Stages of Labor Nursing OB for Nursing Students | Stages of Labour NCLEX Explained Video Lecture
Summary
TLDRIn this informative video, Sarah Thread Sterner provides an in-depth review of the stages of labor as part of a maternity nursing series. She outlines the four stages of labor, emphasizing the importance of understanding each stage for nursing exams. Stage one involves cervical dilation with three phases: latent, active, and transition. Stage two is the baby's delivery, stage three is the placenta's delivery, and stage four is the recovery period. Key points include monitoring cervical dilation, contractions, and nursing interventions. The video also covers signs of the baby's imminent delivery, the appearance of the placenta, and the nurse's role during each stage, concluding with a quiz for knowledge assessment.
Takeaways
- 📚 The video is part of an inkle review series focused on maternity nursing.
- 🤰 There are four stages of labor, each with specific events and nursing interventions.
- 🔑 The first stage is the longest and involves three phases: latent, active, and transition.
- 📏 During the first stage, the cervix dilates from 0 to 10 centimeters.
- 🚑 The latent phase is characterized by mild contractions and may not be recognized as labor.
- 💪 The transition phase is the most intense, with contractions becoming very close together.
- 👶 Stage two is when the baby is delivered, and it can last from 2 to 3 hours for first-time mothers.
- 🌀 In stage two, the mother will experience intense pressure and the urge to push.
- 🩸 Stage three involves the delivery of the placenta, which should happen within 5 to 15 minutes after the baby is born.
- 🔄 The Schultz and Duncan mechanisms are key methods for delivering the placenta.
- 🛌 Stage four is the recovery period, lasting one to four hours post-delivery, where the mother's vital signs and uterine health are closely monitored.
Q & A
What are the four stages of labor mentioned in the video?
-The four stages of labor are: Stage one (cervix dilates from 0 to 10 centimeters), Stage two (baby is delivered), Stage three (placenta is delivered), and Stage four (recovery period one to four hours after the delivery of the placenta).
What are the three phases of the first stage of labor?
-The three phases of the first stage of labor are the latent phase (also called early labor), the active phase, and the transition phase.
What happens during the latent phase of labor?
-During the latent phase, the cervix dilates from one to four centimeters, contractions are every five to thirty minutes and 30 to 45 seconds in length, and they are mild compared to the active and transition phases.
How does the active phase differ from the latent phase?
-In the active phase, the cervix dilates from four to seven centimeters, contractions are every three to five minutes and 45 to 60 seconds long, and they are stronger and longer than in the latent phase.
What is the main goal of the transition phase?
-The main goal of the transition phase is to dilate the cervix from 8 to 10 centimeters, leading to full dilation for the baby to be delivered.
What are the signs that the baby is about to be delivered during stage two of labor?
-Signs that the baby is about to be delivered include intense pressure, the baby descending through the birth canal, and changes in the perineum such as bulging or an increase in bloody show.
What are the two delivery mechanisms for the placenta mentioned in the video?
-The two delivery mechanisms for the placenta are the Schultz mechanism, where the shiny side (baby side) is delivered first, and the Duncan mechanism, where the dull side (maternal side) is delivered first.
What is the significance of the color of the amniotic fluid during labor?
-The color of the amniotic fluid is significant because meconium-stained fluid, which is yellow-brown or greenish, can indicate fetal distress and the risk of the baby aspirating it into its lungs, potentially causing infection or blocking airways.
Why is it important not to push before the cervix is fully dilated during the transition phase?
-It is important not to push before the cervix is fully dilated because pushing before achieving a '10' on the dilation scale can cause the cervix to swell and prevent further dilation, which is necessary for the baby to be born.
What are some nursing interventions during the active phase of labor?
-Nursing interventions during the active phase include providing comfort through nonpharmacological (e.g., warm showers, massage) or pharmacological (e.g., epidural) methods, monitoring vital signs, and ensuring the woman's bladder is empty to prevent interference with uterine contractions.
What is the primary focus of stage four of labor?
-The primary focus of stage four of labor is the recovery period for the mother, which involves monitoring for complications like hemorrhage or infection, assessing the fundus of the uterus, and promoting bonding and breastfeeding with the baby.
Outlines
📝 Introduction to Stages of Labor and Nursing Interventions
In this introductory paragraph, the presenter, Sarah, sets the stage for the video by discussing the stages of labor as part of a review series on maternity nursing. She explains that the video will cover key aspects essential for nursing students, especially for those preparing for the NCLEX exam. The focus is on understanding the four stages of labor, particularly the first stage, which includes three phases. She emphasizes the importance of knowing cervical dilation, contraction patterns, and nursing interventions at each stage.
📊 Overview of the Four Stages of Labor
This paragraph gives a brief overview of the four stages of labor. Stage 1 involves cervical dilation from 0 to 10 cm and is subdivided into three phases: latent, active, and transition. Stage 2 focuses on the delivery of the baby, Stage 3 involves the delivery of the placenta, and Stage 4 is the recovery phase following placental delivery. Each stage has specific nursing roles and signs to monitor, such as cervical dilation, contractions, and fetal monitoring.
👶 Stage 1: Latent Phase
In the latent (early) phase of Stage 1, the cervix dilates from 1 to 4 cm with mild contractions occurring every 5 to 30 minutes, lasting 30 to 45 seconds. This phase can be long, especially for first-time mothers, and may go unnoticed as contractions are mild. If the mother is at home, she should stay there until active labor begins or her water breaks. During this phase, mothers are usually excited and nervous. Nursing interventions include comfort measures and keeping the mother active and comfortable.
🚶♀️ Stage 1: Active Phase
During the active phase, the cervix dilates from 4 to 7 cm, with stronger contractions occurring every 3 to 5 minutes, lasting 45 to 60 seconds. This phase lasts 4 to 8 hours, and mothers should head to the hospital if still at home. Nurses must monitor for signs of meconium-stained fluid (which can indicate fetal distress) and provide comfort through pharmacological or non-pharmacological methods, such as breathing techniques or epidurals. Nurses also monitor vital signs and bladder function, as a full bladder can slow labor.
⏳ Stage 1: Transition Phase
The transition phase is the most intense and shortest, with the cervix dilating from 8 to 10 cm. Contractions are very strong and close together, occurring every 2 to 3 minutes and lasting 60 to 90 seconds. The mother feels intense pressure, especially in the rectum, but must refrain from pushing until fully dilated to avoid complications. Nurses provide encouragement, monitor fetal heart rates, and assess cervical dilation and fetal position. Support is crucial as this phase leads into Stage 2, where the baby will be delivered.
💪 Stage 2: Delivery of the Baby
Stage 2 begins once the cervix is fully dilated and ends with the baby’s delivery. Mothers feel intense pressure as the baby descends through the birth canal. For first-time mothers, this stage can last up to 2 to 3 hours, while for others, it’s typically around 20 minutes. Contractions remain intense, and the nurse’s role includes teaching the mother how to push properly, monitoring vital signs, and offering encouragement. The exact time of birth is recorded, and the perineum is observed for bulging or visible baby parts.
🩺 Stage 3: Delivery of the Placenta
Stage 3 involves the delivery of the placenta, which usually occurs within 5 to 15 minutes after the baby is born. It is crucial for the placenta to be delivered quickly to avoid hemorrhage or complications from retained placenta parts. Nurses monitor for signs of placental delivery, such as lengthening of the umbilical cord and a change in the uterus’ shape. Two mechanisms of placental delivery are highlighted: Schultz (baby side, shiny and new) and Duncan (maternal side, dull and rough).
🔍 Stage 4: Recovery and Postpartum Monitoring
Stage 4 covers the first 1 to 4 hours after placental delivery, focusing on monitoring the mother for signs of hemorrhage, infection, and uterine atony. Nurses frequently check vital signs and assess lochia (post-birth discharge) to ensure no excessive bleeding. The fundus of the uterus is checked to ensure it is firm and positioned correctly. If the fundus is soft or displaced, nurses perform fundal massage and ensure the bladder is empty. Comfort measures and bonding with the baby, including breastfeeding, are promoted.
Mindmap
Keywords
💡Labour Stages
💡Cervical Dilation
💡Contractions
💡Nursing Interventions
💡Meconium
💡Fetal Heart Rate
💡Perineum
💡Placenta Delivery
💡Pitocin
💡Lochia
💡Fundus of the Uterus
Highlights
Sarah Thread Sterner introduces the four stages of labor and their importance in maternity nursing.
The first stage of labor involves cervical dilation from 0 to 10 centimeters and is divided into three phases: latent, active, and transition.
The latent phase is the early labor stage where the cervix dilates from 1 to 4 centimeters.
The active phase sees the cervix dilate from 4 to 7 centimeters with stronger and longer contractions.
The transition phase is the most intense and leads to full cervical dilation at 10 centimeters.
Stage two begins with full cervical dilation and ends after the baby is delivered.
In stage two, the woman experiences intense pressure as the baby descends through the birth canal.
Stage three is the delivery of the placenta, which should occur within 5 to 15 minutes after the baby is born.
The fourth stage of labor is the recovery period, lasting one to four hours after the placenta is delivered.
Nurses play a crucial role in monitoring and supporting the mother during each stage of labor.
The importance of recognizing signs of fetal distress, such as meconium-stained fluid, is highlighted.
Non-pharmacological and pharmacological interventions for pain management during labor are discussed.
The significance of monitoring the fetal heart rate and the mother's vital signs is emphasized.
The role of the nurse in teaching the mother how to push and breathe during stage two is explained.
The Schultz and Duncan mechanisms of placenta delivery are described, with tips for remembering which side is delivered first.
Post-delivery interventions include monitoring for hemorrhage, assessing the placenta, and promoting mother-baby bonding.
The nurse's role in the first few hours after delivery includes monitoring for complications and providing care to the mother.
The importance of assessing the mother's lochia and fundus after delivery is discussed.
The lecture concludes with a reminder to take a quiz to test knowledge on the stages of labor.
Transcripts
hey everyone it's sarah thread sterner
sorry and calm and in this video I want
to be going over the stages of labour
this video is part of an inkless review
series over maternity nursing so if
you're studying this section be sure to
check out the other videos in this
series and as always in the youtube
description below or at the end of this
video you can access the quiz that will
test your knowledge on the stages of
labour so let's get started
okay as we go through the stages of
labour there are some things that you
want to pay attention to for the ink Lex
exam or your maternity lecture exams
like for instance there's four stages
and what is happening during each of
those stages especially your first stage
because first stage has three phases and
you want to know what's happening with
cervical dilation with contractions and
nursing interventions and then
throughout the other stages like 2 3 & 4
you want to pay attention to what's
going on and why your role is as the
nurse like when the baby is delivered
what are some signs and symptoms the
baby's about to be delivered or in stage
3 when the placenta is delivered what
are you looking at after the placenta is
delivered
meaning and what's the placenta supposed
to look like and then in stage 4 what
are you going to be doing during
recovery so be sure you pay attention to
all that as I'm going through this
lecture so let's go over the four stages
of labor
what are they okay Stage one is where
the cervix dilates from 0 to 10
centimeters and this stage has three
phases known as the latent which is also
sometimes called early labor
active and transition then you have
stage to this stage is where the baby
will be delivered and then stage three
will be delivery of the placenta and
then stage four will be the first one to
four hours after the delivery of the
placenta let's look at stage 1 of labor
in debt okay the whole goal of stage one
is to get the cervix dilated from zero
to ten centimeters and a hundred percent
of face so dilation is opening up of the
cervix and effacement is thinning of the
cervix and all this is going to happen
due to the contractions the woman will
be having and they'll start out very
mild in the latent phase and then when
you get to transition phase they're
going to be really intense because that
cervix is trying to open all the way up
so that baby can be born that's the
whole goal of this stage now some facts
about stage one stage one is the longest
stage of all the stages of labor and it
tends to be longer for first-time
mothers compared to women who've already
had children and it starts when true
labor starts now as I said before stage
one has three phases so um I would
remember the name of each phase what
happens in them in regards to the
dilation of the cervix your
interventions and remember the order of
them because the transition which is the
third part of this stage the face will
lead into stage two where the baby will
be delivered so to help you remember the
order in the name of the stages remember
this mnemonic labor actively
transitioning because our labor is
transitioning to stage two which is
where the baby's going to be born the
whole goal is to have contractions open
up that cervix thin that cervix so the
baby can get out and be born okay so
let's look at the first phase this is
called the latent phase or sometimes
referred to as early labor
the cervix is going to dilate from one
to four centimeters in thin contractions
will be every five to thirty minutes and
30 to 45 seconds in length
now these contractions are going to be
very mild compared to what will be
happening in the active and transition
phase and um this phase is longest for
first-time mothers and sometimes women
may not even know that they're in um the
latent stage of labor
because the contractions may be mild
they not they may just have pain in
their back and so they really don't know
now during this phase if the woman's at
home she needs to stay at home until
she's actively in active labour or the
water breaks and the whole goal is to
keep comfortable try to keep busy as the
labor progresses
during this phase mother is going to be
excited and nervous and talking now
we're going to go into the active phase
and this is where things start to heat
up and start to get active okay in this
phase the cervix is going to dilate from
four to seven centimeters the woman will
probably be dilating anywhere between
about one centimeter per hour
contractions are going to be every three
to five minutes and forty-five to sixty
seconds long and the woman is going to
notice that these contractions are a lot
stronger and longer compared to what was
happening in the latent phase this phase
can last between four to eight hours now
if the mother is still at home it's time
for her to go to the hospital also
during this phase the water may break
and you'll want to check and if it
breaks in the hospital or if it broke at
home you'll want to ask for what color
was the fluid that was leaking and
because you're looking for what's called
meconium staying fluid and this fluid
will look like a yellow brown or
greenish fluid and what can happen is
that the baby can aspirate this into its
lungs cause infection block the Airways
and it can be an indication of fetal
distress so you want to ask that another
thing you may be doing is performing a
nitrazine paper test where you'll take
the fluid put it on a little strip of
paper and if it turns blue that means
that the woman is for surely leaking
amniotic fluid okay interventions during
this phase is comfort because she's want
to be having those intense contractions
so comfort either through nonfarm
illogical or Pharma logical techniques
and non pharmacological could be warm
shower
or baths or massage during contractions
or an epidural which is pharmacological
breathing techniques and keeping the
bladder empty I'm helping her if she has
an epidural she'll get a Foley but I'm
helping her go to the bathroom every
couple hours to void to empty that
bladder because a full bladder can
prevent the uterus from contracting
properly which can slow down labor and
you'll also want to be monitoring the
woman's vital signs and the heart rate
of the baby and I have a whole video on
fetal decelerations talking about early
and variable how to monitor those and a
card should be popping up so you can
access that and the mom she's going to
be a lot different in this phase
especially as it progresses she's going
to be serious in pain and anxious now
let's look at the transition phase this
phase is going to lead into stage 2
where the baby will be delivered the
cervix is going to dilate from 8 to 10
centimeters remember 10 is where we
wanted to get that perfect 10 so the
baby can be delivered now the thing with
this phase is it's um shortest of all
the phases but it's the most intense and
most painful for the mother it can last
anywhere from 30 minutes to 2 hours
contractions are going to be very
intense they're going to be long
sometimes back-to-back overlapping each
other they can occur every 2 to 3
minutes and lasts 60 to 90 seconds the
mom will be concentrating she's not
going to feel like talking be irritated
very much in pain and could be shivering
also she may start to feel an intense
pressure in the rectum as that baby is
pushing down and descending and you
don't want the mother to start pushing
even though she's going to want to push
until that cervix is fully dilated
because if the cervix is not dilated to
10 centimeters you can be pushing which
can cause and the cervix to become
swollen and then
we'll never dilate so you want to make
sure that she's all the way to ten
before she starts pushing so some
interventions a lot of support
encouragement and praise let her know
you've made it this far you can do this
we're almost there the breathing
techniques monitoring vital signs of
mother and especially baby the fetal
heart rate and especially during those
contractions after them and before how's
the baby responding making sure it's not
any distress and assessing cervical
dilation and effacement is she at the 10
yet and fetal positioning and what
station is that is the baby I and 0 is
where the baby is engaged it's a little
imaginary line you would draw on the
pelvis 0 would be at the ischial spine
which is the most narrow part of the
pelvis and as the baby advances it will
be entering into the positive numbers
because behind 0 above the ischial spine
our negative numbers like negative 1
negative 2 2 3 4 or 5 but as the baby's
starting to descend and will be coming
out and we get positive numbers so it'll
go from plus 1 to plus 5 and plus 5 is
crowning so you'll want to be watching
where baby is at okay now let's look at
stage 2
okay this stage starts when the cervix
has fully dilated in a face so it's all
the way open to that 10 centimeters and
it's a hundred percent sin and it ends
after the baby is delivered then we go
into stage 3 where our placenta will be
delivered so what's the big highlights
you need to know about stage 2 okay
stage 2 is where this woman is going to
be feeling some really intense pressure
at the end of the transition stage and
set phase in stage 1 she felt some
pressure as that baby was pushing down
but now the baby is going to start
descending through the birth canal so
it's going to start changing fetal
stations remember + 1 2 + 5 is where
we're going in 5 is crowning
and and for first-time mothers this
stage
and lasts approximately about one hour
anywhere it could last anywhere from two
to three hours so it lasts a little bit
longer for the first time others and for
my women who've already had children
last about twenty minutes and the main
thing was going to be making up this
phase is pushing the woman's going to be
pushing that baby out of the birth canal
to be born
okay so contractions will be similar to
what she experienced in the transition
phase they're going to be painful
they're going to hurt they're going to
be about 60 to 90 seconds in length and
occurring every two to three minutes now
interventions from the nurse you're
going to be teaching her how to push
propria when to push because if she has
an epidural she may not be able to feel
the contractions but you can see the
contractions on the monitor you're going
to help her breathe through them how to
do them positioning and high fowlers and
lithotomy or squatting or sideline
you're also going to be offering lots of
encouragement and praise talking to her
and telling her how far the baby is
along and you're going to be recording
that exact time that baby is fully
delivered because that's the birth time
and monitoring bottle sons and the fetal
heart rate of course making sure
everyone's doing good although you're
going to be looking at the perineum and
there will be specific changes in the
perineum before the baby is born so I
would remember these and you may see
bulging of the perineum and the anus or
rectum as the baby's head is coming
through that canal an increase in bloody
show or visible baby parts of course you
may see the baby's head depending on the
fetal position
you may see it presenting there so that
is telling you hey this baby is fixing
to come out okay now on to stage three
okay stage three starts with the full
delivery of the baby and ends with full
delivery of the placenta
okay this stage is pretty short pretty
easy for moments smooth sailing really
after this and then we go into stage
four which is a
period so this stage lasts about five to
15 minutes we want it to be quick
because the longer the stages the longer
it takes to deliver the placenta it
increases the risk of hemorrhage or
retain placenta parts which will cause
hemorrhage or infection now some signs
and symptoms that you want to remember
that the placenta is about to be
delivered and the umbilical cord starts
to lengthen there may be a trickle or a
gush of blood all of a sudden and the
uterus will change shape from an oval to
a globular shape so that are some signs
and symptoms that the placenta is fixing
to make its entrance okay some delivery
mechanisms I would remember this I
remembered questions from my maternity
lecture exams on this okay and this is
when the placenta is delivered which
side is delivered first and so remember
that and which side is the baby side and
which side is the maternal side that was
attached to the uterus okay so you have
two delivery mechanisms you have the
Schultz and you have the Duncan okay
Schultz is the side that is shiny that
um was delivered first so it was the
baby side and how liked remember this
was taught this shiny Schultz and
remember it's the baby side because the
baby is shiny and new so it's shiny a
new length of baby it's the shiny Shultz
and it was the saw that was facing the
baby it was delivered first then you
have the Duncan side the Duncan
mechanism and this is the side of the
mother the maternal side of the placenta
that was delivered first a lot of people
like to remember this dull dull dirty
Duncan the 3ds and because this side
looks dull red and rough and remember
momma just went through labor so she is
dirty from labor and she's in rough
condition so that's the maternal side so
remember those in some interventions for
this what you need to remember is you'll
be monitoring the MoMA's blood pressure
before and after delivery placenta
there's a risk of hemorrhage so you want
to monitor that and the doctor may order
what's called pitocin a master the
delivery of the placenta because this
prevents hemorrhage so remember you may
be giving pitocin after the delivery of
the placenta and you'll be assessing the
placenta making sure it's fully intact
and nothing is missing and still inside
the uterus and you'll be looking at that
cord which should have two arteries in
one vein and making mother comfortable
getting her cleaned up the sheets
changed peri care encouraging bonding
between the mother and the baby and
helping her with breastfeeding okay now
stage four this is our last stage and
this is the hours one to two one to four
hours after delivery of the placenta so
what you're going to be doing is you're
going to be monitoring the mom making
sure her health is doing good and she's
adjusting after she's just given birth
because she's at risk for a lot of
things like hemorrhage infection uterine
atony all that stuff so you want to make
sure you're monitoring those things so
you'll be monitoring bottle signs
especially her heart rate and blood
pressure because I'm hemorrhage if she's
hemorrhaging she'll have job and blood
pressure and she'll become tachycardic
as she's losing blood volume and her
temperature because I'm risk of
infection so your monitor that and the
lochia this is the discharge after birth
she'll be having a moderate to read
amounts of lochia there may be little
small clots but large clots is a huge
warning sign and you want to assess how
often she's having to change that parry
pad and she's changing it every 15
minutes because there's just so much
blood that is not normal that's abnormal
she's possibly hemorrhaging so you'll
want to assess that and another thing is
you'll be assessing the fundus of the
uterus this is the top portion of the
uterus and you want to make sure that it
is firm
midline and near or at the bellybutton
the umbilicus make sure it's there so
you will be filling that and depending
on Hospital protocol you'll be checking
it every 15 minutes for one hour and
then every 30 minutes for two hours now
a lot of questions like to ask you okay
you feel the fundus it's soft and boggy
and it's displaced what are you going to
do and videos are going to provide funds
and massage on that fundus of the uterus
and a sister to the bathroom because a
lot of times a full bladder can cause
the fundus to become displaced and soft
so those are the things you would do for
that if that question ever came up and
other things you're going to do is
you're going to administer pain relief
per doctor's orders provide peri care
like ice and witch hazel because she'll
have a lot of swelling and she may have
suffered from some tears or an
episiotomy and promote bonding and
breastfeeding with the woman and her
baby okay so that wraps up the lecture
on stages of labor thank you so much for
watching don't forget to take the free
quiz and subscribe to our channel for
more videos
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