NURSING CARE DURING THE STAGES OF LABOR

NOTES IN MATERNAL AND CHILD NURSING Reference: NURSES NOTES: MATERNAL and CHILD NURSING Maritess Manalang-Quinto, RN, MAN(c) Nursing Care of the Mother 1. Care of the Woman During the First Stage Stage Profile: Marked by duration and stress of labor Nursing interventions: - Reduce anxiety and offer assistance - Do not interrupt breathing during contractions - Promote change of positions - Encourage voiding and promote bladder care - Encourage client to suck on hard candy, ice chips - Apply cream on dry lips of client - Administer IV solution in case of DHN - When hyperventilating, keep paper bag nearby and teach on how to use it 2. Care of the Woman During the Second Stage Stage Profile: Marked by intense contractions Nursing Interventions: - Provide client support - Assess and record v/s, FHR, uterine contractions - Prepare place of birth in advance - Convert the labor room to birth room - Make the client select positioning for birth - Promote second stage pushing - Clean perineum with warm antiseptic before birth As soon as head is about 8cm across: Perform the Ritgens maneuver Encourage the woman to continue pushing until the occiput of fetal head is firmly a the pubic arch Once head is delivered Note time of birth, announce sex of infant Cut and clamp the cord Introduce infant to initiate parent child relationship 3. Care of the Woman in the Third and Fourth Stages of Labor Stage Profile: Placental separation and delivery Nursing interventions: - Administer oxytocin (IM or IV - Inspect delivered placenta - Monitor vital signs (q 15 minutes) - Palpate fundus - Observe character and amount of lochia Non Pharmacologic Pain relief Relaxation Focusing on imagery Support from a doula or coach Breathing techniques Bathing/ hydrotherapy : C/I in ruptured membranes Therapeutic touch and massage Hypnosis: deep form of relaxation Biofeedback: based on belief that people can control and regulate internal events like HR and pain response Acupressure and acupuncture Heat or cold application Pharmacologic pain relief Local infiltration Pudendal nerve block

Spinal anesthesia Epidural anesthesia