Exam 2 review
Intr
Intrapartum
apartum
Leopold’
Leopold’s s maneuv
maneuver
er – which maneuv
maneuver
er correlates with what part of
the fetal assess
assessment
ment
o 1st step – assessing fundus – which part is up
2 maneuver
nd
Find baby’
baby’ss back for optimal FHR monitor
monitoring
ing
3rd outline of head
4th face feet to see what direction the baby’s head is
Important nursing actions o off e
each
ach labor stage: latent, a
ac
ctive, &
tra
transition
nsition
Latent: Vital Signs, EFM, clear liquids, rest/activity as tolerated
Active: all above + assess for ROM, massage, counterpressure,
partner slow dance, coached breathing, doula, pain meds
Transition: all above + encourage relaxation/breathing between
contx, constant coaching. REMAIN AT BEDSIDE
Define each labor stag
stage:
e: latent, active, & tr
transition
ansition (how do we
determine the stage, what is the patient’
patient’s
s activity like)
Latent
0 (onset of true labor)-3 cm dilation
Contx: irregular, mild-moderate
Freq: 5-30 mins
Duration: 30-45 secs
Pt= talkative & eager
Active
4-7 cm dilation
Contx: more regular, moderate-strong
Freq: 3-5 min
Duration: 40-70 secs
Rapid dilation & effacement, some descent
Pt= anxious, restless
Transition
8-10 cm dilation
Contx: strong-very strong
, Freq: 2-3 mins
Duration: 45-90 secs
Most difficult part of labor
N/V, bloody show
Increased rectal pressure, urge to push
Pt= tired, restless, irritable, feeling out of control, “cannot
continue”
Maternal positioning – wha
whatt is OK vs what is not OK; wh
why?
y?
Supine, head flat is NOT OK
Any position mom is comfortable in is OK
How do contr
contractions
actions change from latent labor through activ
active
e labor &
the tra
transition
nsition period (fre
(frequency
quency
quency,, dur
duration,
ation, strength)
Latent
Contx: irregular
mild-moderate
Freq: 5-30 mins
Duration: 30-45 secs
Active
Contx: more regular
moderate-strong
Freq: 3-5 min
Duration: 40-70 secs
Transition
Contx: regular
strong-very strong
Freq: 2-3 mins
Duration: 45-90 secs
How to measure uteri
uterine
ne contra
contraction
ction strength externa
externally
lly (nose, chin,
& forehea
forehead)
d)
Palpation!!!
Nose= mild
Chin= moderate
Forehead= strong
Intr
Intrapartum
apartum
Leopold’
Leopold’s s maneuv
maneuver
er – which maneuv
maneuver
er correlates with what part of
the fetal assess
assessment
ment
o 1st step – assessing fundus – which part is up
2 maneuver
nd
Find baby’
baby’ss back for optimal FHR monitor
monitoring
ing
3rd outline of head
4th face feet to see what direction the baby’s head is
Important nursing actions o off e
each
ach labor stage: latent, a
ac
ctive, &
tra
transition
nsition
Latent: Vital Signs, EFM, clear liquids, rest/activity as tolerated
Active: all above + assess for ROM, massage, counterpressure,
partner slow dance, coached breathing, doula, pain meds
Transition: all above + encourage relaxation/breathing between
contx, constant coaching. REMAIN AT BEDSIDE
Define each labor stag
stage:
e: latent, active, & tr
transition
ansition (how do we
determine the stage, what is the patient’
patient’s
s activity like)
Latent
0 (onset of true labor)-3 cm dilation
Contx: irregular, mild-moderate
Freq: 5-30 mins
Duration: 30-45 secs
Pt= talkative & eager
Active
4-7 cm dilation
Contx: more regular, moderate-strong
Freq: 3-5 min
Duration: 40-70 secs
Rapid dilation & effacement, some descent
Pt= anxious, restless
Transition
8-10 cm dilation
Contx: strong-very strong
, Freq: 2-3 mins
Duration: 45-90 secs
Most difficult part of labor
N/V, bloody show
Increased rectal pressure, urge to push
Pt= tired, restless, irritable, feeling out of control, “cannot
continue”
Maternal positioning – wha
whatt is OK vs what is not OK; wh
why?
y?
Supine, head flat is NOT OK
Any position mom is comfortable in is OK
How do contr
contractions
actions change from latent labor through activ
active
e labor &
the tra
transition
nsition period (fre
(frequency
quency
quency,, dur
duration,
ation, strength)
Latent
Contx: irregular
mild-moderate
Freq: 5-30 mins
Duration: 30-45 secs
Active
Contx: more regular
moderate-strong
Freq: 3-5 min
Duration: 40-70 secs
Transition
Contx: regular
strong-very strong
Freq: 2-3 mins
Duration: 45-90 secs
How to measure uteri
uterine
ne contra
contraction
ction strength externa
externally
lly (nose, chin,
& forehea
forehead)
d)
Palpation!!!
Nose= mild
Chin= moderate
Forehead= strong
