UNIT 3 CARE OF A WOMAN IN LABOR Flashcards
STAGES OF LABOR
- The time woman experience true signs of labor to full cervical dilation.
- To full cervical dilation to delievery of the baby.
- To delivery of the baby to the delivery of the placenta.
Monitor vital signs every ___ hours
4
Monitor temp every ___ hours
2 hours
Assess VS in ____
in between contractions
encourage to void every____
2 to 4 hours
For pain characreristics, assess ____, ____, _____
Intensity, Location and radiation
FHR
Beggining labor
every 30 minutes
FHR
Active Labor
every 15 minutes
FHR
Second Stage of Labor
every 5 minutes
AF is Green or Black
Meconium StainedFluid, sign of fetal distress
AF is absent
Membranes might have ruptured already
Normal FHR
120-160 bpm
Fetal Bradychardia
Below 120 bpm for 10 minutes
Moderate Bradychardia
100-119 bpm
Marked Bradychardia
less than 100 bpm
Fetal Tachycardia
160 bpm or faster for 10 minutes
Moderate tachycardia
161-180 bpm
Marked tachycardia
greater than 180
The average rate of fetal heart beat per minute
BASELINE FHR
On baseline FHR, the rate flcutuates slightly (__ to __ bpm) when the baby moves
5 to 15
It is one of the most reliable indicators of fetal well-being.
VARIABILITY
It is a light irregularity or “jitter” to the wave.
VARIABILITY
Are fluctuations in the FHR of more than 2 cycles per minute
VARIABILITY
What type of Variability: Beep-to-beep
Short Term Variability
What type of Variability: Differences in heart rate over the 20-minute period time
LONG TERM VARIABILITY
fluctuations in the FHR, of 6 to 10 bpm, that occur 3 to 10 times per minute
LONG TERM VARIABILITY
Temporary normal increase in FHR
caused by fetal movement or
compression of the umbilical vein
during contraction
ACCELERATIONS
an abrupt increase
in FHR above baseline with onset to
peak of the acceleration less than 30
seconds, and less than 2 minutes in
duration.
ACCELERATIONS
The ________ is defined as the time
from the initial change in heart rate
from the baseline to the time of return
to the FHR to baseline.
duration of the
acceleration
Normal periodic decreases in the FHR
resulting from pressure on the fetal
head during contractions
EARLY DECELERATIONS
delayed decrease in the FHR until 30
to 40 sec after the onset of a
contractions and continue beyond the
end of the contraction.
LATE DECELERATIONS
this sign may result from marked
hypertonia caused by administration of
Oxytocin.
LATE DECELERATION
It is an ominous sign of fetal hypoxia
caused by utero-placental
insufficiency
LATE DECELERATION
Unpredictable decrease in FHR of ≥
15 beats per minute measured from the
most recently determined baseline
rate
VARIABLE DECELERATIONS
This is a sign of umbilical cord
compression probably due to
stretching of cord, a nuchal cord,
prolapsed cord, a true knot, or it may
also be because the fetus is lying on
the cord
VARIABLE DECELERATION
decelerations of more than 15 beats per minute
measured from the most recently
determined baseline rate that last
longer than 2 or 3 minutes but less
than 10 minute
PROLONGED DECELERATION
color of amniotic fluid
CLEAR
NORMAL
color of amniotic fluid
YELLOW
STAINING
color of amniotic fluid
GREENISH
MECONIUM
2 Ways of Monitoring Uterine Contractions
a. Manual Palpation
b. Cardiotocography
It tells how strong is the contraction
INTENSITY
INTENSITY
a. Easily pressed- mild
b. Firm- Moderate
c. Hard as a board- severe
start of contraction to start
of the next contraction.
FREQUENCY
start of contraction to end of
each contraction
DURATION
end of contraction to start of
another contraction
INTERVAL
VAGINAL/ INTERNAL EXAM
____________ first
Every __ hours.
BED: _____________ Position
DR BED:_____ Position
Abdominal examination
4
Dorsal Recumbent
Lithotomy
Touch the cervix. Note for:
1.
2.
3.
- CONSISTENCY
- DILATATION
- EFFACEMENT
Nitrazine paper test:
When the
Nitrazine paper turns blue-green or gray to deep blue
AMNIOTIC FLUID HAS PASSED THROUGH THE VAGINA
Fern Test:
Amniotic fluid will show a fern pattern
DRIED AND EXAMINED IN THIS WAY
_____ is the opening of the cervix
DILATION
Cervical Dilation Scale
Index finger =1 cm
Middle finger =1.5 cm.
Both enter cervix =2.5 to 3 cm.
Double the width of the 2 fingers =5 to 6 cm.
Four times = 10 cm
It is the Thinning of the cervix
EFFACEMENT
Effacement Scale
Prelabor = 2 to 2.5 cm thick
1 cm thick = 50% effaced
Tissue paper thin = 100% effaced
Cephalic Presentation
head is sharply flexed (good attitude)
- parietal bones or the space in b/n the fontanelles (vertex) presents
- suboccipitobregmatic diameter
VERTEX
Cephalic Presentation
Head is moderately flexed (Moderate attitude)
-brow or sinciput presents
-occipitofrontal diameter = 11- 12 cm
BROW
Cephalic Presentation
fetus has extended the head (Poor attitude)
- face presents
- Supraoccipitomental diameter = 13.5 cm
FACE
Cephallic Presentation
Fetus has completely hyperextended (Very Poor
Attitude)
- Chin presents
- Occipitomental diameter
MENTUM
Breech Presentation
both the buttocks and the
tightly flexed knees present (good
attitude)
COMPLETE
Breech Presentation
Buttocks only (moderate
attitude)
FRANK
Breech Presentation
neither the thighs nor the
lower legs are flexed
FOOTLING (Single footling or Double Footling)
presenting part is usually one of the 2
shoulders (acromion process), an iliac
crest, a hand, or an elbow
SHOULDER PRESENTATION
0 Station
ENGAGEMENT
the
presenting part is at the
perineum and can be seen if
the vulva is separated
(crowning)
+3 OR +4 STATION
Relationship of the presenting part to a
specific quadrant of a woman’s pelvis
FETAL PRESENTATION
Four Quadrants:
- Right anterior
- Left anterior
- Right posterior
- Left posterior
4 Part of the Fetus used as landmarks:
O= OCCIPUT
M= MENTUM
Sa= SACRUM
A= ACROMION PROCESS
Tool for monitoring the progress of
labor
PARTOGRAPH
Guides birth attendant to identify
women whose labor is delayed and
therefore decide on appropriate actions
PARTOGRAPH
