MAMC exam 9 nursing care during labor & birth
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| show | small functional room for labor moved to delivery area transferred to recovery area to postpartum unit
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| show | safe
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| show | impersonal multiple moves uncomfortable for mother disrupts family's time together separate parents & infant
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| show | one setting for labor, delivery, recovery remain in LDR for 1-2 hours
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| advantages of LDR | show 🗑
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| show | family may regard technologic components as disadvantages
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| show | similar to LDR not transferred to a postpartum unit after recovery
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| show | support person encouraged stays with the mother and infant sleeping equipment may be provided
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| show | designed to provide maternity care to low-risk women outside the hospital setting birth often by certified nurse midwife
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| show | less expensive safe and home-like setting for low-risk
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| show | not equipped for major obstetric emergencies
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| show | keeps family together in own environment
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| show | long transfer time to hospital in an emergency
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| guidelines for reporting to a birthing facility | show 🗑
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| contraction guidelines for reporting | show 🗑
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| show | important for l&d shapes values, their expectations of birth & response to it knowledge provides framework to assess & care for woman & family
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| show | father usually not present stoic response to pain side-lying position preferred
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| show | squat for birth prefer female attendants
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| show | natural childbirth methods used female relatives present as caregivers
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| show | father not present female caregivers & support people present at birth
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| show | stoic about pain until 2nd stage father & female relatives present
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| show | bury placenta for good luck
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| show | cervix thins & dilates supine hypotension depth & resp rate increase, hyperventilation may occur reduced sensation of a full bladder decreased GI motility may result in N/V clotting factors increased even higher
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| show | placental circulation - compression by uterine muscle, the maternal supply to placenta decreases cardiovascular - reflect normal labor effects or suggest fetal intolerance pulmonary - lung fluid must be cleared to allow normal breathing after birth
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| 4 Ps: components of the birth process | show 🗑
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| show | involuntary uterine contractions which cause the cervix to open and that propel the fetus downward through the birth canal
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| show | responsible for effacement and dilation of the cervix
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| secondary powers | show 🗑
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| show | coordinated uterine contractions are the primary powers of labor during the first stage involuntary
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| show | effacement dilation
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| show | thinning of the cervix & is described as a percentage of the original length of the cervix
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| show | enlargement or widening of the opening of the cervix & the cervical canal. increases from less than 1cm - 10cm
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| characteristics of contractions | show 🗑
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| hypertonic contractions (tachysystole) | show 🗑
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| show | when cervix fully dilated the combination of contractions & the maternal pushing propel the baby downward through the pelvis
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| show | maternal exhaustion epidural anesthesia some women may want to push prematurely due to fetal head causing rectal pressure
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| show | bony pelvis and the soft tissue of the pelvis and perineum
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| show | false pelvis true pelvis
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| soft tissues of the passage | show 🗑
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| show | includes the fetus along with the placenta and membranes
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| fetal lie | show 🗑
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| most common fetal lie | show 🗑
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| show | relationship of fetal body parts to one another
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| ideal fetal attitude | show 🗑
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| the psyche | show 🗑
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| contractions of TRUE labor | show 🗑
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| show | cervix softens, effaces, dilates fetus descends into the pelvis
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| show | rarely follow a pattern vary in length & intensity frequently stop with ambulation & position changes & eventually stop with relaxation interventions discomfort in ABD & groin
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| show | cervix doesn't change no significant change in fetal position
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| show | fetal heart tones maternal VS presence & frequency of contractions
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| fetal condition | show 🗑
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| confirm ruptured membranes with | show 🗑
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| signs of impending birth | show 🗑
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| what to do if birth imminent | show 🗑
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| process of childbirth | show 🗑
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| stages of labor | show 🗑
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| precipitous labor | show 🗑
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| show | labor begins abruptly & intensifies quickly contractions may be frequent & intense
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| show | uterine rupture cervical/vaginal lacerations & hematoma amniotic fluid embolism postpartum hemorrhage abruptio placentae can be associated
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| fetal risks of precipitous labor | show 🗑
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| external devics for EFM | show 🗑
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| internal devices for EFM | show 🗑
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| nursing response to reassuring to monitor patterns | show 🗑
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| show | repositioning usually first response, may require several changes before pattern improves amnioinfusion may be used to increase the fluid around the fetus & cushion the cord
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| show | initially treated by measures to increase maternal oxygenation & blodd flow to the placenta - repositioning usually first IV fluid bolus of NS or LR per SOP to increase placental perfusion
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| show | O2 at 8-10L/min per SFM stop Pitocin if it's infusing treat hypertonic contractions with terbutaline if ordered notify the doctor of any non-reassuring fetal pattern
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