Labor and Delivery exam

labor - series of processes by which the fetus, placenta, and membranes are expelled from the uterus and through the birth canal products of conception - fetus, placenta, membranes onset of labor theory - estrogen increased; progesterone decreased; fetal fibronectin found in plasma and cervicovaginal secretions prior to onset of labor; oxytocin; aging placenta admission assessment - gather FHR, maternal vital signs, dilation; GBS status; test for amniotic fluid (TACO); when the client last ate; obstetrical history; prenatal history; how previous pregnancies have gone gbs - can cause death in babies; screened around 35 wks; if positive, on antibiotics during labor; if unknown antibiotics started anyway contractions measurement - beginning of 1 contraction to beginning of another vertex - head down breech - butt down; turn baby externally or have a C section locating fhr - best to hear fh tones on their back; heard lower on vertex, higher on breech signs of labor - uterus more irritable; braxton hick's; contractions stronger and more frequent; bloody show; increased vaginal secretions; membranes may rupture; cervix ripens; sudden burst of energy; backache; lightening nurse role - assessment of FHR and contractions; facilitate comfort and progress; emotional assessment and support; promote safe and satisfying birth experience true contractions - begins in lower back and extends from back to abdomen; increases in intensity, frequency, and duration; change in cervix (softening, effacement, dilation, more anterior position) false contractions - confined to lower abdomen; does not increase in intensity, frequency, or duration; no change in cervix; walking may relieve discomfort; presenting part may not be engaged 6 Ps - powers, passenger, passageway, position, psyche, people powers - forces generated by uterine musculature; measured by observation, manual palpation, tocodynamometry, IUPC; involuntary and intermittent; bearing-down passenger - fetal size; fetal lie (longitudinal, transverse, oblique); fetal presentation; position; OA is good