labor and delivery nursing care

labor and delivery nursing care There are five factors that affect the labour and delivery process. They are often called the 5 Ps: _ (fetus and placenta); _ (birth canal); _ (contractions); _ of the mother; _ response. These factors affect the progression of labour and the birthing process, and each one will be expanded on in the following sections. - passenger passageway powers position physiological The _ is the fetus and the placenta that must pass through the birth canal. The way the fetus goes through the birth canal is affected by the size of the fetal head, the fetal presentation, the fetal lie, fetal attitude and fetal position - passenger The part of the fetus that enters the pelvic inlet first and leads through the birth canal. - presentation The relation of the long axis (spine) of the fetus compared to the long axis (spine) of the mother. - lie The relation of the fetal body parts to one another. - attitude The relation of the presenting part to the four quadrants of the mother's pelvis. - position fetal _ is also identified in terms of engagement and station - position the moment when the presenting part's largest transverse diameter has passed through the maternal pelvic brim presenting part's largest transverse diameter reaches 0 (zero) station. Zero station is determined by drawing an imaginary line between the maternal ischial spines - engagement a measure of the descent of the presenting part in the birth canal (e.g., how far the presenting part has progressed into the pelvis). relationship of the presenting part to the imaginary line. - station What enables the fetus's skull to adapt to the maternal pelvis during the birthing process? The cerebral _ and the two _ (anterior and posterior). - sutures fontanels During birth, the slight overlapping of cerebral bones can occur, causing molding of the fetus's head. How many days does it take for most newborns to assume their normal shape? - 3 days 7 cardinal movements of the fetus: _: the babys head moving downward into the pelvis cavity _ : after the babys head passes the pelvic cavity, it comes in contact with pelvis muscles, the babys head pulls in (flexes) and chin goes to chest _: when head enters the inlet, head should go through it in transverse position, widest part is side to side at inlet, when it gets to the outlet, it needs to turn its face to the back (occiput anterior) _: no pressure on the head and so it is going to extend _: no movement _: since the widest part of the outlet is front to back, the shoulders must move and be aligned with the front to back so that the head is going to turn to the side and teh shoulders will go through _: use force to wiggle up and down ward and this delivers the rest of the baby - decent flexion internal rotation extension restitution external rotation expulsion The _ is the bony pelvis and soft tissues of the cervix, pelvic floor and vagina. The labour and delivery nurse assesses the woman's cervix, vagina and perineum when indicated, in order to determine the potential for healthy progression of the baby through the birth canal. When the nurse assesses the cervix, presenting fetal part and membranes, the findings must include the following: Dilatation Effacement Station Position Consistency Presenting part Status of membranes - passageway Which pelvic type is the most common in women and is conducive to vaginal births? - gynecoid Which pelvic type increases the mother's risk of having a caesarean section? - android _ is needed to promote fetal descent and to expel the fetus and placenta from the uterus. There are two types of powers during the labour process: _ powers are involuntary uterine contractions, _ powers are voluntary efforts. - powers primary secondary primary or secondary powers involuntary contractions during labor process of shortening or thinning of cervix (effacement) the process of dilation of the cervix until it is fully dilated (10 cm) - primary primary or secondary powers valsalva maneuver adds force to uterine contractions to augment the forces of involuntary contractions voluntary pushing effort during labor feeling of wanting to bear down - secondary Ms. Chang is in labour with her first baby. Her contraction started at 8:12:15 and ends at 8:13:25. The next contractions starts at 8:15:15 and ends at 8:16:25. The fundus is difficult to indent with finger-tips during the contraction and soft between contractions.