💓 Savvy NurseLouvri aplikasyon an

🤱 Matènite ak Tibebe Ki Fenk Fèt · Leson 6 sou 6 · 6 min

Etap Travay Akouchman an ak Sa Enfimyè a Fè nan Chak

Stages of Labor and What the Nurse Does in Each

⏱️ 'Konbyen mwen dilate?' se kesyon chak pasyan k ap akouche poze. 'Nan ki etap li ye epi ki travay mwen kounye a?' se kesyon egzamen an poze ou.

⏱️ 'How dilated am I?' is the question every laboring client asks. 'What stage is she in and what is my job right now?' is the question the exam asks you.

💡 Ide prensipal

Premye etap jiska 10 cm (latant, aktif, tranzisyon), dezyèm etap jiska nesans, twazyèm etap plasenta a, katriyèm etap rekiperasyon ak tcheke fundus chak 15 minit pou premye èdtan an.

First stage to 10 cm (latent, active, transition), second stage to birth, third stage the placenta, fourth stage recovery with fundal checks every 15 minutes for the first hour.

🧠 Poukisa sa enpòtan

VRÈ travay akouchman: kontraksyon regilye ki vin pi fò ak aktivite, chanjman nan kòl matris la, ak doulè ki kòmanse nan do a epi ki ale devan; kontraksyon FO travay akouchman yo iregilye, yo soulaje lè ou mache epi yo pa koze chanjman nan kòl matris la. PREMYE ETAP la ale depi kòmansman travay la jiska dilatasyon konplè (10 cm): faz LATANT la (0 a apeprè 5 oswa 6 cm) se moman pou anseye epi ankouraje mache; faz AKTIF la pote kontraksyon ki pi fò ak dilatasyon ki pi rapid, ak siveyans kontraksyon yo, rit kè fetis la ak siy vital manman an; TRANZISYON (8 a 10 cm) se sa ki pi entans, ak kè plen, tranbleman, iritabilite ak yon anvi pouse yo dwe reziste jiskaske dilatasyon an konplè. DEZYÈM ETAP la ale depi dilatasyon konplè jiska nesans la: soutni pouse a ak kontraksyon yo, siveye rit kè fetis la apre chak kontraksyon, epi prepare pou akouchman an. TWAZYÈM ETAP la se akouchman plasenta a, nan apeprè 30 minit, ak siy separasyon (yon kouran san, kòdon ki vin pi long, matris ki vin won); yo bay oxytocin prevantif touswit apre tibebe a fèt (oswa apre plasenta a soti, dapre pwotokòl etablisman an) pou anpeche emoraji. KATRIYÈM ETAP la se premye 1 a 4 èdtan rekiperasyon yo, ak siy vital ak tcheke fundus chak 15 minit pou premye èdtan an. Mezi konfò ak epidural yo: yon bolus likid anvan plasman an, siveye ipotansyon manman an (trete ak kouche sou kote, likid ak ephedrine) ak bradikadi fetis, ak tcheke vesi paske pasyan an pa ka santi li plen.

TRUE labor: regular contractions that intensify with activity, cervical change, and pain starting in the back and moving to the front; FALSE labor contractions are irregular, ease with walking and cause no cervical change. FIRST STAGE runs from the onset of labor to full dilation (10 cm): the LATENT phase (0 to about 5 or 6 cm) is the time for teaching and encouraging ambulation; the ACTIVE phase brings stronger contractions and faster dilation, with monitoring of contractions, fetal heart rate and maternal vital signs; TRANSITION (8 to 10 cm) is the most intense, with nausea, shaking, irritability and an urge to push that must be resisted until full dilation. SECOND STAGE runs from full dilation to birth: support pushing with contractions, monitor the fetal heart rate after each contraction, and prepare for delivery. THIRD STAGE is the delivery of the placenta, within about 30 minutes, with signs of separation (a gush of blood, lengthening cord, globular uterus); prophylactic oxytocin is given right after the baby is born (or after the placenta delivers, per facility protocol) to prevent hemorrhage. FOURTH STAGE is the first 1 to 4 hours of recovery, with vital signs and fundal checks every 15 minutes for the first hour. Comfort measures and epidurals: a fluid bolus before placement, monitor for maternal hypotension (treat with side-lying, fluids and ephedrine) and fetal bradycardia, and bladder checks because the client cannot feel fullness.

🏥 Nan lavi reyèl

🧊 Yon pasyan nan tranzisyon di li pa ka kontinye ankò epi li vle pouse nan 8 cm. Enfimyè a gide li pou soufle pandan kontraksyon yo, rasire li faz sa a se sa ki pi kout, epi anpeche li pouse sou yon kòl matris ki poko ouvri. Ven minit pita li konplè, epi pouse a vin pwodiktif olye li danjere.

🧊 A client in transition says she cannot do this anymore and wants to push at 8 cm. The nurse coaches her to blow through contractions, reassures her that this phase is the shortest, and keeps her from pushing on a cervix that is not yet open. Twenty minutes later she is complete, and pushing becomes productive instead of harmful.

📌 Sa pou retni

  • Vrè travay akouchman chanje kòl matris la; fo travay akouchman pa fè saTrue labor changes the cervix; false labor does not
  • Tranzisyon: 8 a 10 cm, entans, pa pouse jiskaske li konplèTransition: 8 to 10 cm, intense, no pushing until complete
  • Apre yon epidural: siveye tansyon manman an ak vesi aAfter an epidural: watch maternal blood pressure and bladder

📖 Tèm nan leson sa a

Oxytocin: Òmòn IV ki pwovoke oswa ranfòse tranche epi ki kontrakte matris la apre nesans; titre pa ponp ak siveyans fetal kontinyèl, epi sispann li, vire pasyan an, bay oksijèn epi notifye founisè a pou plis pase senk kontraksyon nan 10 minit oswa deselerasyon ta.

Terbutaline: Yon agonis beta ki detann matris la pou retade tranche prematire yon ti moman; itilizasyon enjektab pi lwen pase 48 a 72 èdtan (ak nenpòt itilizasyon oral) pote yon avètisman nan bwat pou lanmò kadyak matènèl, kidonk kenbe li pou yon batman matènèl pi wo pase 120 epi rapòte doulè pwatrin.

Betamethasone (esteroyid anvan nesans) (Betamethasone (antenatal steroids)): De dòz IM 12 mg yo bay a 24 èdtan distans bay yon fanm yo atann li akouche ant 24 ak 34 semèn, pou matire poumon fetal la epi diminye detrès respiratwa, senyen nan sèvo ak blesi trip; veye glikoz manman an ak siy enfeksyon.

✅ Teste tèt ou

Yon pasyan k ap akouche nan 8 cm ap tranble, li gen kè plen epi li di li dwe pouse. Ki pi bon repons enfimyè a?A laboring client at 8 cm is shaking, nauseated and says she has to push. What is the nurse's best response?
  1. Gide li pou respire pandan kontraksyon yo jiskaske li dilate nètCoach her to breathe through contractions until she is fully dilated
  2. Di li li pa nan vrè travay akouchmanTell her she is not in real labor
  3. Kite li pou al avèti founisè aLeave to notify the provider
  4. Ankouraje li pouse ak chak kontraksyonEncourage pushing with each contraction

Repons: A · Gide li pou respire pandan kontraksyon yo jiskaske li dilate nèt

Tranzisyon pote yon anvi pouse ki vini twò bonè; pouse anvan 10 cm ka koze èdèm nan kòl matris la ak blesi.

Transition brings a premature urge to push; pushing before 10 cm can cause cervical edema and injury.

Ki rezilta ki fè diferans ant vrè travay akouchman ak fo travay akouchman?Which finding distinguishes true labor from false labor?
  1. Kontraksyon ki kanpe lè pasyan an macheContractions that stop when the client walks around
  2. Dilatasyon ak efasman kòl matris la ki pwogreseProgressive cervical dilation and effacement
  3. Kontraksyon iregilye ki varye nan entansiteIrregular contractions that vary in intensity
  4. Malèz yo santi sitou nan pati anba vant ak arènDiscomfort felt mainly in the lower abdomen and groin

Repons: B · Dilatasyon ak efasman kòl matris la ki pwogrese

Chanjman nan kòl matris la se karakteristik ki defini vrè travay akouchman an kèlkeswa jan kontraksyon yo santi. Malèz yo santi sitou nan pati anba vant ak arèn tipik pou fo travay akouchman; doulè vrè travay akouchman an anjeneral kòmanse nan pati anba do a epi li vlope ale devan.

Cervical change is the defining feature of true labor regardless of how the contractions feel. Discomfort felt mainly in the lower abdomen and groin is typical of false labor; true labor pain usually starts in the lower back and wraps around to the front.

Kenz minit apre yo mete yon epidural, tansyon pasyan an bese de 124/78 a 88/50. Kisa enfimyè a ta dwe fè an premye?Fifteen minutes after an epidural is placed, the client's blood pressure drops from 124/78 to 88/50. What should the nurse do first?
  1. Mete pasyan an nan pozisyon Fowler wo ak janm li pandyePlace the client in a high Fowler's position with her legs dangling
  2. Kanpe monitè fetis la pou diminye enkyetidStop the fetal monitor to reduce anxiety
  3. Prepare sal operasyon an pou yon akouchman sezaryèn imedyaPrepare the operating room for an immediate cesarean delivery
  4. Vire pasyan an sou kote li epi ogmante vitès likid IV laTurn the client to her side and increase the IV fluid rate

Repons: D · Vire pasyan an sou kote li epi ogmante vitès likid IV la

Ipotansyon ki gen rapò ak epidural trete ak pozisyon lateral ak yon bolus likid; yo bay ephedrine si li kontinye. Fowler wo ak janm yo pandye akimile san nan pati anba kò a epi diminye retou venè a, sa ki vin pi grav ipotansyon an olye li korije li.

Epidural-related hypotension is treated with lateral positioning and a fluid bolus; ephedrine is given if it persists. High Fowler's with the legs dangling pools blood in the lower body and reduces venous return, worsening the hypotension instead of correcting it.

Kòmanse leson sa a gratis →

Kesyon tankou NCLEX, XP ak seri jou nan aplikasyon an, an angle ak èd an kreyòl. Pa bezwen enskri.

Plis nan Matènite ak Tibebe Ki Fenk Fèt

🔗 Leson ki gen rapò