OB unit 2 section 1
Not a question... Phrases to Remember Variability = oxygenation Accelerations = yay! Early Decelerations = head compression = not to worry Variable Decelerations = cord compression = change mom's position Late Decelerations = uteroplacental blood supply insufficiency = big guns slide 64
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fetal postion is named for the way that the passenger (fetus) is presenting at delivery. Know this image in the answer...
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look at chart *slide 58
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not a question VEAL = CHOP Intra monitor fetal heart monitoring V-variabel decleration E-early deceleration A=acceleration L-late deceleration C-cord compression/prolapse H-head compression O-OK P-placental insuficency *slide 65
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Accelerations are A normal in labor B a reason for concern C are not apart of labor *slide 61
A
Can pressure from the baby's head on the cervix cause labor? A Yes B No
A
Part of the nurse's role to make her patients and family happy? A True B False
A
The first stage of labor can be broken down into 3 phases, Active, Transition and Latent. What are the defining cervical dilation measurements in the active phase? A 0-4 cm dilation; she may not even know B 4-8 cm dilation; you can tell she is actively in labor C 8-10 cm dilation; most intense and shortest *Slide 32
A
What does Progesterone do? A Rises to help prepare the cervix, then drops as the placenta ages, signaling the body 'I'm done!" B Rises to prepare the uterus to contract effectively C Rises to help prepare the cervix, encourage effective contractions, prepare the body to make milk, and enhance bonding D Rises to soften connective tissue E mature babies lungs
A
What is External Cephalic Version? A means to change babies position manually B means to change mom's position C another name for a C-section D means that the baby is rolling freely in the uterus *slide 27
A
What is Leopold's Maneuvers? A Palpating mom's abdomen to identify fetus position B checking cervical dilation C turning the fetus from breech to occipital-anterior position D striping the membranes slide 53
A
What is Lightening? A Baby has visibly "dropped" position in moms uterus B Contractions that are irregular in time C The need to organize and clean D Emptying of the colon to prepare for delivery E Mucus plug, possibly pink-tinged
A
What is the difference between open/closed glottis pushing? A Closed the mother holds her breath as she pushes B Open the mother holds her breath as she pushes C Closed is what we should be recommending D Open can increase maternal BP *slide 44
A
What is the favorable passenger for birth A occipital-anterior position B occipital-posterior position slide 22
A
What is the outcome of the first stage of labor? A cervical dilation B birth of baby skin to skin C birth of the placenta D recovery 2-4 hours *Slide 32
A
When mom is actually pushing this is an example of ____ pushing. A Voluntary B Involuntary C Maternal slide 30
A
When the fetus' spine is not parrel with the mother's this is A transverse B longitudinal *slide 18
A
Which type of fetal monitor has risk to the fetus? A Internal B External *slide 55
A
Pre-Labor Hormones are? (SATA) A Progesterone B Estrogen C Oxytocin D Relaxin E Epinephrine
A B C D
What are the nurse's responsibilities? (SATA) A preparing/administering meds B Initial maternal/fetal assessment C Vital Signs, EFM/IA, Vaginal Exams D I&O E doing exactly as ordered by the MD Slide 48
A B C D
What is impending/pre-labor? (SATA) A Lightening B Braxton-Hicks C Cervical changes D Nesting E Weight Loss/Diarrhea F Bloody Show * slide 9
A B C D E F
When should mom go to the hospital? (SATA) A Bleeding B Rupture of membranes C Severe head ache E Sudden onset edema F Mom does not feel baby moving slide 12
A B C D E F
What are some of "the bads" of an epidural? (SATA) A They don't function perfectly B They're expensive C The rate for addiction is high D They don't always work E It can be too late or too early F Increase the risk for Cesarean birth *slide 42
A B D E F
Early Decelerations are (SATA) A this is safe and a misnomer B Dangerous and requires immediate intervention C they are caused by head compression D no need for intervention if variability is within the normal range (6-10) and the FHR is within the normal range. E cause for concern *slide 62
A C D
What are the causes of labor? (SATA) A Uterus has reached maximum expansion B Becuase the due date was reached C Baby says 'I'm ready!' D Hormones make the right cocktail E only the rupture of water is the cause of labor
A C D
What is a natural induction? (SATA) A Castor oil B Pelvic examination C Nipple stimulation D Stripping the membranes E Spicy food slide 9
A C D
What nursing interventions can be done to help with labor pains? This is not a complete list, just a basic one(SATA) A Movement/Change position. B Lying in a bed C Water tub/shower/hydrotherapy D Distraction E Massage F Walking G sitting still *Slide 36
A C D E
A patient's mother is assisting her daughter in labor. The mother states, "When I labored, I lay in bed the entire time. Why are you making her walk around and sit in the rocking chair?" The best response by the nurse is? A Your daughter wants to walk around and sit up. B Walking and sitting have been shown to reduce the length of labor. C It is better for her to sit up. D That was a long time ago; things have changed.
B
An epidural is ____ where a spinal is ____. Both have a major chance of hypotension. That's important! A long-lasting (greater than 8 hours); Short-acting (less than 2 hours) B Continous; bolus that will last 2-24 hours C intermittent; occasional D Risky; safe *slide 43
B
External Fetal Monitoring is what 2 parts A stethoscope and ultrasound B Ultrasound transducer/doppler and Tocodynamometer C MRI and ultrasound D EKG and transducer slide 52
B
Labor is a _____ loop? A negative B positive C continuous D spontaneous
B
Labor is most ____ type of pushing. A Voluntary B Involuntary C Maternal slide 30
B
The first stage of labor can be broken down into 3 phases, Active, Transition and Latent. What are the defining cervical dilation measurements in the transition phase? A 0-4 cm dilation; she may not even know B 4-8 cm dilation; you can tell she is actively in labor C 8-10 cm dilation; most intense and shortest *Slide 32
B
What does Estrogen do? A Rises to help prepare the cervix, then drops as the placenta ages, signaling the body 'I'm done!" B Rises to prepare the uterus to contract effectively C Rises to help prepare the cervix, encourage effective contractions, prepare the body to make milk, and enhance bonding D Rises to soften connective tissue E mature babies lungs
B
What is Braxton-HIcks? A Baby has visibly "dropped" position in moms uterus B Contractions that are irregular in time C The need to organize and clean D Emptying of the colon to prepare for delivery E Mucus plug, possibly pink-tinged
B
What is the outcome of second stage of labor? A cervical dilation B birth of baby skin to skin C birth of the placenta D recovery 2-4 hours *Slide 32
B
What would be an appropriate first nursing action when caring for a 20-year-old G1P0 woman at 39 weeks gestation who is in active labor and for whom an assessment reveals mild variable fetal heart rate decelerations? (SATA) A nothing B Change the maternal position C Notify the provider D Prepare for delivery E Readjust the fetal monitor
B
When the fetus' spine is parrel with the mother's this is A transverse B longitudinal *slide 18
B
what is the nursing intervention if a fetus is Asyncliticism? A External Cephalic version B Change mom's position C there is nothing, mom needs a C-section D Nothing, this is a normal position Slide 24
B
when it comes to maternal position for delivery ____ is the position that creates the smallest space in the true pelvis. A squatting B Lithotomy C semi fowler D prone
B
What are the (3) phases of the first stage of labor? (SATA) A Opening B Active C Transition D Latent E softening slide 32
B C D
What is false labor? (SATA) A contractions and progressive cervical change B Contractions (for days) and no cervical change C Rupture of membranes D un-timeable labor pains E Mom asks, "Am I in labor?" *slide 8
B C D E
When can/should an internal fetal monitor be applied? (SATA) A before the rupture of membranes B after the rupture of membranes C once the PT is dilated at least 1 cm D the PT needs to be dilated >4 cm E the mom has an STI F The health of the baby needs to be closely monitored slide 55
B C F
How can the nurse best support a woman in labor? (SATA) A Encourage the prone position at all times, so health care provider can easily assess labor progression B Encourage whatever position mom wants. C Do try to distract her from her during her contractions D Don't try to talk to her/do anything to her during a contraction. E Be supportive of her decisions *slide 11
B D E
What are nursing priorities in labor? (SATA) A Sterile technique B Healthy, Happy, Safe Mom and Baby C doing exactly as ordered by the MD D Following Her Birth Plan E Always preparing several steps ahead slide 48
B D E
Which of the following are TRUE about labor? (SATA) A Irregualr B Coordinated/regular C Controllable D Involuntary E Intermittent F Gradual onset/offset *Slide 10
B D E F
What is 5-1-1? (SATA) A a contraction lasting longer than 5 minutes B contractions that are 5 minutes or closer C contractions that have varying regularity from 1-5 minutes D contraction lasting at least 1 minute E contractions lasting at least 30 minutes F contractions lasting at least 1 hour *slide 12
B D F
The first stage of labor can be broken down into 3 phases, Active, Transition and Latent. What are the defining cervical dilation measurements in the Latent phase? A 0-4 cm dilation; she may not even know B 4-8 cm dilation; you can tell she is actively in labor C 8-10 cm dilation; most intense and shortest *Slide 32
C
The phrase occipito-anterior position means? A head down, facing mother's spine, so that their back is oppostie of the mother's stomach B head down, facing mothers umbilicus, spine close to mom's spine C head down, facing mother's spine - so that their back is towards the front of the mother's stomach slide 22
C
What does Oxytocin do? A Rises to help prepare the cervix, then drops as the placenta ages, signaling the body 'I'm done!" B Rises to prepare the uterus to contract effectively C Rises to help prepare the cervix, encourage effective contractions, prepare the body to make milk, and enhance bonding D Rises to soften connective tissue E mature babies lungs
C
What is Nesting? A Baby has visibly "dropped" position in moms uterus B Contractions that are irregular in time C The need to organize and clean D Emptying of the colon to prepare for delivery E Mucus plug, possibly pink-tinged
C
What is an Intradermal Water Block? A narcodic given through the IV line B non-narcodic (Tylenol) pain reliver given IM C Sterile water inserted in the dimples of Venus to relieve pain D Sterile water inserted into the AC pressure point to relieve pain *slide 39
C
What is the outcome of third stage of labor? A cervical dilation B birth of baby skin to skin C birth of the placenta D recovery 2-4 hours *Slide 32
C
What is true labor? A The due date is reached B Contractions (for days) and no cervical change C contractions and progressive cervical change D Rupture of membranes *slide 8
C
Why can't the receive narcotics in labor? A at any time she chooses B it depends on the facility C if she is within 2 hours of delivery D it was not apart of her birth plan *slide 36
C
what level of electronic fetal monitoring (EFM) does the NICHD recommend immediate intervention? A 1 everything is fine, no worries B 2- grey zone, could get better or worse C 3-everything real bad-running to OR * Slide 55
C
Not only are TWO lives at stake, but you're responsible for the care you give for ___ years. A 5 B 1 C 10 D 18 E 21 + slide 48
D
What are the 5 P's affecting labor? A pushing, power, person, place, pace B position, passenger, people, perception, power C power, passage, position (mother), psyche, position (mother) D power, passage, position (fetus), psyche, position (mother) E power, passage, position (fetus), psyche, position (fetus) *slide 17
D
What does Relaxin do? A Rises to help prepare the cervix, then drops as the placenta ages, signaling the body 'I'm done!" B Rises to prepare the uterus to contract effectively C Rises to help prepare the cervix, encourage effective contractions, prepare the body to make milk, and enhance bonding D Rises to soften connective tissue E mature babies lungs
D
What does the phrase "being at zero station mean? A the baby is crowning B the baby is breech C the mother is ready to push D the head and ischial spine are equal *slide 14
D
What is the outcome of fourth stage of labor? A cervical dilation B birth of baby skin to skin C birth of the placenta D recovery 2-4 hours *Slide 32
D
What is weightloss/Diarrhea for in labor? A Baby has visibly "dropped" position in moms uterus B Contractions that are irregular in time C The need to organize and clean D Emptying of the colon to prepare for delivery E Mucus plug, possibly pink-tinged
D
What do Catecholamines do? A Rises to help prepare the cervix, then drops as the placenta ages, signaling the body 'I'm done!" B Rises to prepare the uterus to contract effectively C Rises to help prepare the cervix, encourage effective contractions, prepare the body to make milk, and enhance bonding D Rises to soften connective tissue E mature babies lungs
E
What is Bloody show? A Baby has visibly "dropped" position in moms uterus B Contractions that are irregular in time C The need to organize and clean D Emptying of the colon to prepare for delivery E Mucus plug, possibly pink-tinged
E
