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27402513-birth-process-labor-and-delivery - Giving Birth(22...

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Giving Birth (22) Debbie Amason, RN,MS Labor Labor-and involuntary physiologic process whereby the contents fo the gravid uterus are expelled through the birth canal into the external environment Theories/factors that influence…. .Exact cause is unknown, but believed to be influenced by several factors: Uterine muscle stretching —uterus can no longer expand pressure on cervix ---pressure drops onto cervix Stimulated by oxytocin Change in ratio of estrogen and progesterone ---shift of these causes labor Decreasing function of placenta —placenta only develops to a certain point and then starts deteriorating, thus causing labor Increase in fetal cortisol * fetal membranes production of prostaglandin Signs of labor Preliminary signs of labor : lightening, increased energy levels, Braxton Hicks contractions, cervical ripening, increased vaginal secretions,cervical softening, bloody show True -regular uterine contractions that increase in frequency, strength, and duration, and do not disappear when lying down or walking around; effacement (shortening or thinning of the cervix) and dialation of the cervix; SROM-spontaneous rupture of membranes Differentiate between true and false labor-- True labor will cause the cervix to dilate & are regular, gradually increasing in intensity, false labor will not dialate cervix & may or may not be regular and do not increase Duration of labor: Primipara – 14 hrs & not more than 20 hrs & False Labor True Labor Irregular contractions No increase in intensity Pain – confined to abdomen Pain – relived by walking No cervical changes Contractions are regular Increased intensity Pain – begins lower back radiates to abdomen Pain – intensified by walking Cervical effacement & dilatation * major sx of true labor.
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Issues for new nurses Pain-- Most people want to relieve pain promptly, however pain is an expected part of the labor process Inexperience-- If never had a baby, basic skills, assess critical thinking, provide comfort, problems solving Unpredictability-- Own timetable Intimacy-- maintain professional behavior Physiological responses Cardiovascular Hemapoetic Respiratory Temp. regulation Urinary Musculoskeletal GI Neuro Integumentary Components of Labor The 4 P’s passage passenger powers psyche 1. Passage refers to pelvis & soft tissues which include: lower uterine segment, cervix, vaginal canal 2 pelvic measurements --Necessary to determine adequacy: diagonal conjugate- narrowest at inlet; transverse diameter- narrowest at outlet if disproportion occurs usually the pelvis ( If fetus presents in unusual position); could be R/t mother: being < 4’9” tall being < 18 years old Underwent pelvic dislocation 4 main pelvic types 1. Gynecoid – round, wide, deeper most suitable (normal female
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27402513-birth-process-labor-and-delivery - Giving Birth(22...

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