T2- Stages of Labor

Question 1

What is the goal of stage 1 labor?

Answer 1

Dilation of cervix; descent of fetus

Question 2

How much is the cervix dilated in the latent phase of stage 1 labor?

Answer 2

0-3 cm

Question 3

Latent phase UC:
Frequency?
Duration?
Intensity?

Answer 3

Frequency: q5-30 min
Duration: 10-30 seconds
Intensity: Mild-moderate

Question 4

What is the client like in the latent phase of stage one labor?

Answer 4

Happy; excited and apprehensive; need for independence; attempts to care for own needs; uses focusing and relaxing techniques; seeks info about care

Question 5

When do we monitor VS?

Answer 5

In between contractions

Question 6

During the latent phase of stage one labor, how often are VS taken?

Answer 6

BP, P, R on admission and then q hour and PRN

*after regional anesthesia every 5 min for first 20 min, then q 30 min

Question 7

Amniotic fluid. What would normal amniotic fluid from ROM look like?

Answer 7

Clear with white specks

Question 8

What does yellow amniotic fluid indicate?

Answer 8

Fetal distress about 35 hours previously

Question 9

What does green amniotic fluid with meconium with fetus in vertex position indicate?

Answer 9

Fetal distress secondary to respiratory distress in fetus

Question 10

After membranes have been ruptured, how often do we monitor temp and why?

Answer 10

q2h; the longer the time the membranes are ruptured the more risk for infection

Question 11

If membranes rupture on our watch, what do we immediately check?

Answer 11

Fetal heart tracing for decels or variability

Question 12

How much is the cervix dilated in the active phase of stage 1 labor?

Answer 12

4-7 cm

Question 13

UC of active phase of stage 1 labor
Frequency?
Duration?
Intensity?

Answer 13

Frequency: q3-5 min
Duration: 30-45 seconds
Intensity: Moderate-strong

Question 14

What are the clients response to active phase of stage 1 labor?

Answer 14

More seriously labor oriented; concentration is inward; demanding of support person; continues to focus/relax; uses breathing techniques

Question 15

How often should we encourage the client to void?

Answer 15

q1-2 hours

Question 16

Why is it important to check the bladder for complete emptying?

Answer 16

A full bladder may impede the labor progress or result in trauma to the bladder

Question 17

When can regional anesthesia be given?

Answer 17

After contraction pattern has been established and cervix is dilated 5-6 cm

Question 18

What is the cervix dilation in the transition phase of labor?

Answer 18

7-10 cm

Question 19

Transition phase of stage 1 labor...UC 
Frequency?
Duration?
Intensity?
Station?

Answer 19

Frequency: q2-3 min
Duration: 45-90 seconds
Intensity: Strong
Station: +2 to +3

Question 20

What are some of the symptoms of the transition phase of stage 1 labor?

Answer 20

NV
Perspiration/legs trembling
Increased vaginal show

Question 21

What happens in stage 2 of labor?

Answer 21

Effacement & complete dilation to expulsion of fetus

Question 22

What is the goal of the stage 2 labor?

Answer 22

Descent to birth of a baby

Question 23

Stage 2 labor: Contractions
Frequency?
Duration?
Intensity?

Answer 23

Frequency: q 1.5-2 min
Duration: 60-90 seconds
Intensity: Strong

Question 24

What do we assess about the baby when the mom has a UC?

Answer 24

Check FHR

Question 25

When is the best time to administer meds to a mom in labor and why?

Answer 25

During a contraction so amount delivered to the fetus will be minimized; during a contraction that is a time of little placental perfusion, so giving a drug during a contraction limits the amount the receive would receive inutero

Question 26

If we give maintenance dose of meds, when do we check the VS?

Answer 26

Monitor VS after each maintenance drug of medication

Question 27

What do we do if hypotension occurs to the mother in labor?

Answer 27

``` Increase IV fluids Turn off pit Begin O2 by face mask Elevate clients legs slightly Call doc ```

Question 28

If the patient is hyperventilating we can suggest the client breathe into a paper bag or cupped hands. What does this do?

Answer 28

Minimizes fetal acidosis and relieves symptoms of vertigo and syncope

Question 29

What are the 2 goals of stage 3 of labor?

Answer 29

Expulsion of placenta | Prevention of hemorrhage

Question 30

What are the UC like in stage 3 of labor?

Answer 30

Temporarily stop

Question 31

What are the 3 signs of placental separation?

Answer 31

- Upward rise of uterus in abdomen; uterus is globular shape - Visible lengthening of the cord - Trickle or gush of blood

Question 32

What drug do we administer after the delivery of the placenta?

Answer 32

Pitocin

Question 33

What are the 2 goals of stage 4 of labor?

Answer 33

- Prevent hemorrhage | - Facilitate maternal-infant bonding

Question 34

After birth, how often are VS checked?

Answer 34

q15 min for at least one hour

Question 35

What can be done if the fundus is not firm?

Answer 35

If it is boggy, we can massage and help the client empty the bladder

Question 36

Warning signs of pregnancy: | Relaxation time must equal ______ or loner in order for uterus to be perfused between

Answer 36

30 seconds or longer

Question 37

What may a sharp, rigid abdomen signal?

Answer 37

Abruption placenta

Question 38

What FHR patterns are warning signs during labor?

Answer 38

Late decels Prolonged variable decls Bradycardia Tachycardia

Question 39

What may a PROM put a client at risk for?

Answer 39

Uterine infection