Labor & Delivery

Question 1

5 P’s affecting Labor

Answer 1

1. passenger
2. passageway
3. power
4. position
5. psychological response

Question 2

Passenger (slapp)

Answer 2

1. fetal size
2. fetal lie
3. fetal attitude
4. fetal position
5. fetal presentation

Question 3

fetal presentation

Answer 3

what part is lowest in pelvis (closest to cervix)

cephalic (head)
breech (feet)

Question 4

fetal lie

Answer 4

vertical or horizontal orientation of fetus

Question 5

fetal attitude

Answer 5

level of flexion- curled not extended

Question 6

fetal position

Answer 6

how baby rotates

Question 7

Passageway

Answer 7

o upper pelvis= false, no part in child bearing (fundus)

o lower pelvis= true pelvis (ischium)

Question 8

Pelvis shapes

Answer 8

Gynecoid= good

android, anthropoid, patypelloid

Question 9

Power

Answer 9

• involuntary contracting of the uterine muscle

* voluntary efforts of the mother to expel the fetus at the time of delivery

Question 10

Psychiological response

Answer 10

 release of catecholamine (adrenal hormones) increase fear and anxiety and actually impede contractions, slowing labor

Question 11

Stages of Labor (4)

Answer 11

1st stage- start of contractions to 10cm
(latent 0-3cm, active 3-8cm, transitional 8-10cm)
2nd stage-delivery of baby
3rd stage- delivery of placenta
4th stage- 2 hours after

Question 12

Medications

Answer 12

•	Opioid agonist analgesics
o	Demeral
o	Fentanyl
•	Opioid agonist-antagonist analgesics		
o	Stadol
o	Nubain
•	Tranquilizers
o	Vistaril
o	Phenergan
•	Opioid antagonists
o	given to counteract effects of narcotics
o	Narcan

Question 13

anesthesia (4)

Answer 13

1. pudenal block
2. spinal
3. epidural
4. general

Question 14

fetal heart rate assessment (tsdd)

Answer 14

• The time of onset
• The shape of the deceleration
• The depth of the deceleration
• The duration of the deceleration

Question 15

Interventions for decelerations

Answer 15

change mom position
Correct hypotension, increase IV rate
Discontinue oxytocin
Administer O2 at 8-10 L/min via MASK
Vaginal exam with scalp stimulation and to assess for cord prolapse
Contact provider

Question 16

APGAR

Answer 16

respiration, heart rate, ski color, muscle tone, reflexes