CNM Varney's Review Book Part D Flashcards Preview

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Flashcards in CNM Varney's Review Book Part D Deck (70)
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1

What describes the cervix of the average primigravida on the verge of true labor?

50-100% effacement with fingertip to 1cm dilation

2

how do uterine contractions differentiate the uterus into two segments?

upper zone of uterus shortens and thickens, while lower zone legnthens and thins

3

What is the definition of fetal engagement?

when the widest diameter of fetal presenting part has passed through pelvic inlet

4

Which landmark of the fetal head would you use to determine station in a well-flexed, cephalic presentation?

occipital bone

5

What are some characteristics of true labor contractions?

regular; increase in freuquency, duration, intenstiy; radiate from fundus to back

6

Which of the following findings would be LEAST likely to give a false positive result when confirming ROM?
+nitrazine test
+ferning
being unable to visualize or feel membranes bulging over presenting part
visualizing amniotic fluid escaping from cervical os

visualizing aminiotic fluid escaping from cervical os

7

G1P0 at 39 wks. Calls at 10 pm; has been having ctxn since 11 am, is exhuasted and unable to sleep. No signs of ROM, neg bleeding. Ctxn q 10-30 min, lasting 20-30 sec. Have not changed in character, but most comfortable ambulating, least comfortable sitting/laying. Normal fetal movement. You suspect she is experiencing what?

false labor

8

What is your management of this person in false labor?

Take a warm bath and have a hot drink with sugar and call you back if unable to sleep.

9

At 2 am, woman comes in who had false labor since 11am previous morning. 2/90/-1 contractions moderate intensity q 7-10 min, lasing 20-40 sec. FHR 130, neg decels. She has had no sleep, is tired and frustrated. What is she experiencing, and what should you do?

Latent phase of labor
send her home with sedatives and encourage her to rest

10

during what stage of labor does majority of progressive descent of fetal presenting part occur?

During deceleration phase and second stage

11

what are some traditional s/s of transitional phase/impending second stage?

uncontrollable desire to bear down
expulsive grunt upon exhalation
ROM

12

What is the most common position, lie, presentation and variety of the fetus at onset of labor?

LOT

13

Waht is the term used to describe changes in fetal heart rate associated with uterine contractions?

periodic changes

14

what is considered teh cut-off lower limit for marked tachycardia?

180 bpm

15

What method of FH evaluation provides the most reliable, comprehensive data?

internal continuous monitoring with FSE

16

What is considered the critical level of fetal scalp pH at which immediate deliver becomes necessary?

a second reading of a pH <7.20

17

normal arterial and venous cord blood pH levels

arterial: 7.11-7.36
venous: 7.25-7.45
fetal scalp capillary: 7.25-7.35

18

What represents a normal rise of BP during contractions for a woman in labor?

systolic rise of 10-20 mm Hg
diastolic rise of 5-10 mm Hg

19

Which position will be helpful in facilitating the long arc rotation of a fetus in ROP?

Right-lateral position

20

second stage is also known as what stage?

expulsion stage

21

according to friedman, what is the avg length of second stage for primigravidas?

60 minutes

22

G3P2 in active labor turns to you and cires, "the baby is coming!" You checked her 15 min ago and she was 8cm, 0 station. Waht do you do?

Ask her to start panting respirations and while you keep an eye on her perineum, put on your gloves.

23

what mechanism of labor occurs thorughout labor?

descent

24

birth of the head occurs throgh which mechanism for an OA delivery?

extension

25

External rotation accomplishes what in a birth with cephalic presentation?

brings the bisacromial diameter of the fetus into alignment with the AP diameter of the pelvic outlet

26

what is the bisacromial diameter?

the distance between the outermost parts of the fetal shoulders

27

internal rotation accomplishes what in a birth with cephalic presentation?

brings A-P diameter of fetal head into alignment with A-P diameter of maternal pelvis

28

If engagement took place in ROP, how many degrees does the fetal head rotate during internal rotation for OA delivery?

135 degrees
???
shouldn't it be 180?

29

If engagement was in ROT, how many degrees for birth in OA?

90

30

birth in OA from RO, head will restitute to what position?

ROA