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: Mia Grace Garcia Instructor: Mrs. Katherine Arellano

ID No.: 2019-01-227 Date: May 09, 2021
Section: F Semester/AY: 2021

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
Contractions come at regular intervals and will
begin to build up overtime.
Felt in lower back and radiates to the abdomen.
Mucusy discharge with small to moderate
amounts of blood.
Waters may break and the amniotic fluid has no
odor.
Increasing discomfort.
Cervix softens, shortens and dilates
Signs and Symptoms of False labor
Contractions are irregular, unvarying in frequency
and duration.
Felt in abdomen, around or above the navel.
Can produce some vaginal discharge, brownish in
color instead of blood-tinged.
Waters will not break.
Discomfort remains the same.
No changes to the cervix.

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

Passenger (Fetus) Fetal head & molding
Passage (Birth Canal) Refer to the route the fetus must travel from uterus
through the cervix & vagina to external
perineum.
Powers (Contractions) Important requirement for a successful labor.
Position (Maternal) Position used frequently.
Psyche (Maternal Psychological status) 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
st
1 Stage - Begin with the onset of
contractions of the uterus
to fully dilated of the
cervix.
- Rate of cervical
dilatation is 1.2 cm/hour
in primiparous and 1.5
cm/hour for multiparous.
2nd Stage - Begins with complete
dilation of the cervix and
ends with delivery of
fetus.
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Onset/Duration Danger signs Nursing Responsibilities/Action
12 ½ Hours in Sudden Swelling 1. Encourage active
primiparous participation in labor by
7 Hours 20 min in keeping active, assuming
multiparous most.
1 h 20 min in primiparous Decrease in BP 1. Instruct patient on quality pushing.
30 min in multiparous The abdominal muscles must aid
the involuntary uterine contractions
to deliver the baby out.
2. Provide a quiet environment for the
patient to concentrate on bearing
down.
3. Provide positive feedback as the
patient pushes.
4. Repeat doctor’s instructions. At this
phase, the patient barely hears the
conversation around the room
because all her energy and thoughts
are being directed toward giving
birth.
5. Take note of the time of delivery
and proceed to initiate essential
newborn care. Delayed cord
clamping is recommended.
6. Assist in restrictive episiotomy for
 patients who had vaginal births.
3rd Stage Begins after delivery of baby and Primiparous: 10 min High or Low fetal heart 1. Coach in relaxation for delivery of
ends with delivery of the Multiparous: 10 min rate placenta.
placenta. 2. Congratulate on delivery of baby.
3. Encourage skin-to-skin contact to
facilitate bonding and early
breastfeeding.
4. Ask patient whether placenta is
important to them before it is
destroyed. For those who want to
take it home, ensure that they
understand and follow standard
infection precautions and hospital
policy.
5. Administer prophylactic oxytocin
as ordered.
6. Utilize controlled cord traction
technique for placental expulsion.
7. Utilize absorbable synthetic suture
materials (over chromic catgut) for
primary repair of episiotomy or
perineal lacerations.

4th stage First 1 to 4 hour after birth of 1-4 hours (after birth) Experience increasing 1. Immediate
the placenta (close maternal pressure in your back postpartum
monitoring) assessment
and Nursing
Care
2. Assess:
Contractions,
Vital Sign
q15min,

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 Fundus,
Perineal
Care,
Observe
Lochia.
*** 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)
1st Latent Phase Preparatory Phase starts Primiparous: 8- mild and short, Minimal effacement, 1. Assess patient’s
from the onset of true labor 10 hours lasts 20 to 40 dilatation is 3 to 4 cm psychological readiness.
contractions to 3 cm cervical Multiparous: 5 seconds, Provide continuous maternal
dilatation hours occurring 5 to 10 support (compared to usual
care).
minutes apart
2. Measure duration of latent
phase. For nulliparas, it
should not be more than 6
hours. On the other hand, for
multiparas, it should be
within 4.5 hours. Determine
if patient received anesthesia
because it can prolong latent
phase. One of the most
common cause of prolonged
latent phase is cephalopelvic
disproportion (CPD) and it
requires cesarean birth.
3. Allow patient to be
continually active. Upright
maternal positions are
recommended for women on
the first stage of labor.
Patients without pregnancy

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 complications can still walk
around and make necessary
birth preparations.
4. Conduct interviews and
filling in of forms (e.g. birth
certificate) at this phase
while the patient experiences
minimal discomfort and has
control over contraction
pains.
5. 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.
6. Educate patient on different
relaxation techniques. As
early as this phase,
encourage patient to begin
alternative therapy of pain
relief.
7. Ensure that the total number
of internal examinations the
woman receives in the entire
course of labor is limited to
5 only.
8. Ensure that birthing
companion of choice is
present all throughout the
course of labor.

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2nd Active Phase Active Phase starts from 4 Primiparous: 3-6 Stronger, 40 to 60 Cervical Dilatation 1. Inform patient on the
cm cervical dilatation to 7 hours seconds, occurring reaches 4 to 8 cm progress of her labor to
cm cervical dilatation. Multiparous: 4 every 3 to 5 lessen her anxiety and obtain
During this phase, hours minutes her trust and cooperation.
contraction intensity is
stronger, interval shortens, 2. Start monitoring progress of
and duration lengthens.  labor with the use of WHO
partograph, 2-hour action
line.
3. Encourage patient to be
continually active to
maximize the effect of
uterine contractions. Upright
maternal positions are
recommended if tolerated.
4. 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.
5. Monitor maternal vital
signs and fetal heart rate
every 2 hours, or depending
on the doctor’s order.
6. Anticipate patient needs
(e.g. sponging face with cool
cloth, keeping bed clean and
dry, providing ice chips or
lip balm) to promote
comfort.
7. Determine when patient last
voided because a full

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3rd Transition Phase Transition Phase starts from
8 cm cervical dilatation to 10
cm (full) cervical dilatation
and full cervical effacement.
*** include differences between primiparous and multiparous women
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bladder can hinder fast labor
progress.
8. Institute non-
pharmacological pain
measures (e.g. breathing
exercises, distraction
method, imagery, music
therapy, etc.)
Primiparous: 2 Every 2 to 3 Reaches 8 cm to full 1. Inform patient on progress
hours minutes lasting dilatation of 10 cm of her labor.
Multiparous: 1 for 60 to 70
2. Assist patient with pant-
hours seconds blow breathing.
3. 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.
4. 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.
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