1. Describe the second stage of labor. What does cervical dilation and efface- ment look like?
What two phases make up the second stage of labor?
Answer
- The stage in which the infant is born
- full cervical dilation (10cm) and complete effacement (100%)
- Two phases the latent phase and the active pushing phase
2. What forces facilitate an uncomplicated vaginal birth (3)?
Answer
Force exerted by uterine contractions, gravity, and maternal bearing-down efforts facilitates
achieve- ment of the expected outcome of a spontaneous, uncomplicated vaginal birth
3. What do contractions look like in the second stage of labor?
Answer
- Contraction pattern is every 2-3 minutes progressing to every 1-2 minutes.
- Each contraction lasts 40-60 seconds.
4. How often is fetal monitoring done in the second stage of labor? What about VS and cervix?
Answer
- Fetal monitoring should be done every 5-15 minutes, depending on risk status.
- VS are monitored every 5-30 minutes (maternal BP, pulse, and respiration)
- Cervix is monitored every 10-15 minutes.
5. Describe the latent phase of the second stage of labor. What does the fetus do?
Answer
- delayed pushing, laboring down, or passive descent.
,- Time from complete cervical dilation until the woman begins actively pushing.
- Fetus continues to descend passively through the birth canal and rotate to an anterior position
because of ongoing uterine contractions.
6. What does the mother do during the latent phase of the second stage of labor?
Answer
- Woman is quiet and often relaxes with eyes closed between contractions.
- Urge to bear down is not strong - some women do not experience it at all or only during the
acme (peak) of a contraction.
7. Describe the active phase of the second stage of labor. What does the woman do?
Answer
- woman has strong urges to bear down as the Ferguson reflex is activated
- Physiologic management involves spontaneous, rather than directed, pushing
8. Describe the S/S of the active phase of the second stage of labor (6)?
Answer
- ring of fire (burning sensation of acute pain as vagina stretches and fetal head crowns)
- Feeling of powerlessness
- Decreased ability to listen or concentrate on anything but giving birth
- Alters respiratory pattern
short 4- to 5-second breath holds with regular breaths in between, 5-7 times per contraction
- Frequent repositioning
- Often shows excitement immediately after birth of head
9. Describe the physiologic changes that occur in the second stage of labor
(5).
Answer
- cervix is fully dilated and effaced
, - bulging perineum
- significant decent of fetal head
- lots of pressure
- labia part
10. episiotomy
Answer
- incision made in the perineum to enlarge the vaginal outlet.
- No role in modern obstetric care and should be avoided whenever possible.
- Indicated episiotomy may still be performed in specific situations, such as the need to hasten
birth when FHR abnormalities are present.
11. What is a laceration? What are the different types (4)?
Answer
- occur naturally as the fetal head is being born.
- 1st degree extends through the skin and structures superficial to muscles.
- 2nd degree extends through muscles of the perineal body
- 3rd degree continues through anal sphincter muscle
- 4th degree extends completely through the anal sphincter and the rectal mucosa
12. What nursing assessment is included with a laceration? What nursing action is necessary?
Answer
- Nursing assessment
redness (erythema), edema, ecchymosis (bruising), drainage, and approximation (REEDA)
- Nursing action
after necessary repairs, the nurse cleanses the vulvar area gently with warm water or NS and
applies a perineal pad or an ice pack to the perineum
13. What teaching do we provide to patients with a laceration?
Answer
- some discom- fort during post-birth vaginal exam
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