Labor, Delivery, and Postpartum Nursing Care

Vocabulary flashcards covering the components and stages of labor, fetal heart rate monitoring, lochia characteristics, and postpartum maternal assessments.

Dilation

The opening of the cervix during labor, assessed from $0\text{-}10\,\text{cm}$.

Effacement

The thinning and shortening of the cervix during labor, measured from $0\text{-}100\%$.

Rupture of Membranes

The breaking of the amniotic fluid sac; normal fluid is clear, odorless, with a streak of red, while abnormal fluid is green/brown (NICU alert).

Presentation

The part of the fetus that enters the maternal pelvic inlet first.

Fetal Lie

The relationship of the mother's spine to the fetal long axis, classified as transverse or longitudinal.

Fetal Attitude

The posturing of the fetal body parts in relation to one another, categorized as flexion or extension.

Fetal Station

The measurement of the fetal presenting part in relation to the mother's ischial spine.

Powers (Uterine Contractions)

Involuntary uterine forces used to thin and dilate the cervix, assessed by duration (how long it lasts), frequency (how often it occurs), and intensity (strength).

True Labor Signs

Manifestations indicating the onset of true labor, including bloody show (mucus & blood), water breaking, cervical dilation, and contractions that increase in frequency, duration, and intensity.

Back Labor Pain

Discomfort that typically occurs when the baby is in the occiput posterior position; managed by applying counter pressure to the sacrum during contractions and repositioning the mother on hands and knees every $30\text{-}60\,\text{min}$.

Stage 1: Early/Latent Phase

The initial labor phase characterized by $0\text{-}3\,\text{cm}$ dilation, $0\text{-}30\%$ effacement, and irregular contractions occurring every $5\text{-}30\,\text{min}$ lasting $<30\,\text{sec}$; monitor for late decelerations.

Stage 1: Active Phase

The labor phase where the mother goes to the hospital, characterized by $4\text{-}7\,\text{cm}$ dilation, $100\%$ effacement, and stronger/longer contractions; interventions include breathing techniques, epidural, and IV narcotics given slowly during contractions.

Stage 1: Transitional Phase

The most intense labor phase characterized by $8\text{-}10\,\text{cm}$ dilation, $100\%$ effacement, strongest and closest contractions, anxiety/vomiting, urge for a bowel movement, and amniotic sac rupture (do not push until $10\,\text{cm}$).

Ferguson Reflex

The spontaneous pushing urge that occurs in Stage 2 of labor once the cervix is completely dilated to $10\,\text{cm}$ and $100\%$ effaced.

Stage 2 Labor

The stage of labor dedicated to delivering the baby once the cervix is $10\,\text{cm}$ dilated and $100\%$ effaced; maternal positioning includes high fowlers, lithotomy, or side lying, with instructions to avoid holding breath and breathe out slowly with mouth open while pushing.

Stage 3 Labor

The stage of labor involving placenta delivery; carries a high risk for infection and hemorrhage, requires not pulling on the placental cord, and utilizes pitocin/oxytocin to stimulate contractions and prevent hemorrhage.

Stage 4 Labor

The postpartum monitoring period lasting $2\text{-}4\,\text{hours}$ involving skin-to-skin contact, breastfeeding, and monitoring for infection (temperature over $100.4$) and hemorrhage (decreased blood pressure, increased heart rate, peri pad checks).

Boggy Uterus

A soft, poorly contracted uterus postpartum requiring fundal massage $3 \times 5\,\text{min}$ every $15\,\text{minutes}$, bladder emptying, breastfeeding, and pitocin administration.

Lochia Rubra

Bright red vaginal discharge occurring $3\text{-}4\,\text{days}$ postpartum.

Lochia Serosa

Pink-brown vaginal discharge occurring $4\text{-}10\,\text{days}$ postpartum.

Lochia Alba

White-yellow vaginal discharge occurring $10\text{-}28\,\text{days}$ postpartum.

Abnormal Lochia

Postpartum lochia signs indicating complications, including large clots, malodorous odor, and excessive bleeding defined as saturating $1\,\text{pad}$ in $15\,\text{min}$.

Variable Decelerations

Fetal heart rate dips with a W or V shape, caused by cord compression, managed by changing the mother's position.

Early Decelerations

Fetal heart rate dips that mirror uterine contractions, caused by head compression, signifying a happy baby ready for delivery.

Late Decelerations

A lowering of the fetal heart rate that occurs after a uterine contraction, caused by placental insufficiency, indicating a critical problem.

Accelerations

Temporary increases in the fetal heart rate indicating adequate oxygenation for the baby.

Postpartum Uterus Assessment

Evaluation of the fundus, which normally should be firm, midline, and descending at a rate of $1\,\text{cm/day}$; a boggy fundus requires fundal massage.

Postpartum Bladder Care

Frequent emptying of the maternal bladder to prevent uterine displacement.

Episiotomy Care

Postpartum perineal assessment and comfort interventions, including checking healing and using ice, sitz bath, or witch hazel.

Postpartum Emotional Assessment

Monitoring maternal psychological recovery by tracking Rubin's phases and screening for prolonged postpartum issues.