Problems with Power Flashcards
Time-honored term to denote sluggishness of contractions
Inertia
The force of labor is less than usual
Inertia
Dysfunction can occur at any point in labor but it is generally classified as
Primary (occurring at the onset of labor)
Secondary (occurring later in labor)
Having a prolonged labor are usually at risks of what conditions
- Postpartum infection
- Hemorrhage
- Infant mortality
Factors that can lead to having a prolonged labor
- Fetus is large
- Contractions are hypotonic, hypertonic, or uncoordinated
Components of Pregnancy
Power
Passenger
Passageway
Psyche
Placenta
Force that propels the fetus
Power
It refers to the fetus itself
Passenger
It refers the birth canal
Passageway
Perception of events both the birthing parent’s and the family
Psyche
2 phases of Uterine Contraction
Contraction (systole)
Relaxation (diastole)
Cervical dilatation during active phase
Nullipara - 1.2cm/hr
Multipara - 1.5cm/hr
Denotes sluggishness of contractions or force of labor
Dysfunctional labor
Inertia
Number of contractions is unusually low or infrequent
Resting tone remains less than 10mmHg
Hypotonic Contractions
Signs of Hypotensive Shock
- Rapid, weak pulse
- Falling blood pressure
- Cold, clammy skin
- Dilatation of the nostrils from air starvation
Strength does not rise above 25mmHg
May occur after administration of analgesia or if there is bladder distention
Hypotonic Contractions
Hypotonic Contractions may occur at what conditions?
- May occur after administration of analgesia
- Bladder distention is present
Occurs in the uterus which is overstretched, larger than usual single fetus, polyhydramnios, or lax uterus
Hypotonic Contractions
Management of Hypotonic Contractions
- Palpate the uterine fundus
- Obtain the patient’s blood pressure
- Assess the amount of lochia every 15 minutes
Increasing in resting tone to more than 15mmHg
Hypertonic Contractions
Occurs frequently in the latent phase of labor
More painful, myometrium becomes tender because of lack of relaxation
Hypertonic Contractions
Uterine pacemakers arise in other areas of the uterus
Hypertonic Contractions
What are the possible dangers? (having problems in power of contractions)
- Could lead to fetal anoxia
- Contractions are strong but ineffective
Management of Hypertonic Contractions
- Apply external uterine and fetal monitor
- Prepare for possible cesarean birth
More than one pacemaker may be initiating contractions or receptor points in the myometrium may be acting independently
Uncoordinated Contractions
Occur erratically, may be difficult for a woman to rest between contractions
Uncoordinated Contractions
Management for Uncoordinated Contractions
- Apply uterine and fetal monitor
- Administer oxytocin
Dysfunction at the First Stage of Labor
Give the 4 phases
- Prolonged Latent Phase
- Protracted Active Phase
- Prolonged Deceleration Phase
- Secondary Arrest of Dilatation
Dysfunction at the First Stage of Labor
Latent phase that is longer than 20hrs in a nullipara or 14hrs in multipara
Prolonged Latent Phase
Dysfunction at the First Stage of Labor
It may occur if the cervix is not “ripe” at the beginning
Prolonged Latent Phase