Page 53 - 2023 Elctronic Book (3) Normal Labor_Neat

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Care of Bladder

• The woman should be encouraged to pass urine every 2-3 hours during labor.
• The urine should be tested for the presence of glucose, protein and ketone

bodies.
• A full bladder causes poor uterine contractions, postpartum hemorrhage and
injury or vescio-vaginal fistula when the bladder is nipped between the fetal

head and the pelvis. It prevents the descent of the fetal head, increases pain
and causes unnecessary discomfort.
• Retention of urine occurs frequently in labor due to:

o Lack of muscle tone of the urinary bladder.
o Uncomfortable use of bedpan.
o Pressure on the urethra.

o Elongation of the urethra, which inhibits relaxation of the urethral sphincter.
Observation:
Close observation is important for both the woman and fetus. The nurse should

observe the following:
• Reaction of the woman to labor.

• Vaginal discharge, show, amniotic fluid, and meconium.
• Progress of labor through descent of head and cervical dilatation.
• Uterine action: The frequency, duration and intensity of uterine contractions

should be checked and recorded every 30 minutes. See table .( )
Interval minutes 30 minutes 20 - 15 minutes 2 - 3
Duration seconds 35 - 25 seconds 45 - 35 sseconds 70 - 60

Intensity Mild Moderate Strong

 Maternal condition:

o Temperature is checked and recorded every 4 hours.
o Respiration, pulse, and BP are checked and recorded every hour.
Signs of maternal distress:

• Increased pulse rates over 100 b/min.
• Elevated temperature, more than 37.5°C.

• Decreased blood pressure.
• Sweating and pale face.

• Signs of dehydration.

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