T2- Stages of Labor Flashcards
What is the goal of stage 1 labor?
Dilation of cervix; descent of fetus
How much is the cervix dilated in the latent phase of stage 1 labor?
0-3 cm
Latent phase UC:
Frequency?
Duration?
Intensity?
Frequency: q5-30 min
Duration: 10-30 seconds
Intensity: Mild-moderate
What is the client like in the latent phase of stage one labor?
Happy; excited and apprehensive; need for independence; attempts to care for own needs; uses focusing and relaxing techniques; seeks info about care
When do we monitor VS?
In between contractions
During the latent phase of stage one labor, how often are VS taken?
BP, P, R on admission and then q hour and PRN
*after regional anesthesia every 5 min for first 20 min, then q 30 min
Amniotic fluid. What would normal amniotic fluid from ROM look like?
Clear with white specks
What does yellow amniotic fluid indicate?
Fetal distress about 35 hours previously
What does green amniotic fluid with meconium with fetus in vertex position indicate?
Fetal distress secondary to respiratory distress in fetus
After membranes have been ruptured, how often do we monitor temp and why?
q2h; the longer the time the membranes are ruptured the more risk for infection
If membranes rupture on our watch, what do we immediately check?
Fetal heart tracing for decels or variability
How much is the cervix dilated in the active phase of stage 1 labor?
4-7 cm
UC of active phase of stage 1 labor
Frequency?
Duration?
Intensity?
Frequency: q3-5 min
Duration: 30-45 seconds
Intensity: Moderate-strong
What are the clients response to active phase of stage 1 labor?
More seriously labor oriented; concentration is inward; demanding of support person; continues to focus/relax; uses breathing techniques
How often should we encourage the client to void?
q1-2 hours
Why is it important to check the bladder for complete emptying?
A full bladder may impede the labor progress or result in trauma to the bladder
When can regional anesthesia be given?
After contraction pattern has been established and cervix is dilated 5-6 cm
What is the cervix dilation in the transition phase of labor?
7-10 cm
Transition phase of stage 1 labor...UC Frequency? Duration? Intensity? Station?
Frequency: q2-3 min
Duration: 45-90 seconds
Intensity: Strong
Station: +2 to +3
What are some of the symptoms of the transition phase of stage 1 labor?
NV
Perspiration/legs trembling
Increased vaginal show
What happens in stage 2 of labor?
Effacement & complete dilation to expulsion of fetus
What is the goal of the stage 2 labor?
Descent to birth of a baby
Stage 2 labor: Contractions
Frequency?
Duration?
Intensity?
Frequency: q 1.5-2 min
Duration: 60-90 seconds
Intensity: Strong
What do we assess about the baby when the mom has a UC?
Check FHR
When is the best time to administer meds to a mom in labor and why?
During a contraction so amount delivered to the fetus will be minimized; during a contraction that is a time of little placental perfusion, so giving a drug during a contraction limits the amount the receive would receive inutero
If we give maintenance dose of meds, when do we check the VS?
Monitor VS after each maintenance drug of medication
What do we do if hypotension occurs to the mother in labor?
Increase IV fluids Turn off pit Begin O2 by face mask Elevate clients legs slightly Call doc
If the patient is hyperventilating we can suggest the client breathe into a paper bag or cupped hands. What does this do?
Minimizes fetal acidosis and relieves symptoms of vertigo and syncope
What are the 2 goals of stage 3 of labor?
Expulsion of placenta
Prevention of hemorrhage
What are the UC like in stage 3 of labor?
Temporarily stop
What are the 3 signs of placental separation?
- Upward rise of uterus in abdomen; uterus is globular shape
- Visible lengthening of the cord
- Trickle or gush of blood
What drug do we administer after the delivery of the placenta?
Pitocin
What are the 2 goals of stage 4 of labor?
- Prevent hemorrhage
- Facilitate maternal-infant bonding
After birth, how often are VS checked?
q15 min for at least one hour
What can be done if the fundus is not firm?
If it is boggy, we can massage and help the client empty the bladder
Warning signs of pregnancy:
Relaxation time must equal ______ or loner in order for uterus to be perfused between
30 seconds or longer
What may a sharp, rigid abdomen signal?
Abruption placenta
What FHR patterns are warning signs during labor?
Late decels
Prolonged variable decls
Bradycardia
Tachycardia
What may a PROM put a client at risk for?
Uterine infection
