Definition one of the four ps or major factors that

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Definition: One of the four Ps or major factors that interact for a safe de- livery, it refers to the woman’s emotional state during labor. The emotional response of a woman impacts her physiological and psychological func- tioning during labor and may impede or facilitate the labor process. Lightening Engagement of the fetal head in the pelvis; takes place two weeks before labor in primiparas but often not until labor begins in multiparas; may cause increased pressure on the bladder, resulting in urinary frequency. Nesting Urge to clean the house, prepare the nursery, or do other things to prepare the “nest” for the arrival of the baby. Braxton Hicks Increase in strength and frequency. Decreased Weight Hormonal changes decrease water retention. Bloody Show Passage of blood-tinged mucous from the vagina; labor may begin in 24 to 48 hours. Cervical Changes Cervix is shorter, softer, and may be dilated 1 to 2 cm. Rupture of Membranes May be a gush or a trickle; mother should be advised to come to hospital, as labor may begin within 24 hours. OBSTETRICS
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[ 289 ] STAGE OF LABOR, THIRD STAGE OF LABOR, SECOND STAGE OF LABOR, FIRST Intrapartum PART III
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[ 290 ] NCLEX-RN Flash Review First Stage of Labor Begins with onset of true labor and ends when cervix is com- pletely effaced and dilated to 10 cm. Latent Phase Contractions are regular with a frequency of 5–15 minutes, dura- tion of 10–30 seconds, and mild intensity; station –2 to –1. Active Phase Cervix dilates from 3 or 4 cm to 8 cm. Fetus descends through birth canal to 0 or +1 station. Contractions 3–5 minutes apart with duration of 30–45 seconds, moderate intensity. Transition Phase Cervix dilates from 8 to 10 cm. Contractions occur every 1.5 to 2 minutes, last 60–90 seconds, and have a strong intensity. Station +1 to +2. Nursing Interventions Assess vital signs, contractions, fetal heart rate, bladder disten- sion, cervical changes; keep NPO (nothing by mouth); reinforce breathing/relaxation techniques; care for symptoms; administer pain medications as ordered; provide support. Definition: From cervical dilation of 10 cm to delivered infant. Assessment Findings: Contractions every 2 to 3 minutes lasting 60 to 90 seconds; maternal urge to push; visibility of presenting part; bulging perineum; increased bloody show. Nursing Interventions: Monitor maternal vital signs and fetal heart rate; pad stirrups, raise both legs simultaneously into stirrups; cleanse vulva and peri- neum as needed; provide oxygen if decreased fetal heart rate; encourage mother to take a deep breath before pushing and to push as long as possi- ble with each contraction; involve father: where to stand, what is occurring. Special Consideration: Mother may need to be catheterized if distended bladder prevents fetal descent.
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