Podcast
Questions and Answers
What characterizes the active phase of the first stage of labor?
What characterizes the active phase of the first stage of labor?
At what dilatation level is the mother considered fully dilated?
At what dilatation level is the mother considered fully dilated?
During which phase of labor might a mother experience hyperesthesia?
During which phase of labor might a mother experience hyperesthesia?
What indicates that the presenting part is engaged during labor?
What indicates that the presenting part is engaged during labor?
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What is the purpose of sacral pressure during the transitional phase of labor?
What is the purpose of sacral pressure during the transitional phase of labor?
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What is the primary purpose of monitoring vital signs during the first stage of labor?
What is the primary purpose of monitoring vital signs during the first stage of labor?
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In which position should a laboring mother rest to prevent supine vena cava syndrome?
In which position should a laboring mother rest to prevent supine vena cava syndrome?
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What is the contraindication for administering DEMEROL during the latent phase of labor?
What is the contraindication for administering DEMEROL during the latent phase of labor?
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What does the term 'lightening' refer to in the context of labor?
What does the term 'lightening' refer to in the context of labor?
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Which stage of labor includes the delivery of the head in vertex presentation?
Which stage of labor includes the delivery of the head in vertex presentation?
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What is the primary risk associated with a median episiotomy?
What is the primary risk associated with a median episiotomy?
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What is the first requisite for the birth of the baby during labor?
What is the first requisite for the birth of the baby during labor?
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What occurs during the external rotation phase of labor?
What occurs during the external rotation phase of labor?
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What is typically done to address hypotension caused by epidural anesthesia?
What is typically done to address hypotension caused by epidural anesthesia?
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Which of the following describes the mechanism of engagement during labor?
Which of the following describes the mechanism of engagement during labor?
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Study Notes
First Stage of Labor
- Duration: 12 hours
- Definition: Onset of true labor contractions to full dilatation and effacement of the cervix
Stages of Effacement & Dilatation
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Latent Phase:
- Cervical dilation: 0-3 cm
- Contraction frequency: 5-10 minutes, duration: 20-40 seconds
- Contraction intensity: Mild
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Active Phase:
- Cervical dilation: 4-7 cm
- Contraction frequency: every 3-5 minutes, duration: 40-60 seconds
- Contraction intensity: Moderate
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Transitional Phase:
- Cervical dilation: 8-10 cm
- Contraction frequency: every 2-3 minutes, duration: 60-70 seconds
- Contraction intensity: Strong
- Duration: Primi (1 hour), Multi (30 minutes)
- Emotional and sensory changes: Increased sensitivity (hyperesthesia)
- Management: Sacral pressure, cold compress
- Nursing care: Provide emotional support, encourage relaxation techniques, monitor discomfort
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Pelvic Exams:
- Effacement: Shortening of the cervical canal. Measured as a percentage (e.g., 25%, 50%, 75%, 100%).
- Dilatation: Opening of the cervical canal. Measured in centimeters (e.g., 1 cm, 2 cm, etc.). 100% means complete dilation.
- Station: Relationship of the presenting part to the ischial spine (-4 to -1 = above the spine, 0 = at the spine, +1 to +4 = below the spine)
Nursing Considerations during First Stage of Labor
- Hygiene: Bath recommended
- Vital Signs: Monitor blood pressure; elevated BP requires physician notification
- Nutrition: Light meal
- Urinary Function: Encourage voiding
- Perineal Preparation: Perineal care (rule of 7)
- Positioning: Left lateral recumbent position to prevent supine hypotension syndrome
- Amniotomy: If membranes haven't ruptured, amniotomy may be required
- Fetal Distress: Monitor for fetal distress
Pain Management
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Systemic Analgesics:
- Demerol (Meperidine HCl): Narcotic and antispasmodic. Avoid in latent phase. Used at 6-8 cm dilation. Watch for respiratory depression.
- Epidural Anesthesia: Watch for hypotension risk. Pre-hydrate the patient. In case of hypotension, elevate legs, increase IV fluids.
Second Stage of Labor (Fetal Stage)
- Definition: From complete dilation and effacement to birth
- Characteristics: Crowning, lithotomy position
Fetal Descent
- Engagement: Fetal head passing through pelvic inlet.
- Descent: Moving through the pelvis.
- Flexion: Fetal chin to chest
- Internal Rotation: Head turns towards the pubic bone.
- Extension: Head emerges from vaginal opening
- External Rotation: Restitution- return to original position.
- Expulsion: Complete birth of baby.
Episiotomy
- Surgical incision of the perineum.
-
Types:
- Median episiotomy: Common, midline incision, easier to repair.
- Mediolateral episiotomy: Incision starts midline & extends towards the anus.
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Description
Test your knowledge on the first stage of labor, including the phases of effacement and dilation. This quiz covers key aspects such as contraction frequency, intensity, and nursing care during labor. Ideal for nursing students and healthcare professionals.
