NUR 4445 Third and Fourth Stages of Labor
1. What is the third stage of labor characterized by?
- The third stage of labor lasts from the birth of the baby until the placenta is expelled.
- The placenta has separated and has been delivered
2. What are indications that the placenta has separated (4)?
· Contraction of the uterus - globular shaped uterus and rises in the abdomen
· Gush of blood
· Lengthening of the cord
· Vaginal fullness/urge to push - per mom
3. What medications may be used after the delivery of the placenta (3)?
· Cytotec
· Methergine
· Hemabate
4. How and when do we administer cytotec?
- do not give while pregnant, induces labor
- Given rectally
- Also given PO or vaginally but in situation of atonic uterus and increased bleeding PR for
fastest absorption
5. How do we give Methergine? Who is it contraindicated in?
- Given IM
,- Not given to person with hypertension as it can precipitate a hypertensive crisis!
6. Who is hemabate contraindicated in?
Not for asthmatic patients
7. At what stage of labor should newborn initial care be performed?
Newborn initial care should be done during the third stage of labor.
8. What is included in initial newborn care (5)?
· Placing newborn on abdomen of mother or under radiant-heated unit.
· Dry newborn immediately
· Keep newborn warm with warmed blankets and skin-to-skin contact with mother.
· Suction nose and mouth of newborn as needed - if newborn has a lot of secretions or needs
suctioning place them in modified Trendelenburg position!
· APGAR score
9. What are the requirements for receiving an Apgar score of 0 in the following categories
heart rate, respirations, muscle tone reflex response, skin color?
- Heart Rate
Absent
- Respirations
Absent
- Muscle Tone
, Flaccid
- Reflex Response
Absent
- Skin Color
Pale or blue
10. What are the requirements for receiving an Apgar score of 1 in the fol- lowing categories
heart rate, respirations, muscle tone reflex response, skin color?
- Heart Rate
< 100 bpm
- Respirations
Slow & irregular
- Muscle Tone
Some flexion of extremities
- Reflex Response
Grimace, Noticeable facial movement
- Skin Color
1. What is the third stage of labor characterized by?
- The third stage of labor lasts from the birth of the baby until the placenta is expelled.
- The placenta has separated and has been delivered
2. What are indications that the placenta has separated (4)?
· Contraction of the uterus - globular shaped uterus and rises in the abdomen
· Gush of blood
· Lengthening of the cord
· Vaginal fullness/urge to push - per mom
3. What medications may be used after the delivery of the placenta (3)?
· Cytotec
· Methergine
· Hemabate
4. How and when do we administer cytotec?
- do not give while pregnant, induces labor
- Given rectally
- Also given PO or vaginally but in situation of atonic uterus and increased bleeding PR for
fastest absorption
5. How do we give Methergine? Who is it contraindicated in?
- Given IM
,- Not given to person with hypertension as it can precipitate a hypertensive crisis!
6. Who is hemabate contraindicated in?
Not for asthmatic patients
7. At what stage of labor should newborn initial care be performed?
Newborn initial care should be done during the third stage of labor.
8. What is included in initial newborn care (5)?
· Placing newborn on abdomen of mother or under radiant-heated unit.
· Dry newborn immediately
· Keep newborn warm with warmed blankets and skin-to-skin contact with mother.
· Suction nose and mouth of newborn as needed - if newborn has a lot of secretions or needs
suctioning place them in modified Trendelenburg position!
· APGAR score
9. What are the requirements for receiving an Apgar score of 0 in the following categories
heart rate, respirations, muscle tone reflex response, skin color?
- Heart Rate
Absent
- Respirations
Absent
- Muscle Tone
, Flaccid
- Reflex Response
Absent
- Skin Color
Pale or blue
10. What are the requirements for receiving an Apgar score of 1 in the fol- lowing categories
heart rate, respirations, muscle tone reflex response, skin color?
- Heart Rate
< 100 bpm
- Respirations
Slow & irregular
- Muscle Tone
Some flexion of extremities
- Reflex Response
Grimace, Noticeable facial movement
- Skin Color
