Comprehensive Maternity Pharmacology & Labor Stages: Medications, Fetal Monitoring, and Nursing Interventions |Latest Updated 2026 with A+ Graded Rationales

Comprehensive Maternity Pharmacology & Labor Stages: Medications, Fetal Monitoring, and Nursing Interventions |Latest Updated 2026 with A+ Graded Rationales Betamethasone glucocorticosteroid given to enhance fetal lung maturity Nifedipine preterm labor tocolytic Magnesium sulfate antidote calcium gluconate Tocolytics Medication used for cessation of uterine contractions -terbutaline(brethine) -magnesium sulfate first stage of labor the initial stage of childbirth in which regular contractions begin and the cervix dilates second stage of labor Full dilation Intense contractions Birth of baby third stage of labor Delivery of the placenta fourth stage of labor the first 1-4 hours after delivery of the placenta, maternal VS stabilize Nitrazine test this is a test of vaginal secretions if the client is uncertain whether the membranes have ruptured. Color will indicate whether amniotic fluid is present. Yellow = urine. Blue = Amniotic fluid. transverse lie shoulder presentation longitudinal lie the long axis of the mother and fetus are parallel (most common) can be breech or cephalic normal FHR between contractions 110-160 BPM early decels - Indicate progression of labor and are benign. - Nurses should continue to observe FHR. late decels uteroplacental insufficiency, may need c-section Fetal tachycardia 160 bpm for 10 minutes or longer Station (labor) negative 3 to positive three (superior) zero is at the ischial spines +1-3 is past the ischial spines (inferior) Oxytocin A hormone released by the posterior pituitary that stimulates uterine contractions during childbirth and milk ejection during breastfeeding. nursing action when FHR slows and there is loss of variability Turn mom to side and give O2 8-10 L/min first nursing action in any abnormality in L&D change mother's position variable decels Cord Compression - have mom reposition - sometimes emergency c-section ROADI reposition to side-lying position oxygen with facemask alert provider discontinue Oxytocin increase IV fluids Amnioinfusion introduction of a solution into the amniotic sac; an isotonic solution is most commonly used to relieve fetal distress late decels FHR continued to decreased beyond the end of contraction Leopold's Maneuvers Palpation to determine presentation and position of the fetus and aid in location of fetal heart sounds. Head=hard, round, movable object Buttocks=soft and irregular shape Back=smooth, hard surface felt on one side of the abdomen Irregular knobs and lumps on opposite side of abdomen may be hands, feet, elbows, and knees variable decels umbilical cord compression, can have amnioinfusion full term infant 37 weeks of more Signs of true labor -contractions are regular with increasing frequency (shortened intervals), duration, and intensity -discomfort radiates from back to abdomen -cervix progressively effaces and dilates -bloody show -water breaks Braxton Hicks contractions intermittent painless uterine contractions that occur with increasing frequency as the pregnancy progresses decrease with walking or changing position true labor signs LBP that moves to abdomen cervical effacement/dilation regular contractions that increase in frequency walking makes contractions more intense occiput posterior position OP= "oh poop", no good (back labor) delivery presentation with infant's head downward and facing mothers back OP position interventions To help rotate baby: -Position mom on hands and knees To help alleviate pain: -Sacral counter-pressure -Use birth ball with knees on the floor late first stage of labor needs to poop can vomit irritability bloody mucus sinusoidal pattern of FHR: •Jagged, saw-tooth sine waves •Due to sudden intrapartum fetomaternal hemorrhage •Usually requires emergency delivery and neonatal transfusion first stage Latent active transition Latent- contractions 5-30 min, dilated 0-3 cm active - contractions 3-5 min, dilated 4-7 cm transition - contractions 2-3 min, dilated 8-10 cm Ferguson reflex reflex contractions (urge to push) of the uterus after stimulation of the cervix when the presenting part of the fetus reaches the perineal floor Bishop score Determines maternal readiness for labor by evaluating whether the cervix is favorable by rating cervical dilation, effacement, consistency, position, and station, scores 0-3 for each Firm Fundus firm, midline, level with umbilicus displaced fundus can indicate increased bleeding or bladder distention boggy fundus (uterine atony) massage until firm Medications: pitocin, methergine, hemabate know the last time she voided full bladder with displace a uterus amniotomy artificial rupture of membranes lochia the postpartum vaginal discharge that typically continues for 4-6 weeks after childbirth lochia rubra, bright red with small clots lochia serosa, brown then pink lochia alba, white Misoprostol Cytotec for either miscarriage or to ripen cervix during labor Nifedipine calcium channel blocker, used to stop pre-term labor Oxytocin used before and after birth to cause contractions Methylergonovine (Methergine) Acts directly on the uterine muscle to stimulate forceful contractions. Used for postpartum hemorrhage. Ceftriaxone (Rocephin) antibiotic for gonorrhea Magnesium Sulfate smooth muscle relaxant - monitor respirations and deep tendon reflexes vitamin K Helps the blood clot Bulging fontanel increased intracranial pressure Erthromycin Ophthalmic Ointment all newborns are given this 1 hour after birth and before leaving the delivery room to protect against eye infections caused by STI's ROP Positioning fetal occiput is presenting closest to right posterior pelvis breech presentation birth position in which the buttocks, feet, or knees emerge first cephalic presentation most common birth position in which any part of the head emerges first. vertex presentation A delivery in which the head comes out first. (same as cephalic) gynecoid pelvis most favorable pelvis for successful labor. gestational diabetes hyperglycemia s/s Increased urinary output nausea and vomiting reports of thirst drowsiness fruity breath odor urine positive for sugar and acetone, and a blood glucose level greater than 200 mg/dL. Betamethasone glucocorticosteroid given to enhance fetal lung maturity "betta" breathing for the baby positive contraction stress test indicates a biophysical profile LOA position Left Occiput Anterior This means fetus is head down, over on mom's left side w/fetal face looking backward & occiput facing front fetal heart tones best heard in LLQ stages of labor 1st: dilating stage 3 phases: Latent (0-3cm) Active (4-7cm) Transition (8-10cm w/ urge to push) 2nd stage: delivery 3rd: placental delivery 4th: recovery- primary goal to prevent hemorrhage from uterine atony