Nursing Practice Experience Week 1 and 2

Caring

Value and guiding principle for perinatal nursing that includes:

Providing safe, compassionate, competent, and ethical care. Demonstrated through authentic presence which is achieved by addressing physical, emotional, and spiritual needs throughout care.

Health and Wellbeing

Value and guiding principle for perinatal nursing that includes:

assisting mothers and their families to strengthen their optimal level of well-being throughout the childbearing continuum.

Justice

Value and guiding principle for perinatal nursing that includes:

Safeguarding human rights, equity gender-inclusiveness, and fairness

Informed Decision Making

Value and guiding principle for perinatal nursing that includes:

Recognizing the rights of patients to make decisions that are congruent with their own beliefs and values

Dignity

Value and guiding principle for perinatal nursing that includes:

Creating a healing environment that protects and promotes human ______

Confidentiality

Value and guiding principle for perinatal nursing that includes:

recognizing the importance of privacy and trust of women and their families

Accountability

Value and guiding principle for perinatal nursing that includes:

Acting with integrity consistent with professional obligations, responsibilities, and standards of practice

Perinatal

______ nursing is a recognized specialty in Canada. ______ nurses work collaboratively with women and their families from preconception through pregnancy, childbirth, and the postpartum period.

Neonatal Nursing

Nursing speciality that intersects closely with perinatal nursing. Nurses provide care for high-risk neonates.

Expected Date of Birth

also known as the due date— occurs 266 days after conception or 280 days (40 weeks) after the first day of the LMP.

Nägele's rule

adding 7 days to the LMP and subtracting 3 months to estimate DOB.

5-8

Gestational age of _ to _ weeks:

Heart developing in fetus. Arm/legs forming. Head large and features beginning to form.

Women misses menstrual period. Nausea, fatigue, tingling of breasts, uterus size of lemon. Increased urinary frequency as enlarging uterus presses on the bladder.

Back

As the weight of the pregnant woman increases, so does the weight and strain on their _____, pelvis, and hips.

Health teaching includes sleeping on a firm mattress with a pillow between their legs, maintaining good posture.

Bloating and Gas

Hormone changes during pregnancy slows down digestion, allowing bacteria to produce ____ and ___.

Health teaching includes limiting large meals and gas-producing foods.

First Stage

Stage of labour characterized by 0-10cm dilation; three phases.

Second Stage

Stage of labour characterized by complete dilation (10cm) to birth of newborn; lasts up to 1 hour.

Third Stage

Stage of labour characterized by separation and delivery of the placenta.

Fourth Stage

Stage of labour 1-4 hours after delivery characterized by maternal physiologic adjustment.

Latent Phase

Phase 1 of stage 1 of labour characterized by 0-3cm dilation, contractions every 5-10 mins with 30-45 second durations.

Nulipara : up to 6 hours

Multigravida: up to 4.5 hours

Active Phase

Phase 2 of stage 1 labour characterized by 4-7cm dilation, contractions every 2-5 minutes with 45-60 second durations.

Nulipara: average of 9 hours

Multigravida: average of 6.5 hours

Transition Phase

Phase 3 of stage 1 labour characterized by 8-10cm dilation, contraction frequency every 1-2 minutes with 60-90 second durations.

Pelvic Phase

Phase of stage 2 labour characterized by fetal descent

Perineal Phase

Phase of stage 2 labour characterized by period of active pushing. Contractions every 2-3 minutes or less for 60-90s. Strong urge to push during later stage.

Placental Separation

Phase of stage 3 labour where placenta detaches from the uterine wall.

Placental Expulsion

Phase of stage 3 labour where placenta leaves the vaginal opening

The passageway

1 of the Ps of labour

Consists of maternal pelvis and soft tissues. Bony pelvis more important to outcome due to inability to yield to forces of labour. Three subdivisions: inlet, pelvic cavity, outlet.

Passenger

1 of the Ps of labour. Refers to the fetus plus the membranes and placenta. Fetal shoulders of importance due to their width, usually flex and adapt to pelvis.

Powers

1 of the Ps of labour consisting of the uterine contraction and maternal pushing effort.

Psychological Response

1 of the Ps of labour that marks the woman’s ability to cope with pain and labor.

Maternal Position

1 of the Ps of labour that details the position of the mother during birth.

Electronic Fetal Monitoring

involves the continuous use of equipment to monitor contractions and fetal heart rate.

Inlet

Subdivision of pelvis first encountered by fetus when being birthed. If it is too small, the fetal head will not be able to pass through. Almost entirely surrounded by bone without much room for expansion.

Midpelvis

Subdivision of pelvis second encountered by fetus when being birthed. Narrowest part of pelvis fetus must pass through. Measured at the level of ischial spines w/ average diameter of 12cm.

Outlet

Subdivision of pelvis last encountered by fetus. Numerous shapes with various degrees of birthing difficulties

Full flexion

It is favourable to have the fetal head in ____ ____ (head perpendicular to exit) to have a shorter suboccipitobregmatic diameter (9.5cm). The largest diameter is the supraoccipitomental diameter (13.5cm).

Vertex Presentation

fetus is in a headfirst, head down position with its chin tucked towards its chest (ideal).

Face Presentation

abnormal form of cephalic presentation where the presenting part is the mentum (face)

Brow Presentation

abnormal form of cephalic presentation where fetal head is midway between full flexion (vertex) and hyperextension (face) along a longitudinal axis.

Shoulder Presentation

abnormal form of cephalic presentation where the baby is in a transverse lie, thus the leading part is an arm, a shoulder, or the trunk

Breech Presentation

abnormal form of cephalic presentation where the baby is born bottom first.

Station

Refers to the descent of the fetus in relation to the ischial spines. Approximated by counting fingers above and below the belly button.

Leopold maneuver

Used to determine the position of the fetus through palpitation of the belly.

Uterine contraction

Characteristics of a contraction: coordinated, involuntary & intermittent.

Uterine Body

Characteristics of _____ _____ contractions include:

The upper 2/3 of the uterus contracts actively
to push the fetus down.
• The lower 1/3 of the uterus remains less
active, allowing downward passage of the
fetus.
• The cervix is similar to the lower uterine
segment in that it is also passive.
• The physiologic retraction ring marks the
division of the upper and the lower segments
of the uterus.

Cervical Changes

______ ______ during contractions include:

Effacement (thinning and shortening of
the cervix)
• Dilation (opening of the cervical os)
• They occur together but at different rates

100-160bpm

Fetal heart rate.