Intrapartum care study notes Essay

Pathophysiology,etiology and resultand indirectcauses in yourown wordsPathophysiologyBoth mother and baby begin to name for birth in the nal weeks of pregnancy. The mother is instructed to call the health care provider and come into the birthing unit if any(prenominal) of the following occur. Rupture of membranes, regular, frequent uterine contractions (nulliparas, 5 minutes apart for one hour multiparas, 6-8 minutes apart for 1 hour), any vaginal bleeding or decreased fetal movement. Family concern care is a model of care based on the philosophy that physical, socio crazeural, spiritual, and economic needs of the family are combined and considered collectively when planning for the childbearing family. 5 factors are important in the process of assiduity and birth. 1)Birth passage is the size of the agnatic pelvis or diameters of the pelvic inlet, midpelvis, and outlet. The type of maternal pelvis, and the ability of the neck opening to dilate and efface and ability of the v aginal canal and the external opening of the vagina to distend. 2) The fetus-fetal head, fetal attitude, fetal lie, and fetal presentation. 3) Relationship between passage and fetusengagement of the fetal presenting part, institutionalise or location of fetal presenting part in the maternal pelvis in relation to the spine, and fetal position. 4) Physiologic forces of labor -frequency, duration, and intensity of uterine contractions as the fetus moves through the passage, and effectiveness of the maternal pushing effort.5)Psychosocial considerations-mental and physical preparation for childbirth, socio-cultural values and beliefs, previous childbirth experience, support from signicant other, and emotional status. Labor comm barely begins between 30 and 42 weeks of gestation. Pro just her own relaxes the smooth muscletissue, estrogen stimulates uterine muscle contractions, and connective tissue loosens to permit the softening, thinning, and eventual(prenominal) opening of the cervix . In true labor, with each contraction the muscles of the upper uterine segment shortening and exert a Longitudinal traction on the cervix, cause effacement in which is the drawing up of the internal OS and the cervical canal into the uterine sidewalls. The contractions of true labor produced progressive dilation and effacement of the cervix. They only occur regularly and increase in frequency, duration, and intensity. The discomfort of true labor contractions usually starts in the back and radiates around to the abdomen. The pain is not relieved by ambulation. The contractions of false labor do not produce progressive cervical effacement and dilation. They are you regular and do not change magnitude frequency, duration, and intensity. The discomfort whitethorn be relieved by ambulation, changing positions, drinking a large amount of water, or taking a warm shower.Exemplar grammatical case aeroplane SP12Exemplar Face SheetPathophysiology,etiology and directand indirectcauses in yourown wordsThe rst deliver begins with the onset of true labor and ends when the cervix is in all dilated at 10 cm. The second stage begins with complete dilation and ends with the birth of the newborn. The third stage begins with the birth of the newborn and ends with the delivery of the placenta. Some clinicians identify a fourth stage. This stage lasts 1 to 4 hours after delivery of the placenta, the uterus effectively contracts to control bleeding at the placental site. Maternal systemic answer to labor. The mothers cardiovascular system is stressed both by the uterine contractions and by the pain, anxiety, and apprehension she experiences. During pregnancy the circulating blood volume increases by 50%. The increasing cardiac outputpeaks between the second and third trimester. Maternal position also affects cardiac output. In the supine position, cardiac output bring lows heart dictate increases and stroke volume decreases. When turned to a lateral side laying position c ardiac output increases. As a result blood-pressure rises during uterinecontractions. oxygen demand and consumption increased at the onset of the labor because of the presence of uterine contractions. By the end of the rst stage of labor most women develop a mild metabolic acidosis compensated by respiratory alkalosis. The changes in acid-base status that occur in labor quickly reversed in the fourth stage because of changes in the womans respiratory rate.During labor there is an increase in maternal renin level, plasma renin activity, and angiotensinogen level. These help control uteroplacental bloodow during birth and the premature postpartum period. Gastric mobility and absorption of solid food are reduced. Some narcotics also delayed gastric emptying. White blood cell count increases to 25,000 to 30,000 cells during labor and the early postpartum Period. The change in wbcs is mostly because of the increased neutrophils resulting from a physiologic response to stress. The incre ased WBC count makes it difcult to identify the presence of an infection. Maternal blood glucose levels decrease during labor because glucoses uses an energy source. Fetalresponse to labor. The mechanical and hemodynamic changes of normal labor have no adverse effect when the fetus is healthy. Heart rate deceleration can occur with intracranial pressure as the head pushes against the cervix. Bloodow is decreased to the fetus at the peak of each contraction, leading to a slow decrease in pH status. The adequate exchange of nutrients and gases in the fetal capillaries depends in part on the fetal blood pressure. Fetal blood pressure is a protective mechanism for the normal fetus in the anoxic periods caused by the contracting uterus during labor. The fetus is able to experience sensations of light, sound, and touch beginning at approximately 37 or 38 weeks of gestation.Exemplar Face Sheet SP12Exemplar Face SheetPathophysiology,etiology anddirect and indirectcauses in yourown wordsSom etimes procedures are necessary to maintain the preventive of the woman and the fetus. The most frequent of theseprocedures are labor induction, episiotomy, cesarean birth, and vaginal birth following a previous cesarean birth. Labor induction is the stimulation of the uterine contractions before the extemporaneous onset of labor, with or without ruptured fetalmembranes, for the purpose of accomplishing birth.RiskFactors Other alterations may occur during the intrapartumperiod. These include precipitous birth (rapid progression of labor, with birthing occuring within 3 hours or less), abruption placentae (premature separation of a normally implantedplacenta from the uterine wall. Considered to be a catastrophic event because of the severity of the resulting hemorrhage),placenta previa (implantation of the placenta day in the lower uterine segment rather than the upper portion, resulting inplacental separation with dilation of the cervix), premature rupture of membranes (spontaneou s rupture of the membranesbefore the onset of labor), preterm (Labor that occurs between 20 and 36 completed weeks of pregnancy) and postterm labor (A pregnancy that exceeds 42 weeks since the last menstrualperiod), hypertonic labor (ineffective uterine contractions of poor quality occurring in the latent arrange of labor with increased resting tone of the myometrium and frequent contractions),hypotonic labor (usually developing in the active phase of labor, characterized by 4000g at birth, often associated with excessive maternal weight, maternal obesity, maternal diabetes, orprolonged gestation), nonreassuring fetal status (when theoxygen supply is insufcient to meet the physiologic needs of the fetus),prolapsed umbilical heap (The umbilical cord precedes the fetal presenting part, placing pressure on the cord and reducing or stopping bloodow to and from the fetus), amniotic uid embolism (The presence of a small tear in the amnion or chorion high in the uterus, an area of separa tion in the placenta, or cervical tear where a small amount of amniotic uid may leak into the chorionic plate and enter the maternal system as an amniotic uid embolism), cephalopelvic disproportion (occurs when the fetal head is too large to pass through any part of the birth passage, which can result in prolonged labor, uterinerupture, necrosis of maternal soft tissue, cord prolapse,excessive molding of the fetal head, or damage to the fetal skull and central nervous system), retained placenta (retention of the placenta beyond 30 minutes after birth, resulting in bleeding that may lead to shock), lacerations (tearing of the cervix or vagina. The highest risk is in young or nullipara woman, forceps assisted birth, or administration of an epidural),Exemplar Face Sheet SP12Exemplar Face SheetPathophysiology,etiology anddirect andindirect causesin your ownwordsplacenta accreta (The chorionic villa attached directly to the myometrium of the uterus.. The adherence itself maybe total, par tial, or focal, depending on the amount of placentalinvolved), and perinatal hurt (death of a fetus or infant from the time of conception through the end of the newborn period 28 days after delivery).Inter thinkConcepts (3 ormore)Comfort, Mobility, Family, and SexualityPrioritized1. Risk for injury related to hyperstimulation of uterus caused Nursingby induction of labor.Diagnoses (4 ormore in two or2. Anxiety related to discomfort of labor and unknown laborthree partoutcomes as evidence by verbal communication.statements)3. Acute Pain related to uterine contractions as evidence by verbal complaints of pain.4. Readiness for enhanced cognition related to the birthprocess as evidence by verbalizing concerns to nurse.Resource Links Grassley, J. S., & Sauls, D. J. (2012). paygrade of the (2 or more)Supportive Needs of Adolescents during ChildbirthIntrapartum Nursing Intervention on Adolescents ChildbirthSatisfaction and Breastfeeding Rates. JOGNN Journal OfObstetric, Gynecologic & Ne onatal Nursing, 41(1), 33-44. doi 10.1111/j.1552-6909.2011.01310.xMathew, D., Dougall, A., Konfortion, J., & Johnson, S. (2011). The Intrapartum Scorecard Enhancing safety on the labourward. British Journal Of Midwifery, 19(9), 578-586.