Labor And Birth Process

Question 1

What are the 5 Ps that effect labor?

Answer 1

-Passenger (fetus and placenta)
- passageway (birth canal)
- Powers (contractions)
-Postion of mother
-Psycholigcal response

Question 2

WhaT IS THE INTROITUS

Answer 2

External opening to the vagina

Question 3

What are the the 4 stages of labor?

Answer 3

Stage 1 - dialiation
Stage 2- from full dilation to birth
Stage 3- placenta up to like 5 mins after birth
Stage 4- first 2 to 4 hours post-Partum

Question 4

A nurse can consider the fetus’s head to be engaged when?
a. The presenting part moves through the pelvis
b. The fetal head rotates to pass through the ischial spines
c. The fetal head extends as it passes under the symphasis pubis
d. The biparietal diameter passes the pelvic inle

Answer 4

D

Question 5

When assessing a woman in labour, the nurse is aware that the relationship of the fetal body parts to one another is called fetal:

a. Lie
b. Presentation
c. Attitude
d. Position

Answer 5

C. Attitude

Question 6

What position is least effective when gravity is desired to assist in fetal descent?

a. Lithotomy
b. Kneeling
c. Sitting
d. Walking

Answer 6

a. Lithotomy

Question 7

A client is dilated to 4 cm. She’s asking for an epidural; however, her mother states that because of their culture, she has to “bite the bullet” as she did. What should the nurse do to make sure her client’s request is honoured?

a.Ask the client in a non-threatening way if it’s her wish to have an epidural
b.Honour the client’s mother’s request for no epidural
c.Knowing the client’s culture, have the family call a meeting to make the decision
d.Call anesthesiology and request that he perform the epidural because the client is uncomfortable

Answer 7

a.Ask the client in a non-threatening way if it’s her wish to have an epidural

Question 8

What is the Ferguson reflex?

Answer 8

The urges to push

Question 9

To detect fetal distress during labour, a nurse should be alert for which finding?

a.Fetal scalp pH of 7.14

b.Fetal heart rate of 144 beats/min

c.Acceleration of fetal heart rate with contractions

d.Presence of long term variability

Answer 9

c.Acceleration of fetal heart rate with contractions

Question 10

Which fetal heart rate would be expected in the fetus of a laboring woman who is full term?

a. 80-100 beats/min

b. 100-120 beats/min

c. 120-160 beats/min

d. 160-180 beats/min

Answer 10

Really 110-160

Question 11

A nurse is caring for a full-term pregnant client in active labour. The EFM reveals a fetal heart rate of less then 70 beats/min. The finding is considered:

a.Severe fetal bradycardia
b.Normal fetal heart rate
c.Fetal tachycardia
d.Moderate fetal bradycardia

Answer 11

a.Severe fetal bradycardia

Question 12

A nurse is monitoring a client in labour and the EFM reveals that the FHR drops with each contraction. What action should the nurse take?

a.Turn client to left side
b.Continue to observe FHR closely
c.Administer oxygen by face mask
d.Place the client in Trendelenburg position

Answer 12

c.Administer oxygen by face mask

Question 13

Variable decelerations in FHR during labour are severe dips occurring at the peak of contraction. This FHR problem is associated with which one of the following conditions?
a.utero-placental insufficiency
b.Fetal head compression
c.Uterine insufficiency
d.Pressure on the umbilical cord

Answer 13

d.Pressure on the umbilical cord

Question 14

A nurse is caring for a client in labour and I monitoring the FHR pattern. The nurse notes the presence of episodic accelerations on the electronic fetal monitor tracing. Which of the following actions is most appropriate?
a.Document the findings and tell the mother that the monitor indicates fetal well-being.
b.Take the mothers vital signs and tell the mother that bed rest is required to conserve oxygen
c.Notify the physician of the findings
d.Reposition the mother and check the monitor for changes in the fetal tracing

Answer 14

a.Document the findings and tell the mother that the monitor indicates fetal well-being.

Question 15

A nurse is admitting a pregnant client to the labour room and attaches an EFM to her abdomen. After attachment of the monitor, the initial nursing assessment is which of the following?
a.Identifying the types of accelerations
b.Assessing the baseline FHR
c.Determining the frequency of contractions
d.Determining the intensity of contractions

Answer 15

B) assessing the baseline FHR

Question 16

A nurse is monitoring a client in labour. The nurse suspects umbilical cord compression if which of the following is noted on the EFM during a contraction?
a.Early decelerations
b.Variable decelerations
c.Late decelerations
d.Short-term variability

Answer 16

b.Variable decelerations

Question 17

Nursing care measures are commonly offered to women in labour. Which nursing measure reflects application of the gate-control theory?

a. Massage the woman’s back.
b. Give the prescribed medication.
c. Encourage the woman to rest between contractions.
d. None of the above

Answer 17

The nursing measure that reflects the application of the gate-control theory is:

a. Massage the woman’s back.

Massaging the woman’s back can help stimulate sensory nerves that may “close the gate” to some of the pain signals from uterine contractions, providing relief and applying the principles of the gate-control theory.

Question 18

A woman in labour has just received an epidural block. The most important nursing intervention is to:

a. Limit parenteral fluids
b. Monitor the fetus for possible tachycardia
c. Monitor the maternal blood pressure for possible hypotension
d. Monitor the maternal pulse for possible bradycardia

Answer 18

c. Monitor the maternal blood pressure for possible hypotension

Question 19

what is invoultion and subinvoultion

Answer 19

–Involution: return of uterus to nonpregnant state following birth
•Progresses rapidly
–Fundus descends 1 to 2 cm every 24 hours
–2 weeks after childbirth uterus lies in true pelvis
•Subinvolution: failure of uterus to return to nonpregnant state
–Common causes are retained placental fragments and infection

Question 20

what is lochia and the 3 coulours?

Answer 20

lochia= postbirth utertine discharcharge

1. lochia rubra
2. lochia serosa
   3.lochia alba

Question 21

Review Question
In performing a routine fundal assessment, a nurse finds that a client’s fundus is boggy. What should the nurse do first?

a.Call the physician
b.Massage the fundus
c.Assess lochia flow
d.Obtain order for oxytocin

Answer 21

massage fundus

Question 22

A client is 3 days postpartum. She states that she hasn’t had a bowel movement since before delivery and is experiencing discomfort. She has had a fourth-degree tear. The nurse knows the best remedy is:

a.A suppository
b.An enema to alleviate gas pains quickly
c.Stool softeners and fluids
d.Pain medication for discomfort

Answer 22

c.Stool softeners and fluids

Question 23

post partum care, what does BUBBLEHE stand for?

Answer 23

-B - breasts
•U - uterus
•B – bladder
•B - bowel
•L - lochia
•E – episiotomy/perineum
•H – hemmorhoids/Homan’s Sign
•E - emotional

Question 24

SATA when a fetus most make the transtion to neonate it must do what?

A) spontaneous breathing
B) thermoregulation
C) The mom goes through sublimation
D) successful cardiopulmonary changes
E) Independent system functioning

Answer 24

all but C

Question 25

what are four ways to gain or lose heat?

Answer 25

conduction, radation, convention, evapouration

Question 26

neonate was delivered 1 hour ago. He’s pink with acrocyanosis and exhibits occasional shivering
movements of his upper extremities. Which nursing action should take priority?
a. Obtain vital signs
b. Provide warmth with swaddling
c. Perform a neurological assessment
d. Evaluate blood glucose

Answer 26

b. Provide warmth with swaddling

Question 27

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