ATI - Labor in delivery process (the five Ps)

What is considered to frequent contractions?

More than five contractions and a 10 minute period

What are some nursing actions you would you do in between the labor and birth process?

-assess vital signs per agency protocol -assess fetal heart rate to determine feel well been this may be performed by use of Fetal monitoring -assess uterine labor contraction characteristics by palpation (place a hound over the funders to assess contraction frequency, duration, and intensity)

How long is the active phase for the pregnant woman?

-cervix goes from 4 cm to 7 cm -more regular moderate to strong contractions -frequent contractions 3 to 5 minutes -duration forty to seventy seconds -there is the fetal descent going on

What happens during the transition phase of labor?

-cervix goes from 8 cm to 10 cm -strong to very strong contractions -frequency is 2 to 3 minutes -duration is 45 to 90 seconds

What are some laboratory tests that you would want to analyze before the birthing process?

-if the patient has a group B strep (culture will be obtained if results are not available from screening at 36 to 37 weeks) * if the patient is positive IV prophylactic antibiotics prescribed -urinalysis( (to checks for hydration status to check for any ketones, to check for protein which is indicated for gestational hypertension, to see if there is a urinary track infection) -blood test (check hematocrit level and blood type and part H type if not previously done)

What are some signs and symptoms of true labor in regards to contractions?

-maybe can irregularly become regular and frequency -stronger last longer and are more frequent -Felt more in the lower back and can radiate into the abdomen -walking can increase contraction and intensity -continue despite comfort measures -Progressive change in effacement -moves to a anterior position -bloody show -presenting part engages in pelvis

What are some signs and symptoms of false labor in regards to contractions?

-painless, irregular frequency, an intermittent -decrease in frequency, duration and intensity with walking position changes -Felt and lower back or abdomen above umbilicus -often stopped with sleeper comfort measures such as oral hydration or emptying of the bladder -no significant change in dilation or effacement -often remains in posterior position -no significant bloody show - presenting part is not in the pelvis

What are the five factors that affect and define the labor and birth process?

-passenger -passageway -Powers -Position -psychologic response

What are some nursing actions you can do to prepare for the labor and birth process?

-perform Leopold maneuvers -external electronic monitoring also known as the toco transducer -external fetal monitoring that is applied to the abdomen of the client to assess fetal heart rate patterns during labor and birth

How long does the fourth stage labor last?

1 - 4 hours this is when the vital signs returns to homeostasis and the Lochia goes from s scant two rubra

How long is the first stage of labor

12 hours

How long is the transition phase of labor?

20 to 40 minutes

How is the pregnant woman during the active phase of labor?

She is feeling helpless -her anxiety and restlessness increases as contraction become stronger

What should the contractions be when in the latent phase?

Cervix can go from 0 cm to 3 cm -irregular mild to moderate contractions -frequency 5 to 30 minutes -duration 30 to 45 seconds

What is fetal flexion?

Chin is flexed two chest, extremities flexed into torso

What is passenger?

Consist of the fetus and the placenta. The size of the feel head, fetal presentation, lie, attitude, and position affect the ability of the fetus to navigate the birth canal. The placenta can be considered a passenger because it also passes the birth canal

How is the pregnant patient during the latent phase?

She is talkative and eager

What is parallel or longitudinal lie?

Fetal spine is parallel to maternal spine either a cephalic or breach presentation but breach presentation may require a cesarean birth

How long is the third stage last?

Five to thirty minutes

How long is the latent phase?

For the primi gravida six hours but for the multigravida four hours

What is considered a prolonged contraction duration?

Greater than 90 seconds

What is transverse lie?

The fetal spine is horizontal and forms the right angle to maternal spine and will not accommodate vaginal birth. The shoulder is the presenting part and may require delivery by cesarean birth if the fetus is not rotate spontaneously

What is frequency in regards to contractions?

It is from the beginning of one contraction to the beginning of the next contraction

How long does the second stage last?

It lasted spent thirty minutes to two hours for the primigravida. It lasted 5 to 30 minutes for the multigravida.

What occurs if a prolonged contraction and to many frequent contractions occur?

It reduces blood flow to the placenta this can result in pedal hypoxia and decrease fetal heart rate

What psychological response can impair labor?

Maternal stress, tension and anxiety can produce physiological changes that can impair the progress of labor

What is descent?

Progress of the presenting part preferably the occiput through the pelvis as either negative station if superior to station zero and not yet engaged, Or positive station measured in centimeters if it fair to station zero

How is the pregnant women during the transition phase?

She is tired restless and irritable. irritable she feels out of control client states I cannot continue. May have nausea and vomiting. She has the urge to push. She has increased it rectal pressure and feelings and needing to have a bowel movement. Increased bloody show. This is the most difficult part of labor

What is the intensity in regards to contractions?

Strength of contraction at its peak described as mild moderate for strong

What is the mechanism of labor?

The adaptations that fetus makes as it progresses through the birth canal during the birthing process

What is passageway?

The birth canal that is composed of the bony pelvis, cervix, pelvic floor, vagina, vaginal opening. The size and shape of the bony pelvis must be adequate to allow the fetus to pass through it. The cervix was daily interface in response to contractions in fetal descent

What is fetal extension?

The chin is extended away from the chest and extremities are extended

What is internal rotation?

The fetal occiput ideally rotates to a lateral anterior position as it progresses and if ischial spine to the lower pelvis and a corkscrew motion to pass through the pelvis

What do the three letters and fetal position mean?

The first letter indicates the right or left side of the maternal pelvis. The second letter is the presenting part of the fetus. The third letter is either the anterior, posterior, Or transverse part of the maternal pelvis

What is presentation?

The part of the fetus that is entering the pelvic first. It can be the back of the head, Occiput. -It can be the chin which is mentum -it can be the shoulder which is the scapula -or it can be breach which is sacrum or feet

What happens during the second stage of labor>

The patient has full dilation. She has intense contractions every 1 to 2 minutes resulting in birth

What happens during the third stage?

The placenta is delivered

What is fetal attitude?

The relationship of fetal body parts to one another

What is lie?

The relationship of the maternal spine to the fetal spine

What is fetal position?

The relationship with the presenting part of the fetus which could be the sacrum, Mentum, or occiput. -preferably the occiput in reference to his directional position as it relates to one of the four maternal pelvic quadrants

What is schultze presentation?

The shiny fetal surface of placenta emerges first

What is duration in regards to contractions?

The time between the beginning of a contraction to the end of the same contraction

What is position?

The woman's position during labor. The client should engage in frequent position changes during labor to increased comfort, relieve fatigue, and promote circulation. Positions during the second stage is determined by material preference, provider preference, and a condition of the mother and fetus

What is resting tone?

Tone of the uterine muscle in between contractions

What is Powers?

Uterine contractions cost effacement and dilation of the cervix and descent of the fetus. In voluntary urge to push an involuntary bearing down and decided stage of labor helps the expulsion of the fetus

What is flexion?

When the fetal head meets resistance of the cervix, pelvic wall, for pelvic floor. The head flexes bring the chain close the chest presenting a small diameter to pass the pelvis

What is engagement?

When the presenting part usually the largest diameter of the fetal head passes the pelvic at the level of that ischial spine referred to station zero

What is Duncan presentation?

the dull maternal surface the placenta emerges first