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MaternalThe uterus releasing prostaglandins that stimulate contractionsIncrease pressure on the cervixEstrogen increaseProgesterone decreaseOxytocin levels increaseFetalPlacenta ages/deteriorates and triggers contractionsPlacenta releases prostaglandins to initiate contractionsFetal cortisol rises and reduces progesteroneSigns of impending laboroOccurs a few weeks before labor, changes occur that indicate to the women’s body that is preparing for the onset of laborLightening: Decent of the fetus to the true pelvis, the woman can breathe easierBraxton-Hicks contractions: Irregular UC that do not result in no changes to the cervix, then they start to coordinate when true labor beginsCervical changes: The cervix becomes soft and beings to dialate.Surge in energy: some woman say they have a burst in energyBackache: Due to the relaxation of the pelvic jointsBloody show: Brownish-blood tinge cervical mucous (what?!)5 P’s of Labor List and describeoPowers(contractions)oPassage(pelvis and birth canal)oPassenger(The fetus)oPsyche(Response of the womanoPosition(Maternal postures and physical position to facilitate labor)Premonitory Signs of Labor (5) Identify and define
West Coast UniversityPage 1RF: 06/06/19Mechanisms of Labor/Cardinal movementsoEngagementoDescentoFlexionoInternal rotationoExtensionoExternal rotationoExpulsionFerguson’s ReflexoWomans physiological response when the presenting part of the fetus is at least +1 station, accompanied by spontaneous bearing down efforts 4 Stages of Labor oFirst stage3 phasesLatent: 0-3 cmActive: 4-7 cmTransition: 8-10 cmWater breaks, pulse increase and cardiac outputoSecond stageCervix is 10 cm dilated Baby is deliveredoThird stageBegins after delivery and involves the expulsion of the placenta and membranesoFourth stageTypically 4 hours after the delivery of the placenta Assess for all signs of post partum damage, episiotomy etcTypes of pharmacological management of Labor DiscomfortoMedications such as Demerol, stadol, fentanyl, epidural blockGate Control theory of painoStates that sensation of pain is transmitted from the periphery of the body along ascending nerve pathways to the brain; due to the limited number of sensations that can travel along these pathways at any given time, an alternate activity can replace travel of the pain sensation; thus closing the gate control at the spinal cordand reducing pain impulses traveling to the brainNursing actions before, during and after epidural administrationoMonitor vital signs every 5-15 minutes, assess for hypotension and respiratory distressoFacilitate upright or lateral positioning to minimize supine hypotension