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The laboring

woman

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G2 T0 P0 A1 L0

This is Sara going to the Maternity Center

She is 28 years old at 37 weeks

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Gra(ida

Parity

Lightening

Me&ranes

Contractions

Stages o"

La&or

Tr%e (s)

*alse La&or

Sterile

+aginal

,-a

Leo!old's

Mane%(er

Assessment

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True or False?

Is Sara in true or false labor?

28 yo 1-0-0-1-0 @ 37 wks.

Symptoms:

 pain in her back (radiating toront o her stomach!"

occasiona# na$sea" 1cm" sot

(% days ago!" membranes

intact" and &erte' position.

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Leopold Maneuvers?

What is that?

•*o%r ane%(ers "or diagnosing "etal !osition &y e-ternal !al!ation)

How can we use it?

•. o" *et%ses

•Presenting !art/ "etal lie/ and "etal attit%de

•egree o" Presenting !art's descent into the !el(is

•PM

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As the nurse applies the monitors the patientstates ! "eel water runnin# down m$ le#s.%

For Further assessment& the nurse applies

the'

#traso$nd

)ransd$cer 

(*+,!

)ocotransd$cer 

(ontractions!

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M

*4

Color +iscosity

Ao%nt

ursin! Assessment

dor

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"assen!erPowers

 Passage :ay  Position o" other

 Psychological res!onse o" the other

Five #ssential Factors for Labor

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• Si;e o" the "etal head

• Presentation

• Lie

• Attit%de

• Position

 Station

 ,ngageent

"assen!er

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Si$e of the fetal head

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Fetal "resentation

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Fetal lie

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Fetal Attitude

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Fetal "osition

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Fetal Station

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"assa!e%a&

bon& pelvis and soft tissues

4 t$pes o" (on$ pelvis )table 1*+2& p#.3,*- ++• G$necoid• Android• Anthropoid•

Plat$pelloid

o"t tissues ++ lower uterine se#ment& cervi/& pelvic0oor muscles& va#ina& introitus.

• ower uterine se#ment ++ distends toaccommodate intrauterine contents

• cervi/ ++ thins and opens to allow descent into theva#ina

• pelvic 0oor muscles ++ helps rotate the "etus as itpasses throu#h birth canal

• va#ina and introitus ++ dilate to accommodate the

"etus and permit passa#e.

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T&pes of 'on& "elvis

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"o%ers

"rimar&(Secondar&

Primary- in(ol%ntary %terine contractions

Secondary- 

(ol%ntary !%shing < a&doinal %scles•  o effect on dilation or effacement

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"osition and role of !ravit&

•

A""ects ada!tation to la&or• elie(es "atig%e/ co"ort/ circ%lation• Prootes descent o" "et%s• eectiveness o" contractions 5

shorter labor• cardiac output 5 blood 0ow• 6orrectl$ ali#ns abdomen "or pushin#

eorts

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Sta!e 1 ) Labor 

 

1-3cm

4-7cm

8-10cm

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ormal Labor *urve

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ursin! +ia!noses +urin! Labor 'irth

2) >nowledge e"icit

?) Pain

 

3) n"ection

) Altered rinary Stat%s

8) !aired Gas ,-change

7) Loss o" sel" control

1) An-iety

 

$) *l%id (ol%e de"icit

 

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Sta!e - )) Baby 

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Cardinal Mo(eents o" La&or

,ngageent

escent

*le-ion

nternal

rotation

,-tension

,-ternal

rotation@restit%tion

,-!%lsion

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%ring the ne-t

n%rsing

assessent the

!atient a!!ears

tense/

irrita&le and

!%shes her

s!o%se away"ro the &ed)

*ase #xample

She tells

the n%rseB

want this &a&yo%t D:E a

going to

PS4EEEF

.hat nursin! action %ould prevent in/ur& in this circumstance?

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D%rsing Assessent

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Assessment of 0terine *ontractions

Waves

DurationAcme

Period of Relaxation

Frequenc

!ntensitDecrement

!ncrement

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Sta!e - ) Baby 

9min:a#inal7eliver$ ;1

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•Lengthening cord

Sta!e

•S%dden g%sh o" &lood

•ise o" %ter%s a&o(e the sy!hysis !%&is

•terine sha!echanges "ro

o(al to glo&%lar

•+aginal"%llness

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Sta!e

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Sta!e 2 )) Recovery 

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"s&cholo!ical 3esponse

4ow can a other's res!onse tola&or e""ect her la&or !rogress9 

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4uestions?