Labor & Delivery

Question 1

In True Labor are contractions regular or irregular ?

Answer 1

Regular

Question 2

In True Labor, due contractions increase or decrease in frequency and duration ?

Answer 2

Increase

Question 3

In True Labor, where does Discomfort in the back radiate too ?

Answer 3

Radiates to the abdomen

Question 4

In True Labor, what happens to the pain level with a change in activity ?

Answer 4

It increases

Question 5

In False Labor, what are the contractions like ?

Answer 5

Irregular

Braxton Hicks - which usually go away if movement by mom, etc

Question 6

In False Labor, where is the discomfort ?

Answer 6

The abdomen (just in front)

Question 7

In False Labor, what happens to the pain with a change in activity ?

Answer 7

The pain decreases

Question 8

With Premature labor or preterm labor, contractions occur when ?

Answer 8

Occur with dilation, between 20 and 37 weeks

Question 9

What is the goal with Premature labor or preterm labor ?

Answer 9

Goal = Stop the labor

Question 10

What things will often stop preterm labor ?

Answer 10

• Treating any existing vaginal or UTI’s

- Hydrating the mom

Question 11

A client in Premature Labor or Preterm labor will be on what ?

Answer 11

Bedrest

Question 12

What are medications that may be prescribed in premature labor or preterm labor ?

Answer 12

• Magnesium Sulfate (IV) - relaxes the uterus
• Betamethasone (IM) - a steroid that helps the fetal lungs mature
• Terbutaline (SQ)
• Indomethacin (PO)
• Nifedipine (PO)

Question 13

How should you position a client receiving Epidural Anesthesia ?

Answer 13

Lying on the left side, legs flexed, & proper over the bedside table

Question 14

When is Epidural Anesthesia given ?

Answer 14

In Stage 1, 3 to 4cm dilation

Question 15

Does a headache usually accompany Epidural Anesthesia ?

Answer 15

No

Question 16

What is a Major complication of Epidural Anesthesia ?

Answer 16

Hypotension

monitor BP closely

Question 17

Because Hypotension is usually a complication with Epidural Anesthesia, what is given ?

Answer 17

IVF’s

Bolus with 1000mL of NS or LR

Question 18

Vena Cava compression will do what to venous return ?

Answer 18

Decrease it

Question 19

If venous return is decreased d/t vena cava compression, what will the result be ?

Answer 19

It will reduce CO and BP & if BP is decreased then placental perfusion also decreases

Question 20

What should a client who received Epidural Anesthesia do ?

Answer 20

Alternate position from side to side Hourly (in semi-fowlers)

Question 21

What should you not forget to check in a patient who received an Epidural Anesthesia ?

Answer 21

Don’t forget to check their Urine output and assess the bladder

Question 22

What do clients receiving Oxytocin need, in regards to care ?

Answer 22

Need one-on-one care (Don’t leave the client!)

Question 23

What complications should you be alert for in a client reviewing Oxytocin ?

Answer 23

• Hypertonic Labor
• Fetal distress
• Uterine rupture

Question 24

Why is a Uterine rupture a possible complication in a client receiving Oxytocin ?

Answer 24

The uterus may rupture due to rupture of the scar from a previous C-section

Question 25

What type of Moms are at risk for Uterine rupture ?

Answer 25

Vaginal Birth After C-Section moms

Question 26

In a Client receiving Oxytocin, you want a contraction rate of what ?

Answer 26

A contraction rate of 1 every 2 to 3 minutes with each lasting 60 seconds

Question 27

When should Oxytocin be discontinued ?

Answer 27

- When the contractions are too often, - The contractions last too long OR - With any sign of fetal distress

Question 28

How is Oxytocin hung ?

Answer 28

Oxytocin is piggy backed into a main IV | so when you discontinue the oxytocin, make sure you do not turn off your main IV fluid

Question 29

What position should the client receiving oxytocin be placed ?

Answer 29

Any position Except Flat on their back

Question 30

How will you position the client receiving Oxytocin if the client has any unreassuring fetal heart tones (ex: fetal bradycardia) ?

Answer 30

Put the client on her LEFT SIDE to enhance uterine perfusion

Question 31

What should be done with the Oxytocin infusion if late decelerations occur ?

Answer 31

Turn it off

Question 32

Where is IV oxytocin given ?

Answer 32

At the lowest IV port, incase it needs to be turned off quickly, the patient will get less of it

Question 33

Oxytocin is a what ?

Answer 33

High alert medication

Question 34

When giving Oxytocing to a client, what things should you label ?

Answer 34

Always label both the IV bag with an oxytocin sticker and the IV tubing and ports

Question 35

How should you administer Oxytocin ?

Answer 35

Only administer oxytocin with its own bag and close all clamps before you remove the tubing from the pump

Question 36

How should you discontinue Oxytocin when you're done with it ?

Answer 36

Remove the IV bag and all the tubing from the room