NLE Antepartum, Intrapartum & Postpartum Care — Normal Labor & DeliveryConcept Map

Normal Labor & Delivery: Comprehensive Concept Hierarchy

Comprehensive mind map showing all major concepts in Normal Labor & Delivery organized hierarchically. Shows the Five Ps framework, stages of labor with their phases, monitoring parameters, pharmacologic interventions, stage-specific nursing care, and the DOH Unang Yakap protocol. This map provides the complete conceptual overview needed for NLE preparation.

Labor Progression and First Stage Phases with Nursing Actions

Flowchart demonstrating normal labor progression through all four stages with key decision points and nursing actions at each phase. Shows the diagnostic criteria for true labor, the three phases of first stage with contraction patterns and appropriate interventions, the transition to second stage at full dilation, and the critical assessment points in third and fourth stages. Includes the decision to NOT push until fully dilated and the initiation of Unang Yakap protocol.

Fetal Distress Recognition and Intrauterine Resuscitation Bundle

Critical action flowchart for recognizing fetal distress patterns and implementing the intrauterine resuscitation bundle. Distinguishes between the three types of decelerations with their physiologic causes and clinical significance. Shows the priority sequence of interventions for variable and late decelerations: stop oxytocin, reposition to left lateral, give oxygen, increase IV fluids, and notify physician. Includes assessment of response and escalation to emergency delivery if needed.

Cardinal Movements of Labor: The Seven Mechanisms

Linear flowchart illustrating the seven cardinal movements of labor in sequential order. Each movement shows the mechanism and anatomic change that occurs as the fetal head navigates through the maternal pelvis during second stage labor. The mnemonic device helps learners recall the sequence, which is essential for understanding normal labor mechanics and recognizing when labor is not progressing normally.

Rupture of Membranes: Assessment and Cord Prolapse Response

Critical emergency response flowchart for rupture of membranes with emphasis on cord prolapse recognition and immediate management. Shows the priority action of checking FHR immediately after membrane rupture due to cord prolapse risk. Demonstrates differentiation between normal clear fluid, meconium-stained fluid indicating fetal distress, and foul-smelling fluid indicating infection. Includes the emergency management protocol for cord prolapse: knee-chest positioning, relief of cord compression, oxygen, and emergency delivery notification.

Oxytocin (Pitocin) Administration for Labor Induction and Augmentation

Comprehensive flowchart for safe oxytocin administration in labor induction and augmentation. Emphasizes the critical high-alert drug protocol: IV infusion only, never IV push, and titration to effect via pump. Shows baseline assessment requirements before starting, continuous monitoring parameters, and the critical action to STOP oxytocin if hyperstimulation occurs. Includes the cascade of interventions for hyperstimulation (reposition, oxygen, fluids, assess cord compression, notify physician). Demonstrates the ongoing cycle of titration and monitoring until appropriate contractions are achieved and labor progresses normally.

Fourth Stage (1-2 Hours Post-delivery): PPH Risk Assessment and Management

Systematic assessment flowchart for fourth stage recovery with emphasis on early recognition and management of postpartum hemorrhage (PPH). Shows the 15-minute assessment frequency during the peak risk period (first hour). Highlights that a BOGGY (soft) uterus is the first sign of uterine atony and requires immediate massage. Demonstrates the sequential assessment of fundus, lochia, vital signs, bladder, and perineum. Includes the escalation pathway for abnormal findings and oxytocin administration for persistent atony. This critical protocol aligns with RA 9173 requirements for safe postpartum nursing care.

Unang Yakap (EINC) Protocol: Immediate Newborn Care

Step-by-step flowchart of the DOH Unang Yakap (EINC - Essential Intrapartum and Newborn Care) protocol aligned with Philippine healthcare policy and evidence-based practice. Shows the four core time-bound interventions: immediate drying within seconds, early skin-to-skin contact for thermoregulation, delayed cord clamping (1-3 minutes) for improved iron stores, and non-separation with early breastfeeding initiation. Emphasizes avoiding unnecessary interventions like suctioning and early bathing that interrupt the critical bonding and physiologic adaptation period. This protocol represents the Philippine approach to optimizing maternal-newborn outcomes.

Normal Labor Progression: Interaction of Five Ps Components

Sequence diagram showing the dynamic interactions between the Five Ps components during normal labor progression. Demonstrates how the passenger (fetus) engagement stimulates uterine contractions, how optimal maternal positioning enhances pelvic dimensions and contraction strength, how emotional state affects both contractions and positioning cooperation, and how the pelvic passage anatomically guides fetal descent and cardinal movements. This illustrates the integrated physiologic processes rather than viewing each P in isolation.

Fetal Heart Rate Status During Labor: Normal to Abnormal Transitions

State diagram showing the normal and abnormal transitions of fetal heart rate status during labor. Illustrates the normal baseline (110-160 bpm with moderate variability) and reassuring accelerations that indicate fetal well-being. Shows the three types of decelerations and their clinical significance: early decelerations (benign, mirror contractions), variable decelerations (cord compression, require intervention and repositioning), and late decelerations (ominous, indicate uteroplacental insufficiency). Demonstrates how variable and late decelerations that don't respond to interventions lead to emergency delivery. Includes recognition of abnormal baseline FHR patterns (tachycardia and bradycardia) and their escalation pathways.