I'm Labor!?!?
Initial assessment findings consistent with labor:
• Pain = 8 on a scale of 0–10, woman breathing heavily with contractions
• Blood pressure = 112/78 mm Hg
• Apical pulse = 80 beats/min
• Temperature = 37.2°C (98.9 °F)
• Oxygen saturation = 98% on room air
• Fetal heart rate = 145 beats/min with accelerations noted
• Uterine monitoring = contraction frequency every 4 min, lasting 60 s and strong on palpation
• Cervical examination = 6 cm/75%/−1 LOA
What is a_________________________?
Pain = 8 on a scale of 0–10, woman breathing heavily with contractions
Uterine monitoring = contraction frequency every 4 min, lasting 60 s and strong on palpation
Cervical examination = 6 cm/75%/−1 LOA
Forces that cause the cervix to open and push the fetus through the birth canal
Powers
Bonus points: What are the two powers?
Catecholamine secretion
What is_________________magnifies pain perception, muscle tension increases, the effectiveness of uterine contractions, potentially resulting in reduced effectiveness of the pain relief measures being used?
A pregnant women who present with contractions or who may be in labor are considered unstable and must be assessed, stabilized, and treated at the hospital where they present regardless of their insurance status or ability to pay
What is the Emergency Medical Treatment and Active Labor Act (EMTALA)?
The patient is admitted in the latent phase of labor.
What is 0-5cm or the onset of contractions to the beginning of the active phase?
Lightening, backache, cervical ripening (softens), and weight loss of 1 lb
What are signs of preceding labor?
Consists of the mother's bony pelvis and the soft tissues of her pelvis and perineum
Passageway
Pelvic examinations, being connected to a fetal monitor, and experiencing pain in the pelvic region may trigger increased pain and anxiety in women with a history of sexual abuse
What is risk for retraumatization?
Used to rule out spontaneous rupture of membranes
What are nitrazine paper, fern test, vaginal pooling on speculum exam or amnisure?
2 hours after birth
What is the fourth stage?
Two findings that require immediate follow-up.
1. No change in dilation and 100% effacement
2. Woman alone in the labor and birth unit
3. Client concern that nothing is happening
4. Fetal heart rate of 140 to 156 BPM with accelerations
5. Uterine contractions every 3 minutes lasting 50 seconds
What is___________________?
Woman alone in the labor and birth unit
Client concern that nothing is happening
Passenger
During an assessment the woman tells the nurse that she is feeling intense pain in her back and does want to medicated.
What care will the nurse provide to this woman? Select all that apply.
What is___________________
repositioning, acupressure, hydrotherapy, music, aromatherapy TENS,etc.
The patient has had an arrest of fetal descent, foul-smelling discharge, and maternal temp of 100.4.
What are signs of potential complications?
Expulsion of the placenta
Third stage
The head is deflected anteriorly or posteriorly in the pelvis. This is called_______________ and can cause_________________________________.
What is asynclitism and cephalopelvic disportion?
Maternal ________ has a significant impact on the progress of labor
Position
IV fluid bolus
Left lateral positioning
Notify anesthesia health care providers
Anticipate IV vasopressor previous measures have been ineffective
What are nursing interventions for hypotension post epidural procedure?
Post-epidural procedure, the patient in labor is unable to void spontaneously.
What is catheterization with foley or per unit protocol?
Patient may appear apprehensive
Active part of the first stage 6-10 cm
Two effects of contractions on the cervix
What are effacement and dilation?
Childbirth is more than a physical process. It involves the woman's whole being, including perception, birth expectations, and preparations.
Psyche
Regarding safety and side effects of IV opioid medication are correct. Select all that apply.
A. May continue to ambulate after receiving IV pain medications.
B. Opioids rarely cross the placenta or affect the fetus.
C. The most serious side effect of opioids is respiratory depression.
D. The analgesic effect of opioids during labor is limited.
E. Opioids are most effective when given in the early part of active labor.
F. Opioids increase maternal heart rate and blood pressure.
What are the
The most serious side effect of opioids is respiratory depression.
The analgesic effect of opioids during labor is limited. Opioids are most effective when given in the early part of active labor.
The nurse is teaching new nurses about labor support and the benefits.
What is a shorter labor duration, decreased cesarean rates, and less pharmacological intervention
The nurse checks the patient who is now fully dilated
What is second stage or 10 cm?