University:
Northwest College
Course:
VN 220 | Medical/ Surgical
Academic year:

2024
Views:

243

Pages:

4
Author:

Yesenia M.

Stages of Labor "Labor typically divided into 4 stages:" "1. dilation" "2. expulsive" "3. placental" "4. restorative" "First Stage - Is the longest stage" "fundamental change underlying the process is progressive dilation of the cervix" "cervical dilation gauged subjectively by vaginal examination and expressed in cm" "1st stage ends when cervix is dilated to 10cm and large enough to permit passage of a fetal head of average size" "Fetal membranes usually rupture during the 1st stage" "can last up to 20hrs in a primigranda" "2 Phases" "latent phase: begins at start of regular contractions and ends when rapid cervical dilation begins" "dilation: 1-6cm" "active phase: encompasses the time from an increase in the rate of cervical dilation (end of latent phase of labor) until completion of cervical dilation" "Second Stage:" Second Stage: Begins with complete cervical dilation (10cm) and effacement. Ends with the birth of the newborn. Involves moving the fetus through the birth canal and out of the body. Pushing: Active pushing is when the laboring mother feels rectal pressure by the fetal presenting part and physiologically feels the urge to push. When the baby's head no longer regresses between contractions, it is said to have crowned. Spontaneous pushing: following mom's urge. Directed pushing: pushing directed by the caregiver. Third Stage: Begins with the birth of the newborn and ends with the separation and birth of the placenta. Consists of 2 phases: Placental separation Placental expulsion The most common cause of death right after childbirth is bleeding, which can kill a woman within hours if untreated. Placental Separation: After the infant is born, the uterus continues to contract strongly and can retract, decreasing in size. Signs that indicate the placenta is ready to deliver: Uterus rises Umbilical cord lengthens Sudden trickle of blood is released from the vaginal opening Uterus changes its shape to globular Placental Expulsion: After separation of the placenta from the uterine wall, continued uterine contractions cause the placenta to be expelled in 2-30 minutes unless there is gentle external traction to assist. After the placenta is expelled, the uterus is massaged until firm so that uterine blood vessels constrict and minimize the possibility of hemorrhage. Fourth Stage: Begins with the completion of the expulsion of the placenta and membranes and ends with the initial physiologic adjustment and stabilization of the mom (1-4 hours after birth). Focus of this stage: Monitor mom and prevent hemorrhage, bladder distention, venous thrombosis. Usually mom is thirsty and hungry during this stage. "time . . . Vitals, fundus and lochia monitored Q15mins x 1hr."