Chapter 15 Flashcards Preview

Healing I > Chapter 15 > Flashcards

Flashcards in Chapter 15 Deck (21):
1

A new mother asks the nurse when the “soft spot” on her son’s head will go away. The nurse’s answer is based on the knowledge that the anterior fontanel closes how many months after birth?
a.
2 months
b.
8 months
c.
12 months
d.
18 months

D

2

When assessing a woman in labour, the nurse is aware that the relationship of the fetal body parts to one another is referred to as which of the following?
a.
Lie
b.
Presentation
c.
Attitude
d.
Position

C

3

When assessing the fetus using Leopold manoeuvres, the nurse feels a round, firm, movable fetal part in the fundal portion of the uterus and a long, smooth surface in the mother’s right side close to midline. What is the likely position of the fetus?
a.
ROA
b.
LSP
c.
RSA
d.
LOA

C

4

The nurse has received a report about a woman in labour. The woman’s last vaginal examination was recorded as 3 cm, 30%, and –2. What is the nurse’s interpretation of this assessment?
a.
The cervix is effaced 3 cm, it is dilated 30%, and the presenting part is 2 cm above the ischial spines.
b.
The cervix is 3 cm dilated, it is effaced 30%, and the presenting part is 2 cm above the ischial spines.
c.
The cervix is effaced 3 cm, it is dilated 30%, and the presenting part is 2 cm below the ischial spines.
d.
The cervix is dilated 3 cm, it is effaced 30%, and the presenting part is 2 cm below the ischial spines.

B

5

Which position would be least effective when gravity is needed to assist in fetal descent?
a.
Lithotomy
b.
Kneeling
c.
Sitting
d.
Walking

A

6

Which position would the nurse suggest for second-stage labour if the pelvic outlet needs to be increased?
a.
Semirecumbent
b.
Sitting
c.
Squatting
d.
Side-lying

C

7

To adequately care for a labouring woman, the nurse should know that which stage of labour varies most in length?
a.
First
b.
Second
c.
Third
d.
Fourth

A

8

The nurse would expect which maternal cardiovascular finding during labour?
a.
Increased cardiac output
b.
Decreased pulse rate
c.
Decreased white blood cell (WBC) count
d.
Decreased blood pressure

A

9

Which of the following represents one of the factors that affect the process of labour and birth, known commonly as the five P’s?
a.
Pelvic diameters
b.
Position
c.
Powers
d.
Pressure

C

10

What is the term for the slight overlapping of cranial bones or shaping of the fetal head during labour?
a.
Lightening
b.
Moulding
c.
Ferguson reflex
d.
Valsalva manoeuvre

B

11

Which presentation is described accurately in terms of both presenting part and frequency of occurrence?
a.
Cephalic: occiput; at least 95%
b.
Breech: sacrum; 10% to 15%
c.
Shoulder: scapula; 10% to 15%
d.
Cephalic: cranial; 80% to 85%

A

12

With regard to factors that affect how the fetus moves through the birth canal, nurses should be aware of which of the following?
a.
The fetal attitude describes the angle at which the fetus exits the uterus.
b.
Of the two primary fetal lies, the horizontal lie is that in which the long axis of the fetus is parallel to the long axis of the mother.
c.
The normal attitude of the fetus is called general flexion.
d.
The transverse lie is preferred for vaginal birth.

C

13

What should the nurse be aware of with regard to fetal positioning during labour?
a.
Position is a measure of the degree of descent of the presenting part of the fetus through the birth canal.
b.
Birth is imminent when the presenting part is at +4 to +5 cm, below the spine.
c.
The largest transverse diameter of the presenting part is the suboccipitobregmatic diameter.
d.
Engagement is the term used to describe the beginning of labour.

B

14

Which basic type of pelvis includes the correct description and percentage of occurrence in women?
a.
Gynecoid: classic female; heart shaped; 75%
b.
Android: resembling the male; wider oval; 15%
c.
Anthropoid: resembling the ape; narrower; 10%
d.
Platypelloid: flattened, wide, shallow; 3%

D

15

What should the nurse know with regard to primary and secondary powers?
a.
Primary powers are responsible for effacement and dilation of the cervix.
b.
Effacement generally is well ahead of dilation in women giving birth for the first time; effacement and dilation are more together in subsequent pregnancies.
c.
Scarring of the cervix caused by a previous infection or surgery may make the delivery a bit more painful, but it should not slow or inhibit dilation.
d.
Pushing in the second stage of labour is more effective if the woman can breathe deeply and control some of her involuntary needs to push, as the nurse directs.

A

16

What should the nurse teach the woman about her position during labour?
a.
The supine position commonly used in North America increases blood flow.
b.
The “all fours” position, on her hands and knees, is hard on her back.
c.
Frequent changes in position will help relieve her fatigue and increase her comfort.
d.
In a sitting or squatting position her abdominal muscles will have to work harder.

C

17

Which description of the four stages of labour is correct for both definition and duration?
a.
First stage: onset of regular uterine contractions to full dilation; less than 1 hour to 18 hours
b.
Second stage: full effacement to 4 to 5 cm; visible presenting part; 1 to 2 hours
c.
Third state: active pushing to birth; 20 minutes (multipara), 50 minutes (primipara)
d.
Fourth stage: delivery of the placenta to recovery; 30 minutes to 1 hour

A

18

With regard to the turns and other adjustments of the fetus during the birth process, known as the mechanism of labour, nurses should be aware of which of the following?
a.
The seven critical movements must progress in a more or less orderly sequence.
b.
Asynclitism sometimes is achieved by means of the Leopold manoeuvre.
c.
The effects of the forces determining descent are modified by the shape of the woman’s pelvis and the size of the fetal head.
d.
At birth the baby is said to achieve “restitution” (i.e., a return to the C-shape of the womb).

C

19

What should the nurse be aware of to accurately assess the health of the mother during labour?
a.
The woman’s blood pressure will increase during contractions and fall back to prelabour normal between contractions.
b.
Use of the Valsalva manoeuvre is encouraged during the second stage of labour to relieve fetal hypoxia.
c.
Having the woman point her toes will reduce leg cramps.
d.
The endogenous endorphins released during labour will raise the woman’s pain threshold and produce sedation.

D

20

Which of the following may be a sign that precedes labour?
a.
Lightening
b.
Exhaustion
c.
Weight gain
d.
Decreased fetal movement

A

21

Which of the following factors influences cervical dilation?
a.
The size of the fetus
b.
The diameters of the bony pelvis
c.
The size of the female
d.
The pressure applied by the amniotic sac

D