a nurse is caring for a client who is in labor. for which fetal response should the nurse monitor? This is a topic that many people are looking for. bluevelvetrestaurant.com is a channel providing useful information about learning, life, digital marketing and online courses …. it will help you have an overview and solid multi-faceted knowledge . Today, bluevelvetrestaurant.com would like to introduce to you Stages of Labor Nursing OB for Nursing Students | Stages of Labour NCLEX Explained Video Lecture. Following along are instructions in the video below:
Everyone its sarah thread sterner. Sorry and calm and in this video. I want want to be going over the stages of labour.
This video is part of an review series over maternity nursing. So if youre studying this section. Be sure to check out the other videos in this series.
And as always in the youtube description below or at the end of this video. You can access. The quiz that will test your knowledge on the stages of labour.
So lets get started okay as we go through the stages of labour. There are some things that you want to pay attention to for the ink lex exam or your maternity lecture exams like for instance theres four stages and what is happening during each of those stages. Especially your first stage.
Because first stage has three phases and you want to know whats happening with cervical dilation with contractions and nursing interventions and then throughout the other stages like 2 3. 4. You want to pay attention to whats going on and why your role is as the nurse like when the baby is delivered.
What are some signs and symptoms. The babys about to be delivered or in stage. 3.
When the placenta is delivered. What are you looking at after the placenta is delivered meaning. And whats the placenta supposed to look like and then in stage.
4. What are you going to be doing during recovery. So be sure you pay attention to all that as im going through this lecture.
So lets go over the four stages of labor. What are they okay stage. One is where the cervix dilates from 0.
To 10 centimeters. And this stage has three phases known as the latent. Which is also sometimes called early labor active and transition.
Then you have stage to this stage. Is where the baby will be delivered and then stage. Three will be delivery of the placenta and then stage.
Four will be the first one to four hours after the delivery of the placenta. Lets look at stage 1 of labor in debt. Okay.
The whole goal of stage. One is to get the cervix dilated from zero to ten centimeters and a hundred percent of face. So dilation is opening up of the cervix and effacement is thinning of the cervix and all this is going to happen due to the contractions.
The woman will be having and theyll start out very mild in the latent phase. And then when you get to transition phase. Theyre going to be really intense because that cervix is trying to open all the way up.
So that baby can be born thats the whole goal of this stage now some facts about stage one stage. One is the longest stage of all the stages of labor. And it tends to be longer for first time mothers.
Compared to women whove already had children and it starts when true labor starts now as i said before stage one has three phases so um. I would remember the name of each phase. What happens in them in regards to the dilation of the cervix your interventions and remember the order of them because the transition.
Which is the third part of this stage. The face will lead into stage. Two.
Where the baby will be delivered so to help you remember the order in the name of the stages. Remember this mnemonic labor actively transitioning because our labor is transitioning to stage two which is where the babys going to be born the whole goal is to have contractions open up that cervix thin. That cervix so the baby can get out and be born okay.
So lets look at the first phase. This is called the latent phase or sometimes referred to as early labor. The cervix is going to dilate from one to four centimeters in thin contractions will be every five to thirty minutes and 30 to 45 seconds in length.
Now these contractions are going to be very mild compared to what will be happening in the active and transition phase. And um. This phase is longest for first time mothers and sometimes women may not even know that theyre in um.
The latent stage of labor because the contractions may be mild. They not they may just have pain in their back. And so they really dont know now during this phase.
If the womans at home. She needs to stay at home until shes actively in active labour or the water breaks and the whole goal is to keep comfortable try to keep busy as the labor progresses during this phase. Mother is going to be excited and nervous and talking now were going to go into the active phase.
And this is where things start to heat up and start to get active okay in this phase. The cervix is going to dilate from four to seven centimeters. The woman will probably be dilating anywhere between about one centimeter per hour contractions are going to be every three to five minutes and forty five to sixty seconds long and the woman is going to notice that these contractions are a lot stronger and longer compared to what was happening in the latent phase.
This phase can last between four to eight hours now if the mother is still at home. Its time for her to go to the hospital also during this phase. The water may break and youll want to check and if it breaks in the hospital or if it broke at home youll want to ask for what color was the fluid that was leaking and because youre looking for whats called meconium staying fluid and this fluid will look like a yellow brown or greenish fluid.
And what can happen is that the baby can aspirate this into its lungs cause infection block. The airways and it can be an indication of fetal distress. So you want to ask that another thing you may be doing is performing a nitrazine paper test where youll take the fluid put it on a little strip of paper and if it turns blue that means that the woman is for surely leaking amniotic fluid.
Okay interventions during this phase is comfort. Because shes want to be having those intense contractions so comfort either through nonfarm illogical or pharma. Logical techniques and non pharmacological could be warm shower or baths or massage during contractions or an epidural.
Which is pharmacological breathing techniques and keeping the bladder empty. Im helping her if she has an epidural shell get a foley. But im helping her go to the bathroom every couple hours to void to empty that bladder because a full bladder can prevent the uterus from contracting properly.
Which can slow down labor and youll also want to be monitoring. The womans vital signs and the heart rate of the baby and i have a whole video on fetal decelerations. Talking about early and variable how to monitor those and a card should be popping up.
So you can access that and the mom. Shes going to be a lot different in this phase. Especially as it progresses.
Shes going to be serious in pain and anxious now lets look at the transition phase. This phase is going to lead into stage. 2.
Where the baby will be delivered the cervix is going to dilate from 8 to 10 centimeters remember. 10. Is where we wanted to get that perfect 10.
So the baby can be delivered. Now the thing with this phase. Is its um shortest of all the phases.
But its the most intense and most painful for the mother it can last anywhere from 30 minutes to 2 hours. Contractions are going to be very intense. Theyre going to be long sometimes back to back overlapping each other they can occur every 2 to 3 minutes and lasts 60 to 90 seconds.
The mom will be concentrating. Shes not going to feel like talking be irritated. Very much in pain and could be shivering.
Also she may start to feel an intense pressure in the rectum as that baby is pushing down and descending and you dont want the mother to start pushing even though shes going to want to push until that cervix is fully dilated because if the cervix is not dilated to 10 centimeters you can be pushing. Which can cause and the cervix to become swollen and then well never dilate. So you want to make sure that shes all the way to ten before she starts.
Pushing so some interventions a lot of support encouragement and praise let her know youve made it this far you can do this were almost there the breathing techniques monitoring vital signs of mother and especially baby the fetal heart rate and especially during those contractions after them and before hows the baby responding making sure its not any distress and assessing cervical dilation and effacement is she at the 10 yet and fetal positioning and what station is that is the baby. I and 0. Is where the baby is engaged its a little imaginary line you would draw on the pelvis.
0. Would be at the ischial spine. Which is the most narrow part of the pelvis and as the baby advances.
It will be entering into the positive numbers because behind 0 above the ischial spine our negative numbers like negative 1 negative 2 2 3 4 or 5. But as the babys starting to descend and will be coming out and we get positive numbers. So itll go from plus 1 to plus 5.
And plus. 5. Is crowning.
So youll want to be watching. Where baby is at okay. Now lets look at stage.
2. Okay this stage starts when the cervix has fully dilated in a face so its all the way open to that 10 centimeters. And its a hundred percent sin and it ends after the baby is delivered then we go into stage.
3. Where our placenta will be delivered. So whats the big highlights you need to know about stage.
2. Okay stage. 2.
Is where this woman is going to be feeling some really intense pressure at the end of the transition stage and set phase in stage. 1. She felt some pressure as that baby was pushing down.
But now the baby is going to start descending through the birth canal. So its going to start changing. Fetal stations.
Remember 1 2. 5. Is where were going in.
5. Is crowning and and for first time mothers this stage and lasts. Approximately about one hour anywhere it could last anywhere from two to three hours so it lasts.
A little bit longer for the first time others. And for my women whove already had children last about twenty minutes and the main thing was going to be making up this phase is pushing the womans going to be pushing that baby out of the birth canal to be born okay. So contractions will be similar to what she experienced in the transition phase.
Theyre going to be painful. Theyre going to hurt theyre going to be about 60 to 90 seconds in length and occurring every two to three minutes now interventions from the nurse. Youre going to be teaching her how to push propria when to push because if she has an epidural she may not be able to feel the contractions.
But you can see the contractions on the monitor youre going to help her breathe through them how to do them positioning and high fowlers and lithotomy or squatting or sideline. Youre also going to be offering lots of encouragement and praise talking to her and telling her how far the baby is along and youre going to be recording that exact time that baby is fully delivered. Because thats the birth time and monitoring bottle.
Sons and the fetal heart rate of course making sure everyones doing good although youre going to be looking at the perineum and there will be specific changes in the perineum before the baby is born so i would remember these and you may see bulging of the perineum and the anus or rectum as the babys head is coming through that canal an increase in bloody show or visible baby. Parts of course. You may see the babys head depending on the fetal position.
You may see it presenting there so that is telling you hey this baby is fixing to come out okay now on to stage. Three okay stage three starts with the full delivery of the baby and ends with full delivery of the placenta. Okay this stage is pretty short pretty easy for moments smooth sailing really after this and then we go into stage four which is a period so this stage lasts about five to 15 minutes.
We want it to be quick because the longer the stages the longer it takes to deliver the placenta it increases the risk of hemorrhage or retain placenta parts. Which will cause hemorrhage or infection. Now some signs and symptoms that you want to remember that the placenta is about to be delivered and the umbilical cord starts to lengthen there may be a trickle or a gush of blood.
All of a sudden and the uterus will change shape from an oval to a globular shape. So that are some signs and symptoms that the placenta is fixing to make its entrance okay some delivery mechanisms i would remember this i remembered questions from my maternity lecture exams on this okay and this is when the placenta is delivered which side is delivered first and so remember that and which side is the baby side and which side is the maternal side that was attached to the uterus. Okay.
So you have two delivery mechanisms. You have the schultz and you have the duncan okay. Schultz is the side that is shiny that um was delivered first so it was the baby side.
And how liked remember this was taught this shiny schultz and remember its the baby side. Because the baby is shiny and new. So its shiny.
A new length of baby. Its the shiny shultz and it was the saw that was facing the baby. It was delivered first then you have the duncan side.
The duncan mechanism and this is the side of the mother. The maternal side of the placenta that was delivered first a lot of people like to remember this dull. Dull dirty duncan.
The 3ds and because this side looks dull red and rough and remember momma just went through labor. So she is dirty from labor and shes in rough condition. So thats the maternal side.
So remember those in some interventions for this what you need to remember is youll be monitoring. The momas blood pressure before and after delivery placenta. Theres a risk of hemorrhage so you want to monitor that and the doctor may order.
Whats called pitocin. A master the delivery of the placenta because this prevents hemorrhage. So remember you may be giving pitocin after the delivery of the placenta and youll be assessing the placenta making sure.
Its fully intact and nothing is missing and still inside the uterus and youll be looking at that cord. Which should have two arteries in one vein and making mother comfortable getting her cleaned up the sheets changed peri care. Encouraging bonding between the mother and the baby and helping her with breastfeeding.
Okay now stage four this is our last stage. And this is the hours one to two one to four hours after delivery of the placenta. So what youre going to be doing is youre going to be monitoring.
The mom making sure her health is doing good and shes adjusting after shes just given birth. Because shes at risk for a lot of things like hemorrhage infection uterine atony. All that stuff so you want to make sure youre monitoring.
Those things. So youll be monitoring bottle signs especially her heart rate and blood pressure because im hemorrhage if shes hemorrhaging shell have job and blood pressure and shell become tachycardic as shes losing blood volume and her temperature. Because im risk of infection.
So your monitor that and the lochia. This is the discharge after birth shell be having a moderate to read amounts of lochia. There may be little small clots.
But large clots is a huge warning sign and you want to assess how often shes having to change that parry pad and shes changing it every 15 minutes. Because theres just so much blood that is not normal thats abnormal shes possibly hemorrhaging so youll want to assess that and another thing is youll be assessing the fundus of the uterus. This is the top portion of the uterus and you want to make sure that it is firm midline and near or at the bellybutton.
The umbilicus make sure. Its there so you will be filling that and depending on hospital protocol. Youll be checking it every 15 minutes for one hour and then every 30 minutes for two hours now a lot of questions like to ask you okay you feel the fundus.
Its soft and boggy and its displaced. What are you going to do and videos are going to provide funds and massage on that fundus of the uterus and a sister to the bathroom. Because a lot of times.
A full bladder can cause the fundus to become displaced and soft. So those are the things you would do for that if that question ever came up and other things youre going to do is youre going to administer pain relief per doctors orders provide peri care like ice and witch hazel because shell have a lot of swelling and she may have suffered from some tears or an episiotomy and promote bonding and breastfeeding with the woman and her baby okay so that wraps up the lecture on stages of labor. Thank you so much for watching dont forget to take the free quiz and subscribe to our channel for more videos.
Thank you for watching all the articles on the topic Stages of Labor Nursing OB for Nursing Students | Stages of Labour NCLEX Explained Video Lecture. All shares of bluevelvetrestaurant.com are very good. We hope you are satisfied with the article. For any questions, please leave a comment below. Hopefully you guys support our website even more.