Study Guide 6 – Friday, March 1st
Know the 4 P’s
Power – Uterine contractions and maternal pushing efforts (all about the mom’s labor and delivery powers) Problems with Power
Hypotonic dysfunction – ineffective contractions, coordinated, infrequent contractions, brief, too weak, active phase, uterine wall is stretched and contracts poorly**, INDIVIDUALS AT RISK are multiparous women, over distention of the uterus such as multiples, over distended uterus that poorly contracts Hypertonic dysfunction – produces ischemia and fetus has low O2 (hypoxia)**, latent phase, erratic in duration and effectiveness, constant cramping
Passage – Maternal pelvis structure and soft tissues, pelvic measurements are done to see if the passage is big enough to deliver vaginally Problems with Passage
Full bladder can cause obstruction and prolonged labor: have mother void every 1-2 hours**, misshaped pelvis
Passenger – Fetus plus the placenta and membranes (fetal head will mold to deliver through passage Problems with passenger
fetal size**, macrosomia (larger than 8.8 lbs), shoulder dystocia** Abnormal fetal position, labor is longer and uncomfortable, occiput posterior and transverse position** Deflexion abnormalities** (chin or breech position which is potential for cord compression)**
Psyche – Crucial part of childbirth, individual cultural values (how long family has been in delivery room, family members expectations, primarily language, support teams, concerns about touch Problems with psyche
Perceived threat of pain, fear, nonsupport, body responds to stress via fight or flight Shoulder dystocia and what is role as a nurse?
Shoulder dystocia is head is born and retracts against the perineum (like a turtle) Intervention is required to prevent cord compression:
McRobert’s maneuver: Women flexes her thighs against abdomen Superpubic pressure: Done by an assistant to push fetal shoulder downward to displace it from the mothers pubis symphysis Assessment:...
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