RNSG 1412 - Nursing Care of the Childbearing and Childrearing Family

Nursing Care of the Individual with Normal Labor and Delivery


Module Objectives:  

Utilizing critical thinking and the nursing process, the student is expected to:

 Physiologic Effects of the Birth Process

 1.  Analyze the maternal responses to labor including:

  • Characteristics of contractions
    • increment, peak, decrement
    • duration and frequency
    • interval
  • Cervical Changes
    • Effacement
    • Dilation
  • Cardiovascular changes
  • Respiratory changes
  • Gastrointestinal changes
  • Urinary changes
  • Hematopoietic changes

 2. Analyze the fetal response to labor

 3. Analyze the affect the powers / uterine contractions, has on the process

    of labor including:

  • Primary powers
  • Secondary powers

 4. Analyze the affect the passageway, or birth canal, has on the process of

      labor including:

  • true pelvis and false pelvis
  • pelvic inlet and outlet

 5. Analyze the affect the passenger, the fetus, has on labor in relation to:

  • The fetal head
  • Lie of the fetus
  • Attitude
  • Presentation
  • Position

 6.  Analyze the affect the psyche has on the process of labor. 

 7.  Analyze ways the psychological response of the mother to labor can

     affect the normal labor process including:

  • Previous experiences
  • Preparation for childbirth
  • Cultural background
  • Support systems 


Normal Labor:

 8. Analyze the theories as to the cause of onset of labor.

 9. Analyze the premonitory signs and symptoms of labor including:

  • Braxton-Hicks contractions
  • Lightening
  • Increase in vaginal secretions
  • Bloody Show
  • ROM
  • Sudden increase in energy

 10. Compare the signs and symptoms of true labor with false labor.

 11. Analyze the mechanisms (cardinal movements) of labor as fetus is moved

      through the pelvis.

 12. Differentiate the stages and phases of labor and the characteristics of each.


Nursing Care during Labor and Delivery:

 13. Analyze the guidelines for when to go to the hospital.

 14. Analyze the responsibilities of the nursing during admission to labor including:

  • Establishing a therapeutic relationship
  • Assessment of woman and fetus including:
  • Fetal assessment
  • Maternal vital signs
  • Labor status
  • Abdominal palpation
  • Leopold’s maneuver
  • Vaginal examination
  • Presentation and Position
  • Condition of membranes
  • Dilatation and Effacement
  • Station
  • Engagement
  • Ultrasound
  • Physical examination 


15. Analyze the responsibilities of the nurse in assessing fetal well-being.

 16. Analyze measures in providing comfort for the laboring woman and related

      patient teaching:

  • Lighting
  • Temperature
  • Hygiene
  • Bladder
  • Positioning

 17. Analyze the nursing care for the third stage of labor and the signs and

       symptoms of placental separation.

 Pain Management in Labor

 18. Analyze the adverse effects of pain on the woman and fetus.

 19. Analyze the sources of pain in labor and delivery including:

  1. Stage One
  2. Stage Two
  3. Stage Three

 20. Analyze factors that affect the mother’s response to pain.

 21. Analyze non-pharmacological methods of pain relief.

 22. Compare the various breathing techniques for each phase and stage

      of labor.

 23. Analyze common analgesics used in labor and delivery including

      advantages and disadvantages and nursing care.

 24. Analyze the advantages and disadvantages of the various types of

      anesthesia used during labor and delivery.

  • General Anesthesia
  • Regional Anesthesia
    • Epidural
    • Spinal
    • Pudendal
  • Local anesthesia 

Learning Activities:

1. Review module objectives.

2. Learning Resources:

  • Read: McKinney (2009)
    • Chapter 17, pp. 336-382; Chapter 19, pp. 409- 432. 

3. Complete Critical Thinking Exercises:

  • Physiological Adaptations in L & D – in Blackboard
  • Pain Management in L & D -  in Blackboard

4. Supplemental Learning:


5. Review module objectives and check for knowledge gaps.

6. Complete module quiz

  • “Normal Labor and Delivery- Physiological Adaptations”
  • “Normal Labor and Delivery: Nursing Care"
  • “Labor and Delivery: Pain Management”