NSG 222 Family Health Nursing Exam #2 for 2024/2025 COMPLETE SOLUTION 100%
VERIFIED ANSWERS A+ GRADED Free
The process of cervical effacement (thinning of cervix) and dilation is analogous to that
of pulling a turtleneck sweater over your head.
Passenger
- Head:
- Attitude:
- Lie:
- Presentation:
- Position:
- Station:
- Engagement:
Molding
molding goes down in about 3 days
Powers (contractions)
- Causes effacement (thinning of cervix, 0-100%) and dilation (0-10 cm)
- Frequency, duration, intensity
- Uterine contractions are rhythmic and intermittent, with a period of relaxation between
contractions.
- this pause restores blood flow to the uterus and placenta, which is temporarily reduced
during each uterine contraction.
- Uterine contractions are responsible for thinning and dilating the cervix,
- Cervical canal 2 cm in length would be described as 0% effaced.
- Cervical canal 1 cm in length would be described as 50% effaced.
- Cervical canal 0 cm in length would be described as 100% effaced.
- frequency refers to how often the contractions occur and is measured from the
beginning of one contraction to the beginning of the next contraction.
- Duration refers to how long a contraction lasts and is measured from the beginning of
one contraction to the end of that same contraction.
- Intensity refers to the strength of the contraction determined by manual palpation or
measured by an internal intrauterine pressure catheter.
Position (maternal)
-Lithotomy position: increases control of provider and improves ability to monitor fetus
- Upright: decreases labor time, increases rate of vaginal delivery, increases comfort,
gravity assists fetus to move downward, etc
Psychological response
Factors promoting a positive birth experience include:
•Clear information about procedures
•Support; not being alone
•Sense of mastery, self-confidence
•Trust in staff caring for her
, •Positive reaction to the pregnancy
•Personal control over breathing
•Preparation for the childbirth experience
- emotional, physical, and/or spiritual support during labor is the norm for most cultures.
Patient (Client) Preparation: Prenatal Education
•Help manage labor process
•Feeling in control
•Less medical intervention required
•Less likely to require analgesia or anesthesia
Less likely to have cesarean birth
Stages of Labor
•First: Dilation 0-10cm
•Second: Expulsive
•Third: Placental
•Fourth: Restorative
First Stage
•Progressive dilation of cervix
•Ends when cervix is 10 cm dilated
•Membranes usually, but not always, rupture
•Latent phase: 0-6 cm dilation, 0-40% effaced. Mild, cramping pain.
•Active phase: 7-10 cm dilation, 40-100% effaced. Intense pain.
Second stage
•Moving fetus through birth canal
•Pushing phase
1. pelvic phase: fetal descent
2. perineal phase: period of active pushing, contraction every 2-3 minutes lasts 60-90
seconds
Third stage
•Begins with birth of newborn, ends with delivery of the placenta
•Ideal placement for newborn following delivery is on mother's abdomen
•Postpartum hemorrhage most common cause of maternal morbidity
- separation and delivery of the placenta takes 5-10 minutes, but up to 30 minutes
1. Placental separation
2. Placental expulsion
Fourth stage
•Begins after expulsion of placenta, ends with initial stabilization of mother (1-4 hours
after birth)
•Focus: monitor for hemorrhage, bladder distention, venous thrombosis
Assessing the Laboring Mother and Baby
Vaginal examination
•Invasive, provide privacy and fully educate patient on the procedure
•Purpose: dilation, effacement, fetal membrane status, presentation, station,
swelling/molding status
•Procedure: sterile gloves, lubricant, use index and middle fingers
Performing Leopold Maneuvers
purpose is for determining the presentation, position, and lie
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