NUR 4445 Third and Fourth Stages of Labor
- What is the third stage of labor characterized by?
- The third stage of labor lasts from the birth of the baby until the placenta is expelled.
- The placenta has separated and has been delivered
- What are indications that the placenta has separated (4)?
· Contraction of the uterus - globular shaped uterus and rises in the abdomen
· Gush of blood · Lengthening of the cord · Vaginal fullness/urge to push - per mom
- What medications may be used after the delivery of the placenta (3)?
· Cytotec
· Methergine · Hemabate
- How and when do we administer cytotec?
- do not give while pregnant, induces labor
- Given rectally
- Also given PO or vaginally but in situation of atonic uterus and increased bleeding PR for
fastest absorption
- How do we give Methergine? Who is it contraindicated in?
- Given IM 1 / 3
- Not given to person with hypertension as it can precipitate a hypertensive crisis!
- Who is hemabate contraindicated in?
Not for asthmatic patients
- At what stage of labor should newborn initial care be performed?
Newborn initial care should be done during the third stage of labor.
- What is included in initial newborn care (5)?
· Placing newborn on abdomen of mother or under radiant-heated unit.
· Dry newborn immediately · Keep newborn warm with warmed blankets and skin-to-skin contact with mother.· Suction nose and mouth of newborn as needed - if newborn has a lot of secretions or needs suctioning place them in modified Trendelenburg position!· APGAR score
- What are the requirements for receiving an Apgar score of 0 in the following categories
heart rate, respirations, muscle tone reflex response, skin color?
- Heart Rate
Absent
- Respirations
Absent
- Muscle Tone 2 / 3
Flaccid
- Reflex Response
Absent
- Skin Color
Pale or blue
- What are the requirements for receiving an Apgar score of 1 in the fol- lowing categories
heart rate, respirations, muscle tone reflex response, skin color?
- Heart Rate
< 100 bpm
- Respirations
Slow & irregular
- Muscle Tone
Some flexion of extremities
- Reflex Response
Grimace, Noticeable facial movement
- Skin Color
- / 3