HOLY ANGEL UNIVERSITY

Holy Angel University

School of Nursing and Allied Medical Sciences
Angeles City

NCM107RLE
CARE OF MOTHER, CHILD, ADOLESCENT (WELL)
(Labor and Delivery)

Partograph

Submitted by:
Alyssa Marie R. Mercado

Submitted to:
Prof. Arlene M. Gaddi, RN, MAN
(Clinical Instructor)

School of Nursing and Allied Medical Sciences

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LABOR CASE 1
STEP 1

• A was admitted at 6:00am on September 18, 2020

• Membranes ruptured 5:00am
• Gravida 3, Para 2+0
• On admission the fetal head was 4/5 palpable above the symphysis pubis and
the cervix was 2 cm dilated

Question: What should be recorded on the partograph?

- The patient’s information such as name, gravida, para, date and time of
admission should be recorded on the partograph.

STEP 2

• 10:00am
• The fetal head is 3/5 palpable above the symphysis pubis
• The cervix is 5 cm dilated

Question: What should you now record on the partograph?

- The descent of the fetal head and the cervical dilatation at 10:00 AM should
be recorded now on the partograph.

• A is now in the active phase of labor. Plot this and the following information
o 3 contractions in 10 minutes, each lasting 20–40 seconds
o Fetal heart rate (FHR) 120/minute
o Membranes ruptured; amniotic fluid clear
o Sutures of the skull bones are opposed (moulding/overlap of parietal bones)
o Blood pressure 120/70 mmHg
o Temperature 36.8°C
o Pulse 80/minute
o Urine output 200 mL; negative protein

Question: What steps should be taken?

- Since the patient is now in the active phase of labor wherein her cervix is
already 5 cm dilated, the next step that should be taken is start recording the
actual time, chart the contractions every 30 minutes, record the pulse rate
every 30 minutes, record the blood pressure every 4 hours and record the
temperature every 2 hours and measure urine if it only passed.

School of Nursing and Allied Medical Sciences

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Question: What advice should be given?

- At this active phase of labor, the needs of the woman will increase as she will
require lots of care and the best advice that should be given is to give the
support that she needs and do not leave her alone. Additionally, encourage
the patient to use abdominal breathing by taking slow deep breaths as the
contraction continues.
Question: What do you expect to find at 2:00pm?
- At 2:00 PM, it is expected that the woman will have a fully dilated cervix.
STEP 3

• Plot the following information on the partograph:

o 10:30am - FHR 120, Contractions 3/10 each 30 seconds, Pulse 80/minute
o 00am - FHR 136, Contractions 3/10 each 30 seconds, Pulse 80/minute
o 30am - FHR 140, Contractions 3/10 each 35 seconds, Pulse 88/minute
o 12:00nn - FHR 130, Contractions 3/10 each 40 seconds, Pulse 88/minute,
Temperature37°C
o 12:30 - FHR 136, Contractions 4/10 each 40 seconds, Pulse 84/minute,
Head is 2/5 palpable
o 1:00 - FHR 140, Contractions 4/10 each 40 seconds, Pulse 88/minute
o 1:30nn - FHR 130, Contractions 4/10 each 45 seconds, Pulse 88/minute
o 2:00pm - FHR 140, Contractions 4/10 each 45 seconds, Pulse 90/minute,
Temperature37°C
• 2:00pm:
o The fetal head is 0/5 palpable above the symphysis pubis
o The cervix is fully dilated
o Amniotic fluid clear
o Sutures apposed
o Blood pressure 100/70 mmHg
o Urine output 150 mL; (-) protein

Question: What steps should be taken?

- At this point, the steps that should be taken next is to assist the patient in
preparation for delivery by encouraging her to assume a comfortable position
for pushing that aids in the descent of the fetus and encourage her to push
only when the urge is felt. In addition to that, continue recording all of the
information needed in the partograph.

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Question: What advice should be given?

- As a responsible nurse, inform the patient that it may be required to stop
pushing in order for the baby to born slowly and with that, instruct the patient
to start panting by rapid breathing through the mouth and throat while the
chest goes up and down.
Question: What do you expect to happen next?
- It is expected that the baby will be fully delivered at this point as well as the
placenta which is in the 3rd stage of labor.
STEP 4

• Record the following information on the partograph:

• At 2:25pm - Spontaneous birth of a live baby girl weighing 7.2lbs

Question: How long was the active phase of the first stage of labor?
- During the active phase of the first stage of labor which is the longest stage,
it usually lasts from 12 – 19 hours for primigravida. But in this case, the
patient is multigravida which means this is not her first pregnancy and with
that the active phase of the first stage of labor may last for about 14 hours
(March of Dimes, 2019).
Question: How long was the second stage of labor?
- For the second stage of labor, it is expected that the pushing phase for
primigravida usually lasts from 1 – 2.5 hours but in this case the patient is
multigravida so the pushing phase lasts for about a few minutes to an hour.

School of Nursing and Allied Medical Sciences

 HOLY ANGEL UNIVERSITY

PARTOGRAPH

School of Nursing and Allied Medical Sciences

 HOLY ANGEL UNIVERSITY

Reference:

March of Dimes. (2019, March). Stages of labor. Www.Marchofdimes.Org.

https://www.marchofdimes.org/pregnancy/stages-of-

labor.aspx#:~:text=The%20first%20stage%20of%20labor%20is%20the%2

0longest%20stage.

School of Nursing and Allied Medical Sciences