Intrapartum care study notes Essay

Pathophysiology,etiology and controland in controlcauses in your throw wordsPathophysiologyBoth get down and baby begin to prep are for birth in the nal weeks of pregnancy. The mother is instructed to foreknow the health care provider and come into the birthing unit if every of the following emit. Rupture of membranes, regular, grass uterine contractions (nulliparas, 5 minutes unconnected for one hour multiparas, 6-8 minutes apart for 1 hour), any vaginal hemorrhage or comed fetal movement. Family centered care is a model of care based on the philosophy that physical, sociocultural, spiritual, and economic take of the family are combined and considered collectively when planning for the childbearing family. Five factors are important in the process of weary and birth. 1)Birth passage is the size of the agnate pelvis or diameters of the pelvic inlet, midpelvis, and outlet. The type of agnate pelvis, and the ability of the cervix uteri to dilate and efface and ability of the vaginal canal and the external interruption of the vagina to distend. 2) The foetus-fetal head, fetal attitude, fetal lie, and fetal presentation. 3) Relationship between passage and fetusengagement of the fetal presenting part, station or location of fetal presenting part in the maternal pelvis in relation to the spine, and fetal position. 4) Physiologic forces of outwear -frequency, duration, and excitement of uterine contractions as the fetus moves with the passage, and effectiveness of the maternal button effort.5)Psychosocial considerations-mental and physical preparation for childbirth, socio-cultural values and beliefs, previous childbirth experience, support from signi chamfer other, and emotional status. Labor commonly begins between 30 and 42 weeks of gestation. pro just her own relaxes the smooth muscular tissue tissue, estrogen stimulates uterine muscle contractions, and connective tissue loosens to permit the softening, thinning, and eventual opening of the cervix. In straightforward labor, with each contraction the muscles of the upper uterine segment shortening and maintain a Longitudinal traction on the cervix, causing effacement in which is the drawing up of the internal OS and the cervical canal into the uterine sidewalls. The contractions of authentic labor produced progressive dilation and effacement of the cervix. They only issue forth regularly and increase in frequency, duration, and intensity. The uncomfortableness 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 increasing frequency, duration, and intensity. The discomfort whitethorn be relieved by ambulation, changing positions, drinking a large amount of water, or taking a warm shower. instance Face Sheet SP12 sample Face SheetPathophysiology,etiology and direc tand indirectcauses in yourown wordsThe rst make up begins with the plan of attack of true labor and ends when the cervix is completely dilated at 10 cm. The second stage begins with complete dilation and ends with the birth of the young. The third stage begins with the birth of the new-sprung(a) and ends with the delivery of the placenta. Some clinicians commit 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 mammal site. Maternal arrangingic response 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 output peaks between the second and third trimester. Maternal position in addition affects cardiac output. In the supine position, cardiac output lowers heart aim increases and stroke volume d ecreases. When turned to a lateral side put position cardiac output increases. As a result blood- printing press rises during uterine contractions. Oxygen demand and consumption increased at the onrush of the labor because of the presence of uterine contractions. By the end of the rst stage of labor some women develop a mild metabolic acidosis compensated by respiratory alkalosis. The changes in acid-base status that fare in labor quickly change 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 table service control uteroplacental bloodow during birth and the early postpartum period. Gastric mobility and assiduity of solid food are reduced. Some narcotics also delayed stomachic 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 incre ased neutrophils resulting from a physiological response to stress. The increased 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. foetal response to labor. The mechanical and hemodynamic changes of normal labor have no uncomely effect when the fetus is healthy. Heart rate deceleration can occur with intracranial constrict 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 cope with beginning at approximately 37 or 38 weeks of gestation. exemplification Face S heet SP12Exemplar Face SheetPathophysiology,etiology anddirect and indirectcauses in yourown wordsSometimes procedures are unavoidable to maintain the safety of the woman and the fetus. The most common of these procedures are labor knowledgeability, episiotomy, caesarian birth, and vaginal birth following a previous cesarean birth. Labor induction is the stimulation of the uterine contractions before the spontaneous onset of labor, with or without ruptured fetal membranes, for the purpose of accomplishing birth.Risk Factors Other alterations whitethorn occur during the intrapartum period. These include precipitous birth (rapid progression of labor, with birthing occuring within 3 hours or less), abruption placentae (premature separation of a normally implanted placenta 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 in placental separation with dilation of the cervix), premature rupture of membranes (spontaneous rupture of the membranes before 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 menstrual period), hypertonic labor (ineffective uterine contractions of poor fibre occurring in the latent phase 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, or  protracted gestation), nonreassuring fetal status (when the oxygen supply is insufcient to meet the physiologic needs of the fetus), prolapsed umbilical cord (The umbilical cord precedes the fetal presenting part, placing pressure on the cord and reducing or stopping bloodow to and from the fetus), amniosic uid embolism (The presence of a small tear in the amnion or chorion high in the uterus, an area of separation 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, uterine rupture, necrosis of maternal soft tissue, cord prolapse, excessive modeling of the fetal head, or damage to the fetal skull and central nervous system), retain 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 SheetPathophys iology,etiology anddirect andindirect causesin your ownwordsplacenta accreta (The chorionic villa attached directly to the myometrium of the uterus.. The adherence itself maybe total, partial, or focal, depending on the amount of placentalinvolved), and perinatal loss (death of a fetus or infant from the time of conception through the end of the newborn period 28 days after delivery).InterrelatedConcepts (3 ormore)Comfort, Mobility, Family, and sex activityPrioritized1. 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 noesis related to the birthprocess as evidence by verbalizing concerns to nurse.imagination Links Grassley, J. S., & Sauls, D. J. (2012). Evaluation of the (2 or more)Supportive Needs of Adolescents during childbearingIntrapartum Nursing Intervention on Adolescents ChildbirthSatisfaction and Breastfeeding Rates. JOGNN Journal OfObstetric, gynaecological & Neonatal 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.