maternal health nursing

• Labor is the delivery of the baby from the mother into the world.
• The fetus is considered full term when labor occurs between 37 to 42 weeks.
• Premature labor occurs before 37 weeks.
• The four stages of labor are: stage one begins with uterine contractions to help open up the cervix, known as cervix stylation, stage two is the delivery of the baby, stage three is the placenta delivery, and stage four is the postpartum recovery.
• The goal in stage one is to get to 10 centimeters of dilation.
• The goal in stage two is to push the baby out.
• Monitor for a decreasing blood pressure and an increasing heart rate as these both indicate severe hemorrhaging.
• The fundus is the top portion of the uterus and if it's soft and boggy, it should be massaged until firm to stop bleeding.
• Breastfeeding stimulates the release of natural oxytocin from the mother which helps the uterus to contract and stop bleeding.
• Perry pads are priority in less than one hour.
• Pitocin or oxytocin is given IV or IM, a synthetic hormone that causes the uterus to contract, used to control the bleeding after childbirth and to induce labor before birth.
• A displaced fundus is above the umbilicus or to one side, typically from bladder distension.
• During this phase, uterine involution occurs where the uterus returns to its pre-pregnant size and location, continuing until 15 to 21 days after delivery.
• Interventions for a soft or boggy fundus include oxytocin infusion and fundal massage.
• A normal fundus should be firm, midline, and level with the umbilicus.
• The goal in stage three is to deliver the placenta.
• The goal in stage four is to recover from the delivery.
• The whole process typically takes around 12 to 18 hours but time can vary greatly.
• The four signs of true labor before birth are: cervical changes, including a bloody show, water breaking, true labor contractions, and the cervix.
• Cervical changes include a bloody show, which is mucus and blood, and water breaking, where the amniotic sac ruptures and clear watery fluid discharges from the mother.
• True labor contractions progress in terms of frequency, regularity, and intensity, and cause Progressive cervical changes to open up the cervix.
• Repositioning the mother on her hands and knees with a birth ball and encouraging her to change positions every 30 to 60 minutes during labor is done to promote fetal rotation and descent.
• Effacement is when the cervix gets thinner and shorter as the cervix stretches upward with contractions, measured in percentages from zero to a hundred percent.
• Applying counter pressure to the sacrum during contractions is a big NCLEX tip for back labor pain control.
• The cervix can be measured during a vaginal exam, with a thick cervix being zero percent, a middle knuckle being 50 percent, and a halfway point between the tip and the first knuckle being 80 percent.
• Pain in the lower back that moves to the lower abdomen, Progressive cervical effacement and dilation, regular and rhythmic contractions that increase in frequency and intensity, and contractions that become more intense with walking are signs most indicative of true labor.
• Signs that true labor is present include pain in the lower back that moves to the lower abdomen, Progressive cervical effacement and dilation, regular and rhythmic contractions that increase in frequency and intensity, and contractions that become more intense with walking.
• Left lateral Position will not alleviate the client's back pain, which is good for fetal oxygenation and blood flow but not really good for back pain.
• A cervix that is paper thin is a hundred percent effaced.
• Back pain or back labor is a big NCLEX tip, with lower back pain experience with contractions likely when the fetus is in an occiput posterior position.
• False labor contractions, also known as Braxton Hicks contractions, disappear with walking or position changes and do not lead to dilation of the cervix, making them a false labor sign.
• No position changes and remaining in bed during early labor actually increases the risk for persistent fetal malposition and slows labor progression.
• True labor increases in intensity and the cervical change is Progressive.
• True labor contractions are regular, increase in frequency, duration, and intensity, and do not decrease with rest.
• Breastfeeding stimulates maternal oxytocin release which helps contract that uterus, provides nourishment, and supports the blood sugar of the newborn.
• The client is at high risk for infection if placenta parts are not fully removed from the uterus and for Hemorrhage if there's pulling on the cord during placenta delivery.
• Assessments for The Mother during the fourth stage of Labor prioritize blood loss and infection, with a temperature over 100.4 requiring further evaluation.
• The second stage of Labor sees a significant increase in contractions, activation of the Ferguson reflex, and the client experiences a strong urge to Bear down.
• Having a slightly elevated temperature in the first 24 hours following delivery is a normal physiological finding.
• During the third stage of Labor, the placenta delivery, the uterus contracts and the placenta slowly detaches from the uterine wall.