of contractions
Increases
TRUE LABOR
TRUE LABOR AND FALSE LABOR
Pain relief
Pain is relieved by
walking
FALSE LABOR
TRUE LABOR AND FALSE LABOR
Pain relief
Pain is intensified by
walking
TRUE LABOR
TRUE LABOR AND FALSE LABOR
Pain location
Confined on abdomen
FALSE LABOR
TRUE LABOR AND FALSE LABOR
Pain location
Begins on lower back and
radiates to abdomen
TRUE LABOR
TRUE LABOR AND FALSE LABOR
Cervical Changes
No cervical changes
FALSE LABOR
TRUE LABOR AND FALSE LABOR
Cervical Changes
Effacement and dilation
TRUE LABOR
DURATION OF LABOR
*14 HOURS
BUT NOT
MORE THAN
20 HOURS
*PRIMIPARA:
DURATION OF LABOR
*8 HOURS BUT
NOT MORE
THAN 14
HOURS
*MULTIPARA:
Factors affecting Labor & Delivery:
5 P’s OF LABOR
*PASSENGER (FETUS)
*PASSAGEWAY
*POWER
* PSYCHOLOGICAL RESPONSE
*PLACENTAL FACTOR
A. PASSENGER (FETUS)
MENTUM (CHIN)
SINCIPUT
VERTEX
OCCIPUT
OCCIPITOFRONTAL
12CM
OCCIPITOMENTAL
13.5CM
SUBOCCIPITOBREGMATIC
9.5CM
B. PASSENGER (FETUS)
OCCIPUT
BIPARETAL
VERTEX
SINCIPUT
BIPARIETAL
9.25CM
C. PASSENGER (FETUS)
ANTERIOR FONTANELLE
POSTERIOR FONTANELLE
LAMBDOIDAL SUTURE
SAGITTAL SUTURE
CORONAL SUTURE
METOPIC SUTURE
PASSAGEWAY
CALDWELL-MOLOY PELVIC TYPES
GYNECOID
PLATYPELLOID
ANDROID
ANTHROPOID
CALDWELL-MOLOY PELVIC TYPES
ROUND
GYNECOID
CALDWELL-MOLOY PELVIC TYPES
OVAL
PLATYPELLOID
CALDWELL-MOLOY PELVIC TYPES
WEDGE
ANDROID
CALDWELL-MOLOY PELVIC TYPES
OVAL-LONG
ANTHROPOID
INLET
Anterior-Posterior
(AP)
11cm
INLET
Transverse
13cm
INLET
Diagonal
12cm
Cavity
Anterior-Posterior
(AP)
12cm
Cavity
Transverse
12cm
Cavity
Diagonal
12cm
Outlet
Anterior-Posterior
(AP)
13cm
Outlet
Transverse
11cm
Outlet
Diagonal
12cm
POWER
BEFORE LABOR 0% EFFACEMENT
EARLY EFFACEMENT 30%
COMPLETE EFFACEMENT 100%
COMPLETE DILATION
PLACENTAL FACTOR
NORMAL PLACENTA
PLACENTA PREVIA
FOUR STAGES OF LABOR
- 1ST STAGE (DILATATION STAGE)
- 2ND STAGE ( EXPULSION STAGE)
- 3RD STAGE (PLACENTAL STAGE)
- 4TH STAGE (RECOVERY STAGE)
begins with the onset of
true uterine contractions
and ends when the cervix
is fully dilated.
DILATATION STAGE
DILATATION STAGE
THREE (3) PHASES
- LATENT 0 - 3 CM DILATED
- ACTIVE 4 - 7 CM DILATE
- TRANSITION 8 - 10 CM DILATED
DILATATION
LATENT
0-3CM
DILATATION
ACTIVE
4-8cm
DILATATION
TRANSITION
8-10cm
FREQUENCY
LATENT
q 5-10mins
FREQUENCY
ACTIVE
q 3-5 min
FREQUENCY
TRANSITION
q2-3min
DURATION
LATENT
20-40 secs
DURATION
ACTIVE
30-60 secs
DURATION
TRANSITION
60-90 secs
INTENSITY
LATENT
MILD
INTENSITY
ACTIVE
MODERATE
INTENSITY
TRANSITION
STRONG
MOTHER’S BEHAVIOR
LATENT
Apprehensive, excited but can
communicate
MOTHER’S BEHAVIOR
ACTIVE
Fear of losing control of
herself
MOTHER’S BEHAVIOR
TRANSITION
Sudden behavioral or mood
changes usually accompanied by
hyperesthesia
NURSING CARE
LATENT
Encourage walking to shorten the
1st stage of labor, Chest breathing,
Encourage to void every 2-3hrs
NURSING CARE
ACTIVE
Medication redied
Assess vital signs, progress
of labor
NURSING CARE
TRANSITION
Tired
Restless
Apply sacral pressure
Relationship of
the presenting
part to the
ischial spine and
denoted in
centimeters
ASSESSING FETAL ENGAGEMENT
AND STATION
FETAL PRESENTATION
VERTEX PRESENTATION
MILITARY PRESENTATION
BROW PRESENTATION
FACE PRESENTATION
COMPLETE FLEXION
MODERATE FLEXION
POOR FLEXION (EXTENSION)
FULL EXTENSION
SHOULDER
COMPOUND
BREECH PRESENTATION
FRANK
COMPLETE
KNEELING
INCOMPLETE
FOOTLING
FETAL PRESENTATION
RIGHT OCCIPITOPOSTERIOR (ROP)
RIGHT OCCIPUT TRANSVERSE (ROT)
RIGHT OCCIPITOANTERIOR (ROA)
LEFT OCCIPITOPOSTERIOR (LOP)
LEFT OCCIPUT TRANSVERS (LOT)
LEFT OCCIPITOANTERIOR (LOA)
most
common and
favorable
birthing position
LOA
most common
malposition and most painful as
well.
LOP and ROP
FETAL LIE
OBLIQUE LIE
LONGITUDINAL LIE
TRANSVERSE LIE
NURSING MANAGEMENT
If the client complains of headache,
take the
blood pressure
NURSING MANAGEMENT
Encourage the client to
bathe
NURSING MANAGEMENT
Allow the mother to eat
crackers or sip of
water or NPO as doctor’s order.
Observe
aspiration precaution
NURSING MANAGEMENT
Provide
perineal care
NURSING MANAGEMENT
Encourage the mother to
maintain left
lateral position
NURSING MANAGEMENT
Monitor
fetal heart tone
which encompasses the actual birth, begins
when the cervix is fully dilated and ends with
the delivery of the fetus.
EXPULSION/DELIVERY OF THE BABY
CARDINAL MOVEMENTS / MECHANISM OF LABOR
D - DESCENT
F - FLEXION
IR - INTERNAL ROTATION
E - EXTENSION
ER - EXTERNAL ROTATION
E - EXPULSION
ONSET OF LABOUR
FLEXION
INTERNAL ROTATION OF HEAD
EXTENSION
EXTERNAL ROTATION OF HEAD
UTERUS IMMEDIATELY AFTER BIRTH
BULGING OF THE PERINEUM
A. ANTEROPOSTERIOR SLIT
B. OVAL OPENING
C. CICULAR SHAPE
D. CROWNING
EPISIOTOMY (PERINEOTOMY)
MIDLINE INCISION
MEDIOLATERAL INCISION
This is a birthing manoeuvre for delivering fetal head in second stage of labor without use of episiotomy.
RITGEN’S MANEUVER
This involves suturing the injured tissue to promote healing and restore the normal anatomy of the perineum. The procedure is typically performed immediately after delivery, using absorbable stitches that dissolve over time. Proper care and hygiene are essential during recovery to prevent infection and ensure proper healing.
EPISIORRHAPHY
DEGREE OF PERINEAL LACERATION
FIRST DEGREE PERINEAL TEAR
SECOND DEGREE PERINEAL TEAR
THIRD DEGREE PERINEAL TEAR
FOURTH DEGREE PERINEAL TEAR
begins
immediately after the neonate is
delivered and ends when the placenta is
delivered
PLACENTAL STAGE
SIGNS OF PLACENTAL
SEPARATION
- Rising of fundus
- CALKIN’S SIGN
- SUDDEN GUSH OF BLOOD
- LENGTHENING OF THE
CORD
*
CONTROLLED CORD TRACTION
WITH COUNTER TRACTION(CCTCT)
TYPES OF PLACENTAL SEPARATION
SCHULTZ
DUNCAN
Cotyledons 16-20
begins
after delivery of the placenta and
the 1st four hours after delivery.
RECOVERY STAGE
NURSING INTERVENTION
*Monitor vital signs every
15mins
for 1 hour and every 30mins until
the client transferred to the ward
NURSING INTERVENTION
*Monitor
vaginal bleeding
NURSING INTERVENTION
*Monitor if the
uterus is contracted
NURSING INTERVENTION
Observe the
episiorraphy site
NURSING INTERVENTION
*Monitor the baby’s
vital signs