Ch.19

• Second Stage of Labor

  • _cm to _cm
  • _ stage
  • Complete E_
  • Ends with I_ B_?

  6, 10, pushing, effacement infant birth
• Second Stage (Two Phases):

  • L_ - D_ P_, L_ D_, or P_ D_
  • A_ - P_ and U_ to B_ D_
  • F_ R_
  • _ pushes per C_?
  • latent, delayed pushing, laboring down, passive descent, active, pushing, urge, bear down, Ferguson reflex, 3, contraction
• Second Stage Care Management:

  • Preparation
  • V_ maneuver
  • F_ H_ R_ and P_
  • S_ of P_
  • E_
  • Birth in a delivery room or birthing room
  • L_ position (S_, S_ recumbent)
  • C_
  • R_ maneuver
  • N_ C_?
  • Valsalva, fetal heart rate, pattern, support, partner, equipment, lithotomy, supine, semi, crowning, ritgen, nuchal cord
• Second Stage Care Management:

  • No F_ P_
  • S_ to S_ care for newborn
  • L_ birth is D_ and K_ E_ together
  • Have D_ C_ C_ as much as possible
  • Manage the P_ T_ due to L_ can cause H_?

  fundal pressure, skin, skin, lotus, deliver, keep everything, delayed cord clamming, perineal trauma, laceration, hemorrhage
• Perineal Lacerations:

  • First Degree - C_ to the S_
  • Second Degree - E_ into the P_ B_
  • Third Degree - Involves the E_ A_ sphincter
  • Fourth Degree - Completely goes thru R_ M_ disrupting the E_ and I_ A_ sphincter
  • U_ and need P_ M_?
  • confined, skin, extends, perineal body, external, anal, rectal mucosa, external, internal anal, uncomfortable, pain meds
• Third Stage of Labor:

  • B_ until P_ is expelled and N_ T_ L_
  • P_ expelled withing _ to _ after birth; problematic if more than _ minutes
  • P_ S_ is a S_ G_ of D_ B_ from the introitus and A_ L_ of the U_ C_
  • V_ F_
  • P_ E_ and D_?

  birth, placenta, not too long, placenta, 10, 15, 30, placental separation, sudden gush, dark blood, apparent lengthening, umbilical cord, vaginal fullness, placental examination, Disposal
• Fourth Stage of Labor:

  • P_ then R_
  • First _ to _ hrs after birth
  • Assess maternal P_ S_ which is P_ changes to P_ S_
  • Fundus every _ min
  • Signs of potential problems
  • E_ B_ L_
  • Alterations in V_ S_ and C_
  • Newborn
  • Maintain A_, Support R_ E_ and Prevent C_ S_
  • Importance of S_ to S_
  • Infant's A_ S_ (1st period of R_)?
  • placenta, recovery, 1, 2, physical status, physiologic, prepregnancy status, 15, excessive blood loss, vital signs, consciousness, airway, respiratory effort, cold stress, skin, skin, alert state, reactivity
• Fourth Stage of Labor (Postanesthesia):

  • C_ or R_ anesthesia for V_ birth
  • A_
  • R_
  • B_
  • L_
  • C_
  • P_ of L and D is key
  • L_ - good for B_ P_
  • T_ - S_ L_, D_ more into the P_ region?
  • section, regional, vaginal, activity, respirations, blood pressure, LOC, Color, position, lateral, blood perfusion, throne, station lower, distend, pelvic