Factors Affecting Labor
Patients Age, Parity, pelvic size, presentation, gestational age uterine abnormalities
What is Fixed Factors affecting labor
pH Test, Pooling Ferning, Point of Care immunoassay test
What is Confirmation of Rupture of Membranes
May be used for patients who are considered to be low risk
What is Intermittent Ausculatation
Begins with onset of regular contractions and ends when completely dilated
What is first stage of labor
Initiated by injecting an anesthetic through the lateral vaginal walls. Provides vaginal, vulvar and perineal anesthesia during second stage of labor
What is Pudendal Block
progressive dilation and effacement of cervix
What is Labor
Engagement, Descent, flexion/Internal rotation
What is mechansims that take place in labor
The average rate or approximate mean fetal heart rate rounded to increments of 5 beats per min. during 10 min. segment, excluding accelerations, decelerations, and periods of marked variability.
What is baseline fetal heart rate.
Patients may have an urge to push before complete dilation caused by a Reflex in which the fetal presenting part stretches the pelvic floor muscles causing the release of endogenous oxytocin.
What is Ferguson's Reflex
Abnormal FHR Pattern requiring immediate birth, Progressive neurologic disease, Coagulation disorders, Heparin Administration within the past 12 hours or high does administered within less than 24 hours
What is Contraindications to anesthesia
Regular contractions, activity has no effect or decreases contractions disappear with sleep, no change in cervix
What is false labor
Placenta previa, unexplained vaginal bleeding, Preterm prelabor rupture of membranes
What is Cervical Exam contraindications
Irregular fluctuations along the fetal heart rate baseline represents the reactivity of fetal sympathetic and parasympathetic nervous system
What is Variability
Coached pushing with sustained breath-holding in the presence of an abnormal fetal heart rate pattern, supine lithotomy positioning, forcing the patient's legs back against their abdomen
What is Safety Risk during second stage of labor
Assessment of BP every 5min for 15 min, then in 30 min then at 1 hours. assessment of pulse and RR after initiation or rebolus, assess uterine activity and FHR every 5 min for 15 min,
What is nursing care for patients receiving epidural analgesia/ anesthesia
Oxytocin release, Cervix, uterine muscles, Decreased progesterone
What are theories of maternal factors of labor onset
Thinning and shortening of the cervix
What is Effacement and dilation
The measurement of the strength of the contractions at it's peak
Intensity
Can lead to physiologic and psychological fatigue increase the risk of structural and neuologic injury to the pelvic floor and perineum. may force the vaginal wall, bladder and supporting structures down in front of the fetal presenting part
What is prolonged strenuous bearing-down efforts that begin prior to the urge to push
Hypotension and FHR changes, such as Bradycardia and late or prolonged decelerations
What is side effects of local anesthetics
Power Passage, Position, Psychology, passenger
What is five P'S affecting Labor
Takes place as the fetal head continues to descend from the pelvic inlet through the midpelvis to the pelvic outlet.
What is internal rotation
Not predictive of abonormal fetal acid-base status
Category II (indeterminate) fetal status
Begins at 5-6cm dilation and is marked by more rapid dilation and increased rate of fetal descent
What is Active Phase of Labor
A key element of helping patients manage pain and discomfort of labor and the use of breathing and relaxation techniques
What is LABOR SUPPORT