Exam 2 - Labor Variations

Question 1

process that prepares the cervix for labor induction

Answer 1

cervical ripening

Question 2

procedure that stimulates uterine contractions of labor

Answer 2

labor induction

Question 3

stimulates uterine contractions after labor has already started

Answer 3

augmentation

Question 4

artificial initiation of labor before spontaneous onset

Answer 4

induction of labor (IOL)

Question 5

maternal indications of IOL include…

Answer 5

(1) PROM
(2) HTN disorders
(3) IUFD
(4) maternal diabetes
(5) post-term pregnancy
(6) elective

Question 6

fetal indications of IOL include

Answer 6

(1) fetal growth restriction
(2) oligohydramnios
(3) chorioamnionitis
(4) non-reassuring FHR tracings

Question 7

complete placenta previa, non-cephalic presentation, prior uterine rupture, and active genital herpes are what?

Answer 7

contraindications for IOL

Question 8

if we can’t do IOL, we ___

Answer 8

do a c-section

Question 9

to start an induction we do a ____

Answer 9

vaginal exam

Question 10

bishop score of ___ or less means you are eligible for cervical ripening

Answer 10

6

Question 11

the two main methods of cervical ripening are

Answer 11

mechanical and pharmacologic

Question 12

___ is the mechanical method of cervical ripening

Answer 12

intracervical balloon

Question 13

the benefit of an intracervical balloon is

Answer 13

it is safe for those with previous c-section

Question 14

intracervical balloon can ____ when inserted

Answer 14

rupture the membranes and displace the fetal head

Question 15

____ are the pharmacologic method of cervical ripening

Answer 15

prostaglandins

Question 16

the prostaglandins used for cervical ripening are

Answer 16

misoprostol; dinoprostone (cytotex, cervidil)

Question 17

pharmacologic cervical ripening is contraindicated in ____

Answer 17

those with previous C-section or uterine surgery

Question 18

____ is a main risk of pharmacologic cervical ripening

Answer 18

tachysystole

Question 19

prostaglandins are given ____ (route)

Answer 19

vaginally

Question 20

What are the main nursing interventions for tachysystole?

Answer 20

(1) reposition
(2) stop pitocin and/or cervadil (miso)
(3) fluid bolus

Question 21

the most common methods of IOL and augmentation are

Answer 21

(1) IV pitocin
(2) artificial rupture of membranes (AROM)

Question 22

___ is the synthetic version of oxytocin

Answer 22

pitocin

Question 23

the 3 main risks of pitocin are

Answer 23

(1) tachysystole
(2) uterine rupture
(3) uterine atony and PPH

Question 24

why do you hang the IV pitocin as close to the venipuncture site as possible?

Answer 24

it limits the amount of drug that is infused after stopping it

Question 25

how do you administer IV pitocin?

Answer 25

start at a low dose and increase every 20-30 minutes until regular uterine contractions

Question 26

___ is a high-risk med

Answer 26

pitocin

Question 27

monitor what q30 minutes when giving pitocin?

Answer 27

maternal BP and HR

Question 28

continuous fetal monitoring should be on when

Answer 28

giving pitocin

Question 29

if you see non-reassuring FHR while giving pitocin, what can you do?

Answer 29

(1) reduce or stop infusion (2) increase rate of primary IV line (3) move pt to side-lying position (4) monitor FHR and contractions (5) administer terbutaline

Question 30

2 reasons for AROM are

Answer 30

labor augmentation and induction

Question 31

risks of AROM are

Answer 31

cord prolapse and chorioamnionitis

Question 32

amnihook used by provider to perforate the amniotic sac

Answer 32

AROM

Question 33

what should you obtain before the AROM procedure?

Answer 33

baseline FHR tracing

Question 34

what should you assess for after AROM?

Answer 34

signs of infection

Question 35

what are the two types of operative vaginal delivery?

Answer 35

vacuum and forceps

Question 36

the main purpose of operative vaginal delivery is...

Answer 36

to shorten the 2nd stage with indicated reason

Question 37

name at least 3 indications for operative vaginal delivery

Answer 37

(1) exhaustion (2) cardiac or pulmonary disease (3) intrapartum infection (4) fetal cord compression (5) premature separation of placenta (6) non-reassuring FHR pattern

Question 38

maternal risks of operative vaginal delivery are

Answer 38

(1) laceration (2) hematoma (3) episiotomy

Question 39

fetal risks of operative vaginal delivery are

Answer 39

(1) ecchymoses (2) facial and scalp lacerations or abrasions (3) facial nerve injury (4) cephalohematoma (5) intracranial hemorrhage

Question 40

make sure pt's bladder is empty before ____

Answer 40

operative vaginal delivery

Question 41

3 things to assess in the newborn after operative vaginal delivery are

Answer 41

(1) skin breaks (2) facial asymmetry (3) neuro abnormalities (4) scalp edema

Question 42

TOLAC stands for

Answer 42

trial of labor after cesarean

Question 43

VBAC stands for

Answer 43

vaginal birth after cesarean

Question 44

what are contraindicated in TOLAC?

Answer 44

prostaglandins

Question 45

benefits of TOLAC - name at least 3

Answer 45

(1) achieved VBAC (2) avoid surgery (3) lower rates of hemorrhage, infection, TE (4) shorter recovery

Question 46

unsuccessful TOLAC ending in C-section is ____ than elective repeat

Answer 46

worse

Question 47

the 2 major indications for cesarean delivery are...

Answer 47

(1) labor dystocia (2) abnormal / indeterminate FHR tracing

Question 48

name at least 3 other indications of C-section

Answer 48

(1) fetal malpresentation (2) suspected macrosomia (3) active genital herpes (4) cord prolapse (5) placental abnormalities

Question 49

name at least 3 risks of cesarean birth

Answer 49

(1) major hemorrhage (2) uterine rupture (3) anesthetic complications (4) shock (5) cardiac arrest (6) infection (7) wound disruption (8) injury to newborn

Question 50

how long do you need to be NPO before c-section?

Answer 50

8 hours

Question 51

the typical pre-op antibiotic before c-section is ____

Answer 51

Ancef - IV push

Question 52

____ or ___ can be used to manage gastric secretions during cesarean birth

Answer 52

Bicitra, pepcid