maternal health exam 2 review

during transition phase what to do

breathe 3 to something and then exhale after contractions

feetal heart rate heard midline above umbilicus what position

breeched

patient who just had a c-section asking if she can have a vaginal delivery

only contraindication is depending on the type of incision made on the delivery

fetal bradycardia for the strip that looks like baseline is

90 bpm

question about statement made by patient who just had a ROM and needed correction from her statement

"I will have to remain in bed throughout the labor

c-section and family cant handle it

"tell me more"

med math about fentanyl

1ml

vacuum assisted delivery

3 pull rule

it asks alot of questions about tachysystole so know what that qualifies as one of the answers is

6 contractions in a 10 minute period

Tachysystole: what is the wrong definition

6 or more contractions in 10 minutes

the pushing question youll know when you see it

6-8 seconds

Early Variable Late Bradycardia

Early deceleration is a visually apparent gradual decrease in FHR from baseline to nadir (lowest point of the deceleration) taking more than 30 seconds. The nadir occurs at the same time as the peak of the UC. Onset, nadir, and recovery match the onset, peak, and end of the UC. It's always periodic. • Variable deceleration is a visually apparent abrupt decrease in the FHR from baseline to nadir taking less than 30 seconds. The decrease in FHR is greater or equal to 15 bpm and less than 2 minutes in duration. It can be periodic or intermittent. • Late deceleration is a visually apparent gradual decrease of FHR from baseline to nadir taking more than 30 seconds. Nadir occurs at the peak of the UC. Onset, nadir, and recovery occur after the respective onset, peak, and end of the UC. It is always periodic. Bradycardia • Baseline FHR of less than 110 bpm lasting for 10 minutes or longer.

Cardinal movement order

Engagement: When the greatest diameter of the fetal head passes through the pelvic inlet; can occur late in pregnancy or early in labor Decent: Movement of the fetus through the birth canal during the first and second stages of labor Flexion: When the chin of the fetus moves toward the fetal chest; occurs when the descending head meets resistance from maternal tissues; results in the smallest fetal diameter to the maternal pelvic dimensions; normally occurs early in labor Internal rotation: When the rotation of the fetal head aligns the long axis of the fetal head with the long axis of the maternal pelvis; occurs mainly during the second stage of labor Extension: Facilitated by resistance of the pelvic floor that causes the presenting part to pivot beneath the pubic symphysis and the head to be delivered; occurs during the second stage of labor External rotation and restitution: The sagittal suture moves to a transverse diameter and the shoulders align in the anteroposterior diameter. The sagittal suture maintains alignment with the fetal trunk as the trunk navigates through the pelvis. Head and shoulders rotate to move under the symphysis pubis. Expulsion: The anterior shoulder usually comes first followed by the remainder of the body

chorioamnionitis

FHR 100 not related to

Cat 1

FHR 130 with minimal variability

Question about further teaching for a patient who had a c-section

I will stay in bed for 3-5 days to insure my incision will heal

prevent operative complications for c-section

IV fluids, antiemetic, and antibiotics

questions that has all the maneuvers

Mac donalds maneuver

"turtle mark"

McRoberts maneuver

what to do with oxytocin, 2cm increase in dilation and frequency of UC was 3-5 minutes

Stop oxytocin infusion

question about fetal heart tracing you will see baseline below 100 bpm

bradycardia

prior actions before external version

administer magnesium sulfate

SATA question

all the answers except the husband leave

questions about strip was a variable and nurse needed to do an extra intervention

amnionfusion

what is the test for after rupture of membrane

amniotic protein (amnisure)

there is a case study dont know the details will know when you see it

answer is bishop score

nurse assisting HCP for vacuum assisted deliivery

answer should be a triple something look for key word triple

questions about strip knowing fetal heart rate baseline above 160 bpm action was

assess maternal blood pressure before giving epidural prior actions of nurse was to set up and IV for LR

most concerning finding

bishop score 5

question about prep for epidural

boils fluids before

one strip where we were told to determine the category

category 1

cant remember the question something about a c section

category 3 fetal heart tracings

question about following providers order

cefazosin

if labor is working

cervical change 1-4 cm

all questions about nurse actions either through strip tracing or statement

change postions (about 4 questions like this)

after epidural and all interventions

change to the left

(image) absent variability

check maternal strip

when given epidural FHR decreases what would you do first ?

check mother vital signs

when to take out cervadil

contractions 1 minute apart

stimulants of labor

estrogen and oxytocin

what not to use to test for fluid

fetofibrinectin, nitrazine paper and amnisure and ferning are right so pick the one that isnt these

question about oxytocin/Pitocin infusion

given by IV pump

preeclampsia question

hypoglycemia

strip or question indicated an early decel

keep monitoring patient

impending signs of labor

know this

how to verify where to place EFM

leopolds maneuver

prolapsed cord

lift head with examining hand

prior to doing an amniotomy

make sure the head is is engaged

when performing procedure to turn baby

make sure you have a team on standby for emergency delivery

Dr is doing cephalic maneuver prepare for c-section

monitor the epidural will cross the fetal membrane and cause respiratory depression

questions about the 5 P's

powers are the uterine musclesand contractions

SATA question what contributes to labor dystocia

primigravida, epidural at latent stage and one more answer

most decels answers

reposition

pitocin

should be stopped at active labor 6cm

Cant remember questions but its only one like it

stage 1 transition

question about breaking water

stay in bed

client saying "im about to push the baby right now or im feeling pressure"

stay with patient and delegate tasks for delivery

meconium question

suction and things prepared is one answer another answer is resuscitation (sucking out fluid so they don't aspirate)

what would you do if meconium stain

suction pharynx, nose and mouth

patient is panicking yelling " I cant do this" what phase

transition phase- not active

unknown question

transversal fetal lie to disqualify tolac

SATA

true labor, everything but braxton hicks

most nonpharm intervention

walk in the hallway

SATA for non pharm make sure you pick

warm tub, other 2 answers are easy to pick 3 answers total