Test 2 Blueprint (2)

Question 1

Beginning of one contraction to the beginning of the next contraction.

Answer 1

Frequency

Question 2

Beginning to end of one contraction.

Answer 2

Duration

Question 3

Frequency is measured in ____.

Duration is measured in ____.

Answer 3

minutes

seconds

Question 4

How strong the contraction FEELS upon palpation.

Answer 4

Intensity

Question 5

Intensity is classified as:

Answer 5

mild (nose)
moderate (chin)
strong (forehead)

Question 6

The period in between contractions; palpation of uterus when no contraction is taking place.

Answer 6

Resting tone

Question 7

Interventions for Late or Variable decels:

The Big 5

Answer 7

1) Reposition pt…prop on side
2) O2 per facemask
3) IV fluids or fluid bolus
4) Stop oxytocin
5) Call the doctor

Question 8

What level of O2 is generally ordered?

Answer 8

8 to 10 L/min

Question 9

Accelerations are indicative of ____ ____ ____ and ____ ____ which are considered signs of fetal well being.

Answer 9

well oxygenated fetus

fetal movement

Question 10

What is an amniotomy?

Answer 10

AROM

Question 11

Why is an amniotomy performed?

Answer 11

Induce or augment labor

Question 12

The longer the membranes are ruptured, the greater the risk for ____.

Answer 12

infection

Question 13

How often is temp measured after ROM?

Answer 13

q 1-2 hr

Question 14

If membranes are ruptured more than 24, what intervention is performed?

Answer 14

prophylactic antibiotics as ordered

Question 15

What would you assess immediately following ROM?

Answer 15

Amniotic fluid: color & odor

FHT: decels or change in variability

Question 16

If variable decels are noted, check for ____ ____.

Answer 16

cord prolapse

This is an emergency!

Question 17

Normal amniotic fluid…

Answer 17

Pale/straw colored
Flecks of vernix caseosa, lanugo, scalp hair
Characteristic odor

Question 18

Abnormal amniotic fluid…

Greenish brown color

Answer 18

Meconium in fluid

Risk for fetal meconium aspiration

Question 19

Abnormal amniotic fluid…

Yellow color

Answer 19

• Infection
• Breech presentation r/t pressure on fetal abdominal wall during decent
  (May also be rupture of gonorrhea/chlamydia lesions)

Question 20

Abnormal amniotic fluid…

Port wine color

Answer 20

Bleeding, possible abruption, premature separation of placenta

Question 21

Abnormal amniotic fluid…

Thick, cloudy, foul odor

Answer 21

Intrauterine infection

Question 22

What 5 things are assessed in the APGAR score?

Answer 22

Appearance (color)
Pulse (HR)
Grimace (Reflex irritability)
Activity (Muscle tone)
Respirations

Question 23

When is APGAR score performed? What is considered normal?

Answer 23

1 and 5 min immediately after delivery

7-10 score normal

Question 24

APGAR…

Appearance (Color)

Answer 24

0 blue, pale
1 acrocyanosis
2 completely pink

Question 25

APGAR... | Pulse (HR)

Answer 25

0 absent | 1 100

Question 26

APGAR... | Grimace (Reflex irritability)

Answer 26

0 none 1 grimace 2 cry

Question 27

APGAR... | Activity (Muscle tone)

Answer 27

0 flaccid 1 some flexion 2 well-flexed

Question 28

APGAR... | Respirations

Answer 28

0 absent 1 slow, weak cry 2 good cry

Question 29

Why is oxytocin important after delivery?

Answer 29

promotes uterine contractions | vasoconstriction

Question 30

Why don't we want contractions any closer than 2 min apart?

Answer 30

Insufficient time to reoxygenate fetus between contractions

Question 31

What happens if mother is hypotensive?

Answer 31

not enough pressure to adequately reperfuse placenta

Question 32

When do you give Stadol (butorphanol tartrate)?

Answer 32

At the top of the contraction; due to vasoconstriction during contraction, the fetus will get less and the mom will get more

Question 33

What is the goal of pain relief?

Answer 33

adequate pain relief without increasing maternal or fetal risk OR affecting the progress of labor

Question 34

Is it ok to give a preganant/laboring woman BENZODIAZEPINES?

Answer 34

No, this will effect the baby's ability to thermoregulate

Question 35

What is the #1 stressor to a newborn?

Answer 35

cold

Question 36

What are 2 examples of barbiturates?

Answer 36

Seconal (secobarbital) **this is no longer given | Nembutal (pentobarbital)

Question 37

Can barbiturates be given during active labor? Why or why not?

Answer 37

NO | Causes CNS depression of newborn

Question 38

Name 2 ataractics:

Answer 38

Reglan (metoclopramide) | Phenergan (promethazine)

Question 39

What effect do ataractics have on the fetus?

Answer 39

CNS depression

Question 40

Can ataractics be given with benzos?

Answer 40

No

Question 41

Name 4 examples of opioids?

Answer 41

Dilaudid (hydromorphone) Demerol (meperidine) Sublimaze (fentanyl) Sufenta (sufentanil)

Question 42

What effect does Demerol (meperidine) have on the newborn?

Answer 42

Causes prolonged neurobehavioral changes that can last for 2-3 days

Question 43

Sufenta (sufentanil) does not cross the ____ as readily so ____ fetal exposure.

Answer 43

placenta | less

Question 44

What is an antidote for opioid overdose?

Answer 44

Narcan (naloxone hcl)

Question 45

Can Narcan (naloxone hcl) reverse Stadol or Nubain?

Answer 45

No, these are opioid agonist-antagonists

Question 46

List 2 opioid agonist-antagonists:

Answer 46

Stadol (butorphanol tartrate) | Nubain (nalbuphine hcl)

Question 47

What is a positive characteristic of opioid agonist-antagonists like Stadol and Nubain?

Answer 47

Adequate analgesia w/o resp depression in mom or baby

Question 48

What is a negative characteristic of opioid agonist-antagonists like Stadol or Nubain?

Answer 48

May precipitate withdrawal symptoms in narcotic dependent women and babies

Question 49

What interventions can be performed in an infant with resp depression to get opioid out of system faster?

Answer 49

stimulation (rub vigorously with towel) | fluids

Question 50

What is negative about a spinal block?

Answer 50

Increased incidence and degree of hypotension

Question 51

Negative of general anesthesia?

Answer 51

fetal resp depression, hypotonia, lethargy