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WorksheetsExam 3 (OB) Study Guide - Labor & Delivery
Total questions: 125
Worksheet time: 1hrs 6mins
What national goal for healthcare improvement relates most to OB nursing?
Reducing mortality rates and eliminating inequalities of care
Increasing hospital revenue, removing social practices
Promoting technological advancements in surgery
Expanding geriatric care programs
The difference between true and false labor is:
True labor involves regular contractions that lead to cervical changes, while false labor does not.
False labor involves regular contractions that lead to cervical changes, while true labor does not.
True labor and false labor both involve cervical changes.
False labor is always more painful than true labor.
Uterine contractions _____ decrease with ambulation during true labor.
Do not
Do
Contractions increase in frequency, duration, and intensity (pain) during true labor.
True
False
Fill in the blank: Progesterone ______ smooth muscle during labor onset.
relaxes
contracts
stimulates
hardens
Fill in the blank: Estrogen stimulates ______ muscle contractions during labor onset.
uterine
cardiac
skeletal
smooth
Fill in the blank: Connective tissue loosens to allow softening, thinning, and ______ of cervix during labor onset.
dilation
calcification
contraction
ossification
Fill in the blank: The positive feedback loop during labor onset is caused by endogenous ______.
oxytocin
terbutaline
tocolytics
magnesium sulfate
The different phases of Stage 1 labor are:
Latent, Active, Transition
Early, Middle, Late
Initial, Progressive, Final
Start, Peak, End
Fill in the blank: Braxton Hicks contractions are often confused with ________.
real labor
menstrual cramps
digestive issues
muscle spasms
Braxton Hicks contractions cause cervical changes.
True
False
Fill in the blank: Blood show is characterized by ________ tinged mucus secretion.
pink
bright red
black
coffee-ground
Fill in the blank: Latent phase is defined as when the cervix is dilated ________ cm.
0-3
4-6
7-9
10-12
Fill in the blank: Active phase is defined as when the cervix is dilated ________ cm.
4-7
1-3
8-10
0-1
Fill in the blank: Transitional phase is defined as when the cervix is dilated ________ cm.
8-10
2-4
4-6
6-8
Fill in the blank: Stage 2 of labor starts at cervical dilation of ________ cm dilated to delivery of _____.
10, baby
5, baby
7, placenta
8, placenta
Fill in the blank: The third stage of labor starts with infant delivery and ends with ________ delivery.
placental
umbilical
cord
membrane
Molding is:
Shape change of the placenta as it is being delivered
Shape change of the fundus as labor progresses
Shape change of the fetal head as it passes through the birth canal
Shape change of the umbilical cord as it prolapses with birth
Fill in the blank: Uterine contractions during the Transitional Phase have a frequency of occurring every ______ minutes with durations of ______ seconds.
2-3 minutes, 45-90 seconds
5-6 minutes, 20-40 seconds
1-2 minutes, 100-120 seconds
4-5 minutes, 30-60 seconds
Fill in the blank: The fetal skull is the ______ diameter of the body during birth.
largest
smallest
average
shortest
longest
Fill in the blank: The anterior fontanel is at the junction of ______ and ______ suture line, is also called ______, and is ______ in shape.
coronal and sagittal, Bregma, diamond
lambdoid and sagittal, Lambda, triangular
coronal and lambdoid, Pterion, oval
squamosal and sagittal, Asterion, circular
Fill in the blank: The posterior fontanel is at the junction of ______ and ______ sutures and is ______ in shape.
sagittal and lambdoidal, triangular
coronal and sagittal, oval
lambdoidal and coronal, square
squamosal and sagittal, round
Which of the following describes the fetal attitude of 'complete flexion'?
Baby's chin towards chest, BACK of baby's head presenting through pelvis
Baby's head looking straight forward, TOP of baby's head presenting through pelvis
Baby's head looking slightly up, baby's FOREHEAD presenting through pelvis
Baby's head looking all the way up, baby's FACE presenting through pelvis
What is the best 'attitude' for the fetus in relation to the passageway?
Complete flexion
Moderate flexion
Partial extension
Extension
What is the worst 'attitude' for the fetus in relation to the passageway?
Complete flexion
Moderate flexion
Partial extension
Extension
SATA: What are the different fetal presentations in relation to mom’s pelvis?
Vertex/Cephalic
Breech
Transverse/Shoulder
Complete Flexion
Complete Extension
'Breech' presentation in relation to the maternal pelvis refers to:
The fetus presenting buttocks or feet first instead of the head
The fetus presenting head first
The fetus lying transversely across the pelvis
The fetus presenting with the chest first
SATA: Evaluation of different fetal presentations is done by:
abdominal palpation
SVE
determined by fetal lie
determined by fetal attitude
X-ray
SATA: What presentation(s) could lead to a difficult vaginal delivery?
Cephalic presentation
Vertex presentation
Occiput anterior presentation
Breech presentation
Transverse presentation
Common breech positions include which of the following?
Frank, complete, footling, double footling
Cephalic, transverse, oblique, compound
Vertex, face, brow, shoulder
Longitudinal, transverse, oblique, breech
If a fetus is breech, what delivery technique will be used?
Cesarean section
Forceps delivery
Vacuum extraction
Normal vaginal delivery
“Station” refers to:
A place where trains stop for passengers to get on or off
Measurement of fetal descent in pelvis
The relationship of fetal parts to each other, determines the part of the head and diameter of the skull that presents
The changing of the fetal head shape as it passes through the birth canal
Fetal station is analyzed by:
Assessing the position of the fetal head in relation to the ischial spines
Measuring the fetal heart rate
Assessing the position of the fetal chest in relation to the symphisis pubis
Intensity, duration, and frequency of maternal uterine contractions
What is 'engagement' in obstetrics?
Engagement is when the baby's head descends into the pelvic cavity.
Engagement refers to the onset of labor contractions.
Engagement is the rupture of the amniotic sac before delivery.
Engagement is the process of cervical dilation during labor.
What does 'vertex' mean in fetal presentation?
Vertex presentation: ideal, baby's HEAD is in the lowest part of the pelvis.
Vertex presentation: baby's FEET are in the lowest part of the pelvis.
Vertex presentation: baby's SHOULDERS are in the lowest part of the pelvis.
Vertex presentation: baby's BUTTOCKS are in the lowest part of the pelvis.
Leopold’s maneuver is:
A series of abdominal palpation techniques used to determine fetal position.
A series of abdominal auscultation techniques used to determine fetal position.
A method for measuring blood pressure in pregnancy.
A series of abdominal palpation techniques used to determine cervical dilation.
How does the nurse measure duration of uterine contractions?
Measured from the beginning to the end of one singular contraction
Measured from the end of one contraction to the beginning of the next
Measured from the peak to the end of one contraction
Measured from the beginning to the peak of one contraction
How does the nurse measure frequency of uterine contractions?
Time between the beginning of one contraction to the beginning of the next contraction
Time between the end of one contraction to the end of the next contraction
Duration of a single contraction
Number of contractions in ten minutes
SATA: How does the nurse measure strength/intensity of uterine contractions?
Internal uterine pressure catheter (IUPC), only accurate way to measure pressure
Maternal self-report, not always accurate
By timing the duration of contractions with a stopwatch, only accurate method
Tocodynamometer, not always accurate
Abdominal palpation, not always accurate
What are the 4 steps of Leopold's maneuver?
1. Fundal grip: palpate the uppermost part of the abdomen, determines fetal LIE and fundal HEIGHT
2. Lateral/umbilical grip: place hands on both sides between flanks and umbilicus, used to locate fetal BACK/LIMBS, as well as fetal POSITION
3. Pawlik’s grip: grasp the fundus in one hand and the lower pole of the uterus in the other, used to evaluate fetal PRESENTING PART as well as fetal ENGAGEMENT
4. Pelvic grip: place hands below umbilicus and walk fingers towards presenting part, determines fetal ATTITUDE
1. Pelvic grip: palpate the lower part of the abdomen, determines fetal LIE and fundal HEIGHT
2. Lateral grip: place hands on both sides of the pelvis, used to locate fetal HEAD/LIMBS, as well as fetal POSITION
3. Pawlik’s grip: grasp the lower pole of the uterus in one hand and the fundus in the other, used to evaluate fetal PRESENTING PART as well as fetal ENGAGEMENT
4. Fundal grip: place hands above umbilicus and walk fingers towards presenting part, determines fetal ATTITUDE
1. Fundal grip: palpate the uppermost part of the abdomen, determines fetal POSITION and fundal HEIGHT
2. Lateral/umbilical grip: place hands on both sides between flanks and umbilicus, used to locate fetal HEAD/LIMBS, as well as fetal LIE
3. Pawlik’s grip: grasp the fundus in one hand and the lower pole of the uterus in the other, used to evaluate fetal ENGAGEMENT as well as fetal ATTITUDE
4. Pelvic grip: place hands below umbilicus and walk fingers towards presenting part, determines fetal PRESENTING PART
1. Fundal grip: palpate the lower part of the abdomen, determines fetal LIE and fetal ENGAGEMENT
2. Lateral grip: place hands on both sides of the pelvis, used to locate fetal BACK/LIMBS, as well as fetal ATTITUDE
3. Pawlik’s grip: grasp the lower pole of the uterus in one hand and the fundus in the other, used to evaluate fetal POSITION as well as fetal HEIGHT
4. Pelvic grip: place hands above umbilicus and walk fingers towards presenting part, determines fetal PRESENTING PART
List the 5 Ps of labor.
Power, Passage, Passenger, Position, Psyche
Pain, Pressure, Placenta, Position, Pulse
Power, Placenta, Position, Passage, Pulse
Passenger, Passage, Pain, Pressure, Psyche
What is the only accurate way to determine pressure/intensity of uterine contractions?
Internal uterine pressure catheter (IUPC)
External tocodynamometer
Palpation of the abdomen
Maternal perception of contractions
Uterine contractions are assessed via which 3 metrics?
Frequency, Duration, and Intensity
Pressure, Rate, and Volume
Amplitude, Interval, and Strength
Timing, Force, and Pattern
With the external monitor, what does TOCO measure and how accurate is it?
TOCO measures force exerted by uterus on the abdomen, not very accurate.
TOCO measures fetal heart rate, highly accurate.
TOCO measures maternal blood pressure, moderately accurate.
TOCO measures amniotic fluid volume, very accurate.
Choose the BEST answer. Why should a L&D nurse be concerned with a laboring patient's psyche?
The psyche of the mother can indicate how far along in the laboring process they are.
The psyche of the mother can indicate the baby's gender.
The psyche of the mother can predict the need for a C-section.
The psyche of the mother can indicate the effectiveness of pain medication.
What is the First Stage of Labor?
0-10 cm dilation.
Delivery of the placenta.
Expulsion of the fetus.
Crowning.
What are the differences between the 3 phases related to uterine contractions (ctxs)? List the frequency and duration for each phase of Stage 1 labor.
Phase 1: Uterine ctxs: 15-30 mins frequency, 15-30 sec duration, moderate intensity.
Phase 2: Uterine ctxs: more frequent and longer, 3-5 min frequency, 60 sec duration.
Phase 3: Uterine ctxs: even longer and more frequent, 2-3 min frequency, 45-90 sec duration.
Phase 1: Uterine ctxs: 5-10 mins frequency, 10-20 sec duration, mild intensity.
Phase 2: Uterine ctxs: less frequent and shorter, 10-15 min frequency, 30 sec duration.
Phase 3: Uterine ctxs: less frequent and shorter, 15-20 min frequency, 20 sec duration.
Phase 1: Uterine ctxs: 30-45 mins frequency, 5-10 sec duration, mild intensity.
Phase 2: Uterine ctxs: less frequent and shorter, 20-25 min frequency, 15 sec duration.
Phase 3: Uterine ctxs: less frequent and shorter, 25-30 min frequency, 10 sec duration.
Phase 1: Uterine ctxs: 10-20 mins frequency, 20-40 sec duration, mild intensity.
Phase 2: Uterine ctxs: less frequent and shorter, 8-12 min frequency, 25 sec duration.
Phase 3: Uterine ctxs: less frequent and shorter, 12-18 min frequency, 15 sec duration.
When a pregnant patient is being assessed to determine if they are in labor, what are the priority interventions that need to be completed once the patient presents to the Labor Unit?
Assess vital signs, fetal heart rate, and cervical dilation
Administer pain medication immediately
Send the patient for an ultrasound before any assessment
Discharge the patient if contractions are less than 5 minutes apart
In the BURTH labor assessment, what does the 'B' stand for?
Bladder (keep empty)
Blood pressure
Breathing rate
Body temperature
In the BURTH labor assessment, what does the 'R' stand for?
Rupture of membranes
Respiratory rate
Rectal temperature
Resting heart rate
What is the normal fetal heart rate (FHR) range that should be assessed before, during, and after contractions?
110-160 bpm
80-120 bpm
160-200 bpm
90-130 bpm
Which of the following is NOT part of the BURTH labor assessment?
A) Bladder
B) Uterine ctxs
C) Respiratory rate
D) Heart tones
What interventions would be needed if the patient arrives to the Labor Unit and they are about to deliver? List the priority interventions for Stage 2 (RN will...):
Assist with delivery, provide support, monitor fetal heart rate, and ensure sterile technique.
Prepare for cesarean section immediately without assessment.
Administer pain medication and delay delivery until physician arrives.
Encourage patient to walk around to speed up labor.
What words might the patient state that could indicate to the nurse that the patient could be ready to push?
"I feel a strong urge to have a bowel movement."
"I am hungry."
"I want to sleep."
"I need to urinate really bad."
Nurses who care for patients in labor tend to only be assigned to one active laboring patient. Why?
Labor requires constant individualized bedside care and there are many possible complications that require immediate intervention.
Laboring patients prefer to be alone and do not require much assistance.
Hospitals have a shortage of nurses and cannot assign more than one patient per nurse.
Labor is a quick process and does not require much monitoring.
Will the L&D nurse only focus on mom as their patient?
NO, they focus on mom AND baby!
Yes, only mom is their patient.
No, they focus only on the baby.
Yes, they only assist with paperwork.
What does 'crowning' mean?
The head of the baby crests through the perineum with maternal pushed.
The baby's feet are visible during delivery.
The placenta is delivered before the baby.
The umbilical cord is wrapped around the baby's neck.
SATA: What interventions would you expect to happen next if the nurse discovers crowning?
Have mom STOP BEARING DOWN
Have mom BEAR DOWN HARDER
Encourage maternal ambulation
Prepare for possible episiotomy
Perform modified Ritgen maneuver
SATA: What is assessed during a vaginal exam?
cervical dilation
cervical effacement
fetal station
fetal presentation
status of membranes
How is dilation measured during a vaginal exam?
0-10cm
0-5cm
0-20cm
0-100cm
How is effacement measured during a vaginal exam?
How THIN and SHORT the cervix is.
How WIDE and LONG the cervix is.
How DILATED the cervix is.
The TEMP the cervix is.
How is station measured during a vaginal exam?
The relationship of presenting part of the fetus to the level of ischial spines.
The dilation of the cervix in centimeters.
The effacement of the cervix in percentage.
The position of the placenta in the uterus.
How is presentation measured during a vaginal exam?
Leopold’s maneuver, U/S.
Blood pressure measurement, urine analysis.
Auscultation of fetal heart tones, fundal height.
Pelvic X-ray, CT scan.
Why do we need to do vaginal exams?
To assess the progress of labor and detect complications
To determine the gender of the baby
To check for urinary tract infections
To measure blood pressure
A pregnant patient is experiencing vaginal bleeding. A vaginal examination is:
recommended
not recommended
required
dangerous and contraindicated
SATA: What should be assessed immediately after ROM (both AROM & SROM)?
Fetal heart rate
Maternal temperature
Color of amniotic fluid
Cervical effacement
Uterine contraction pressure
How often does maternal temperature need to be taken after rupture of membranes?
Every 12 hours
Every 8 hours
Every 4 hours
Every 2 hours
The greatest risk with ROM is:
Intrauterine infection
Breech delivery
CPD
Unauthorized access to the uterus
RN will know the tocodynamometer is accurately tracing FETAL HR by comparing the tocodynamometer readings with the _______, and the _____ should ideally be 10+ beats ______.
Maternal HR, Fetal HR, Faster
Fetal HR, Maternal HR, Faster
Maternal HR, Fetal HR, Slower
Uterine contraction, Maternal HR, Slower
How is the fetal heart rate baseline assessed?
Average FHR during a monitoring period of 10 minutes
Lowest FHR recorded during labor
Highest FHR recorded during contractions
Average FHR during a 1-minute interval
What is the normal range for fetal heart rate baseline?
110-160 bpm
90-120 bpm
160-200 bpm
80-100 bpm
How long until a fetal heart rate baseline would be considered shifted/changed?
Over 10 minutes with a new average
Over 5 minutes with a new average
Over 20 minutes with a new average
Over 30 minutes with a new average
What are fetal accelerations?
15+ bpm temporary increase in FHR from baseline
10+ bpm temporary decrease in FHR from baseline
Sustained decrease in FHR below 110 bpm
No change in FHR from baseline
What is the difference between using the external monitor and internal monitor to trace fetal heart tones?
Internal monitor is the only way to get a 'clear' picture. ROM is REQUIRED to be able to use internal monitor.
External monitor is more accurate and does not require ROM.
Internal monitor can be used without ROM and is less invasive.
External monitor provides a 'clear' picture and requires ROM.
What are fetal decelerations?
15+ bpm temporary decrease in FHR from baseline
15+ bpm temporary increase in FHR from baseline
Consistent baseline FHR without variation
Permanent decrease in FHR from baseline
How are the different types of decelerations assessed on the monitor strip?
Can be early, late, or variable
Only early decelerations are assessed
Decelerations are not visible on the monitor strip
Assessment is based solely on maternal heart rate
What does VEAL CHOP MINE stand for in fetal heart rate monitoring?
Veal = FHR pattern, Chop = Cause, Mine = Management
Veal = Management, Chop = FHR pattern, Mine = Cause
Veal = Cause, Chop = Management, Mine = FHR pattern
Veal = Monitoring, Chop = Pattern, Mine = Cause
What is the cause of variable deceleration in fetal heart rate?
Cord compression
Placental abruption
Maternal hypotension
Uterine rupture
Fetal infection
What is the cause of early deceleration in fetal heart rate?
Head compression
Cord prolapse
Placental abruption
Uteroplacental insufficiency
What is the cause of late deceleration in fetal heart rate?
Placental insufficiency
Umbilical cord compression
Fetal movement
Maternal fever
What is the intervention for variable deceleration in fetal heart rate?
Maternal repositioning
Immediate delivery
Administering oxytocin
Performing amniotomy
SATA: What are the components of TTOIV?
TURN OFF THE PITOCIN!
TURN PATIENT ON THEIR SIDE (LATERALLY)!
ADMINISTER O2 THERAPY!
RUN IV FLUIDS WIDE OPEN!
PERFORM VAGINAL EXAM STAT!
What is fetal tachycardia?
Fetal tachycardia: FHR over 160 bpm for longer than 10 minutes.
Fetal tachycardia: FHR below 110 bpm for longer than 10 minutes.
Fetal tachycardia: FHR over 120 bpm for longer than 5 minutes.
Fetal tachycardia: FHR below 90 bpm for longer than 10 minutes.
What is fetal bradycardia?
Fetal bradycardia: FHR under 110 bpm for longer than 10 minutes.
Fetal bradycardia: FHR over 160 bpm for longer than 10 minutes.
Fetal bradycardia: FHR under 120 bpm for longer than 5 minutes.
Fetal bradycardia: FHR over 120 bpm for longer than 10 minutes.
During the second stage of labor, if a patient has had no pain medication, what would be the best position to be in to allow the fetus to work its way down the birth canal?
Squatting
Lying flat on the back
Sitting in a reclined position
Standing upright
During the third stage of labor, what are the three signs that the HCP assesses to determine if the placenta is ready to be delivered?
A gush of blood, lengthening of the umbilical cord, and a change in the shape of the uterus
Increase in maternal blood pressure, fetal movement, and maternal shivering
Decrease in uterine contractions, maternal nausea, and fetal heart rate drop
Shortening of the umbilical cord, uterine relaxation, and maternal sweating
SATA: The placenta gets expelled by which processes?
Active: administration of Pitocin to force out placenta faster than natural
Active: Relaxation of the uterus force out placenta faster than natural
Active: Expansion of the cervix to pass placenta naturally
Physiological: Absorption by the body to pass placenta naturally
Physiological: Gentle maternal pushing to pass placenta naturally
What is the intervention for early deceleration during labor?
Identify labor progress.
Administer oxytocin.
Prepare for emergency cesarean section.
Increase maternal activity.
What is the intervention for acceleration during labor?
No interventions.
Administer sedatives.
Perform cesarean section immediately.
Restrict maternal movement.
To fit through the pelvis, the fetus must position itself so that the skull's _______ diameter is in line with the _______ diameter of the maternal pelvis.
smallest, largest
smallest, smallest
largest, smallest
largest, largest
Out of the different phases of Stage 1 labor, which one lasts the longest?
latent phase
active phase
transitional phase
postpartum recovery phase
How often should the RN encourage voiding of the mother during all three phases of Stage 1 labor?
every 5-10 minutes
every 30-45 minutes
every 1-2 hours
every 4-8 hours
Fetal attitude is defined as the relationship of fetal parts to each other, determines the part of the head and diameter of the skull that presents.
True
False
The mother feeling fetal kicks in the ______ instead of _______ can indicate the fetus is in a breech position.
ribs, pelvis
pelvis, ribs
umbilicus, placenta
placenta, umbilicus
A C-section delivery is ________ in fetuses who are in a breech or transverse presentation.
recommended
contraindicated
not recommended
required
If the fetal station of a baby is written as a negative number between 1 and 5, what does this mean about the location of the fetus?
presenting part is ABOVE the ischial spines
presenting part is BELOW the ischial spines
presenting part is AT the ischial spines
fetus is in breech position
If the fetal station of a baby is written as a positive number between 1 and 5, what does this mean about the location of the fetus?
presenting part is ABOVE the ischial spines
presenting part is BELOW the ischial spines
presenting part is AT the ischial spines
fetus is in breech presentation
If the fetal station of a baby is written as "0", what does this mean about the location of the fetus?
presenting part is ABOVE the ischial spines
presenting part is BELOW the ischial spines
presenting part is AT the ischial spines
fetus is in transverse/shoulder presentation
Engagement is another word for lightening.
True
False
In the BURTH labor assessment, what does the 'T' stand for?
temperature (fetal)
temperature (maternal)
tocodynamometer (fetal)
tocodynamometer (maternal)
In the BURTH labor assessment, what does the 'H' stand for?
heart rate (maternal)
heart rate (paternal)
heart rate (fetal)
head size (fetal)
SATA: What are the goals of the theory that guides interventions for pain relief?
Relax mom and relieve discomfort
Minimal effect on uterine contractions
Minimal effect on maternal ability to push
MINIMAL EFFECT ON FETUS!
What is the difference between an obstetric analgesic and an obstetric anesthetic?
analgesics are for pain management, anesthetics almost fully remove sensation of contractions
anesthetics are for pain management, analgesics almost fully remove sensation of contractions
analgesics induce labor, while anesthetics augment labor
anesthetics induce labor, while analgesics augment labor
What timeframes, in terms of cervical dilation, are most affective for opioid analgesic administration?
Nulliparas: 2-4 cm
Multiparas: 6-8 cm
Nulliparas: 7-8 cm
Multiparas: 9-10 cm
Nulliparas: 4-5 cm
Multiparas: 3-4 cm
Nulliparas: 1-2 cm
Multiparas: 3-4 cm
SATA: During labor, it is ok to give the mother opioid analgesia when:
FHTs are good
Contraction pattern is well established
Presenting part is engaged
Before effacement has begun
Once crowning occurs
If opioid analgesia is given to a laboring patient too EARLY, what can happen?
Baby will be negatively affected upon delivery
Labor can slow dramatically or stop
Immediate miscarriage
Opioids can be given as soon as labor begins
If a laboring patient is given opioid analgesics too LATE, what can happen?
Infant may explode
Labor can slow dramatically and stop
Baby will be negatively affected upon delivery
Opioids can can be administered continuously until the postpartum period
______ opioids given to the mother can cross the placental barrier.
NO
SOME
MOST
ALL
If the fetus is presenting with late decelerations, and/or there are signs of fetal distress, giving the mother opioid analgesics is:
recommended
required
optional
dangerous and contraindicated
The RN and HCP should make sure that the laboring patient's bladder is ______ before initiating an epidural.
Full
Empty
Removed
Bleeding
What priority interventions need to be performed immediately after placement of epidural?
Ask patient their pain scale, as severe headache is the most serious concern post-epidural.
Determine fetal HR, as early decelerations are the most serious concern post-epidural.
Determine station, as double footling breech is the most serious concern post-epidural.
Take maternal blood pressure, as hypotension is the most serious concern post-epidural.
What does "augmentation" mean in terms of labor?
Chemical or mechanical BOOST to the labor process that has already started NATURALLY
Chemical or mechanical initiation to ripen cervix and/or initiate uterine contractions to stimulate labor BEFORE spontaneous onset
Umbilical cord that protrudes through the cervix and caused cord compression, which compromises fetal circulation
Placenta previa, abruptio placentae, molar pregnancy, miscarriage, ruptured uterus
What does "induction" mean in terms of labor?
Chemical or mechanical initiation to ripen cervix and/or initiate uterine contractions to stimulate labor BEFORE spontaneous onset
Chemical or mechanical BOOST to the labor process that has already started NATURALLY
Stimulation of the smooth muscle of uterus and promotion of milk letdown
Umbilical cord that protrudes through the cervix and caused cord compression, which compromises fetal circulation
Oxytocin is a hormone that is produced endogenously in the body. Which gland produces it?
hypothalamus
anterior pituitary
posterior pituitary
adrenal
The synthetic version of oxytocin, which is called _____, is used to augment or induce labor.
Cytotec
Misoprostol
Pitocin
Terbutaline
SATA: Select some patient conditions with which the administration of synthetic oxytocin would be contraindicated.
prolapsed cord
transverse or breech fetal presentation
active genital herpes infection
invasive cancer of cervix
cephalopelvic disproportion
SATA: Why is the low-transverse abdominal incision used for C-sections?
does not compromise upper uterine segment
less blood loss
decreased chance of rupture in future pregnancies
heals faster than other incision types
leaves a smaller scar than other incision types
A prolapsed cord is defined as when the umbilical cord protrudes through the cervix and causes cord compression, which compromises fetal _______.
size for gestational age
station and presentation
circulation
position within the maternal pelvis
SATA: The primary intervention needed to treat a prolapsed cord is to RELEIVE PRESSURE ON THE CORD. What other nursing interventions are a priority if this happens?
gently push fingers on presenting part
initiate maternal O2 therapy
place patient in Trendelenburg position
call for help, prepare for emergency C/S
place patient in Sim's position
What is the most important goal if a patient is in preterm labor?
EMERGENCY C/S
GIVE BIRTH STAT
PREVENT BIRTH UNTIL TERM
EMERGENCY D+C
Why may a laboring patient receive an IM injection of corticosteroids?
to strengthen the fetal immune system
to slow FHR
to increase FHR
to stimulate fetal lung maturity
Tocolytics are medications that:
induce labor
augment labor
suppress contractions and uterine activity
cause miscarriage in low doses
SATA: The acronym that is used to remember the tocolytic medications are INMT (It's Not My Time!). What medications go along with these letters?
I: indomethecin (NSAID)
N: nifedipine (CCB)
M: magnesium sulfate
T: terbutaline (adrenergic agonist)
T: tocolytic nebulizers (albuterol)
What is hypertonic uterine dysfunction?
painful, long, and uncoordinated contractions
short, irregular, and weak contractions
rapid, regular contractions
complete lack of contractions
What is hypotonic uterine dysfunction?
Long, painful, and uncoordinated contractions
Short, irregular, and weak contractions
Rapid, regular contractions
Complete loss of contraction
