OB - Intrapartum Wk 1-1.pptx - OB Nursing Week 1...

OB Nursing
Week 1

Intrapartum
Nursing
Care
Labor!
Nursing
assessments:
maternal &
fetal well-
being
progress of
labor
psychosocial &
cultural factors
3 clients :
fetus, mother,
family

Five Ps of
Labor
•
Factors that affect & define the
labor process besides the fetus
and the placenta
•
3KQ

Five Ps -
Passenger
presentation – what part is entering the pelvis first?
lie – relationship of maternal spine to fetal spine
transverse – horizontal, shoulder is presenting part
parallel or longitudinal – cephalic or breech
attitude – relationship of fetal body parts to one
another
flexion – chin to chest, extremities flexed into torso
extension – chin not on chest, extremities extended

Five Ps-
Passenger
relationship of presenting part to maternal
quadrant
right (R) or left (L)
occiput(O), sacrum(S), mentum(M),
scapula(Sc)
anterior (A), posterior(P) or transverse (T)
e.g. LOA
“ station ” – measurement of fetal descent,
+, 0 or -, ischial spines

Five Ps – Passageway (birth canal
structures)
bony
pelvis
01
cervix
02
pelvic
floor
03
vagina
04
introitus
(vaginal
opening)
05

Five Ps - Powers
UTERINE
CONTRACTIONS
INVOLUNTARY
URGE TO PUSH
VOLUNTARY
BEARING DOWN

Five Ps –
Position
(maternal)
frequent position
changes:
comfort
relieve fatigue
promote circulation
gravity helps

Five Ps - Psychological response
STRESS TENSION & ANXIETY
CAN IMPAIR PROGRESS
INCLUDE SUPPORT
PERSON AS MUCH AS
POSSIBLE

Premonitory
Signs of
Labor
Backache
Weight loss in days leading up to labor onset – 0.5-
1.5kg (1-3.5lbs)
Lightening – “baby dropped”, head descends into
true pelvis, primips feel it more, urinary frequency
Contractions – Braxton Hicks or real?