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68wm6 p2 Car Lab Bir
Nursing Care During Labor and Birth
| Question | Answer |
|---|---|
| What are the traditional labor practices of Southeast asia (China, Japan, Korea)? | *Father usually is not present *Stoic response to pain *Side-lying position preferred |
| What are the traditional labor practices of Laos? | *Squat for birth *Prefer female attendants |
| What are the traditional labor practices of India? | *Natural childbirth methods used *Female relatives present as caregivers |
| What are the traditional labor practices of Iran? | *Father not present *Female caregivers and support people present at birth |
| What are the traditional labor practices of Mexico? | *Stoic about pain until second stage *Father and female relatives present |
| What are the traditional labor practices of American Indians? | Bury placenta for good luck. |
| What are the advantages of traditional hospital settings for birth? | *Safe *All emergency equipment and personnel are available |
| What are the disadvantages of traditional hospital settings for birth? | *Impersonal *Multiple moves (up to 4) create discomfort and separate mom and baby *Medically oriented *Visitors are limited |
| What are the advantages of Labor, Delivery and Recovery (LDR) settings for birth? | *Normal uncomplicated labor, delivery and recovery is in the same room *The rooms are home-like and comfortable *The significant other and family members are allowed in the room. |
| What are the disadvantages of Labor, Delivery and Recovery (LDR) settings for birth? | *Technical aspects *Less equipment |
| What are the advantages of Free-Standing Birth Centers? | *Less technical *Less expensive |
| What are the disadvantages of Free-Standing Birth Centers? | Most are not equipped to handle obstetric emergencies |
| What are the Guidelines for Reporting to a Birthing Facility? | *Contractions 5 minutes apart for 1 hour for first labor *Contractions 10 minutes apart for 1 hour for second and subsequent labors *Ruptured membranes *Bleeding other than bloody show *Decreased fetal movements *Other concerns. |
| What are the characteristics of true labor? | Contractions are regular, closer together, stronger, and last longer *Contractions start in lower back and then travel. *Contractions cannot be stopped *The cervix softens, effaces and dilates *The fetus descends into the pelvis |
| What are the characteristics of false labor? | *Contractions: Rarely follow a pattern, Vary in length and intensity, stop with ambulation and position changes, and eventually stop with relaxation interventions. *Cervix does not change *No significant change in fetal position |
| What is the average Fetal Heart Rate (FHR)? | 110-160 beats/min with 5-15 beat fluctuations |
| How are ruptured membranes confirmed? | *Nitrazine paper *Fern test |
| What are contractions assessed for? | frequency, duration and intensity |
| What are the 'Four Ps'? | *Powers *Passage *Passenger *Psyche |
| In the Four Ps: Components of the Birth Process, what is Powers? | uterine contractions which cause the cervix to open and that propel the fetus downward through the birth canal |
| What are the primary powers? | Coordinated uterine contractions with the effects of Cervical Effacement (thinning) and Cervical Dilation |
| What are the secondary powers? | Bearing down efforts of the woman which add to the power of the expulsive forces but have no effect on cervical dilation |
| What are hypertonic contractions? | *Less than 2 mins apart *Longer than 90-120 secs *Intervals shorter *Incomplete relaxation of the uterus |
| In the Four Ps: Components of the Birth Process, what is Passage? | Anatomy and Physiology of the birth canal and the effects of birth on it |
| In the Four Ps: Components of the Birth Process, what is Passenger? | The child, placenta, and membranes |
| What is the ideal position of the fetus for birth? | Head down, back is bowed outward, chin touches the sternum and arms are crossed on the chest with thighs flexed onto the abdomen (Fetal position with arms and legs crossed) |
| In the Four Ps: Components of the Birth Process, what is Psyche? | *Crucial part of childbirth *Marked anxiety and fear decrease a woman’s ability to cope with pain in labor *Catecholamines inhibit uterine contractions and divert bloodflow from the placenta. |
| What is the only Fetal Heart Rate Assessment method possible if the mother is using a whirlpool or shower during labor, and is the method used with home deliveries? | Intermittent auscultation |
| What are the advantages of Continuous Electronic Fetal Monitoring (EFM)? | *Allows the nurse to collect more data about the fetus than intermittent auscultation *Written recording that becomes part of the mother’s chart *Show how fetus responds in labor *Allows one nurse to observe two laboring women |
| What is external fetal heart monitoring done with? | Doppler transducer |
| What internal Continuous Electronic Fetal Monitoring (EFM) detects electrical signals from fetal heart by penetrating scalp? | Fetal Spiral Electrode (Requires ruptured membranes) |
| On the labor monitoring paper, where is the fetal heart rate and contractions located? | FHR is recorded on the upper grid of the paper, Contraction pattern is recorded on the bottom grid |
| What is the first intervention to correct a rapidly accelerated/decelerated fetal heart rate during labor? | Repositioning the mother |
| This type of fetal heart rate decreases with a contraction and always returns to the baseline by the end of the contractions. They are caused by fetal head compression. What kid of fetal heart rate pattern is this? | Early decelerations |
| What is acceleration and what does it indicate? | : an abrupt, temporary increase in rate by at least 15 beats/min lasting for at least 15 seconds. They suggest a fetus that is well oxygenated |
| What do variable decelerations indicate? | that the umbilical cord is being compressed, often because of a cord around the fetal neck or low amniotic fluid. |
| What are variable decelerations? | do not have a uniform appearance: their shape, duration and degree of fall below baseline rate vary. They begin and end abruptly (within 30 sec) they may be V, W, or U-shaped Do not always exhibit a consistent pattern in relation to contractions |
| What do late decelerations indicate? | deficient exchange of oxygen and uteroplacental insufficiency |
| What FHR changes require no intervention other than continued observation? | Accelerations and early decelerations |
| When does the 'First Stage: Dilation' begin? | with the onset of contractions until full dilation of the cervix (10cm) |
| What is the longest stage of labor? | Dilation (averaging 10 to 12 hours for the nullipara and 6-8 hours for the multipara) |
| What is the first phase of dilation and what can be expected? | Early Latent Phase (0-3cm), Contractions mild and infrequent, Woman sociable & excited; cooperative but anxious, Pain is usually mild |
| What is the second phase of dilation and what can be expected? | Mild/Active Phase (4-7cm), Complete effacement, Contractions moderate to firm every 3-5 mins, Woman less sociable, turns inward, May ask for pain medication |
| What is the third phase of dilation and what can be expected? | Transitional Phase (7-10cm), Shortest phase. Contractions firm; q2-3min & lasting up to 80 seconds. Woman may become uncooperative & hostile, feeling of losing control |
| When does the 'Second Stage: Delivery' begin? | Full dilation to birth |
| How long does delivery usually last? | 30 mins to 2 hours nullipara; 20-90 mins multiparas |
| When does the 'Third Stage: Delivery of the placenta' begin? | Begins with delivery of baby and ends with delivery of the placenta |
| What is the average time of the third stage of childbirth? | Average time is 5 to 20 minutes |
| What is the fourth stage of the process of childbirth? | Stabilization (2-4 hours following birth) |
| When is APGAR monitored? | at 1 and 5 minutes after birth |
| Within how long after childbirth must a complete assessment be done? | Within 1 hour |
| What is precipitous labor? | Labor that is completed in less than 3 hours |
| What are the fetal risks of precipitous labor? | *Hypoxia resulting from decreased periods of uterine relaxation between contractions *Intracranial hemorrhage *Nerve damage *Low apgar score |
| What are the maternal risks of precipitous labor? | *Uterine rupture *Postpartum hemorrhage *Abruptio placentae can be associated with precipitate labor |
| What is precipitous birth? | Birth that occurs unexpectedly, with no trained birth attendant present. Precipitous birth may occur after a labor of any duration |
Created by:
Shanejqb
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