NURS358 Lecture Notes - Lecture 3: Vaginal Bleeding, Trilobite, Fetal Position
3 Jun 2019
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Latent - 0-3 cms - could be in this for days; can walk around and talk in this stage. Active - 4-7 - definitely regular contractions, within less than 5 minutes of each other; she can no longer talk through contractions, a lot more uncomfortable. Determine if birth impending and well being of mom and infant - 3 q"s. Establish rapport from start - ask how she"s doing, causes, allergies. Vs, heart, lungs, abdominal exam (leopolds, feel for back for efm to go on, and will tell you lie; strengths and duration of contraction, uterine relaxation between contractions) Ve (if no bleeding) - cervical dilation, cervical effacement, station of presenting part of fetus (whats going to come out first) Extremities - edema, reflexes (in preeclampsia, reflexes are hyperactive) Labs that may need to be done, especially before iv - cbc, and type/cross of blood. May have to do internal monitor if high risk.
