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L&D 1

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juniperk's version from 2017-11-15 05:30

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Question Answer
What is the hormone the fetus secretes to trigger the uterus to start labor?Fetus cortisol
Are Braxton Hicks contractions true or false labor? Where do they start?False labor. start in the abdomen or in the groin and spread from there.
Where do true labor contractions begin?Begins in the lower back (fundus) and gradually sweeps around to lower abdomen.
If someone is having preterm labor contractions, what is the first thing to tell them to do?Empty bladder. A full bladder is one of the biggest triggers for labor.
What are the four factors of labor in order?Passageway, Passenger, Power, and Psyche
What is the most common fetal attitude when laboring?All the joints are flexed. Fetal back is rounded, the chin is on the chest, the thighs are flexed on the abdomen, and the legs are flexed at the knees.
When is the latent phase in 1st stage of labor? How long does it last for prinip and multip?From beginning of true labor until 0-3 cm cervical dilatation. mild to moderate contraction intensity. Primip 8.5 hours and multip 5 hours
When is the active phase in 1st stage of labor? How long does it last for primip and multip?From 4-7 cm cervical dilatation. expect to see early decels. 4.5 hours for primip and 2.5 h for multip
When is the transition phase in 1st stage of labor? How long does it last for primip and multip?From 8-10 cm cervical dilatation. 3.5 hours for primip and 30 minutes for multip
What are the psychological and physical responses during latent phase of labor?•Mildly anxious, talkative •Able to continue usual activities •Contractions mild, initially 10-20 minutes apart, 15-20 seconds’ duration; later 5-7 minutes apart, 30-40 seconds’ duration
What are the psychological and physical responses during active phase of labor?•Increased anxiety •Increased discomfort •Want to be left alone •Contractions moderate to severe, 2-3 minutes apart, 60 seconds’ duration
What are the psychological and physical responses during transition phase of labor?•Anxiety, helplessness, and fear of loss of control and abandonment of the nurse •Sudden nausea, hiccups •Contractions severe, 1½ minutes apart, 60-90 seconds’ duration
When is does the 2nd stage of labor begin and end? What are the 8 cardinal movements?10 cm to delivery of the fetus. Adaptation fetus undertakes to maneuver through pelvis during labor and birth- Engagement, Descent, Flexion, Internal Rotation, Extension, Restitution, External Rotation, and Expulsion
When is does the 3rd stage of labor begin and end? Delivery of the fetus to delivery of the placenta. lasts about 30 minutes.
When is does the 4th stage of labor begin and end?2 hours after delivery of the placenta (recovery)
What is Leopold manuever?Abdominal palpations used to determine fetal presentation, lie, position, and engagement
What is the normal fetal HR in labor?Normal FHR in labor: 110 to 160 bpm
What are the normal BP pulse and temp for the mom in labor?Normal maternal BP: <140/90 • Normal maternal pulse: <100 bpm •Normal maternal temperature: <100.4° F •Slight elevation in temperature may occur because of dehydration and the work of labor. Anything higher indicates infection and must be reported immediately.
How often do you auscultate the FHR in latent labor?60 for low risk and 30 for high risk
How often do you auscultate the FHR in active labor?every 15 minutes
How often do you auscultate the FHR in transition labor?every 15 min in transition stage
When do you assess the mom during the latent stage?BP, R, and P every hour. T every 4 hours unless ruptured then every 2.
When assessing contractions, how is the frequency determined?Time contractions from beginning of one contraction to the beginning of the next (measured in minutes apart).
When assessing contractions, how is the duration determined?Time the length of the entire contraction (from beginning to end).
When assessing contractions, how is the intensity determined? Assess the intensity of strongest part (peak) of contraction.
How often do you assess BP, pulse, and FHR during 2nd stage?BP, P, R every 5 to 15 minutes. CXNs palpated continuously, FHR every 15 minutes if low risk every 5 minutes if high risk or non-reassuring. Monitor fetal descent, cardinal movements and crowning.
How dilated must the cervix be for pushing?Cervix should be completely dilated (10 cm) before the client begins pushing. If pushing starts too early, the cervix can become edematous and never fully dilate
What drug should the mom have after the placenta is delivered?Give the oxytocin (Pitocin) after the placenta is delivered because the drug will cause the uterus to contract.
When do you assess the mom during the active stage?BP, R, and P every hour. T every 4 hours unless ruptured then every 2.
When do you assess the mom during the transition stage?BP, R, and P every 30 minutes. T every 4 hours unless ruptured then every 2.
Nursing 8 intervention for 1st stageOrient to environment 2. Encourage ambulation 3. Provide comfort 4. Encourage voiding every 2 hours 5. Monitor labor progress and fetal well-being 6. Ice chips and/or clear liquids. 7. Teach, reinforce or support use of relaxation, visualization or breathing patterns. 8. Encourage rest
Length of the 2nd stage for primip and multip?Primip 3 hours Multip 30 min
Nursing 7 intervention for 2nd stage1. Position comfortably, 2. Encourage rest and relaxation between contractions.3. Comfort measures 4. Ice chips 5. Empty bladder 6. Episiotomy 7. Laceration
What does the laceration degrees mean?1st: epidermal layers, poss no bleeding, no sutures; 2nd: epidermal and muscle facia, sutures req.; 3rd: goes into sphincter. ; 4th: through the rectal wall.
How often do you assess during 3rd stage?BP, P, R every 5 minutes. Fundus maintains tone, signs of placental separation after placenta comes out then start pitocin
What are the 3 main signs of placental separation?Uterus rises up in abdomen, gush of blood, and extension of umbilical cord.
Nursing 5 intervention for 3rd stage1. Encourage mom to relax while waiting for placenta delivery. 2. Care for baby. 3. Assist parents to hold and begin attachment with baby. 4. Document placenta delivery time and EBL (md est blood loss not nurse). 5. Administer pitocin as soon as placenta delivers
How often do you assess during 4th stage?▪BP, P, R, fundus, lochia and perineum Q15 min x4, Q30 min x2-4, Q hour x 1-2
Nursing 4 implementations for 4th stage1. Assist with laceration/episiotomy repair. 2. Provide for comfort. 3. Initiate first feeding within 1st hour of life. 4. Provide fluids and food
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