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Oxytocin Stimulation
THEORIES
ON THE ONSET
OF LABOR
Prostaglandins
Four Ps
P PASSAGE
P PASSENGER
P POWER
P PSYCHE
PASSAGE (The
False Pelvis
Pelvis
)
True Pelvis
Pelvic inlet
Mid pelvis
Pelvic outlet
Pelvis
Types
Gynecoid - most common for NSVD
Fetal Head
PASSENGER
(The
Fetal Attitude
Fetus)
Fetal Lie
Fetal Presentation
Fetal Position
Passenger
Fetal
attitude: relationship of
fetal parts to maternal uterus and
pelvis
Flexion (ideal)
Extension: labor will be more
difficult
Longitudinal (cephalic or
breech)
Transverse (c-sec)
Passenger cont
Passenger contd
POWER
Primary Forces-Uterine Contractions
(TheFrequency
Forces of
Duration
Labor)
Intensity
Secondary Forces
Abdominal muscles
Perineal muscles
Pelvic floor muscles
PSYCHE
(The Patients Psychological
State)
PSYCHE
SIGNS /SYMPTOMS
OF
LABOR
Cervical changes
Backache
Bloody Show
Nausea/Vomiting
Rupture of membranes
Indigestion
Diarrhea
Stages of Labor
Stages of Labor
CARDINAL FETAL
MOVEMENTS
ENGAGEMENT
DESCENT
FLEXION
INTERNAL ROTATION
EXTENSION
RESTITUTION
EXTERNAL ROTATION
EXPULSION
Labor Analgesics
Contraindication
sPoor fetal heart tones
Nursing Implications
Monitor fetal and maternal response
Administer narcan/ naloxone prn - Route,
dose
Regional Anesthesia
Epidural
Spinal
Pudenal
Local
Anesthesia for
Labor
General Anesthesia
Advantages
Faster access
Disadvantages
No support person
Discomfort to mother
Nursing
Responsibilities
For Epidurals
Bolus
Baseline vital signs and lab work available
Ensure client has an empty bladder
Position the patient
Ongoing monitoring of mother and baby
For General
As above
Cricoid pressure
Pitocin/Oxytocin
Uses
Contraindications
Side Effects
Abruptio placenta
Water intoxication
Fetal hypoxia
History of rapid labor and/or birth
Uterine rupture
Fetal Monitoring
External Monitoring
Tocodynameter
Ultrasound
Internal Monitoring
IUPC
FSE
Fetal Monitoring
Baseline
Tachycardia >160 bpm
Bradycardia <120 bpm
Acceleration 15 bpm x 15 secs
Decelerations
Early - Head compression
Late - Placental insufficiency
Variables- Cord compression