Page 184 - كتاب تمريض نسا الاكتروني

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 Fetal condition:
Monitor and record fetal heart rate to recognize fetal distress or abnormalities. It should
be heard every 4 hours until rupture of membranes, then every 30 minutes.

Signs of fetal distress:
 Excessive fetal movement.

 Excessive molding of fetal head.
 Excessive formation of caput succedaneum.
 A fetal heart rate increasing to more than 160 b/min, or decreasing to less
than 100 b/m, or becoming irregular.

 Passage of meconium in cephalic presentation.
Complications:
o Powers: Hypotonic or hypertonic uterine action. Passengers: Big infant,

malposition, and malpresentation.
o Passages: CPD/ fetopelvic disproportion (Contracted pelvis), and rigid
cervix.

Evaluation (Expected Outcomes)
• The woman progresses normally.

• She experiences increased comfort.
• The fetal heart rate remains within normal limits.
• The woman's hydration remains with normal limits.

 Second Stage (expulsion of the fetus)
Definition:

It begins with the fully dilatation of the cervix, and ends with delivery of the fetus. It
takes about one hour in the primigravida and half hour in the multigravida

Criteria of the Second Stage of Labor

1- The patient starts to bear down during uterine contractions due to pressure of the
presenting part on the rectum and pelvic floor causing reflex involuntary contraction
of the diaphragm and abdominal muscles.

2- The patient fells the desire to evacuate the rectum or bladder.

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