Labor And Delivery

Question 1

What is stage 1 of labor

Answer 1

Onset of labor and last until complete cervical dilation and effacement

Question 2

What is stage 2 of labor

Answer 2

Complete dilation of cervix until delivery of infant

Question 3

What is stage 3 of labor

Answer 3

After delivery of infant until delivery of placenta

Question 4

When do you admit a pt for active labor

Answer 4

Regular contractions and dilation of cervix 3-4cm

Positive rupture of membranes

Question 5

What are the two stages of stage 1 of labor

Answer 5

Active and latent stage

Question 6

What is the active stage of labor

Answer 6

From 3-4cm to 10cm dilation,

Question 7

What is the latent stage of labor

Answer 7

Onset of labor until 3-4cm dilated (slow)

Question 8

What are the 3 “P’s” of labor

Answer 8

Passenger=size and position of fetus
Power= Stregnth and frequency of uterine contractions
Pelvis= size and shape of maternal pelvis

Question 9

During what phase of stage 1 do you want to use the cervical exam sparingly

Answer 9

Latent phase to reduce the risk of infection

Question 10

How often do you check the cervix in active phase

Answer 10

Every 2 hours

Question 11

What is effacement

Answer 11

Thinning of the cervix, subjective movement

Question 12

What is station

Answer 12

Relation of fetal head to Ishial spine

Question 13

What are the 3 diagnostic test for rupture of membranes

Answer 13

Pool test
Nitrazine
Fern test

Question 14

What is the pool test for testing for rupture of membranes

Answer 14

Collection of fluid pooling in vagina/speculum: ask pt to bear down and more fluid will come

Question 15

What is the Nitrazine test

Answer 15

If it turns blue it’s positive, its testing the vaginal secreations and amniotic fluid is alkaline

Question 16

What is the fern test for rupture of membranes

Answer 16

A fern pattern is seen under microscope (estrogen in the amniotic fluid causes crystallization of salts in amniotic fluid when it dries)

Question 17

What is the most accurate way to measure fetal heart rate

Answer 17

Fetal scalp electrode-used more often for non-reassuring FHT

Question 18

What is a normal fetal HR

Answer 18

110-160

Question 19

What is considered a reactive heart rate

Answer 19

2 accelerations of at least 15 bpm over baseline lasting at least 15 seconds over a period of 20 min

Question 20

What are the 3 types of deceleration

Answer 20

Early
Variable
Late

Question 21

What is early deceleration

Answer 21

Drop in HR that begins and ends with contractions

Question 22

What is variable deceleration

Answer 22

Occur at anytime, abrupt drop in HR

Question 23

What is late deceleration

Answer 23

Begin at the peak of contractions and slowly return to baseline after contraction over

Question 24

What deceleration is due to the increase vag also tone from compression of head during contractions

Answer 24

Early

Question 25

What deceleration is due to umbilical cord compression

Answer 25

Variable

Question 26

What deceleration is a result of uteroplacental insufficiency

Answer 26

Late deceleration

Question 27

When do you need to take immediate action for a heart rate? (At what rate)

Answer 27

HR <90 for more than 2 minutes

Question 28

What is used to measure contractions

Answer 28

Totcodynamometer

Question 29

What are some common indications to induce labor

Answer 29

Pre-eclampsia, non-reassuring FHT, PROM, post-term

Question 30

What drug causes uterine contractions

Answer 30

Pitocin

Question 31

What do you need to do to induce labor

Answer 31

Cervical ripening Pitocin Amniotomy

Question 32

What do you need to check for after an amniotomy

Answer 32

Cord prolapse

Question 33

What is known as intervening to help labor progress, generally by increase uterine contractions

Answer 33

Augmentations of labor

Question 34

What do you do to augment labor.

Answer 34

AROM and/or Pitocin

Question 35

What do you need to be sure to check for with AROM

Answer 35

Meconium in fluid...can lead to meconium aspiration

Question 36

What are the 6 cardinal movements of labor

Answer 36

``` Engagement Descent Flexion Internal rotation Extension External rotation ```

Question 37

What shoulder normally gets impacted with shoulder dystocia

Answer 37

Anterior

Question 38

What are some complications of shoulder dystocia

Answer 38

Fracture of humerous and clavicle Brachial plexus injury Hypoxic brain injury Death

Question 39

What diagnosis is made when the head delivers then retracts back

Answer 39

Shoulder dystocia

Question 40

What is the treatment for shoulder dystocia

Answer 40

McRoberts maneuver | Suprapubic pressure

Question 41

What is often given to help with the delivery of the placenta

Answer 41

Oxytocin

Question 42

What are signs of cord seperation

Answer 42

Gush of blood, cord legnthing, and uterine fundal rebound

Question 43

How much blood loss is considered a postpartum hemorrhage

Answer 43

>500mL after vaginal | >1,000mL after c-section

Question 44

What is it called if you have a pt who has a postpartum hemorrhage, is hypovolemic, and failure to lactate

Answer 44

Sheehan syndrome

Question 45

Was is lack of effective uterine contractions after delivery of placenta

Answer 45

Uterine Atony

Question 46

What is the leading cause of postpartum hemorrhage

Answer 46

Uterine atony

Question 47

How does the uterus feel if there is uterine atony

Answer 47

Instead of feeling firm it is soft, enlarged, and boggy

Question 48

What is the treatment for uterine atony

Answer 48

IV oxytocin and uterine massage if needed IV misoprostol If needed IV Hemabate If needed IV consider tamponade balloon

Question 49

IF there is more bleeding after deliver what do you want to check for

Answer 49

Retained products of conception

Question 50

What is torn in a 3rd degree perineal tear

Answer 50

Anal sphinctor and perineal muscle

Question 51

What is torn in a 2nd degree tear

Answer 51

Perineal muscles

Question 52

What are the two types of assisted delivery

Answer 52

Vacuum assisted | Forcep assisted

Question 53

What is the most common reason for a c-section

Answer 53

Previous c-section

Question 54

What are the signs of a uterine rupture

Answer 54

Abd pain, "pop" sensation, drop in FHR/bradycardia

Question 55

When do you measure the APGAR score

Answer 55

Check 1 & 5 min after birth

Question 56

What is a good/normal score for APGAR | What about a poor/severe depression

Answer 56

8-10 | 0-3

Question 57

If you have a prenatal rubella titer negative what do you need to do

Answer 57

Give MMR