Stages of labor
This stage of labor begins with the onset of regular contractions and ends with full cervical dilation (10 cm)
What is the first stage of labor?
Shoulder dystocia occurs when this part of the baby becomes stuck behind the mother’s pubic bone after the head is delivered
What is the anterior shoulder?
This complication occurs when the umbilical cord slips below or alongside the presenting part of the fetus, leading to fetal distress.
What is a prolapsed umbilical cord?
Labor pain during the first stage of labor is primarily caused by this process as the uterus contracts.
What is cervical dilation and effacement?
This is a pregnancy complication when the placenta abnormally implants in the lower segment of the uterus causing painless, bright red bleeding.
What is Placenta Previa.
The first stage of labor is divided into three phases. Name them in order.
What are the latent (early), active, and transition phases?
This is the classic warning sign during delivery that may indicate shoulder dystocia, when the baby’s head retracts tightly against the perineum after birth.
What is the “turtle sign”?
This complication is characterized by sudden, intense uterine contractions, loss of fetal station, and abdominal pain, often in women with a previous cesarean birth.
What is a uterine rupture?
During the second stage of labor, pain is primarily caused by this type of physical sensation as the baby descends through the birth canal.
What is somatic pain from stretching and distension of pelvic tissues and the perineum?
This is an infection that can occur during pregnancy and if passed to a fetus can cause complications such as Pre-term birth, sepsis or meningitis.
(It's an expected part of the vaginal flora in nonpregnant clients).
What is Group-B Strep
During this stage of labor, the cervix is fully dilated and the mother pushes until the baby is born.
What is the second stage of labor?
The first nursing action when shoulder dystocia is suspected is to do what
What is call for help (activate the obstetric emergency team) and perform the McRoberts Maneuver (and Subrapublc Pressure)
A fetal heart rate tracing showing late decelerations and absent variability may indicate what type of complication?
What is fetal hypoxia or fetal distress?
This nonpharmacologic pain relief method involves rhythmic breathing, focusing, and relaxation techniques to promote comfort during contractions
What is Lamaze or patterned breathing?
These are the infections that make up the TORCH acronym (They pass via the placenta and can have teratogenic effects on the fetus).
What is:
T: Toxoplasmosis
O: Other infections (Hep A, B, Syphillis, Parvo, Varicella)
R: Rubella (German Measles)
C: Cytomegalovirus (Herpes virus family)
H: HSV (Herpes Simplex Virus)
The third stage of labor begins and ends with what two key events?
It begins with the birth of the baby and ends with the delivery of the placenta
Name two maneuvers commonly used to relieve shoulder dystocia.
What are the McRoberts maneuver (hyperflexing the mother’s thighs to her abdomen) and suprapubic pressure (applying pressure above the pubic bone to dislodge the shoulder)?
This emergency occurs when amniotic fluid enters the maternal circulation, leading to respiratory distress, hypotension, and possibly lead to DIC
What is an amniotic fluid embolism?
This type of regional anesthesia blocks pain from the umbilicus to the thighs but may cause maternal hypotension and decreased fetal heart rate if not managed properly.
What is an epidural block?
In the VEAL Chop acronym, what does the VEAL stand for?
What is:
V: Variable Decels
E: Early Decels
A: Accelerations
L: Late Decels
The fourth stage of labor is a period of maternal recovery. What are the two main nursing priorities during this stage?
Monitoring for postpartum hemorrhage and promoting maternal-newborn bonding.
What are two major neonatal complications associated with shoulder dystocia?
What are brachial plexus injury (Erb’s palsy) and clavicle fracture (also acceptable: hypoxia or humerus fracture)?
During labor, the nurse notes that the fetus is in a breech position. What are two key nursing priorities when managing this complication?
What are continuous fetal heart rate monitoring and preparing for possible cesarean delivery (also acceptable: avoid vaginal manipulation or notify provider immediately)?
Name two nursing interventions to reduce pain perception and anxiety (non-pharmacological methods) in the latent phase of labor before pharmacologic measures are used.
What are providing comfort measures such as positioning, massage, breathing techniques, guided imagery or emotional support
Two Part Question:
What does the CHOP stand for in the VEAL CHOP Acronym?
AND, what are the nursing actions for each?
What is:
C: Cord Compression: adjust the Mom's position, administer IVF, give O2 or prepare for C/S
H: Head Compression: changing the Mom's position, (turning to left side) will increase blood to the uterus, continue FHR.
O: OK/Oxygenation (continue monitoring
P: Placental Insufficiency: Most concerning! Turning Mom on side and have her bring her knees to her chest can increase blood flow, Give Oxygen via Mask, IVF and prepare for C/S