Test 2 Blueprint (3)

Question 1

2 reasons the laboring woman must keep her bladder empty:

Answer 1

1) distended bladder may impede descent of baby

2) bladder trauma, leads to decreased bladder tone/uterine atony after birth

Question 2

How often should a laboring woman void?

Answer 2

q1-2hr

Question 3

Why are women given an IV bolus before an epidural?

Answer 3

Increases vascular space
Decreases fetal compromise
Keeps mom from becoming hypotensive

Question 4

Mom needs to wear ____ ____ after epidural.

Answer 4

pulse oximeter

Question 5

What is considered hypotensive for mom?

Answer 5

systolic below 100

Question 6

If mom’s HR drops, baby’s HR ____.

Answer 6

drops

Question 7

What interventions should be done if mom becomes hypotensive?

Answer 7

1) Prop mom on side
2) Increase fluids
3) Admin O2
4) Elevate legs 10-20 degrees
5) Call MD
6) Would need ephedrine (vasoconstrictor)

Question 8

After an epidural, vitals should be taken:

Answer 8

every 5 min for first 20 min

then every 30 min

Question 9

Relation of baby’s spine to mom’s spine:

Answer 9

Fetal lie

Question 10

Transverse means baby’s spine is at ____ ____ to mom’s spine.

Answer 10

right angle

Question 11

Longitudinal or vertical lie means baby’s spine is ____ to mom’s spine.

Answer 11

parallel

Question 12

T/F: Presenting part is the part of the baby that comes out of the vagina first.

Answer 12

True

Question 13

Relation of fetal parts to one another:

Answer 13

Attitude

Question 14

Head flexed, arms folded, legs onto abdomen, back curved in shape of C. Examiner palpates POSTERIOR fontanel.

Answer 14

General flexion

AKA: fetal position

Question 15

Presents wider part of skull to inlet. Examiner palpates the mentum (chin) or brow.

Answer 15

Extended

dangerous position

Question 16

Why is EXTENDED ATTITUDE bad for baby?

Answer 16

Can break baby’s neck

Question 17

Presentation of baby in relation to front, back, or side of maternal pelvis:

Answer 17

Position

Question 18

1st letter
2nd letter
3rd letter

Answer 18

1st letter: R or L of maternal pelvis
2nd letter: specific presenting part of fetus
3rd letter: location of the presenting part in relation to maternal pelvis

Question 19

Labels for presenting part of fetus (2nd letter)

Answer 19

O=occiput
M=mentum (chin)
S=sacrum
A=acromion process (scapula)

Question 20

Labels for presenting part in relation to maternal pelvis (3rd letter)

Answer 20

A=anterior (symphysis pubis)
P=posterior (sacrum)
T=transverse (to mom’s side)

Question 21

Which presentation is best for vaginal delivery?

Answer 21

Cephalic

Question 22

Which fetal position is easiest for vaginal delivery?

Answer 22

LOA

Question 23

Biparietal diameter:

Answer 23

measurement of head at widest part to evaluate if it will fit through birth canal

Question 24

What positions are labeled as “breech”?

Answer 24

sacrum
foot
shoulder

Question 25

These must be C-section:

Answer 25

Mentum (M is the middle letter) Shoulder Transverse (T is the last letter)

Question 26

What constitutes fetal tachycardia?

Answer 26

FHR > than 160 bpm | Lasts more than 10 min

Question 27

What causes fetal tachycardia?

Answer 27

``` Early fetal hypoxemia Maternal fever Maternal dehydration Drug induced Intraamniotic infection Maternal hypothyroidism Fetal anemia Fetal heart failure Fetal cardiac dysrhythmia ```

Question 28

What drugs can cause fetal tachycardia?

Answer 28

atropine ritodrine cocaine methamphetamine

Question 29

What is fetal bradycardia?

Answer 29

FHR

Question 30

What causes fetal bradycardia?

Answer 30

``` Late fetal hypoxemia Hypoxia Drug induced Maternal hypotension/hypertension Prolonged umbilical cord compression Fetal congenital heart block Maternal hypothermia Prolonged maternal hypoglycemia Last sign of hypoxia ```

Question 31

What drugs can cause fetal bradycardia?

Answer 31

``` MgSO4 Propanolol Anesthetics Epidural Stadol ```

Question 32

What 2 things must happen before applying an IUPC or ISE?

Answer 32

ROM | Cervix dilated

Question 33

TN nurses (can/cannot) place IUPC or ISE? What about MS nurses?

Answer 33

TN can | MS cannot

Question 34

When assessing fetal heartrate, what is PMI?

Answer 34

location on maternal abdomen at which the FHR is heard the loudest

Question 35

What part of the fetus is the HR usually heard best?

Answer 35

Over the the fetus' back

Question 36

Where would you find FHT if baby is cephalic? (cephalic = below umilicus)

Answer 36

BELOW the mother's umbilicus | Either the RLQ or LLQ of mom's abdomen (over baby's back)

Question 37

Where would you find FHT if baby is breech? (breech = above umbilicus)

Answer 37

ABOVE the mother's umbilicus

Question 38

What shape pelvis is best for vaginal delivery?

Answer 38

gynecoid

Question 39

In 4th stage of labor, what things are checked?

Answer 39

``` Vitals Activity (can feel legs or wiggle toes) LOC Color of mom Fundus Lochia Perineum ```

Question 40

When assessing mom's color after delivery, what should be done if pallor is seen?

Answer 40

Ask MD to order Hct to see if too much blood was lost during delivery

Question 41

In 4th stage of labor, what should be seen with the fundus?

Answer 41

- firm - midline - halfway between umbilicus and symphysis pubis

Question 42

After delivery, lochia should be:

Answer 42

rubra, no large clots...small ok

Question 43

After delivery, perineum should be assessed by _____.

Answer 43

``` REEDA Redness Edema Ecchymosis Drainage Approximation (suture line straight or gaps/bulges?) ```

Question 44

Intervention for boggy uterus/fundus?

Answer 44

``` Assess bladder - may be distended (void) Breastfeed - releases oxytocin Nipple stimulation - releases oxytocin Uterine massage - promotes vasoconstriction Admin oxytocin ```

Question 45

Intervention for fundus deviated to right of umbilicus?

Answer 45

- Assess bladder - distended bladder may push uterus off center - Void - Reassess fundus

Question 46

True labor results in ___ ___.

Answer 46

cervical change

Question 47

7 signs of true labor:

Answer 47

1) Regular contraction 2) Start in back 3) Contractions increase in intensity and duration 4) Walking intensifies contractions 5) Mucus plug discharged 6) Cervix dilated 7) Sedation doesn't stop contractions

Question 48

Multipara:

Answer 48

completed 2 or more pregnancies to 20 wks or more gestation

Question 49

Nullipara:

Answer 49

not completed a pregnancy with a fetus or fetuses beyond 20 wks gestation

Question 50

The enlargement of widening of the cervical opening and the cervical canal that occurs once labor has begun:

Answer 50

Dilation

Question 51

The shortening and thinning of the cervix during the first stage of labor. Generally progresses significantly in first-time term pregnancy before more than slight dilation occurs. In subsequent pregnancies, this and dilation of the cervix tend to progress together.

Answer 51

Effacement

Question 52

Dilation is expressed in:

Answer 52

0 to 10 cm

Question 53

Effacement is expressed in:

Answer 53

0 to 100%

Question 54

Relationship of the presenting fetal part to an imaginary line drawn between the ischial spines of the pelvis. It is a measure of the degree of descent of the presenting part of the fetus through the birth canal.

Answer 54

Station

Question 55

Signs and symptoms of uterine infection:

Answer 55

- pain in lower abdomen - fever - foul-smelling vaginal discharge - rapid HR - swollen and tender uterus

Question 56

What things can introduce or make uterus susceptible to bacteria?

Answer 56

- ruptured membranes (esp 18-24 hrs later) - vaginal exams (sterile gloves should be used) - mucus plug is expelled - anemia - prolonged labor