L&B 5b/Second stage of Labor/Nursing Interventions

Question 1

Second stage of labor: Assessment/Perineal Laceration

1) 3rd and 4th degree lacerations most commonly occur after ___1___?

Answer 1

Assessment/Perineal Laceration
1) Midline episiotomy

(Hogan 164)

Question 2

Second stage of labor: Assessment/Perineal Laceration

1) 1st degree laceration of perineum or surrounding tissue involves?

Answer 2

1) Only epidermal layers, if no bleeding may not need repair

(Hogan 164)

Question 3

Second stage of labor: Assessment/Perineal Laceration

1) 2nd degree laceration of perineum or surrounding tissue involves?

Answer 3

1) Epidermal and muscle/fascia involvement that requires suturing

(Hogan 164)

Question 4

Second stage of labor: Assessment/Perineal Laceration

1) 3rd degree laceration of perineum or surrounding tissue involves?

Answer 4

1) Extends into rectal sphincter

Hogan 164

Question 5

Second stage of labor: Assessment/Perineal Laceration

1) 4th degree laceration of perineum or surrounding tissue involves?

Answer 5

1) Extends through rectal wall (mucosa)

Hogan 164

Question 6

Second stage of labor: Documentation

1) Document in pt record (5)

Answer 6

1) Time of birth
2) Gender
3) Position
4) Nuchal cord (umbilical cord around the neonate neck
(if present)
5) Medications administered

(Hogan 164)

Question 7

Second stage of labor: Evaluation

Pt states is able to cope with ___1___ and ___2___; maternal and fetal ___3___ maintained through delivery.

Answer 7

1) Contractions
2) Pushing
3) Well-being

(Hogan 164)

Question 8

Second stage of labor: Assessment/Vital Signs

1) Assessed how often?

Answer 8

1) BP, R, HR; every 5-15 mins

Hogan 163

Question 9

Second stage of labor: Assessment/Contractions

1) Assessed how often?

Answer 9

1) Contractions palpated continuously

Hogan 163

Question 10

Second stage of labor:  Assessment/Fetal Heart Rate
Assessed how often? 
1)  Low risk
2)  High risk
3)  If nonreassuring FHR

Answer 10

1) Low risk FHR q15 min
2) High risk FHR q5 min
3) If nonreassuring FHR pattern monitor continuously

(Hogan 163)

Question 11

Second stage of labor: Implementation and collaborative care/Bladder

1) Empty or Full?
2) Straight catheter if (2)

Answer 11

1) Empty bladder
2) Straight catheter if bladder distended or unable to void

(Hogan 163)

Question 12

Second stage of labor: Implementation and collaborative care/Anesthetic Agent

Answer 12

1) Local infiltration administered during 2nd stage of labor by HCP

Question 13

Second stage of labor: Implementation and collaborative care/Episiotomy

1) Usually done when
2) Medically indicated (2)
3) Name 2 types of Episiotomy(s)

Answer 13

1) During or just prior to crowning
2) Medically indicated in the presence of Fetal distress or to prevent tearing
3) Midline: 1-3cm straight back and Mediolateral: 4-5cm from vagina to buttock.

(Hogan 164) Reference for Episiotomy advantages and disadvantages

Question 14

Second stage of labor: Assessment/Monitor Fetal (3)

Answer 14

1) Cardinal Fetal Movements

2) Crowning