RNSG 1412 - Nursing Care of the Childbearing and Childrearing Family

Module 4:  Nursing Care of the Individual with Normal Labor and Delivery

 

Module Objectives:  

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

Essential Factors of Labor:

  1. Analyze the four essential factors that affect the labor process.
    • The Psyche
    • The Passenger
    • The Passageway
    • The Powers
  2. Analyze the dynamic relationship between the factors during the process of labor.
  3. Analyze the affect the passenger, the fetus, has on labor in relation to:
    • The fetal head
    • Lie of the fetus
    • Attitude
    • Presentation
    • Position
  4. Analyze the affect the passageway, or birth canal, has on the process of labor including:
    • normal shape of the pelvis
    • true pelvis and false pelvis
    • pelvic inlet and outlet
  5. Analyze the affect the powers / uterine contractions, has on the process of labor including:
    • Primary powers
    • Secondary powers
  6. 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 

Assessment of Labor:

  1. Analyze the purpose of abdominal palpitation in assessment of the laboring woman.
  2. Analyze the purpose of the Leopold’s maneuver and how to perform.
  3. Analyze the purpose of auscultation of fetal heart rate in assessment of labor.
  4. Analyze the purpose of vaginal examinations in assessment of labor including:
    • Presentation and Position
    • Condition of membranes
    • Dilatation and Effacement
    • Station
    • Engagement
  5. Analyze the purpose of ultrasound, or x-ray in assessment of labor.

Process of Labor:

  1. Analyze the theories as to the cause of onset of labor.
  2. Analyze the forces of labor, uterine contractions including:
    • Frequency
    • Duration
    • Intensity
    • Interval
    • Assessment of a contraction
  3. Analyze the normal duration of labor for a primigravida and a multigravida and factors that affect the normal duration of labor.
  4. Analyze the premonitory signs and symptoms of labor including:
    • Lightening
    • False labor pains
    • Show
    • ROM
    • Backache
    • Diarrhea
    • Sudden increase in energy
  5. Compare the signs and symptoms of true labor with false labor.
  6. Differentiate the stages and phases of labor.

Nursing Care During Labor and Delivery:

  1. Analyze the signs and symptoms and nursing care for each of the phases of the first stage of labor:         
    • Latent: 0-3 cm.
      • Signs and symptoms – mothers response, contractions
      • Admission to the hospital
      • Orient to the hospital
      • Vital signs and FHT’s
      • Assessment of History and Physical
      • Obstetric assessment
      • Admission procedures 
      • Provide support with non-pharmacological measures
      • Provide with diversional activities
      • Elimination assessment
    • Active: 4-7 cm.
      • Signs and symptoms – mother’s response, contractions
      • Anticipate the needs of the childbearing family
      • Use of non-pharmacological measures
      • Offer analgesia and anesthesia
    • Transition: 8-10 cm.
      • Signs and symptoms – mother’s response and contractions
      • Continue with support measures
      • Watch for hyperventilation and intervene
      • Don’t allow to push
  2. Analyze the nursing care for the second stage of labor
    • Signs and symptoms
    • Mechanisms of labor – in correct order
  3. Analyze the nursing care for the third stage of labor and the signs and symptoms of placental separation.

Pain Management in Labor:

  1. Analyze the causes of pain in labor and delivery including:
    • Stage One
    • Stage Two
    • Stage Three
  2. Analyze factors that affect the mother’s response to pain.
  3. Analyze non-pharmacological methods of pain relief.
  4. Analyze common analgesics used in labor and delivery including advantages and disadvantages and nursing care.
  5. Analyze the advantages and disadvantages of the various types of anesthesia used during labor and delivery.
    • General Anesthesia
    • Regional Anesthesia
      • Paracervical
      • Epidural / Caudal
      • Spinal
      • Pudendal
    • Local anesthesia

Learning Activities:

1. Review module objectives.

2. Learning Resources:

  • Read: London 
    • Chapters 17, 18, 19, and 20

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”