NURS 2866 Ch. 16 - Nursing Care of the Family During Labor and Birth

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36 Terms

1
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Labor is divided into four stages. What does this chapter cover?

Nursing care throughout each of the four stages of labor.

2
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When does the first stage of labor begin and end?

Begins with onset of regular uterine contractions and ends with complete cervical effacement and dilation (10 cm).

3
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What is effacement?

Thinning of the cervix.

4
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What is dilation?

Enlargement of the cervix to 10 cm.

5
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What are signs of true labor?

Regular, strong contractions; intensify with walking; cervical change occurs.

6
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What are signs of false labor?

Irregular contractions; decrease with walking; no cervical change; may be due to recent exam, sex, bleeding, or semen.

7
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What subjective data should be collected during labor assessment?

Reason for visit, contraction details (onset, frequency, duration), pain level, discharge or fluid leakage.

8
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How is rupture of membranes confirmed?

Nitrazine test: blue if amniotic fluid (alkaline), yellow if vaginal secretions (acidic).

9
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What can cause a false positive Nitrazine test?

Recent sex, bleeding, or vaginal exams.

10
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What objective data is collected on admission in labor?

Physical exam, vital signs, fetal heart rate, uterine contractions, vaginal exam, bloodwork.

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When should a vaginal exam be done during labor?

On admission and before pain meds; limited if membranes ruptured.

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What blood tests are done during labor assessment?

Hemoglobin, hematocrit, type & screen, Group B Strep (if not done prenatally).

13
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What is important to review from the prenatal record?

GTPAL, risk factors, history of sexual abuse.

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What are key nursing interventions during labor?

Educate, support, encourage position changes, fluids, relaxation, advocate, maintain calm environment.

15
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When does the second stage of labor begin and end?

Begins with full dilation and effacement; ends with birth of the baby.

16
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What are the two phases of the second stage of labor?

Latent phase (passive descent), Active phase (pushing with Ferguson reflex).

17
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How often are vital signs and fetal heart rate checked during second stage?

VS: every 5–30 min; FHR: every 5–15 min.

18
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How often are vaginal exams done in second stage?

Every 10–15 minutes during active phase.

19
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How many nurses are assigned during second stage?

One nurse during labor; two nurses at birth (one for mom, one for baby).

20
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What is done to prepare for birth?

Positioning, pushing techniques, sterile supplies, warm baby table, suction and meds ready.

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What is done immediately after the baby is born?

Skin-to-skin, dry baby, put on hat, delay cord clamping 1–5 min or until pulsation stops.

22
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What is the benefit of delayed cord clamping?

Allows up to 30% more blood volume to transfer from placenta.

23
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What is included in newborn initial assessment?

Apgar score, airway check, breathing monitor, cold stress prevention.

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What happens if baby is stable after birth?

Apply ID bands and continue skin-to-skin contact.

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What happens if baby is not stable?

Move baby to warming table for further assessment and resuscitation.

26
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How is the perineum assessed after birth?

Check for soft tissue trauma and laceration degree.

27
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What are the degrees of laceration?

1st: superficial; 2nd: perineal muscles; 3rd: through anal sphincter; 4th: through rectal mucosa.

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What is an episiotomy?

Surgical incision to enlarge vaginal outlet; not routine.

29
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When does the third stage of labor occur?

From birth of baby to delivery of placenta.

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What are signs of placental separation?

Lengthening cord and vaginal blood gush.

31
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What medication helps deliver placenta and control bleeding?

Pitocin (IV or IM).

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What care is done after placenta delivery?

Perineal care, patient cleaning, breastfeeding encouraged.

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When is the fourth stage of labor?

From placenta delivery to ~1–2 hours postpartum (stabilization period).

34
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What is assessed during the fourth stage of labor?

Vital signs and fundus every 15 minutes for 2 hours.

35
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What if the fundus is boggy?

Perform fundal massage and help empty bladder.

36
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What else is monitored in the fourth stage?

Lochia (bleeding), perineum (laceration or episiotomy status).