1. Nursing Care of Mother and Infant During Labor and Birth

Podcast Beta

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What is the correct method for measuring the frequency of a laboring woman’s contractions?

How long the patient states the contractions last

The time between the end of one contraction and the beginning of the next

The time between the beginning and the end of one contraction

The time between the beginning of one contraction and the beginning of the next (correct)

Why is it essential for the laboring woman to have a relaxation phase between contractions?

Blood flow from the mother into the placenta gradually decreases during contractions

The laboring woman needs to rest

The contractions can interfere with fetal oxygenation (correct)

The uterine muscles fatigue without relaxation (correct)

Which contraction duration and interval is most likely to cause fetal compromise?

Duration longer than 60 seconds, interval shorter than 90 seconds

Duration shorter than 30 seconds, interval longer than 75 seconds

Duration shorter than 90 seconds, interval longer than 120 seconds

Duration longer than 90 seconds, interval shorter than 60 seconds (correct)

What is the term used to describe the fetal presentation when the infant’s head is the presenting part and well flexed on the chest?

Vertex Signup and view all the answers

What does meconium-stained amniotic fluid indicate in a vertex presentation?

Fetal distress Signup and view all the answers

If the presenting part of the fetus is the buttocks, what type of presentation is this classified as?

Breech Signup and view all the answers

What effect does prolonged contraction intervals have on the fetus?

May compromise fetal oxygen levels Signup and view all the answers

What position does the fetus exhibit when in a frank breech presentation?

Hips flexed and knees extended. Signup and view all the answers

Which statement best describes true labor?

Regular contractions become more frequent and intense. Signup and view all the answers

When should a woman ideally go to the hospital during labor?

Upon the rupture of membranes. Signup and view all the answers

What is the primary function of contractions during the first stage of labor?

To dilate and efface the cervix. Signup and view all the answers

What does a shift in behavior to irritability in a woman during labor likely indicate?

Labor has progressed to the transition phase. Signup and view all the answers

What event marks the completion of the third stage of labor?

Expulsion of the placenta and membranes. Signup and view all the answers

Why is it crucial for a mother to void during the fourth stage of labor?

To reduce the risk of uterine hemorrhage. Signup and view all the answers

What action should the nurse take when a patient expresses that 'the baby is coming!'?

Stay with her and use the call bell for help. Signup and view all the answers

What indicates that increased lochia may be a sign of hemorrhage?

One pad soaked per hour Signup and view all the answers

What is the correct initial nursing action for a laboring woman with variable decelerations in fetal heart rate?

Reposition the woman on her side Signup and view all the answers

What is the appropriate way to manage perineal bruising and edema after delivery?

Apply an ice pack for 12 hours Signup and view all the answers

What does an Apgar score of 9 at 1 and 5 minutes of life indicate for a newborn?

The newborn is in stable condition Signup and view all the answers

What does a minus 1 station indicate in relation to fetal position?

Fetal head is above the ischial spines Signup and view all the answers

What is the primary nursing diagnosis for a woman in the fourth stage of labor?

Risk for injury related to hemorrhage Signup and view all the answers

What nursing action is effective in stimulating cervical effacement and enhancing contractions for a patient in potential labor?

Facilitating ambulation in the room Signup and view all the answers

What is the best nursing action to take when late decelerations in fetal heart rate are observed?

Increase oxygen delivery to 10 L/min Signup and view all the answers

What is the nurse's primary concern for the initial care of a newborn immediately after birth?

Thermoregulation Signup and view all the answers

The frequency of contractions is measured from the beginning of one contraction to the beginning of the ______.

next contraction Signup and view all the answers

A contraction duration longer than 90 seconds or an interval shorter than 60 seconds may reduce fetal ______.

oxygen supply Signup and view all the answers

Meconium-stained amniotic fluid typically indicates fetal ______.

distress Signup and view all the answers

Match the following fetal presentations with their correct descriptions:

Vertex = Infant's head is the presenting part, flexed on the chest Frank breech = Infant's buttocks are the presenting part with legs extended Face = Infant's head is extended with the face presenting Brow = Infant's head is partially extended with the forehead presenting Signup and view all the answers

Match the conditions indicated by meconium-stained amniotic fluid:

Fetal distress = Indicates fetal compromise due to early stool passage Fetal maturity = Suggests that the fetus has developed sufficiently Intact gastrointestinal tract = Implies no issues with the fetal bowel system Dehydration in the mother = Could reflect maternal health and hydration levels Signup and view all the answers

Match the following contraction characteristics with their implications:

Duration shorter than 30 seconds = Minimal risk for fetal distress Duration longer than 90 seconds = Increased risk of fetal oxygen compromise Interval longer than 75 seconds = Typically allows for fetal recovery Interval shorter than 60 seconds = Potential danger for fetal well-being Signup and view all the answers

Match the relaxation phase statements with their significance:

Rest for the mother = Allows physical downtime during labor Prevents uterine fatigue = Helps maintain uterine effectiveness during contractions Improves fetal oxygenation = Ensures optimal blood flow to the placenta Facilitates fetal progress = Supports efficient labor progression Signup and view all the answers

Match the time measurement of contractions with the correct definition:

Duration = The time between the beginning and the end of one contraction Frequency = The elapsed time from the beginning of one contraction to the beginning of the next Interval = The time between the end of one contraction and the beginning of the next Rest phase = Time between contractions that allows for recovery Signup and view all the answers

Study Notes

Measuring Frequency of Contractions

Time between the beginning of one contraction and the beginning of the next contraction is called the frequency of contractions.

Relaxation Phase Between Contractions

The relaxation phase after each contraction is important for placental blood refilling and providing the fetus with oxygenated blood.

Contraction Duration and Interval

Contraction durations longer than 90 seconds or intervals less than 60 seconds can reduce fetal oxygen supply.

Vertex Presentation

In a vertex presentation, the fetal head is the presenting part and the head is fully flexed on the chest.

Meconium-Stained Amniotic Fluid

Green-stained amniotic fluid indicates the fetus passed the first stool before birth and signifies fetal distress.

Frank Breech Presentation

In a frank breech position, the fetus’s legs are flexed at the hips and extend toward the shoulders.

True Labor

True labor contractions gradually develop a regular pattern, becoming more frequent, longer, and more intense. They are not relieved by walking.

When to Go to the Hospital

When membranes have ruptured, it signifies a need to go to the hospital.

The First Stage of Labor

The first stage of labor is from the onset of labor until full dilation of the cervix. Contractions dilate and efface the cervix.

Transition Phase of Labor

The transition phase of labor is characterized by increased irritability and a possible loss of control.

Second Stage of Labor

The second stage of labor involves contractions that push the infant out of the mother's body. It ends with the birth of the infant.

Third Stage of Labor

The third stage of labor lasts from the birth of the infant until the placenta is detached and expelled.

Fourth Stage of Labor

The fourth stage of labor is when the most serious risk of hemorrhage occurs. A full bladder can increase the risk of bleeding.

Nursing Interventions

In imminent birth, the nurse should stay with the woman and summon help with the call bell.
Variable decelerations in fetal heart rate during labor are addressed by repositioning the woman on her side.
Late decelerations are addressed by increasing oxygen to 10 L/minute.
The nurse focuses on maintaining thermoregulation for the newborn in its initial care.
Assess the fundus for position and firmness if a new mother saturates three perineal pads in one hour.
Monitor for hemorrhage in the fourth stage of labor.

Fetal Heart Rate Patterns

A 15-beat increase in fetal heart rate that lasts 15 to 20 seconds indicates a well-oxygenated fetus.
Late decelerations indicate uteroplacental insufficiency and fetal heart depression.

Vaginal Birth After Cesarean (VBAC)

The primary concern for a VBAC pregnancy is uterine rupture.

Amniotomy

After an amniotomy, the nurse prioritizes fetal heart rate assessment.

Cultural Considerations for Arab Women

Provide for extreme modesty, arrange for the husband/partner to participate in labor, and provide adequate pain control. Respect protective amulets.

Freestanding Birth Centers

Freestanding birth centers offer a homelike setting and lower costs. They are not designed for high-risk pregnancies, are not attended by certified obstetricians, and do not have immediate emergency access.

Contractions and Labor Processes

Ambulation can intensify contractions and stimulate effacement.
False (prodromal) labor is characterized by painless tightening of abdominal muscles and a cervix thick and not effaced.
Contractions that intensify with ambulation and pink spotting are signs of true labor.

Stations

Minus stations indicate the fetal head is above the ischial spines.

Apgar Score

An Apgar score of 9 indicates the newborn is in stable condition.

Nursing Diagnosis

Risk for injury related to hemorrhage is a key nursing diagnosis in the fourth stage of labor.

Pushing Technique

During the second stage of labor, the woman should take a deep breath and push with the second exhalation at the beginning of each contraction.

Perineal Bruising and Edema

Apply an ice pack to the perineal area for 12 hours after delivery to reduce bruising and edema.

Frequency of Contractions

The frequency of contractions is measured from the beginning of one contraction to the beginning of the next.

Relaxation Phase

The relaxation phase allows for the placenta to refill with oxygenated blood for the fetus.

Contraction Duration and Intervals

Longer than 90-second contractions or contractions intervals less than 60 seconds can result in fetal compromise.

Vertex Presentation

In a vertex presentation, the fetal head is the presenting part, fully flexed on the chest.

Meconium-Stained Amniotic Fluid

Green-stained amniotic fluid, when the infant is in a vertex presentation, indicates fetal distress.

Frank Breech

In a frank breech position, the legs are flexed at the hips and extend toward the shoulders.

True Labor

Regular contractions becoming more frequent and intense indicate true labor

When to Go to the Hospital

Ruptured membranes are an indication to go to the hospital or birthing center.

First Stage of Labor

The first stage of labor is from the onset of labor until full dilation of the cervix.

Transition Phase

In the transition phase of labor, the woman may suddenly lose control and become irritable.

Second Stage of Labor

The contractions push the infant out of the mother’s body during the second stage of labor.

Third Stage of Labor

The third stage of labor ends with the expulsion of the placenta and membranes.

Fourth Stage of Labor

A full bladder in the fourth stage of labor can cause excessive bleeding and predispose the mother to uterine hemorrhage.

Nursing Interventions for Imminent Birth

Stay with the woman and summon help if birth appears imminent.

Fetal Heart Rate Accelerations

15-beat increase in the fetal heart rate that lasts 15 to 20 seconds indicates a well-oxygenated fetus.

Coaching a Woman to Push

Take a deep breath and exhale at the beginning of a contraction, then take another deep breath and push while exhaling.

Fourth Stage of Labor Nursing Interventions

Assess for hemorrhage in the fourth stage of labor.

Excessive Lochia

Three perineal pads saturated in an hour may indicate hemorrhage.

Variable Decelerations

Reposition the woman on her side to relieve cord compression, which causes variable decelerations in fetal heart rate.

Initial Newborn Care

Thermoregulation is necessary to maintain the newborn’s temperature and prevent cold stress.

VBAC Complication

The main concern about VBAC is uterine rupture, which can cause hemorrhage.

Amniotomy Nursing Interventions

Assess fetal heart rate immediately following amniotomy.

Cultural Sensitivity for Arab Women

Provide for extreme modesty, provide adequate pain control, and respect protective amulets.

Freestanding Birth Center Advantages

Homelike setting and lower costs are advantages of a freestanding birth center

Late Decelerations

Late decelerations Indicate uteroplacental insufficiency and fetal heart depression.

False Labor

Painless abdominal tightening and cervix thick and not effaced may indicate false labor.

Late Decelerations Nursing Interventions

Increase oxygen to 10 L/minute to address late decelerations.

Minus 1 Station

Minus stations are above the ischial spines.

Fourth Stage of Labor Nursing Diagnosis

Risk for injury related to hemorrhage is the most appropriate nursing diagnosis during the fourth stage of labor.

Stimulating Cervical Effacement

Ambulation can stimulate effacement and contractions during true labor.

Nursing Diagnosis with a Patient Uncertain About True Labor

The most appropriate nursing diagnosis for a patient who is uncertain if she is in true labor is Risk for Deficient Knowledge.

Labor & Delivery

Contraction Frequency: Measured from the beginning of one contraction to the beginning of the next.
Contraction Relaxation: Important for uterine muscle recovery, allowing placental blood flow for fetal oxygenation.
Fetal Compromise Contraction Pattern: Duration longer than 90 seconds or interval shorter than 60 seconds.
Vertex Presentation: Fetal head is the presenting part, fully flexed on the chest.
Meconium-Stained Amniotic Fluid: Suggests fetal distress.
Frank Breech Presentation: Fetus’s hips are flexed, knees extended.
True Labor: Regular contractions increasing in frequency and intensity.
Hospital Visit for Delivery: When membranes have ruptured.
First Stage of Labor: Time from onset of labor until full cervical dilation.
Transition Phase of Labor: Characterized by sudden behavioral changes, like irritability.
Second Stage of Labor: Time from full cervical dilation to birth of the infant.
Third Stage of Labor: Time from birth of the infant until placenta expulsion.
Fourth Stage of Labor: Time from expulsion of the placenta to stabilization of maternal vital signs.
Fourth Stage Nursing Intervention: Assess for hemorrhage.
Fetal Heart Rate Acceleration: Indicates a well-oxygenated fetus.
Pushing Technique: Take a deep breath and push with the second exhalation at the beginning of a contraction.
Late Decelerations: Indicate uteroplacental insufficiency and fetal heart compression. Intervention includes increasing oxygen.
Newborn Care: Prioritize thermoregulation to minimize heat loss and oxygen consumption.
VBAC (Vaginal Birth After Cesarean Section): Primary concern is uterine scar rupture, potentially causing hemorrhage.
Amniotomy (Artificial Rupture of Membranes): Assess fetal heart rate immediately after procedure.
Arab Culture in Labor: Emphasize modesty, pain control, and respect for amulets.
Freestanding Birth Center: Offers a homelike setting for low-risk pregnancies with lower costs.
False (Prodromal) Labor: Contractions are painless and do not intensify with ambulation, cervix is not effaced.
Perineal Care: Apply ice pack for up to 12 hours to reduce bruising and edema.
Apgar Score: A score of 9 indicates newborn is in stable condition.
Station: Minus stations indicate fetal head is above the ischial spines.
Nursing Diagnosis for Fourth Stage of Labor: Risk for injury related to hemorrhage.

Interventions

Stimulating Effacement & Contractions: Ambulation for patients in true labor.
Variable Decelerations: Reposition the woman on her side to improve fetal blood flow.
Newborn Hypothermia: Minimize heat loss via skin-to-skin contact and wrapping.

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Description

This quiz covers important concepts related to labor, including the frequency and duration of contractions, vertex and breech presentations, and the implications of meconium-stained amniotic fluid. Understanding these factors is critical for monitoring fetal well-being during childbirth.