Labor and Birth Nursing Care
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| How does fatigue affect the body? How should the nurse help prevent it? | it affects the body by using a lot of glucose which makes a person even more tired when there's low levels; have pt. drink and eat! only push when she feels need
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| What is the single most reassuring thing to a mom in labor? | the nurse's presence!
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| What is a possible action by the nurse to decrease anxiety in the mom AND dad? | give information!
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| Should the patient come into the hospital right away when she suspects being in labor? | no! call if she wants to, come in if her water broke (prolapsed cord) but otherwise relax at home =)
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| What's another term for "water breaks"? | SROM - spontaneous rupture of membrane
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| What type of questions do you want to ask the mom on the phone if she says she's in labor? | why do you think you're in labor? what symptoms are you having? describe your symptoms?
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| How can you tell amniotic fluid from vaginal secretions? | vaginal secretions are very acidic, whereas amniotic fluid is alkalotic
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| What should you ask the mom about the color of the fluid if she thinks her water broke? | ask the mom what color it is (should be cloudy/clear) and ask if there is any color in it (if green, means there's meconium in it, baby's hypoxic)
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| What's a "fern test" | to check leaking fluid under the microscope and see if it's crystallized and looks like a fern, if it is, it's amniotic fluid
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| How do you know true labor from prodromal labor? | if contractions are consistent and increasingly painful (gradually getting worse), if it hurts to walk around, if pain starts in back, and cervical changes are noted = true labor
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| What is the best indicator for the difference of prodromal labor and real labor? | CERVIX CHANGES!
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| How can pain make labor progress? | endogenous pitocin is increased which dilates the cervix and effaces; endorphins are also released which can promote comfort
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| What is the ultimate best position that a mom can be in during labor? | sitting upright!
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| How should the nurse ask the mom questions throughout labor? and how should the nurse ask if she's coping good? | direct questions! use coping scale
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| How should the nurse provide information to the mom and dad? Feedback? | thoroughly, throughout the whole process; continually praise the mom and dad and stay with the pt.
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| Describe how you should validate the patient's pain. | acknowledge their level of pain but maybe remind them why they're having pain = labor =baby!
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| In the first stage, phase I: latent phase, what are three things you need to determine? | risk factors, couple's wishes, and labor status (via contractions)
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| In the latent phase, mom and dad need a lot of ________ and _________. | support and information
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| The nurse in the latent phase, active phase, and transition is continually ___________. | assessing!
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| What should the nurse check during the active phase of labor? 5 things | pain, VS, I&O, bladder, and hydration
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| What should the nurse monitor in the active phase with the baby? | FHR during contractions
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| What should the nurse monitor in the active phase with labor progress? | contractions, location of baby, cervical changes
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| The nurse should also assess the need for help with coping (mom and dad), how? | asking them on a "coping scale" offer suggestions of pharmological or nonpharmalogical comfort measures if they haven't already expressed it
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| What does dad need in the active phase? | his coping skills are tested, give them guidance on what to do, or a break
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| Many people think the best comfort measure during active phase is...? | a warm bath! really progresses labor
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| What types of things might help with the positioning of the baby during active phase? 2 | frequently changing positions or using the birthing ball
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| During active phase, it's imporant to offer water frequently so they stay ______! | hydrated
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| If there's too many people in the room talking to each other or watching TV - what is wrong with this situation? | focus should always be on mom! unless culturally contraindicated
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| How do birthing balls help labor? | they separate the pelvis and it's impossible for perineal muscles to tense up
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| What are some other "back labor" methods to use during active labor? 6 | tennis balls (massage), positioning on all fours, breathing, massage, imagery, hot packs
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| Why is it so important for mom to try to relax when she can during labor? 4 | promotes oxygenation, reserves energy, so women can work "with" labor instead of "against", less discomfort
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| How far along is the mom during the transition phase? | dilating to 8-10 cm - hard work!
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| How does the nurse assess the mom during the transition phase? 8 | VS, hydration, bladder, medications or not?, uterine contractions, cervical changes, vaginal show, and behavior
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| How does the nurse assess the baby during transition phase? | fetal descent and FHR
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| Always, in each phase, assess the need for help with ___________! | coping
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| What does dad need during the transition phase? | a hug! lol, normally dad is the brunt of all of the frustration coming from the mom and he needs to know that he is the "safe person"
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| How often does frequency of assessment occur during the transition phase? | every 15-30 min!
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| What type of comfort measures are good during the transition phase? How should you act with the mom? | breathing and relaxation are key here to prevent hyperventilation, massage, reassurance; you need to get right into the mom's face and sternly instruct her on things to do
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| If mom has urge to push before fully dilated, what should the nurse do? | tell mom not yet b/c it will affect her cervix, tell her to focus on breathing more
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| During the 2nd stage of labor, how can you get the baby to move if it's in an awkward position? | move the mom
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| When should the mom push? | when she feels the urge to and she's dilated 10 cm
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| What is REALLY IMPORTANT during the 2nd stage of labor? | HYDRATION
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| What position are women more often comfortable with in pushing? | when they're squatting; toilet
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| What type of temperature does the mom want now? what should you place on her perineum and what might you do to the perineum? | cool packs; warm packs and massage
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| When things don't go acccording to plan in a labor, what is the FIRST THING A NURSE SHOULD DO?! | see if any nursing interventions will help, if so = do them, if not = get help!
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| What should a nurse do if contractions slow down and are not effective? | get the mom up and moving around, or change position
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| What should the nurse do when there's inadequate uterine relaxation? | needs medical intervention! get help
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| What should the nurse do when baby's not happy, and HR decels? | maternal position change
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| what happens when the pt. has increasingly discomfort? | keep trying new interventions!
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| How should the nurse monitor the mom when having an epidural? 4 | watch the medication and how it can interfere with contractions, VS (esp. BP and RR), watch level of hydration and level of discomfort
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| What should the nurse monitor with the baby during an epidural? | FHR and pattern
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| What are some things that could go wrong with an epidural? 5 | hypotension, respiratory depression, non-reassuring fetal patterns, bladder distension, and suppression of labor progress
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| What is the CIWA assessment? What are the 10 areas of assessment? | its an assessment of alcohol use; N&V, tremor, paroxysmal sweats, anxiety, and agitation tactile disturbances, auditory disturbances, visual disturbances, headache, orientation and clouding of sensation
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| What are the two anti-anxiety drugs used to alcohol withdrawal syndrome? | ativan and librium
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Created by:
MeganThomp
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