08 LABOR AND BIRTH.pdf

CARE‌‌OF‌‌MOTHER,‌‌CHILD,‌‌ ‌ ADOLESCENT,‌‌AND‌‌FAMILY‌‌ ‌ IDIANALE‌‌BATCH‌‌2024‌ ‌ ST.‌‌LUKE’S‌‌COLLEGE‌‌OF‌‌NURSING‌ ‌ ‌ TOPIC‌‌8:‌‌LABOR‌‌&‌‌BIRTH‌ ‌ ‌ ‌ T‌‌-‌‌term‌‌del...

CARE‌‌OF‌‌MOTHER,‌‌CHILD,‌‌ ‌ ADOLESCENT,‌‌AND‌‌FAMILY‌‌ ‌ IDIANALE‌‌BATCH‌‌2024‌ ‌ ST.‌‌LUKE’S‌‌COLLEGE‌‌OF‌‌NURSING‌ ‌ ‌ TOPIC‌‌8:‌‌LABOR‌‌&‌‌BIRTH‌ ‌ ‌ ‌ T‌‌-‌‌term‌‌delivery‌ ‌ ‌ P‌‌-‌‌pre-term‌‌delivery‌ ‌ ‌ A‌‌-‌‌bortion‌ ‌ ‌ L‌‌-‌‌#‌‌of‌‌living‌‌children‌ ‌ ‌ ‌ TPAL‌ ‌ T‌‌-‌‌term‌ ‌ ‌ P‌‌-‌‌preterm‌ ‌ ‌ A‌‌-‌‌abortion‌ ‌ L‌‌-‌‌living‌‌children‌ ‌ ‌ ‌ G-P‌ ‌ ‌ G‌‌-‌‌gravida‌‌(#‌‌of‌‌pregnancy)‌ ‌ ‌ P‌‌-‌‌parity‌‌(#‌‌of‌‌delivery)‌ ‌ ‌ ‌ INITIAL‌‌LABOR‌‌ASSESSMENT‌ ‌ amniotic‌‌membrane‌‌status‌ ‌ LABOR‌‌AND‌‌BIRTH‌ ‌ onset‌‌and‌‌f requency‌‌of‌‌contractions‌ ‌ birth‌ ‌process‌ ‌is‌ ‌coordinated‌ ‌effort‌‌ description‌‌of‌‌vaginal‌‌bleeding‌ ‌ depending‌‌on‌‌5‌‌interrelated‌‌factors‌ ‌ location‌‌and‌‌description‌‌of‌‌discomforts‌ ‌ abnormalities‌ ‌in‌ ‌any‌ ‌of‌ ‌5‌ ‌can‌ ‌alter‌ ‌or‌‌ time‌‌last‌‌fetal‌‌movement‌ ‌ prevent‌ ‌labor‌ ‌progress‌ ‌putting‌ ‌mother‌ ‌or‌‌ ‌ baby‌‌at‌‌risk‌ ‌ THEORIES‌‌OF‌‌LABOR‌‌ONSET‌ ‌ ‌ Progesterone‌ ‌withdrawal‌ ‌-‌ ‌anti-progestin‌‌ Nursing‌‌Responsibilities‌ ‌ at‌‌term‌‌inhibits‌‌relaxant‌‌effect‌‌and‌‌enables‌‌ allay‌‌fear‌‌and‌‌anxieties‌‌of‌‌client‌‌and‌‌family‌ ‌ estrogen‌‌to‌‌stimulate‌‌contractions‌ ‌ obtain‌‌complete‌‌OB‌‌history‌ ‌ Prostaglandin‌ ‌synthesis‌ ‌-‌ ‌used‌ ‌to‌ ‌“ripen”‌‌ cervix‌‌for‌‌induction‌ ‌ Observations‌‌on‌‌maternal‌‌and‌‌fetal‌‌status‌ ‌ Corticotrophin-releasing‌ ‌hormone‌ ‌(CRH)‌ ‌-‌‌ keep‌ ‌attending‌ ‌physician‌ ‌informed‌ ‌of‌‌ stimulates‌‌synthesis‌‌of‌‌prostaglandins‌‌and‌‌ progress‌‌of‌‌labor‌ ‌ by‌‌the‌‌amnion‌‌cells‌ ‌ ‌ Oxytocin‌ ‌Stimulation‌ ‌-‌ ‌working‌ ‌together‌‌ Initial‌‌Personal‌‌Data‌ ‌ with‌‌prostaglandin‌‌to‌‌initiate‌‌contractions‌ ‌ Name,‌‌age,‌‌ethnicity‌ ‌ ‌ Obstetric‌‌care‌‌provider‌ ‌ PREMONITORY‌‌SIGNS‌‌OF‌‌LABOR‌ ‌ Presenting‌‌complaint‌ ‌ Lightening‌ ‌ Braxton‌‌Hicks‌‌contractions‌ ‌ LMP‌ ‌ Ripening‌‌of‌‌the‌‌cervix‌ ‌ Estimated‌‌date‌‌of‌‌birth‌ ‌ Bloody‌‌show‌ ‌ OB‌‌SCORE‌ ‌ Backache‌ ‌ Current‌‌medications‌‌(Rx,‌‌OTC,‌‌herbal0‌ ‌ ROM‌ ‌ Allergy‌‌history‌ ‌ 1-3‌‌lbs.‌‌wt.‌‌loss‌ ‌ ‌ Sudden‌‌burst‌‌of‌‌energy‌ ‌ OB‌‌SCORES‌ ‌ Flu-like‌‌symptoms‌ ‌ GTPAL‌ ‌ ‌ G‌‌-‌‌of‌‌pregnancy‌ ‌ True‌‌Labor‌ ‌ ‌ PROPERTY‌‌OF‌‌ODLID‌ ‌ 35‌ ‌ ‌ CARE‌‌OF‌‌MOTHER,‌‌CHILD,‌‌ ‌ ADOLESCENT,‌‌AND‌‌FAMILY‌‌ ‌ IDIANALE‌‌BATCH‌‌2024‌ ‌ ST.‌‌LUKE’S‌‌COLLEGE‌‌OF‌‌NURSING‌ ‌ ‌ progressive‌ ‌cervical‌ ‌change‌ ‌and‌ ‌fetal‌‌ Sinciput‌‌-‌‌anterior‌‌area‌‌(brow)‌ ‌ descent‌ ‌ Bregma‌‌-‌‌anterior‌‌fontanel‌ ‌ regular‌‌intervals‌ ‌ LAmbda‌‌-‌‌posterior‌‌fontanel‌ ‌ intervals‌ ‌between‌ ‌contractions‌ ‌gradually‌‌ Vertex‌ ‌-‌ ‌area‌ ‌between‌ ‌anterior‌ ‌and‌‌ shorten‌ ‌ posterior‌‌fontanelles‌ ‌ contractions‌ ‌increase‌ ‌in‌ ‌duration‌ ‌and‌‌ Occiput‌ ‌-‌ ‌area‌ ‌occupied‌ ‌by‌ ‌the‌ ‌occipital‌‌ intensity‌ ‌ bone,‌‌beneath‌‌the‌‌posterior‌‌fontanel‌ ‌ discomfort‌ ‌begins‌ ‌in‌ ‌back‌ ‌and‌ ‌radiates‌‌ Molding‌‌-‌‌overlapping‌‌of‌‌cranial‌‌bones‌ ‌ around‌‌to‌‌abdomen‌ ‌ Sutures‌ ‌-‌ ‌membranous‌ ‌spaces‌ ‌between‌‌ intensity‌‌usually‌‌increases‌‌with‌‌walking‌ ‌ the‌‌cranial‌‌bones‌ ‌ cervical‌ ‌dilation‌ ‌and‌ ‌effacement‌ ‌are‌‌ Fontanelles‌‌-‌‌intersections‌‌of‌‌the‌‌sutures‌ ‌ progressive‌ ‌ contractions‌ ‌do‌ ‌not‌ ‌decrease‌ ‌with‌ ‌rest‌ ‌or‌‌ warm‌‌tub‌‌bath‌ ‌ ‌ False‌‌Labor‌ ‌ less‌ ‌regular‌ ‌and‌ ‌contractions‌ ‌do‌ ‌not‌‌ progressively‌‌increase‌ ‌ contractions‌‌are‌‌irregular‌ ‌ usually‌ ‌no‌ ‌change‌ ‌in‌ ‌contractions‌‌interval‌‌ and‌‌duration‌‌and‌‌intensity‌ ‌ discomfort‌‌is‌‌usually‌‌in‌‌abdomen‌ ‌ walking‌ ‌has‌ ‌no‌ ‌effect‌ ‌on‌ ‌or‌ ‌lessens‌‌ contractions‌ ‌ no‌‌change‌‌in‌‌cervical‌‌dilation‌ ‌ rest‌ ‌and‌ ‌warm‌ ‌tub‌ ‌baths‌ ‌lessen‌‌ ‌ contractions‌ ‌ COMPONENTS‌‌OF‌‌LABOR‌ ‌ Passenger‌ ‌ fetus‌‌and‌‌placenta‌ ‌ Passageway‌ ‌ pelvis,‌‌uterus,‌‌and‌‌vagina‌ ‌ Powers‌ ‌ contractions‌‌and‌‌pushing‌ ‌ Position‌ ‌ of‌‌the‌‌laboring‌‌mother‌ ‌ Psychological‌‌Response‌ ‌ culture,‌‌experiences,‌‌preparedness‌ ‌ ‌ ‌ PASSENGER‌ ‌ Fetal‌‌Skull‌ ‌ Mentum‌‌-‌‌fetal‌‌chin‌ ‌ ‌ PROPERTY‌‌OF‌‌ODLID‌ ‌ 36‌ ‌ ‌ CARE‌‌OF‌‌MOTHER,‌‌CHILD,‌‌ ‌ ADOLESCENT,‌‌AND‌‌FAMILY‌‌ ‌ IDIANALE‌‌BATCH‌‌2024‌ ‌ ST.‌‌LUKE’S‌‌COLLEGE‌‌OF‌‌NURSING‌ ‌ ‌ ‌ ‌ Fetal‌‌Presentations‌ ‌ Cephalic‌‌-‌‌fetal‌‌head‌‌first‌ ‌ ‌ Breech‌‌-‌‌fetal‌‌buttocks,‌‌feet‌‌or‌‌knees‌‌first‌ ‌ Fetal‌‌Lie‌ ‌ Shoulder‌‌-‌‌transverse‌‌lie‌ ‌ relationship‌‌of‌‌the‌‌long‌‌axis‌‌of‌‌the‌‌baby‌‌to‌‌ the‌‌long‌‌axis‌‌of‌‌the‌‌mother‌ ‌ ○ horizontal‌ ‌ ○ longitudinal‌‌(normal)‌ ‌ Fetal‌‌Attitude‌ ‌ relationship‌‌of‌‌the‌‌fetal‌‌parts‌‌to‌‌each‌‌other‌ ‌ Universal‌‌flexion‌ ‌ ‌ Fetal‌‌Positions‌ ‌ relationship‌ ‌of‌ ‌fetal‌ ‌landmarks‌‌ denominators‌‌to‌‌the‌‌maternal‌‌pelvis‌ ‌ Occiput‌‌-‌‌head‌‌flexed‌ ‌ Mentum‌ ‌-‌ ‌head‌ ‌extended‌ ‌(face‌‌ presentation)‌ ‌ Brow‌‌-‌‌head‌‌partially‌‌extended‌ ‌ Sacrum‌‌-‌‌breech‌ ‌ Acromion‌‌process‌‌-‌‌shoulder‌ ‌ ‌ PROPERTY‌‌OF‌‌ODLID‌ ‌ 37‌ ‌ ‌ CARE‌‌OF‌‌MOTHER,‌‌CHILD,‌‌ ‌ ADOLESCENT,‌‌AND‌‌FAMILY‌‌ ‌ IDIANALE‌‌BATCH‌‌2024‌ ‌ ST.‌‌LUKE’S‌‌COLLEGE‌‌OF‌‌NURSING‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ PROPERTY‌‌OF‌‌ODLID‌ ‌ 38‌ ‌ ‌ CARE‌‌OF‌‌MOTHER,‌‌CHILD,‌‌ ‌ ADOLESCENT,‌‌AND‌‌FAMILY‌‌ ‌ IDIANALE‌‌BATCH‌‌2024‌ ‌ ST.‌‌LUKE’S‌‌COLLEGE‌‌OF‌‌NURSING‌ ‌ ‌ ‌ ‌ ‌ ‌ Placenta‌‌Accreta‌ ‌ ‌ Abruptio‌‌placenta‌ ‌ Stations‌‌and‌‌Engagement‌ ‌ ○ premature‌ ‌separation‌ ‌of‌ ‌the‌‌ Station‌ ‌-‌ ‌relationship‌ ‌of‌ ‌the‌ ‌biparietal‌‌ placenta‌‌f rom‌‌the‌‌uterus‌ ‌ diameter‌‌of‌‌the‌‌infant‌‌to‌‌the‌‌ischial‌‌spines‌‌ of‌‌the‌‌mother‌ ‌ Engagement‌‌-‌‌when‌‌the‌‌head‌‌of‌‌the‌‌fetus‌‌ is‌‌at‌‌Station‌‌0‌ ‌ DETERMINATION‌‌OF‌‌POSITION,‌‌PRESENTATION,‌‌ LIE,‌‌ATTITUDE,‌‌STATION,‌‌AND‌‌ENGAGEMENT‌ ‌ Ultrasound‌‌examination‌ ‌ Leopold’s‌‌maneuvers‌ ‌ vaginal‌‌exam‌ ‌ Location‌‌of‌‌fetal‌‌heart‌‌sounds‌ ‌ ‌ Placenta‌ ‌ Normal‌‌placental‌‌separation‌ ‌ Placenta‌‌previa‌ ‌ PASSAGEWAY‌ ‌ ○ implantation‌ ‌of‌ ‌the‌ ‌placenta‌ ‌at‌‌ Pelvis‌ ‌ least‌‌partially‌‌covering‌‌the‌‌cervix‌ ‌ support‌‌and‌‌protect‌‌the‌‌pelvic‌‌contents‌ ‌ form‌ ‌the‌ ‌relatively‌ ‌fixed‌ ‌axis‌ ‌of‌ ‌the‌ ‌birth‌‌ passage‌ ‌ measurements‌ ‌ parts‌ ‌ ○ inlet‌ ‌ ○ pelvic‌‌cavity‌ ‌ ○ outlet‌ ‌ ‌ ‌ PROPERTY‌‌OF‌‌ODLID‌ ‌ 39‌ ‌ ‌ CARE‌‌OF‌‌MOTHER,‌‌CHILD,‌‌ ‌ ADOLESCENT,‌‌AND‌‌FAMILY‌‌ ‌ IDIANALE‌‌BATCH‌‌2024‌ ‌ ST.‌‌LUKE’S‌‌COLLEGE‌‌OF‌‌NURSING‌ ‌ ‌ ○ not‌‌favorable‌‌for‌‌vaginal‌‌birth‌ ‌ ○ fetal‌ ‌head‌ ‌engages‌ ‌in‌ ‌transverse‌‌ position‌ ‌ ○ difficult‌‌descent‌‌through‌‌midpelvis‌ ‌ ○ frequent‌‌delay‌‌of‌‌progress‌‌at‌‌outlet‌‌ of‌‌pelvis‌ ‌ Cervix‌ ‌ Cervical‌‌dilation‌ ○ from‌ ‌size‌ ‌of‌ ‌fingertip‌ ‌to‌ ‌10‌ ‌cm‌‌ (progressive)‌ ‌ CErvical‌‌effacement‌ ‌ ○ thinning‌‌of‌‌cervix‌‌(%)‌‌(progressive)‌ ‌ ‌ Gynecoid‌‌ ‌ ○ inlet‌ ‌rounded‌ ‌with‌ ‌all‌ ‌inlet‌‌ diameters‌‌adequate.‌‌ ‌ ○ Midpelvis‌ ‌diameters‌‌adequate‌‌with‌‌ parallel‌‌side‌‌walls.‌‌ ‌ ○ Outlet‌‌adequate.‌‌ ‌ ○ Favorable‌‌for‌‌vaginal‌‌birth‌ ‌ ‌ Android‌‌ ‌ POWERS‌ ‌ ○ inlet‌ ‌heart-shaped‌ ‌with‌ ‌short‌‌ Primary‌‌powers‌ ‌ posterior‌‌sagittal‌‌diameter.‌‌ ‌ Uterine‌‌contractions‌‌ ‌ ○ Midpelvis‌‌diameters‌‌reduced.‌‌ ‌ ○ frequency‌ ‌ ○ Outlet‌‌capacity‌‌reduced.‌‌ ‌ ○ regularity‌ ‌ ○ Not‌‌favorable‌‌for‌‌vaginal‌‌birth.‌ ‌ ○ duration‌ ‌ ○ Descent‌‌into‌‌pelvis‌‌is‌‌slow‌ ‌ ○ intensity‌ ‌ ○ fetal‌ ‌head‌ ‌enters‌ ‌pelvis‌ ‌in‌‌ Secondary‌‌powers‌ ‌ transverse‌ ‌or‌ ‌posteriori‌ ‌position‌‌ maternal‌‌bearing‌‌down‌‌pushing‌ ‌ with‌‌arrest‌‌of‌‌labor‌‌f requent‌ ‌ Uterine‌‌Contraction‌ ‌ Anthropoid‌ ‌ contraction‌ ‌wave‌ ‌starts‌ ‌in‌ ‌pacemaker‌ ‌at‌‌ ○ inlet‌ ‌oval‌ ‌in‌ ‌shape‌ ‌with‌ ‌long‌‌ the‌‌cornual‌‌ends‌‌of‌‌the‌‌fallopian‌‌tubes‌‌and‌‌ anteroposterior‌‌diameter.‌‌M‌ ‌ descends‌ ‌down‌ ‌into‌ ‌the‌ ‌lower‌ ‌uterine‌‌ ○ idpelvis‌‌diameters‌‌adequate‌ ‌ segment‌ ‌ ○ outlet‌‌adequate‌ ‌ MATERNAL‌‌POSITIONS‌ ‌ ○ favorable‌‌for‌‌vaginal‌‌birth‌ ‌ upright‌‌position‌‌or‌‌standing‌ ‌ Platypelloid‌ ‌ lithotomy‌‌position‌ ‌ ○ inlet‌ ‌oval‌ ‌in‌ ‌shape‌ ‌with‌ ‌long‌‌ side-lying‌ ‌ transverse‌‌diameters‌ ‌ squatting‌ ‌ ○ midpelvis‌‌diameters‌‌reduced‌ ‌ semi-recumbent‌‌position‌ ‌ ○ Outlet‌‌capacity‌‌inadequate‌ ‌ ‌ PROPERTY‌‌OF‌‌ODLID‌ ‌ 40‌ ‌ ‌ CARE‌‌OF‌‌MOTHER,‌‌CHILD,‌‌ ‌ ADOLESCENT,‌‌AND‌‌FAMILY‌‌ ‌ IDIANALE‌‌BATCH‌‌2024‌ ‌ ST.‌‌LUKE’S‌‌COLLEGE‌‌OF‌‌NURSING‌ ‌ ‌ hands‌‌and‌‌knees‌ ‌ fertility‌ ‌ birthing‌‌chair‌ ‌ SYSTEMIC‌‌EFFECTS‌‌OF‌‌LABOR‌ ‌ increased‌‌cardiac‌‌output‌‌and‌‌BP‌ ‌ ○ never‌ ‌leave‌ ‌a‌ ‌laboring‌ ‌woman‌‌ supine‌ ‌ increased‌ ‌oxygen‌ ‌demand‌ ‌and‌‌ consumption‌ ‌ acid-base‌‌alterations‌ ‌ stimulation‌‌of‌‌renal‌‌secretions‌ ‌ slowed‌‌GI‌‌motility‌‌and‌‌gastric‌‌emptying‌ ‌ Immune‌ ‌response‌ ‌including‌ ‌increased‌‌ WBCS‌ ‌ ‌ Decreased‌ ‌blood‌ ‌glucose‌ ‌and‌ ‌insulin‌‌ requirements‌ ‌ Pain‌‌f rom‌‌varied‌‌causes‌ ‌ ‌ ‌ ‌ PSYCHOLOGICAL‌‌RESPONSE‌ ‌ maternal‌‌past‌‌experience‌ ‌ preparedness‌ ‌ support‌ ‌ financial‌‌stability‌ ‌ impact‌‌of‌‌another‌‌child‌ ‌ other‌‌children‌‌to‌‌care‌‌for‌ ‌ cultural‌‌meaning‌‌of‌‌children‌ ‌ ‌ PROPERTY‌‌OF‌‌ODLID‌ ‌ 41‌ ‌ ‌