Intra-partum

Question 0

1st stage

Active

Answer 0

4-7 cm
Q2-5 min, 40-60 sec
Monitor q15-30 min

Question 1

1st stage of labor

Latent

Answer 1

0-3 cm
Contractions 5-10 minutes, 30-45 seconds
Monitor vs and FSH q30-60 min

Question 2

1st stage

Transition

Answer 2

8-10 cm
Q1.5-3min, 45-90sec
Monitor q5-10 min

Question 3

Fentynal (opioid, mu)
Dosage
Onset
Duration

Answer 3

0.5 - 1 mcg/kg– 50-100mcg, who ur up to 4 times, over a minimum of 1-2 minutes
Onset 3-5 min
Duration 30-60 minutes

Question 4

Cervical ripening

Answer 4

Misoprostol-Cytotek

Dinoprestone-cervadil

Question 5

Misoprostol
Onset
Duration

Answer 5

Cytotec--oral
25mg
30 min
3-6 hr
Use with caution with:
5 or more previous pregnancies
Previous c-sec
Can cause uterine rupture.

Question 6

Bishop’s score

Answer 6

A numerical value assigned by physician that pertains to the positive outcome of labor induction.
The thither the number the more positive the outcome.
0-12

Question 7

Oxytocin

Dosage

Answer 7

1 mu/hour
Increments of 1-2 mu/hour q15 min until contractions are 3-5 minutes apart for 10 min.
If concentration is 20mu/L, then 2 mu/hour would be 1mL/h

Question 8

Functional Dystocia

Answer 8

Powers are not working well

Prolonged, inertia, abnormal contractions

Question 9

Mechanical Dystocia

Answer 9

Macros omit
Malpresentation
Malposition

Question 10

Epidural contraindications

2

Answer 10

Clotting disorders/meds

platelets under 50,000

Question 11

How often do you take VS after administration of test dose for epidural?

Answer 11

Q2min for 15 minutes

If in vien, pt will be dizzy, tinnitus, blurred vision, LOC

Question 12

Uterine irritability
Causes
4

Answer 12

Placental abruption
Dehydration
Infection

Question 13

Causes of excessive uterine activity

3

Answer 13

Artificial stimulants
Uterine over distension
Abruptio Placentae

Question 14

Arrested labor

Answer 14

Progression stops for more than 2 hours

Question 15

Arrest of descent

Answer 15

Second stage is longer than 3 hours with anesthesia, longer than 2 hours without.

Question 16

Coupling or tripling of contractions
Interventions
4

Answer 16

DC oxy
Lateral position
Fluid bolus
Wait 30 minutes before restarting oxy

Question 17

When to suspect choriamnionitis

3

Answer 17

Temp >100.4
HR>120
FHR >160

Question 18

Asphyxial injury with shoulder dystocia, how long do you have?

Answer 18

6-8 minutes

Question 19

Steps for epidural placement

Answer 19

Bolus of 500mL LR
Monitor baby for 30 minutes prior
Mom's baseline BP, set cuff for q2min
O2 monitor on
Platelet count of >55,000

Question 20

Epidural monitoring

Answer 20

BP q15
Temp Qhour
RR
Constant fetal monitoring
No higher than T5
Instruct use of the PCA