OB Class 2

Question 0

False labor contractions

Answer 0

inconsistent
changing activity doesnt alter contractions
activity may decrease them

Question 1

4Ps of labor

Answer 1

Passage
Passenger
Power
Psyche

Question 2

true labor contractions

Answer 2

consistent
increasing frequency, duration and intensity
walking tends to increase contractions

Question 3

discomfort of false labor

Answer 3

abdomen and groin

more annoying that painful

Question 4

discomfort of true labor

Answer 4

begins in lower back and sweeps around to the abdomen like a girdle
feels like menstrual cramps

Question 5

warning signs that labor is near

Answer 5

braxton hicks contractions
lightening
increased clear nonirritating vaginal secretions
energy spurt "nesting"
small weight loss of 1-3lbs

Question 6

First stage of labor

Answer 6

stage of dilation

Question 7

1st stage: stage of dilation

3 stages

Answer 7

latent
active
transition

Question 8

latent phase

Answer 8

0-3cm
contractions 10min apart
bloody show
ROM: gush of fluids

Question 9

active phase

Answer 9

4-7cm
change in cervix
contractions 5min apart
***not encouraged to push

Question 10

transition phase

Answer 10

6-10cm
contractions frequent and close together
increased pressure on rectum and perineum

Question 11

2nd stage of labor

Answer 11

begins with complete cervical dilation and ends with delivery of baby

Question 12

2nd stage of labor

Answer 12

contractions 2min apart (60-90 sec long)
feel of vulva splitting
pain radiate to back and legs
urge to push
avoid valsalva (decreases fetal oxygen)

Question 13

3rd stage of labor

Answer 13

delivery of placenta

have mother nurse baby to stimulate contraction of uterus to prevent hemorrhage

Question 14

when to present to the hospital or birth center

Answer 14

contractions of increasing regularity/ frequency/ duration/ intensity
Nullipara: 5min apart for 1hr
Multipara: 10min for 1hr
ROM: with or w/o contractions
Bleeding: bright red blood w/o mucus
decreased fetal movement

Question 15

assessment for fetal oxygenation

Answer 15

FHR
contractions
amniotic fluid characteristics
maternal VS

Question 16

interventions to promote fetal oxygenation

Answer 16

promoting placental function
:maternal position
:AVOID SUPINE

Question 17

APGAR score

Answer 17

A: acitivity
P: pulse
G: grimace (reflex irritability)
A: appearance (skin color)
R: respirations

Question 18

APGAR scoring

Answer 18

0: absent
1: present but not adequate
2: within normal

Question 19

APGAR scoring: severely depressed

Answer 19

sever depressed: 0-3

***infant needs resuscitation

Question 20

APGAR scoring: moderately depressed

Answer 20

moderately depressed: 4-6

***stimulate by rubbing the infants back while administering oxygen

Question 21

APGAR scoring: excellent condition

Answer 21

excellent condition: 7+

***support infants spontaneous efforts and continue to observe

Question 22

fluctuations in the baseline FHR that cause the printed line to have an irregular wavelike appearance rather than a smooth flat one

Answer 22

baseline FHR variability

Question 23

temporary increase in FHR that peaks at least 15bpm above the baseline and last at least 15sec

Answer 23

accelerations

Question 24

accelerations occur with

Answer 24

``` fetal movement vaginal exams contractions mild cord compression ***accelerations are a reassuring sign reflecting the fetus has a responsive CNS ```

Question 25

early decelerations occur with

Answer 25

contractions | ***not associated with compromis

Question 26

nadir of FHR

Answer 26

low point * **occur at same time the contraction peaks * **usually no lower than 30-40bpm

Question 27

late decelerations caused by

Answer 27

impaired exchange of oxygen and waste in the placenta cause of uteroplacental insufficiency ***not reassuring

Question 28

variable decelerations caused by

Answer 28

conditions that reduce flow thru the umbilical cord | ***fall and rise abruptly with relief of cord compression

Question 29

can receive an epidural

Answer 29

5-7cm effacement 100% contractions close together

Question 30

epidural side effects

Answer 30

``` prolonged 2nd stage of labor ineffective/ no urge to push bladder distention hypotension spinal headache ```

Question 31

station meaning

Answer 31

the closer to being born (+) | the farther from being born (-)

Question 32

3/50/-1

Answer 32

dilation/ effacement/ station dilation up to 10cm effacement up to 100% station: more positive

Question 33

opioid analgesics

Answer 33

crosses placental barrier if given to mother to close to time of delivery can cause resp. depression in neonate

Question 34

opioid analgesics given only with

Answer 34

- labor well established | - vaginal exam shows cervical dilation of 4cm at minimum and fetus engaged

Question 35

dont give opioid IV when

Answer 35

in labor at 9cm | ***causes fetal compromise

Question 36

epidural and spinal regional analgesia

Answer 36

use of short acting opioids administered as a motor block into epidural and intrathecal space w/o anesthesia ***still allow pt to sense contractions and maintain ability to bear down

Question 37

side effects of epidural and spinal regional analgesia

Answer 37

hypotension * **elevated temp resp. depression

Question 38

Epidural block dont give at

Answer 38

0-3cm

Question 39

epidural block give at

Answer 39

4-7cm ***dont give past 7cm pt has to stick back out which causes baby to move down leading to urge to push increased risk in harm w/ multibirth

Question 40

epidural block

Answer 40

local anesthetic w/ an anlagesia injected into epidural space eliminates all sensation from level of umbilicus to thighs

Question 41

spinal block

Answer 41

local anesthetic injected into subarachnoid space into spinal fluid can be done with analgesia eliminates all sensations from level of nipples to feet ***not used for labor

Question 42

postpartum headache from cerebral spinal fluid leak

Answer 42

place pt in supine position recieve autologous blood patch from pharmacy wait 6-12hrs before standing to prevent leakage