Intrapartum problems

Question 1

hypertonic dysfunction contractions

Answer 1

uncoordinated, irregular, poor intensity, short, painful, cramplike

Question 2

hypertonic dysfunction uterine resting tone

Answer 2

higher than normal

Question 3

hypertonic dysfunction phase of labor

Answer 3

latent phase

Question 4

hypertonic dysfunction therapeutic management

Answer 4

correct cause (dehydration, low BP)
sedation
hydration
tocolytics

Question 5

hypertonic dysfunction nursing care

Answer 5

promote rest, relaxation, pain relief, emotional support

Question 6

hypertonic dysfunction maternal risks

Answer 6

discomfort, fatigue, stress, dehydration, risk for infection

Question 7

hypertonic dysfunction fetal risks

Answer 7

fetal stress, prolonged pressure on head: caput, cephalhematoma, molding

Question 8

hypotonic dysfunction contractions

Answer 8

weak, coordinated, become less frequent/intense, minimal discomfort

Question 9

hypotonic dysfunction uterine resting tone

Answer 9

WNL

Question 10

hypotonic dysfunction phase of labor

Answer 10

active phase

Question 11

hypotonic dysfunction therapeutic management

Answer 11

amniotomy
oxytocin augmentation
c/s birth

Question 12

hypotonic dysfunction nursing care

Answer 12

interventions
position changes
ambulation

Question 13

hypotonic dysfunction maternal risks

Answer 13

emotional support
exhaustion
ineffective coping
pp hemorrhage
intrauterine infection

Question 14

hypotonic dysfunction fetal risks

Answer 14

fetal stress, sepsis

Question 15

ineffective maternal pushing

Answer 15

incorrect technique
fear, injury/pain
no urge
exhaustion
analgesia
psychological unreadiness to let go of baby

Question 16

problems with passenger (fetal size)

Answer 16

macrosomia- >4000grams, shoulder dystocia turtle sign

Question 17

problems with passenger (fetal malpresentation, malposition)

Answer 17

OP- maternal position changes
breech- ECV, C/S

Question 18

pelvic types

Answer 18

gynaecoid- ideal
android- poor for SVD
anthropoid
platypelloid

Question 19

maternal soft tissue obstruction

Answer 19

full bladder

Question 20

psyche llabor

Answer 20

stressful event (anxiety and fear)
exacerbates pain

Question 21

maternal responses to excessive/prolonged stress

Answer 21

• glucose consumption increased
• catecholamines secreted by adrenal glands (stimulate uterine beta receptors “tocolytic”, diverts blood to skeletal muscles

Question 22

PTSD

Answer 22

frequent outcome of increase fear, anxiety and loss of control in birth

Question 23

precipitous labor and birth contributing factors

Answer 23

-Hypertonic contractions with tetanic intensity (placental abruption, uterine tachysystole, recent cocaine use)
-Multiparity or Large pelvis and/or small fetus in favorable position
-Previous precipitous birth

Question 24

precipitous labor and birth maternal risks

Answer 24

Loss of coping abilities
Uterine rupture
Lacerations: cervix, vagina, perineum
Amniotic fluid embolism
Postpartum hemorrhage/placental abruption

Question 25

precipitous labor and birht fetal/neonatal risks

Answer 25

fetal stress, hypoxia
cerebral trauma

Question 26

precipitous labor and birth generate solutions

Answer 26

close monitoring in last few weeks of pregnancy to recognize cues
elective induction of labor
nursing actions
- care review of prenatal record
- in labor presence of either/or both indicates risk for precipitous birth accelerated cervical dilation and/or intense UCs with little relaxation between

Question 27

prolonged labor cephalopelvic disproportion

Answer 27

poor fit between maternal pelvis and fetus

Question 28

prolonged labor maternal implications

Answer 28

Prolonged labor: exhaustion, increased anxiety, fear
Risk for maternal infection
Uterine rupture if labor obstructed due to failure of fetal descent
Forceps assisted birth

Question 29

prolonged labor fetal implications

Answer 29

Prolapsed cord if head not engaged
Excessive molding
Fetal skull and neurological damage
risk for neonatal infection