SKILLS LAB

Maternal and child

FIRST MANEUVER .

NORMAL FINDINGS .

SECOND MANEUVER .

NORMAL FINDINGS .

THIRD MANEUVER .

NORMAL FINDINGS .

FOURTH MANEUVER .

NORMAL FINDINGS .

MOVIE CLIP OF LEOPOLD’S MANEUVER .

CARDINAL SIGNS OFF LABOR / MECHANISMS OF LABAOR ENGAGEMENT  DESCENT  FLEXION  INTERNAL ROTATION  EXTENSION  EXTERNAL ROTATION  EXPULSION  (ED FIRE ERE)  .

Cardinal / mechanisms of labor .

5 mins apart with urgency to ST bear down A PHASE III +4 to birth2 mins apart. placental separation 2. placental expulsion 4th First 4 hours after delivery of the placenta STAG *vital signs. fundus and lochia monitoring E every 15 minutes until stable* .STAGES OF LABOR DILATA DURATION / INTENSITY TION INTERVAL 20-40sec. fetal head visible GE increased 3 PLACENTA DELIVERY – Sudden gush of blood. 5Mild to 1ST PHASE I : Latent 0-3 cm 30mins 3-5mins Moderate to ST PHASE II : 4-7 cm 40-60sec. globular uetrus. rising of R D PHASE II STAG the E fundus. Moderate A Active PHASE III : 8-10 cm 60-90sec. lengthening of the cord. 2-3mins Strong Strong GE Transition PHASE STATIO CONTRACTION Nto +2 2 to 3 minutes apart 0 2N PHASE I STA GE PHASE D +2 to +4 2 to 2. 2 PHASES: 1.

Brandth-Andrew maneuver is pushing the uterus upward while gently pulling the cord downward to deliver . At the beginning of contraction.NuRSING MANAGEMENT DURING LABOR      Vital signs and FHR Provide comfort measures ( ambulate and if BOW not yet ruptured . Then engage is shallow breathing. Credes maneuver is gentle pressure on the contracted uterine fundus ( never on the non-contracted state or the uterus may evert and lead to hemorrhage). take a fairly deep breath. Take a deep breath at the end of contraction. puff out every 3rd . Placental delivery may take 5 – 10 minutes ( maximum 20 minutes). weighing about 400 to 600 grams (1lb) and is 1/6 of the fetal weight. If there is an urge to push. Meanwhile. left side lying is the most comfortable position and provide sacral pressures and back rubs)  Note: left side lying position prevents vena cava syndrome Breathing technique during transition phase:  Take a deep breath and exhale slowly and completely. or 5th breath. Either by Duncan (dirty presentation of the uterus) or schultze ( shiny glistening). 4th . Evaluate placental completeness( up to 30 cotyledons.