Chapter 19

Question 1

EDB (estimated date of birth)

Answer 1

38-42 wks TERM
0-20 wks ABORTION
20-37 WKS PRETERM
42 wks+ POST TERM

Question 2

nagel rule

Answer 2

to determine EDC
First day of last LMP — minus 3 months—
plus 7 days
must have babies show up 2 weeks before or after

Question 3

ex of nagel rule last LMP 10/3

Answer 3

• 3 months 7/3 + 7 days then 7/10/13

Question 4

GPA

Answer 4

gravida - pregnancy, para - only delievery > 20 weeks, abortion <20 weeks

Question 5

Leopold’s helps to

Answer 5

determine position of fetus so nurse will know where to listen for fetal heart tones.

Question 6

1st stage of labor

Answer 6

from 1st true contraction till effacement dilation

Question 7

3 phase of labor *****

Answer 7

latent 0-3 cm, active 4-7 cm, transition 8-10 cm

Question 8

Contraction assessment

Answer 8

@ least hourly in- latent phase- at least q30 mins in active/transitional phases, q15 mins in

Question 9

Hypertonic contractions-

Answer 9

duration >90secs, intervals < 60secs, frequency < 2mins, resting tone high

Question 10

Membrane status–

Answer 10

SROM, AROM

Question 11

Pain-

Answer 11

verbal/nonverbal cues, what they want for pain, educating about meds prn

Question 12

Vaginal exams–

Answer 12

as necessary, do not do with bleeding and do as little as possible with ruptured membranes

Question 13

Fetal Heart Tones-

Answer 13

120-160 bpm, 160 tachycardia

Question 14

nursing interventions

Answer 14

Cleanliness- pads, sheets, gowns
Mouth care- dry with mouth breathing, may have limited items (popsicle, ice chips) When did they last eat?
Temperature- room temp, cool cloths
Voiding- check q2 hrs. or cath
Positioning- off back, wedge under one hip

Question 15

Conditions Associated with Fetal Compromise

Answer 15

Abnormal fetal heart rate- lower than 110 higher than 180
Meconium-stained amniotic fluid
Cloudy or foul smelling amniotic fluid
Excessive frequency or duration of contractions
Incomplete uterine relaxation between contractions
Maternal hypo/hypertension
Maternal fever

Question 16

BIRTH ATTENDENT

Answer 16

Control delivery of the head– Ritgens prevents popping of the head
Suctions mouth and nose before first breath
Checks for nuchal cord (around the neck)—if present, remove
After external rotation assists in delivery of the shoulders by pulling head toward perineum
Clamps cord( 3 vessels), suctions again and
hands off the baby to the nurse
Delivery of the placenta
Repair of any laceration or trauma

Question 17

Signs that help identify placental separation:

Answer 17

Uterus must remain firmly contracted to prevent uterine atony that can cause postpartum hemorrhage