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