Complications on Labor and Delivery

Question 1

high risk factors/ ppppp

Answer 1

a. Passenger or fetus
b. Passage
c. Power or uterine contraction
d. Placenta
e. Psyche or psychologic state

Question 2

Problems of Passenger

Answer 2

A. fetal malposition
1. occipito- posterior (OP)
2. occipito- transverse
B. fetal malpresentation
1. Vertex malpresentation
2. Breech presentation
3. Shoulder presentation

Question 3

results from a poorly flexed vertex caused by a flat sacrum resulting to poorly flexed head and weak uterine contractions

Answer 3

occipito-posterior position

Question 4

nursing care position of occipito posterior position

Answer 4

1. side-lying
2. knee-chest
3. hands-and-knees
4. pelvic rocking

Question 5

head initially engages correctly but fails to rotate and remains in transverse position

Answer 5

occipito transverse position

Question 6

alternatives for delivery

Answer 6

1. if the 2nd stage is reached, the head must be manually rotated with Kielland’s forceps or delivered using vaccuum extraction
2. cesarean section if there is failure of forceps delivery

Question 7

3 vertex malpresentation

Answer 7

brow/sinciput - forehead
mentum - chin
face – face; asynclitism

Question 8

buttocks or feet
* occurs in 3% of births

Answer 8

breech presentation

Question 9

types of breech presentation

Answer 9

Complete
Frank
Footling

Question 10

buttocks and
tightly flexed feet

Answer 10

complete

Question 11

buttocks alone

Answer 11

incomplete

Question 12

one foot presents – single footling
* both feet – double footling

Answer 12

footling

Question 13

a procedure used to change the
fetal presentation by abdominal or
intrauterine manipulation

Answer 13

version

Question 14

types of version

Answer 14

1. external cephalic version (ECV)
2. podalic version

Question 15

used when the second fetus during a vaginal twin birth and only if the
twin does not descend readily or if the heart rate is non-reassuring

Answer 15

podalic version

Question 15

breech to cephalic
presentation by external manipulation
of the maternal abdomen

Answer 15

external cephalic version

Question 16

refers to fetal compromise that
results in a stressful and potentially
lethal condition

Answer 16

fetal distress

Question 17

• a loop of the umbilical cord
  slips down in front of the
  presenting fetal part
• occur at any time after the
  membranes rupture if the
  presenting part is not fitted firmly
  into the cervix

Answer 17

prolapse of the umbilical cord

Question 18

• refers to the feelings that
  the woman brings to labor
• feelings may include
  apprehension and fear;
  common are excitement and
  wonderment
• major component is the
  woman’s psychological
  readiness for labor

Answer 18

problems with the psyche

Question 19

any blood loss from the
uterus greater than 500 ml
within a 24-hour period

Answer 19

postpartum hemorrhage

Question 20

Postpartal hemorrhage within the 24 hrs

Answer 20

early

Question 21

postpartal hemorrhage anytime after the first
24 hours during the remaining
days of the 6 week peurperium

Answer 21

late

Question 22

uterus must remain in a contracted state after
birth to allow the open vessel at the placental
site to remain in a contracted state after birth

Answer 22

uterine atony

Question 23

a placenta does not deliver in its entirety; fragments of
it separate and are left behind

Answer 23

retained placental fragments

Question 24

infection of the endometrium, the lining of the uterus

Answer 24

endometritis

Question 25

suture line on the perineum from an episiotomy or laceration repair Assessment: pain, heat, and a feeling of pressure inflammation of suture line

Answer 25

wound infection

Question 26

bacteria may be introduced into the bladder at the time of catheterization

Answer 26

UTI

Question 27

3 Postpartal Puerperal Infection

Answer 27

endometritis wound infection uti

Question 28

deficiency in clotting ability caused by vascular injury

Answer 28

Disseminated Intravascular Coagulation

Question 29

Thromboembolic Disorders

Answer 29

Deep Vein thrombosis Pulmonary embolism

Question 30

formation of a clot in a deep vein * femoral vein, popliteal vein, deep vein of the pelvis

Answer 30

deep vein thrombosis

Question 31

a blockage of the main artery of the lung or one of its branches

Answer 31

Pulmonary embolism

Question 32

small lacerations or tears of the birth canal

Answer 32

laceration

Question 33

laceration sites

Answer 33

1. cervical 2. vaginal 3. perineal

Question 34

vaginal mucous membrane and skin of the perineum to the fourchette

Answer 34

first degree

Question 35

* vagina, perineal skin, fascia, levator ani muscle, and perineal body

Answer 35

second degree

Question 36

entire perineum, and reaches the external sphincter of the rectum

Answer 36

third degree

Question 37

entire perineum, rectal sphincter, and some of the mucous membrane of the rectum

Answer 37

4th degree