General Santos Doctor’s Medical School Foundation, Inc.

National Highway, General Santos City

Name: NARCE, ALMERA ROSE F. Year & Section: BSN 2-A

Clinical Instructor: MS. BELINDA L. JOVER, RN, MAN Subject: MCN-RLE
MS. KENVYNE Q. CALUGAY RN MAN

Concept: Labor and Delivery OCTOBER 27, 2020

Task 1. Review Concept of Labor and Delivery ( Intrapartal Period).

Summarize events using the given table.
Stage Phases/ Salient events Duration Duration Nursing care
s Description & interval Multipara (instructions,
of Primipara Breathing techniques
contracti if necessary)
ons
stage The Latent Begins at the onset of 20 to 40 The 1. During this phase,
1 Phase- regularly perceived seconds phase encourage
uterine contractions averages women to
and ends when rapid 6 hours continue to walk
cervical dilatation in a about and make
begins. nullipara preparations for
Cervical effacement and 4.5 birth. If desired,
occurs, and the cervix hours in a she could begin
dilates from 0 to about multipara. alternative
3 cm. methods of pain
relief such as
aromatherapy,
distraction, or
acupressure.
2. If the woman
should come to a
birthing setting
this early,
encourage her to
continue to be
active and to use
any non-
pharmacotherape
utic measures
she finds
effective.
 The Active During the active Contractio This 1. Encourage
Phase phase of labor, ns lasting phase women to be
cervical dilatation 40 to 60 averages active participants
occurs more rapidly. seconds 3 hours in in labor by
Show (increased and occur a nullipara keeping active
vaginal secretions). approxima and 2 and assuming
This phase can be tely every hours in a whatever position
difficult for a woman 3 to 5 multipara is most
because contractions minutes. comfortable for
grow so much them during this
stronger and last so time, except flat
much longer than on their back.
they did in the latent 2. Monitor maternal
phase that she begins vital signs and
to experience true fetal heart rate
discomfort. It is also every 2 hours or
both an exciting and a depending on the
frightening time doctor’s order.
because it is obvious 3. Anticipate patient
something dramatic is needs (e.g.
happening. sponging face
In a few hours, a with cool cloth,
woman will have a keeping bed
new baby. clean and dry,
providing ice
chips or lip balm)
to promote
comfort.

The During the transition Occurring This 1. Inform patient on

Transition phase, maximum every 2 to phase progress of her
Phase cervical dilatation of 3 minutes lasts from labor.
8 to 10 cm occurs. with a 15 2. Assist patient with
If the membranes duration minutes to pant-blow
have not previously of 60 to 70 an hour. breathing.
ruptured, they seconds 3. Monitor maternal
will usually rupture at vital signs and
full dilatation (10 cm). fetal heart rate
By the end of every 30 minutes
this phase, both full -1 hour or
dilatation (10 cm) and depending on the
complete cervical doctor’s order.
effacement Contraction
(obliteration of the monitoring is also
cervix) have occurred continued.

stage The Second The second stage of 2 to 5 With 1. Instruct patient on

2 Stage labor is the time span minutes uncomplic quality pushing.
 from full dilatation and ated The abdominal
cervical effacement to birth and muscles must aid
birth of the infant. without the involuntary
extending from the epidural uterine
time of full anesthesi contractions to
dilatation until the a this deliver the baby
infant is born. The stage out.
fetus begins descent takes 2. Provide a quiet
and, as the fetal head about 1 environment for
touches the internal hour. the patient to
perineum to begin concentrate on
internal rotation, her bearing down.
perineum begins 3. Provide positive
to bulge and appear feedback as the
tense. Crowning patient pushes.
occurs where the fetal 4. Repeat doctor’s
head pushes against instructions. At
the vaginal introitus, this phase, the
this opens, and the patient barely
fetal scalp appears at hears the
the opening to the conversation
vagina and enlarges. 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.
Assist in
restrictive
episiotomy for
patients who had
vaginal births.

stage Third Stage It is divided into two 20 This stage 1. Coach in

3 of Labor or separate phases: minutes takes a relaxation for
the placental placental separation total of delivery of
stage starts and placental about 15- placenta.
from birth of expulsion. Five 20 2. Congratulate on
infant to minutes after delivery minutes. delivery of baby.
 delivery of baby, the uterus 3. Encourage skin-
of placenta begins to contract to-skin contact to
again, and placenta facilitate bonding
starts to separate and early
from the contracting breastfeeding.
wall. Blood loss of 4. Ask patient
300-500 mL occurs as whether placenta
a normal is important to
consequence of them before it is
placental destroyed. For
separation. During those who want to
Placental take it home,
Separation, the ensure that they
placenta separates understand and
from the inner wall of follow
the uterus before standard infection 
birth. It can deprive precautions and
the baby of oxygen hospital policy.
and nutrients and
cause heavy bleeding
in the mother.
Placental Expulsion
occurs when the
placenta comes out of
the birth canal after
childbirth. The period
from just after the
baby is expelled until
just after the placenta
is expelled.
stage The first 1 to 4 Recovery- the baby is 1 to 4 1 to 4 1. Transfer the
4 hours after born, the placenta has hours hours patient to the
birth of the delivered, and the recovery room
placenta. To woman and her 2. Ensure
emphasize the partner will probably emergency
importance of feel joy, relief, and equipment is
clos maternal fatigue. Most babies available in the
observation are ready to nurse recovery room for
needed at this within a short period possible
time. after birth. Others wait complications
a little longer. If you 3. Monitor lochia
are planning to flow
breastfeed, we 4. Observe the
strongly encourage mother for chills
you to try to nurse as 5. Monitor the
soon as possible after patient's vital
your baby is born. signs and general
Nursing right after condition
 birth will help your
uterus to contract and
will decrease the
amount of bleeding.

Task 2. Essential Newborn Care

A. Please watch the uploaded video on “Unang Yakap”.
Start with the Promotion Video followed by the Training Video.
B. Answer the following: (25 points)
1. Identify the Rationale of the Essential Newborn Care (ENC), “Unang Yakap”.
Relate its significance to Health Care Delivery System. Cite necessary
statistics.
The rationale is to rapidly reduce the maternal and newborn morbidity and
mortality in the country by two thirds which is the MDG no. 4. According to the video,
the Philippines is one of 42 countries accounting for ninety percent of all global deaths
of under five children, 80, 000 Filipinos die even before their 5 th birthday, majority of
newborn deaths occur in their first week of life which is why essential intervention during
labor, delivery, and immediate postpartum are needed to avoid newborn deaths. The
essential newborn care saves lives with the right timing and step by step method. It’s
significance to the healthcare delivery system is providing the best possible care for the
babies and their mothers, it could save thousand of lives every year in the Philippines
2. Identify and Sequence the 4 essential steps of ENC. Describe salient events
occurring in each step.
The first step is drying with rapid assessment of the baby’s breathing in which
you the baby is being dry with warm towels or cloths while being placed on the mother’s
abdomen or in her arms. The second step is initiating immediate uninterrupted skin-to-
skin contact in which the baby is place in the mother’s abdomen to maintain the baby’s
temperature and encourage biological bonding, and to expose the baby to the mother’s
skin flora. The third step is the practice of properly timed cord clamping after 1 to 3
minutes to decrease anemia. The fourth step is initiating early breastfeeding or non-
separation of the newborn from the mother for early breastfeeding initiation and
rooming-in in which the newborn is put to the breast of the mother within the first hour of
life..
3. Identify the rationale/ benefits of the following:
3.1 Immediate drying of the newborn
Immediate and thorough drying of the newborn prevents hypothermia
which is extremely important to newborn survival.
3.2 Early Skin to Skin Contact (SSC).
Keeping the mother and baby in uninterrupted skin-to-skin contact prevents
hypothermia, hypoglycemia, and sepsis, increases colonization with protective
bacterial flora and improved breastfeeding initiation and exclusivity. It promotes
bonding between mother and child, overall success of breastfeeding, stimulation
of the mucosa-associated lymphoid tissue system, colonization with maternal
skin flora.
3.3 Properly timed Cord Clamping
Properly timed cord clamping and cutting until the umbilical cord pulsation
stops decreases anemia in one out of every seven term babies and one out of
every three preterm babies. It also prevents brain (intraventricular) hemorrhage
in one of two preterm babies.
3.4 Early Breastfeeding

Breastfeeding initiation within the first hour of life prevents an

estimated 19.1% of all neonatal deaths.

Familiarize with the Checklists to be used for RD.

DUE: on or before November 2, 2020