Woman in Labor (2): Signs of Preceding Labor Flashcards
The irregular painless contractions of pregnancy
BRAXTON HICKS CONTRACTIONS
The occurrence of these strong contractions, accompanied by engagement and descent of
the presenting, is referred to as ________
PRE-LABOR
is the setting of the presenting part in the pelvic brim or inlet. It occurs about two weeks before labor onset in primiparas and just before or during labor in multiparas.
LIGHTENING
Is when the head is still movable above the pelvic inlet on palpation.
FLOATING
Is the descent of the biparietal plane of the fetal head to a level below that of the pelvic inlet.
ENGAGEMENT
During pregnancy, the consistency of cervix is likened to an earlobe and it becomes butter-soft during labor.
RIPENING OF THE CERVIX
Is the descent of the fetal head to the inlet to a level that it can no longer be moved.
FIXATION
It is caused by the pressure of uterine
contractions and dilatation of the cervix. It is signified by a gush or steady trickle of clear fluid from the vagina.
RUPTURE OF MEMBRANES
About two weeks before labor, the woman experiences sudden
weight loss of _____ to ______ that is a result of a decline in progesterone level.
2-3 POUNDS
When the cervix dilates, this blood tinged mucus is dislodged from the cervical canal
SHOW
What are the signs of preceding labor?
- Increased Braxton-Hicks contractions
- Lightening
- Floating
- Engagement
- Fixation
- Ripening of the cervix
- Increased level of activity
- Weight loss
- Show
- Rupture of membranes
Its purpose is to assess status of amniotic fluid, consistency of
cervix, effacement, dilatation, presentation, station
and obtain pelvic measurement.
INTERNAL EXAMINATION (IE)
when the lowermost portion of the presenting part is at the
level of inlet spines, it is ___ cm station
4 cm
Nurses should not perform IE if?
the patient is bleeding during labor or has a history of bleeding during pregnancy.
when the presenting part is the perineum, it is __ cm station
+3cm
The period from the onset of true labor contractions until full
cervical dilation and effacement is achieved.
FIRST STAGE OF LABOR / CERVICAL STAGE
Two important events take place during the first stage labor
> CERVICAL DILATATION
EFFACEMENT
1st stage of labor: duration for PRIMIPARA & MULTIPARA
10-12 hrs (PRIMI)
6-8 hrs (MULTI)
The first stage of labor is divided into 3 phases:
- LATENT
- ACTIVE
- TRANSITIONAL
Which refer to the shortening of the cervical canal from a length of about 1 to 2 cm until it is paper thin.
CERVICAL EEFACEMENT
As intensity of contractions become stronger and start to cause pain
and much discomfort, the woman prefers to stay in bed.
ACTIVE PHASE
Refers to the enlargement or widening of the cervical canal.
CERVICAL DILATATION
This is a reflex where uterine contraction causes dilatation by pulling the cervix over the presenting part.
FERGUSON REFLEX
Uterine contractions at this time are mild and short, causing only
minimal discomfort. As such, the client will still feel comfortable
walking around and sitting.
LATENT PHASE
It is not contraindicated during the
latent phase but discouraged because it
can prolong this phase of labor.
ANALGESIA-latent phase
2nd Stage Labor: duration for PRIMI & MULTI
30 min - 2 hrs (PRIMI)
20-90 min (MULTI)
This is the most difficult period for the woman because this is the time when she experiences the most discomfort. The woman may feel discouraged and ask the nurse repeatedly when labor
will end.
TRANSITION PHASE
This occurs from full cervical dilatation until the birth of the baby. The main event of this period is the birth of the baby
SECOND STAGE OF LABOR / EXPULSIVE STAGE
A surgical incision of the perineum that is made to prevent tearing of the perineum and to release pressure on the fetal head.
EPISIOTOMY
An incision through the skin and muscles in the perineum, made during a vaginal delivery.
EPISIOTOMY
In the second stage of parturition, the
baby is expelled from the womb
through the vagina by both the uterine
contractions and by the additional
maternal efforts of pushing or “bearing
down”.
DELIVERY
When the head is first visible, it is called _________
CROWNING
Pressure is applied to the fetal chin
through the perineum at the same
time pressure is applied to the
occiput of the fetal head. This
action aids the mechanism of
extension as the fetal head comes
under the symphysis.
RITGEN MANEUVER
When the amniotic sac has not ruptured during labor or pushing, the infant can be born with the membranes intact.
This is referred to as _____
“being born in the caul”.
While the infant is in skin-to-skin contact on the mother’s abdomen, the attendant doubly clamps the umbilical cord.
CORD CLAMPING
This is the period from delivery of the baby to the expulsion of the placenta. Main event is the expulsion of placenta
THIRD STAGE OF LABOR / PLACENTAL STAGE
3RD STAGE: duration of labor for PRIMI & MULTIPARA
PRIMI: 5-20 mins
MULTI: 5-20 mins
2 Methods of placental separation
- SHULTZ MECHANISM
- DUNCAN MECHANISM
In this mechanism of placental separation:
⮚ Separation of the placenta starts from the center.
⮚ The shiny and smooth fetal side is delivered first
SHULTZ MECHANISM
In this mechanism of placental separation:
⮚ Separation begins from the edges of placenta.
⮚ The maternal side is delivered firsts.
DUNCAN MECHANISM
What do you call the management method of Third Stage Labor
AMTSL: Active Management of Third Stage Labor
How do you do the AMSTL?
- Administer Oxytocin (10 IU, IM)
- Controlled cord traction
- Uterine massage
- Cord clamping
Alternative of Oxytocin if not available
ERGOMETRINE 0.2. mg IM
Uterine massage should be repeated every _____
15 mins for first 2 hrs
It is the first sign of placental separation
CALKIN’S SIGN
It is employed If the uterus remains contracted and there is no severe bleeding,
WATCHFUL WAITING
These are drugs that stimulate the uterus to contract and to prevent bleeding
OXYTOCIC AGENTS
The period from delivery of placenta until the condition of the woman has stabilized.
4TH STAGE OF LABOR
The main danger during the fourth stage _____
HEMORRHAGE
Primary PPH occurs when?
<24 HRS
Secondary PPH occurs when?
> 24 HRS UNTIL 6 WKS OF BIRTH
4T’s of Primary PPH
> TONE
TRAUMA
TISSUE
THROMBOSIS
4T’s and its specific causes
- Tone - atonic uterus
- Trauma - lacerations, hematomas, rupture
- Tissue - retained tissue
- Thrombosis - coagulopathies
Uterotonics are routinely given during ))) stage of labor, in all births
3RD STAGE
It is the repair of episiotomy and laceration
EPISIORAPHY
Uterine flow consisting of blood, fragments of decidua, WBC, mucus, and some bacteria
LOCHIA
For the first 3 days, the lochia discharge is mainly red color
LOCHIA RUBRA
The lochia discharge on the fourth day that is pink or brownish
LOCHIA SEROSA
Lochia discharge on the 10th day that has a decreased flow and color becomes colorless or white
LOCHIA ALBA