Ch 8 stages of labor/pain

Question 1

5 P’s of labor

Answer 1

• Powers (UCs)
• Position (fetal)
• Passenger
• Passage
• Psyche

Question 2

4 components of powers/UCs

Answer 2

• frequency
• duration
• intensity
• resting tone

Question 3

What pelvic type is ideal for labor?

Answer 3

gynecoid

Question 4

6 components of passenger

Answer 4

• skull
• attitude (flexion/extension of joints)
• fetal lie (in relation to long axis)
• presentation (cephalic, breech, shoulder)
• presenting part
• position (3 letters)

Question 5

Position 3 components

Answer 5

• 1: presenting part left or right
• 2: presenting part (occiput, sacrum, etc)
• 3: relationship of presenting part to woman’s pelvis

Question 6

factors that influence L&D (psyche)

4

Answer 6

• culture/traditions
• expectations
• support
• nursing care

Question 7

Signs of impending labor

5

Answer 7

• lightening
• braxton-hicks
• cervical changes
• nesting
• general discomfort

Question 8

reasons to go to the hospital

Answer 8

• UCs 5 min apart, last 60 secs, regular for 1 hr
• ROM
• intense pain
• bloody show increases
• decrease in fetal movement
• headache, blurred vision

Question 9

6 parameters of a SVE

Answer 9

• dilation
• effacement
• cervical position
• fetal station, presentation, position

Question 10

4 stages of labor

Answer 10

1: build up of labor
2: birth of baby
3: placental delivery
4: maternal care

Question 11

oxytocin MOA

Answer 11

stimulates uterine smooth muscle intermittent contractions

Question 12

oxytocin side effects

4

Answer 12

• hypotension
• tachycardia
• water retention
• N/V

Question 13

methylergonovine (methergine) MOA

Answer 13

increased tone, rate, and amplitude of UCs (sustains contractions and decreases blood loss)

Question 14

methergine side effects

4 (1 contraindication)

Answer 14

• N/V
• abd pain
• headache
• dizziness
  Contraindicated with preeclampsia

Question 15

hemabate (carboprost) MOA

Answer 15

increased contraction of uterine smooth muscle

Question 16

hemabate (carboprost) side effects

2 (1 caution)

Answer 16

• N/V
• diarrhea
  Caution with asthma

Question 17

Misoprostol (cytotec) MOA

Answer 17

acts as protaglandin analogue, causing UCs

Question 18

misoprostol (Cytotec) side effects

3

Answer 18

• abd pain
• diarrhea
• fever

Question 19

Tranexamic acid MOA

Answer 19

inhibits fibinolysis (stops breakdown of clots)

Question 20

Tranexamic acid side effects

4

Answer 20

• abd pain
• diarrhea
• headache
• N/V

Question 21

intial NB care

3

Answer 21

• erythromycin ointment
• vitamin K IM inj
• Hep B vaccine

Question 22

What does apgar stand for?

Answer 22

• Appearance (color)
• Pulse (110-160)
• Grimace (face)
• Activity (muscle tone)
• Respirations (crying volume)

Question 23

Pharmacological options for pain relief

4

Answer 23

• systemic
• local
• regional
• general

Question 24

Examples of systemic analgesics

Answer 24

• Parenteral opioids: Butorphanol/Stadol, Nalbuphine/Nubain, Fentanyl, Morphine
• Inhaled nitrous oxide

Question 25

Local analgesia common use

Answer 25

prevent pain in a small area of the body- usually for episiotomy

Question 26

Regional Analgesia

Answer 26

Epidural/spinal

Question 27

Nursing care before epidural | 7

Answer 27

* verify consent * vitals * FHR * Time Out * Labs: plt, type, screen * IV fluid bolus * ensure emergency equipment is nearby

Question 28

Nursing care DURING epidural | 3

Answer 28

* Positioning: lateral with head flexed to chest, elbows on knees, feet supported * breathing/relaxation * monitor mom/baby

Question 29

Nursing Care AFTER epidural | 4

Answer 29

* assess for hypotension, resp distress, sedation * FHR q 5-15 min * effective pain relief * side effects: pruritis, N/V, headache, urinary retention