Unit 12: Reproduction - Intrapartum Care Flashcards
What are the 3 phases of the 1st stage of labor?
Latent - up to 3cm of dilation
Active 4-7 cm dilation
Transition 8-10 cm dilation
What care management happens within the 1st stage of labor?
Assess FHR, cervical area, and maternal vital signs
What do you assess during the latent phase? What are interventions?
lab work - blood type, CBC, urine
mental health
cultural preferences
Leopold maneuvers
Interventions: movement, fluid intake, elimination (voiding 1-2hrs)
What do you assess during the active phase? What are interventions?
Assess cervical change, contraction pattern, FHR, pain, and vital signs
Interventions: comfort measures, position changes, pain management
What do you assess during the transition phase? What are interventions?
Assess FHR, UC, dilation
Interventions: prepare for delivery, breathing techniques
What is the second stage of labor and the interventions performed?
Latent
Descent - active pushing
First pregnancy 2-3 hrs
2nd + pregnancy 1-2 hours
Interventions: continuous monitoring (every 5 minutes), anticipate complications
What are complications that can occur during labor?
Fetal distress
Meconium
Fever
Malposition
Arrest of descent
Dystocia
Bleeding
What is the 3rd stage of labor? What are interventions done during this stage?
The delivery of the placenta. Note the time of the placenta
Interventions: fundal massage, encourage breastfeeding, proper hygiene, pain management
What is the immediate newborn assessment?
Patient airway
Preventing clod
Cord clamping
APGAR
Identification
Skin-to-skin
Meds and measurements
What is the 4th stage interventions?
Take VS for a 2hr period (every 15 min for the first hour and every 30 min for the second hour)
Comfort measures
Breastfeeding
Remove epidural, monitor for return of sensation
How can you support the family?
Allow them to be involved
What support can the nurse provide during labor?
Listening to concerns
Acting as an advocate
Protect privacy, modesty, and dignity
Provide continuity of care
What are the culture/religious beliefs in relation to labor?
Hispanic - mother is present
Black - female support
Asian American - partner not an active participant, avoid c-section
Native American - herbs, squatting, family involved
Whites - partner expected to be involved
What are the degrees of perineal trauma?
First degree: Laceration that is confined to the skin
Second degree: Laceration that extends into the perineal body
Third degree: Laceration that involves injury to the external anal sphincter muscle
Fourth degree: Laceration that extends completely through the anal sphincter and the rectal mucosa
