NCMA 217 RLE (LABOR AND DELIVERY) Flashcards by Juls

PRELIMINARY SIGNS OF LABOR

LIGHTENING
SUDDEN WEIGHT LOSS
INCREASE ACTIVITY LEVEL
BRAXTON HICK’S CONTRACTION
RIPENING OF THE CERVIX
SHOW/BLOOD SHOW
RUPTURE OF MEMBRANE

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TRUE LABOR AND FALSE LABOR

Frequency of contractions Irregular

FALSE LABOR

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TRUE LABOR AND FALSE LABOR

Frequency of contractions Regular

TRUE LABOR

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TRUE LABOR AND FALSE LABOR

Intensity of contractions
no increase

FALSE LABOR

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Intensity of contractions
Increases

TRUE LABOR

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TRUE LABOR AND FALSE LABOR

Pain relief
Pain is relieved by
walking

FALSE LABOR

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TRUE LABOR AND FALSE LABOR

Pain relief
Pain is intensified by
walking

TRUE LABOR

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TRUE LABOR AND FALSE LABOR

Pain location
Confined on abdomen

FALSE LABOR

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TRUE LABOR AND FALSE LABOR

Pain location
Begins on lower back and
radiates to abdomen

TRUE LABOR

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TRUE LABOR AND FALSE LABOR

Cervical Changes
No cervical changes

FALSE LABOR

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TRUE LABOR AND FALSE LABOR

Cervical Changes
Effacement and dilation

TRUE LABOR

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DURATION OF LABOR

*14 HOURS
BUT NOT
MORE THAN
20 HOURS

*PRIMIPARA:

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DURATION OF LABOR

*8 HOURS BUT
NOT MORE
THAN 14
HOURS

*MULTIPARA:

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Factors affecting Labor & Delivery:
5 P’s OF LABOR

*PASSENGER (FETUS)
*PASSAGEWAY
*POWER
* PSYCHOLOGICAL RESPONSE
*PLACENTAL FACTOR

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A. PASSENGER (FETUS)

MENTUM (CHIN)
SINCIPUT
VERTEX
OCCIPUT

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OCCIPITOFRONTAL

12CM

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OCCIPITOMENTAL

13.5CM

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SUBOCCIPITOBREGMATIC

9.5CM

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B. PASSENGER (FETUS)

OCCIPUT
BIPARETAL
VERTEX
SINCIPUT

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BIPARIETAL

9.25CM

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C. PASSENGER (FETUS)

ANTERIOR FONTANELLE
POSTERIOR FONTANELLE
LAMBDOIDAL SUTURE
SAGITTAL SUTURE
CORONAL SUTURE
METOPIC SUTURE

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PASSAGEWAY

CALDWELL-MOLOY PELVIC TYPES

GYNECOID
PLATYPELLOID
ANDROID
ANTHROPOID

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CALDWELL-MOLOY PELVIC TYPES

ROUND

GYNECOID

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CALDWELL-MOLOY PELVIC TYPES

OVAL

PLATYPELLOID

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# CALDWELL-MOLOY PELVIC TYPES WEDGE

ANDROID

# CALDWELL-MOLOY PELVIC TYPES OVAL-LONG

ANTHROPOID

# INLET Anterior-Posterior (AP)

11cm

# INLET Transverse

13cm

# INLET Diagonal

12cm

# Cavity Anterior-Posterior (AP)

12cm

# Cavity Transverse

12cm

# Cavity Diagonal

12cm

# Outlet Anterior-Posterior (AP)

13cm

# Outlet Transverse

11cm

# Outlet Diagonal

12cm

POWER

BEFORE LABOR 0% EFFACEMENT EARLY EFFACEMENT 30% COMPLETE EFFACEMENT 100% COMPLETE DILATION

PLACENTAL FACTOR

NORMAL PLACENTA PLACENTA PREVIA

FOUR STAGES OF LABOR

* 1ST STAGE (DILATATION STAGE) * 2ND STAGE ( EXPULSION STAGE) * 3RD STAGE (PLACENTAL STAGE) * 4TH STAGE (RECOVERY STAGE)

begins with the onset of true uterine contractions and ends when the cervix is fully dilated.

DILATATION STAGE

# DILATATION STAGE THREE (3) PHASES

- LATENT 0 - 3 CM DILATED - ACTIVE 4 - 7 CM DILATE - TRANSITION 8 - 10 CM DILATED

# DILATATION LATENT

0-3CM

# DILATATION ACTIVE

4-8cm

# DILATATION TRANSITION

8-10cm

# FREQUENCY LATENT

q 5-10mins

# FREQUENCY ACTIVE

q 3-5 min

# FREQUENCY TRANSITION

q2-3min

# DURATION LATENT

20-40 secs

# DURATION ACTIVE

30-60 secs

# DURATION TRANSITION

60-90 secs

# INTENSITY LATENT

MILD

# INTENSITY ACTIVE

MODERATE

# INTENSITY TRANSITION

STRONG

# MOTHER'S BEHAVIOR LATENT

Apprehensive, excited but can communicate

# MOTHER'S BEHAVIOR ACTIVE

Fear of losing control of herself

# MOTHER'S BEHAVIOR TRANSITION

Sudden behavioral or mood changes usually accompanied by hyperesthesia

# NURSING CARE LATENT

Encourage walking to shorten the 1st stage of labor, Chest breathing, Encourage to void every 2-3hrs

# NURSING CARE ACTIVE

Medication redied Assess vital signs, progress of labor

# NURSING CARE TRANSITION

Tired Restless Apply sacral pressure

Relationship of the presenting part to the ischial spine and denoted in centimeters

ASSESSING FETAL ENGAGEMENT AND STATION

FETAL PRESENTATION

VERTEX PRESENTATION MILITARY PRESENTATION BROW PRESENTATION FACE PRESENTATION COMPLETE FLEXION MODERATE FLEXION POOR FLEXION (EXTENSION) FULL EXTENSION SHOULDER COMPOUND

BREECH PRESENTATION

FRANK COMPLETE KNEELING INCOMPLETE FOOTLING

FETAL PRESENTATION

RIGHT OCCIPITOPOSTERIOR (ROP) RIGHT OCCIPUT TRANSVERSE (ROT) RIGHT OCCIPITOANTERIOR (ROA) LEFT OCCIPITOPOSTERIOR (LOP) LEFT OCCIPUT TRANSVERS (LOT) LEFT OCCIPITOANTERIOR (LOA)

most common and favorable birthing position

LOA

most common malposition and most painful as well.

LOP and ROP

FETAL LIE

OBLIQUE LIE LONGITUDINAL LIE TRANSVERSE LIE

# NURSING MANAGEMENT If the client complains of headache,

take the blood pressure

# NURSING MANAGEMENT Encourage the client to

bathe

# NURSING MANAGEMENT Allow the mother to eat

crackers or sip of water or NPO as doctor’s order. ## Footnote Observe aspiration precaution

# NURSING MANAGEMENT Provide

perineal care

# NURSING MANAGEMENT Encourage the mother to

maintain left lateral position

# NURSING MANAGEMENT Monitor

fetal heart tone

which encompasses the actual birth, begins when the cervix is fully dilated and ends with the delivery of the fetus.

EXPULSION/DELIVERY OF THE BABY

CARDINAL MOVEMENTS / MECHANISM OF LABOR

D - DESCENT F - FLEXION IR - INTERNAL ROTATION E - EXTENSION ER - EXTERNAL ROTATION E - EXPULSION

ONSET OF LABOUR FLEXION INTERNAL ROTATION OF HEAD EXTENSION EXTERNAL ROTATION OF HEAD UTERUS IMMEDIATELY AFTER BIRTH

BULGING OF THE PERINEUM

A. ANTEROPOSTERIOR SLIT B. OVAL OPENING C. CICULAR SHAPE D. CROWNING

EPISIOTOMY (PERINEOTOMY)

MIDLINE INCISION MEDIOLATERAL INCISION

This is a birthing manoeuvre for delivering fetal head in second stage of labor without use of episiotomy.

RITGEN’S MANEUVER

This involves suturing the injured tissue to promote healing and restore the normal anatomy of the perineum. The procedure is typically performed immediately after delivery, using absorbable stitches that dissolve over time. Proper care and hygiene are essential during recovery to prevent infection and ensure proper healing.

EPISIORRHAPHY

DEGREE OF PERINEAL LACERATION

FIRST DEGREE PERINEAL TEAR SECOND DEGREE PERINEAL TEAR THIRD DEGREE PERINEAL TEAR FOURTH DEGREE PERINEAL TEAR

begins immediately after the neonate is delivered and ends when the placenta is delivered

PLACENTAL STAGE

SIGNS OF PLACENTAL SEPARATION

* Rising of fundus * CALKIN'S SIGN * SUDDEN GUSH OF BLOOD * LENGTHENING OF THE CORD * CONTROLLED CORD TRACTION WITH COUNTER TRACTION(CCTCT)

TYPES OF PLACENTAL SEPARATION

SCHULTZ DUNCAN ## Footnote Cotyledons 16-20

begins after delivery of the placenta and the 1st four hours after delivery.

RECOVERY STAGE

# NURSING INTERVENTION *Monitor vital signs every

15mins for 1 hour and every 30mins until the client transferred to the ward

# NURSING INTERVENTION *Monitor

vaginal bleeding

# NURSING INTERVENTION *Monitor if the

uterus is contracted

# NURSING INTERVENTION Observe the

episiorraphy site

# NURSING INTERVENTION *Monitor the baby’s

vital signs

NCMA 217 RLE (LABOR AND DELIVERY) Flashcards

(88 cards)