St.

Paul University Philippines

Tuguegarao City, Cagayan 3500

School of Nursing and Allied Health Sciences

College of Nursing
Bachelor of Science in Nursing – 2
2nd Semester, AY 2020 - 2021

Name: AMPONIN, ELISA JILLIAN E. Instructor: Mrs. Elinor Latupan

ID No.: 2013-00148 Date: May 5, 2021
Section: BSN 2B Semester/AY: 2nd semester

INTRAPARTUM: Labor and Delivery

ACTIVITY:
Direction: Supply the appropriate responses for each item.

1. Compare and contrast TRUE Labor vs FALSE labor:

List down the True and False Signs and Symptoms of Labor

Signs and Symptoms of True Labor Signs and Symptoms of False labor
Contractions occur at regular time. Contractions don’t come regularly and they don’t get
closer together.

Contractions gets stronger over time. Contractions slow down when changing positions.
Cervix Dilate and Effacement. Contraction stop when resting, walking or changing
position
Pain starts from the back then radiate to lower Discomfort felt only in the front of the abdomen
abdomen.
Bloody Mucus Discharge. No changes in cervix.
Rupture of amniotic sac. No rupture of amniotic sac.
2. What are the components of labor? The Ps of labor:
Describe how each component influence labor and delivery.

Components of Labor Description/Influence to Labor and Delivery

Passage  The refers to the route a fetus must travel

from the uterus through the cervix and vagina
to the external perineum.
Passenger  The size, position, and presenting part of the
baby have a major impact on the length of
labor. The size of the baby has to be
compatible with the size of the mother's
pelvis. 
Power  This is the force supplied by the fundus of the
uterus and implemented by uterine
contractions, which causes cervical dilatation
and the expulsion of the fetus from the uterus.

Cervical Changes:

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  EFFACEMENT- is shortening and thinning
of the cervical canal.
 DILATATION - refers to the enlargement or
widening of the cervical canal from an
opening a few millimeters wide to one large
enough (approx. 10cm) to permit passage of
the fetus.
Pelvis  The shape of the pelvis determines how
easily the baby can pass through.
Psyche  A woman's psychological state or feelings of
a woman brings into labor.
 The progress of labor and birth can be
adversely affected maternal fear and tension.

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3. The Stages of labor: Fill the box accordingly.

Stages of labor Description Onset/Duration Danger signs Nursing Responsibilities/Action

1st stage This is the onset of Latent labor- In primiparous  Malpresentation of the  Monitor the vital signs.
labor where cervical it is less than 20 hours while baby  Assess the hydration,
changes happen until in multiparous it is less than  Bradycardia nutrition and
cervix is 10 14 hrs.  Low contractions elimination of the
centimeters dilated. Active labor- primiparous it  Baby lying sideways patient.
This cause the fetus is 1.2 cm/h while in (Transverse)  Educate the patient and
to descend into the multiparous it is 1.5/hr  Sinusoidal Pattern family.
pelvis.  Late decelerations
 Assess the contraction
and fetal heart rate.
 Instruct the patient to
take deep and slow
breathes during
contractions and to
breathe normally
between them.
 Give labor support and
comfort measures.

2nd stage It is the interval With epidural:
between full cervical Primiparous – 3 hours
dilation and delivery Multiparous – 2 hours
of the infant
Without an epidural:
Primiparous – 2 hours
Multiparous – 1 hour
 Arrest(no descent for more than  Instruct the client on
2 hrs.) effective pushing by
 Prolonged labor instructing the mother
 Turtle sign not to close her mouth
 shoulder dyscotia and hold her breath
when pushing
 Prepare the infant’s
warmer by pre heating
it.

 Make sure that the

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 bladder is empty
 Coaching maternal
breathing and pushing
efforts.
 Monitor the contraction
and fetal heart rate.
 Check the fetal descent.
 Take note of the time
of delivery and proceed
to initiate essential
newborn care.
3rd stage This is from the In normal setting, placenta  Retained placenta
delivery of the infant is expected to deliver within  Hemorrhage  Monitor the transition of the
until the delivery of 30 minutes. infant
the placenta. Primiparous – 10 minutes  Monitor for potential
Multiparous – 10 minutes complications
 Assess the perineal area for
trauma.
 Congratulate on the delivery of
the baby.
 Perform essential newborn
care.
 Provide skin to skin contact
with mother and child.
 Encourage breastfeeding.
4th stage Immediate post birth The duration can last up to  High fever  Monitor Vital signs and check
recovery period. 1-4 hours  Severe vaginal bleeding the mother’s fundus
 Observe the perineum
 Transfer the mother to the
postpartum unit
 Perform postpartum
assessment.
 Give teachings regarding
postpartum recoveries.

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*** include differences between primiparous and multiparous women

4. Differentiate the phases of the 1st Stage of Labor according to onset, duration, contraction, cervical dilation, etc.

Phases
Label/Description Onset/Duration Contraction Cervical Dilation Nursing Responsibilities/Action
(1st Stage of Labor)
Latent Phase begins at the onset of regularly
In In primiparous it is On the left cervix minimal effacement, Assess patient’s psychological
perceived uterine contractions less than 20 can be seen to be dilatation is 3 to 4 cm readiness. Provide continuous
and ends up when rapid hours while in fully effaced; the maternal support (compared to
dilatation occurs. multiparous it is rim is very thin usual care).
less than 14 hrs. about 2-3cm  Encourage the patient to walk
dilated. and prepare for birth.
Membranes are  Allow patient to be continually
intact active. Upright maternal
positions are recommended for
women on the first stage of
labor. Patients without
pregnancy complications can
still walk around and make
necessary birth preparations.
 Conduct health teaching on
breastfeeding, newborn care,
and effective bearing down
because during this time,
patient’s anxiety is controlled
and she is able to focus on
nurse’s instructions.

Active Phase Starts when cervical dilation In primiparous it
occurs rapidly. is 1.2cm dilation
per hour while in
multiparous it is
1.5 cm cervix
dilation per hour
Contraction is It reaches 4cm to 8cm  Inform patient on the progress
stronger, last cervical dilation. of her labor to lessen her
about 40 -60 anxiety and obtain her trust and
seconds and cooperation.
come every 3-5  Start monitoring progress of
minutes labor with the use of WHO

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 partograph, 2-hour action line.
 Encourage patient to be
continually active to maximize
the effect of uterine
contractions. Upright maternal
positions are recommended if
tolerated.
 Assist patient in assuming her
position of comfort. For those
who can’t stay upright, left-side
lying is recommended to avoid
disruption in fetal oxygenation.
 Monitor maternal vital signs and
fetal heart rate every 2 hours, or
depending on the doctor’s order.
 Determine when patient last
voided because a full bladder
can hinder fast labor progress.
 Institute non-pharmacological
pain measures (e.g. breathing
exercises, distraction method,
imagery, music therapy, etc.)

Transition The contractions reaches its Strongest The contractions Dilation is 8 – 10  Inform patient on progress of
peak of intensity occurring every is very strong centimeters her labor.
Phase
2 to 3 minutes and can last up to  Assist patient with pant-blow
lasting for 60 to 60-90 secs with breathing.
90 seconds very intense
 Monitor maternal vital signs and
fetal heart rate every 30 minutes
-1 hour, or depending on the
doctor’s order. Contraction
monitoring is also continued.

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  When perineal bulging is
noticeable, prepare for delivery.
 Check room temperature (25-
280C and free of air drafts). The
nurse should also notify staff
and prepare necessary supplies
and equipment, including
resuscitation machine. Lastly,
perform handwashing and
double gloving.

*** include differences between primiparous and multiparous women

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