Labor And Delivery (R-cher) Flashcards
Beginning of contraction, ends when cervix is dilated to 10cm.
(first stage of labor)
0-6cm
Slower and prdictable
Latent Stage
6-10 cm dialtion
Contractions are more predictable with cervical changes
Active phase
Stage when crvinx is dilated to 10cm and ends when the baby is fully dilated.
7 cardinal movements in this stage: engagement, decent, flexion, internal rotation, extension, external rotation, and expulsion.
This is the oushing stage, typically 3 hour for nulliparous women and up to 2 hours for multiparous women.
Second Stage
Placenta is attaching in the birth canal. Can lead to death.
Major symptoms is PAINLESS but there is bright red bleeding!!! Painless because cervix has few nerve endings. Bright red fresh blood!
(Assess the bleeding)
PLACENTA PREVIA
Nursing Intervention og placenta previa
DO NOT DO vaginal exam
Monitor blood losss (pad counts, weigh bloods), bed rest, monitor baby
DO ULTRASOUND!
C-section is indicated in most cases
Placenta is where it is supposed to be but it will start to tear away fro the wall of the uterus.
Incredibly painful!!!
Incomplete(small portion tear, blood will fill opening then uterus will become firm as a rock, and will start to fell as a board - worry internal bleeed)
COmplete (massive amount of external bleeding!! Act fast)
Placental Abruption (Abruptio Placentae)
Dark red bleed. Intense pain.
Board like (internal) rigis uterus
Hypotensiom
Abruptio Placentae
Intervention of Placenta Abruption
STAT C-SECTION
Monitor bleeding (abd pain, board like
Minotor changes of fundal height. Pubis synthesis….. (36 weeks - 36 cm, however women witht this will be crazy high)
BLOOD, IV FLUIDS,
Hysterectomy as last resort. A meedical emergency
It is when the umbilical cord slips throughh the cervix and into the magina after rupture of the membranes and before the baby descends into the birth canal.
During delivery, the __________ become compressed by the presenting part of the fetus.
This cuts off oxygen to the fetus.
Prolapsed cord
What are the nrusing interventions in a prolapsed cord
- Elevate the presenting part of the fetus off of the prolapsed cord
- Keep your hand on the baby’s head lifting it up and call for help
- Positioning: kneew-to-hest position (open the pelvis), Trendelenburg - let gravity shift the baby off the cord.
- Administer oxygen
- Wrap cord in sterile moist towel
((**NEVER STTEMPT TO PUSH THE CORD BACK IN))
*Emergency C-section
Baby’s shoulders get stuck in pubic/sacrum during birth
Can lead to severe complications, including nerve injuries to the baby
Considered a medical emergency
Shoulder Dystocia
What are complications Shoulder Dystocia
Maternal: Tears/lacerations, Hemorhage, Infection, damage to nerves whoch can lead to fecal and urinary incontinence, rectovaginal fistula, uterine rupture, sepaation of the pubic bones
Fetal: BRACHIAL PLEXUS PALSY, fractures to the clavicle or humerus, Horner’s syndrome, compressed umbilical cord
Interventions for Shoulder Dystocia
H call for help!
E Evaluate for episiotomy
Legs
Pressure
Enter maneuvers
Rremove posterior arn
Roll the patient
What to do with post partum hemorrhage
Tell pt ur gonna do fundal massage….
Explain why… Funtal massage every 15 mins until fundus is firm
*estimate blood loss
Medications: Oxytocin(increases contractions to help stop bledding), Methylergonovine(ergaalcaloids, for uterus contractions, for PPH, helps deliver the placenta/ also called as after birth), blood products
