Chapter 19

Question 1

Two tests used to determine ROM

Answer 1

Nitrazine test (uses pH of fluid- amniotic fluid is alkaline-blue/green)
Ferning/Fern pattern test (looks at fluid under microscope for ferning pattern)

Question 2

During the latent phase of the first stage of labor contractions are _______ and _______, ___-____ minutes apart, duration of ________ seconds, with ______ bloody show. This phase typically last _______ hours and dilation of _____cm.

Answer 2

Mild/moderate, irregular, 5-30min, 30-45sec, scant, 6-8hrs, 0-3

Question 3

The active phase of the first stage of labor presents with ____ and _____ contractions, ______minutes apart, lasting ______ seconds. _____ bloody show is present, this stage lasts ______ hours with dilation of ____cm.

Answer 3

Moderate/strong, more regular, 3-5min, 40-70sec, scant/moderate, 3-6hrs, 4-7cm

Question 4

The transition phase of the first stage of labor presents with ____ and ____ contractions, ____ minutes apart, lasting _____ seconds. _____ bloody show is present, this phase lasts ______minutes, for dilation of _____cm.

Answer 4

Strong/very strong, regular, 2-3min, 25-90sec, copious, 20-40min, 8-10cm

Question 5

Blood tests performed for laboring woman

Answer 5

CBC, HIV, Type and screen, GBS

Question 6

True or False: The physician and nurse should use fundal pressure to help expel the infant.

Answer 6

False- it is contraindicated

Question 7

Leopold’s maneuvers are used to answer three questions…

Answer 7

1. what fetal part is in the uterine fundus?
2. Where is the fetal back?
3. What is the presenting part?

Question 8

The fourth leopolds maneuver helps determine…

Answer 8

Attitude of fetal head (flexed or extended)

Question 9

Important intervention after ROM

Answer 9

-Monitor to ensure no umbilical cord prelapse and monitor fetal well-being

Question 10

The second stage of labor should not exceed _____ hours or ___ hours with anesthesia for the nulliparous woman and _____ hours or _____ hours with anesthesia for the multipirous woman

Answer 10

2, 3, 1, 2

Question 11

The latent phase of the second stage of labor consists of…

Answer 11

“laboring down”, passive fetal descent into the birth canal- no urge to bear down.
*woman quiet with eyes closed.

Question 12

The active phase of the second stage of labor the woman…

Answer 12

has the urge to bear down (ferguson reflex)

Question 13

Describe ritgen maneuver

Answer 13

Supporting the perineum/rectum to prevent tearing and prevent rapid head birth

Question 14

True or False: The umbilical cord is usually wrapped around the head and called nuchal cord

Answer 14

True

Question 15

Laceration that extends through the fascia and muscles of the perineal body

Answer 15

Second degree tear

Question 16

Laceration that extends through the skin and vaginal mucous membrane but not underlying fascia muscle.

Answer 16

First degree tear

Question 17

Laceration that involves the external anal sphincter

Answer 17

Third degree tear

Question 18

Laceration that extends completely through the rectal mucosa and disrupts both external and internal anal sphincters

Answer 18

Fourth degree tear

Question 19

Signs placenta is about to be delivered:

Answer 19

Lengthening of cord, bloody gush/trickle, globular/full fundus
*Expulsion will be helped by breastfeeding and fundal massage

Question 20

fThe placenta usually delivers in _____ minutes and after _____ minutes there may be complications

Answer 20

10-15 min, 30 min

Question 21

Describe EMTALA

Answer 21

Ensure assessment of all laboring women- Assume woman is in true labor until complete assessment is performed