The Normal Labor and Delivery Process

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The Normal Labor and Delivery Process by Mind Map: The Normal Labor and Delivery Process

1. PREMONITORY SIGNS OF LABOR

1.1. Lightening-head descends into the pelvis about 14 days before labor

1.2. Backache-constant, low, dull, caused by pelvic muscle relaxation

1.3. Energy spurt- “nesting”

1.4. Weight loss(0.5 to 1.5 kg/1-3.5 lbs.)

1.5. GI upset- n/v

2. The "True" Signs of Labor

2.1. Dilation

2.1.1. Opening of the cervix

2.1.2. 0-10

2.2. Effacement

2.2.1. Thinning of the cervix

2.2.2. 0-100%

2.3. A baby is not coming out unless these two things occur

2.4. Documented as seperated by slashes: dilation/effacement/station

2.4.1. Example: 7/80/+1

2.4.2. The more dilation and effacement, the closer it is to the birth of the baby

3. Nursing Care for the Patient in Labor

3.1. Fetal monitoring

3.2. External

3.2.1. Tocodyameter

3.2.1.1. Ultrasound

3.2.2. Two Belts

3.3. Internal

3.3.1. Intrauterine pressure catheter

3.3.1.1. Fetal scalp electrode

3.3.2. More Invasive

3.4. Vital signs per protocol

3.5. Perform bladder palpation on a regular basis to prevent bladder distention which could impede fetal descent

3.5.1. Encourage voiding/emptying bladder q 2 hrs

3.6. In less there are other factors occurring with your other clients, the client that is the most dilated/effaced would be the priority, as dilation/effacement will result in birth of the fetus

3.7. Frequency

3.8. From the beginning of one contraction to the beginning of the next

3.9. Should not be closer than 2 minutes apart

3.10. Duration

3.11. Beginning to end of one contraction

3.12. Should not exceed 90 seconds

3.13. Intensity

3.14. Strength of the contraction

3.15. External Fetal Monitoring- felt by palpation: mild, moderate, strong

3.16. Internal Fetal Monitoring : consists of a intrauterine pressure catheter(IUCP)

3.17. The average contraction intensity is 50-85 mmHG

3.17.1. Intensity should not be greater than 90 mmHG

3.18. Resting tone:

3.18.1. Must not be greater than 20mmHG

3.19. There must be “rest” between contractions

3.20. Monitor for Decelerations

3.21. The fetal head descending may feel like she has to have a bowel movement

3.22. Hyperventilation may occur, provide a paper bag to breathe into

3.22.1. Tingling/numbness to extremities, rapid breathing

4. First Stage of Labor has 3 Phases

4.1. Latent

4.1.1. Active

4.1.1.1. Transition

4.1.1.1.1. Contractions strong

4.1.1.1.2. Frequency every 2-3 minutes

4.1.1.1.3. Duration 45-90 seconds

4.1.1.1.4. Dilation 8-10 cm

4.1.1.1.5. Client may loose control

4.1.1.2. Contractions more regular and stronger Frequency every 3-5 minutes Duration 40-70 seconds Dilation 4-7 cm Client begins to feel anxious

4.1.2. Contractions are irregular, mild to moderate Frequency every 5-30 minutes Duration 30-45 seconds Dilation 0-3 cm Client is talkative and eager

5. Second Stage of Labor

5.1. 10 cm dilated and 100% effaced

5.2. Contractions are intense and occurring every 1-2 minutes

5.3. Assist client with her pushing efforts

5.4. Have client rest between contractions

6. Third Stage of Labor

6.1. Delivery of the Placenta

7. False Labor

7.1. Painless, irregular

7.2. Decreases in intensity with walking/position change

7.3. Felt in lower back, but do not radiate to the front

7.4. Will often stop with comfort measures such as hydration or emptying the bladder

7.5. No cervical changes

7.6. Presenting part of fetus not engaged in the pelvis

8. Fourth Stage

8.1. Postpartum