NCM 109 MIDTERMS

Question 1

What are the 4P’s of labor?

Answer 1

Power
Passenger
Passage
Psyche

Question 2

POWER: Usually used to refer to a labor that is made longer or more painful due to problems with the mechanisms of labor involving the 4 P’s.

Answer 2

Dystocia/Difficult Labor

Question 3

POWER: is when, after vaginal delivery of the head, the baby’s anterior shoulder gets caught above the mother’s pubic bone.

Answer 3

Shoulder Dystocia

Question 4

POWER: Is a time-honored term to denote the sluggishness of contractions, or that the force of labor, is less than usual

Answer 4

Dysfunction

Question 5

POWER: two general classifications of dysfunction and their occurrence?

Answer 5

primary - occurring at the onset of labor
secondary - occurring later in labor

Question 6

POWER: The risk of maternal postpartal infection, hemorrhage, and infant mortality is higher in women who have a prolonged labor than in those who do not. (T/F)

Answer 6

TRUE

Question 7

POWER: Known as the basic force that moves the fetus through the birth canal.

Answer 7

Uterine Contractions

Question 8

POWER: this describes the total or partial absence of contractions to expel a normal fetus through an unobstructed birth canal.

Answer 8

PRIMARY INERTIA

Question 9

POWER: a condition that develops during the second (expulsive) stage of labor or at the end of dilation stage following normal or satisfactory uterine contractions

Answer 9

SECONDARY INERTIA

Question 10

POWER: Is a time-honored term to denote the sluggishness of contractions, or that
the force of labor, is less than usual

Question 11

POWER: How do you determine hypotonic contractions?

Answer 11

▪ Infrequent contractions – not more than 2- or 3 in a 10-minute period
▪ Resting tone is less than 10 mmHg
▪ Strength of the contraction does not rise above 25 mmHg
▪ Occurs during the active phase of labor
▪ Painless contractions – due to lack of intensity
▪ Increases the length of labor (more of them are needed to achieve cervical dilatation)
▪ Increases risks for postpartal hemorrhage (due exhausted uterus)

Question 12

POWER: How do you determine hypertonic contractions?

Answer 12

▪ Increase resting tone to more than 25 mmHg
▪ Intensity may be no stronger than that associated with hypotonic contractions; occur frequently
▪ Seen in latent phase of labor
▪ May occur because more than one uterine pacemaker is stimulating contractions or because the muscle fibers of the myometrium do not repolarize or relax after a contraction, thereby “wiping it clean” to accept a new pacemaker stimulus.
▪ tend to be more painful than usual because the myometrium becomes tender from constant lack of relaxation and the anoxia of uterine cells that results

Question 13

POWER: What is the management for hypotonic contractions?

Answer 13

1. In the first hour after birth following a labor of hypotonic contractions.
2. palpate the uterus and assess lochia every 15 minutes to ensure that postpartal contractions are
   not also hypotonic and therefore inadequate to halt bleeding.

Question 14

POWER: What is the management for hypertonic contractions?

Answer 14

1. Fetal external monitor for at least 15 minutes to ensure resting phase of contractions is adequate and no late deceleration is present.

Question 15

POWER: If decelerations in FHR occurs what must be done?

Answer 15

C-section is necessary

Question 16

POWER: How do uncoordinated contractions happen?

Answer 16

more than one pacemaker may be initiating contractions, or receptor points in the myometrium may be acting independently of the pacemaker.

Question 17

POWER: uncoordinated contractions cannot occur so closely together that they can interfere with the blood supply to the placenta (T/F)

Answer 17

FALSE

Question 18

POWER: