Nursing Care of Child Bearing Families Session 5:

 

Session 5

 

starting the labor process

  • we don’t really know what starts labor
    • uterine distention
    • aging of the placenta
    • hormones
    • fetal adrenals
    • psychological

 

  • signs of labor
    • lightening – fetus dropping into the pelvis
      • days to weeks before labor
    • bloody show
    • weight loss, from loose stools
    • burst of energy and nesting

 

  • stages of labor
    1. Stage 1: onset of regular contractions
  • latent: 0-3 cm
    • duration of 6-8hr
    • contractions 5 – 30 mins and irregular
  • active: 3-8cm
    • 3-6hr
    • contractions: 3-5 mins and regular and moderate to strong
  • transition: 7-10cm
    • duration: 20-40 min
    • contractions: 2-3 min regular and strong

 

  1. Stage 2: full dilation to the delivery of baby
    1. Pushing with contractions
  2. Stage 3: time between baby born, and the placenta coming out. (20-30) min
    1. retained placenta is over 30 minutes
    2. signs of placental detachment
      1. change of uterus shape
      2. gush of blood
      3. urge to push again, more contractions
    3. prevention of hemorrhage
      1. pitocin – 10-40 units IV
      2. methergine – 0.2 mg IM
        1. do not give if HTN in pt
      3. hemabate – 250 mcg IM
        1. prostaglandin
        2. contraindicated in asthma (bronchoconstriction)
      4. cytotec (misoprostol)- 600- 800 mcg PO
        1. synthetic prostaglandin
        2. do not give vaginally if she is actively bleeding
  3. Stage 4: 0-4hrs after delivery, bonding and breastfeeding

 

episiotomy can be done when…

  • shoulder dystocia
  • fetal distress

 

nullipara women go through 12-18 hr of labor on average 

multipara women have shorter labor time on average

 

  • things we can do to help as a student
    • hygiene
      • chux, washcloth, mouthwash

 

false pregnancy

  • no cervical change

true pregnancy

  • water broke (things to confirm this)
    • ferning seen under a microscope
    • also higher ph than urine

SROM – spontaneous rupture of membranes

AROM – artificial rupture (HOOK)

PROM – Pre labor

pPROM – preterm pre labor

Malodorous fluid- infection in the fluid

 

GBS

    • group beta strep
    • 10 – 30% of women colonized

 

  • universal screening at 35-37 weeks
  • the screen stays negative for about five weeks after negative test.
  • Pen 6million units
  • WHAT, WHY, HOW do we check, and how do we treat.

 

  • then every four hours after
Advertisements

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s