OB Midterm L&D Flashcards
Why is it important to keep bladder empty while mom is getting ready to give birth?
So the babys head can come down
what can happen if mom tries to push and she is only at 8cm?
this can cause swelling or tearing of the cervix
what is the purpose of an epiostomy?
to prevent pressure on the babys head
what is it called when babys head is above 0 station?
Floating, When its at the cervical opening its called Crowning
The nurse examines a woman 1 hour after birth. The woman’s fundus is boggy, midline, and 1 cm below the umbilicus. Her lochial flow is profuse, with two plum-sized clots. The nurse’s initial action would be to:
massage her fundus (This is confirmed by the profuse lochia and passage of clots. The first action would be to massage the fundus until firm. The physician can be called after massaging the fundus, especially if the fundus does not become or remain firm with massage. Methergine can be administered after massaging the fundus, especially if the fundus does not become or remain firm with massage.)
A nurse is caring for a client whose labor is being augmented with oxytocin. The nurse recognizes that the oxytocin should be discontinued immediately if there is evidence of:
A fetal heart rate (FHR) of 180 with absence of variability (The oxytocin should be discontinued if uterine hyperstimulation occurs. Uterine contractions that occur every 8 to 10 minutes do not qualify as hyperstimulation)
A pregnant woman’s amniotic membranes rupture. Prolapsed cord is suspected. Which intervention is the nurse’s top priority?
Place the woman in the knee-chest position.
What condition indicates concealed hemorrhage when the patient experiences an abruptio placentae?
a. Decrease in abdominal pain b.Bradycardia
c. Hard, boardlike abdomen d.Decrease in fundal height
ANS: C Concealed hemorrhage occurs when the edges of the placenta do not separate. The formation of a hematoma behind the placenta and subsequent infiltration of the blood into the uterine muscle results in a very firm, board like abdomen. Abdominal pain may increase. The patient will have shock symptoms that include tachycardia. As bleeding occurs, the fundal height will increase.
The most prevalent clinical manifestation of abruptio placentae (as opposed to placenta previa) is:
a.Bleeding c.Uterine activity b.Intense abdominal pain d.Cramping
ANS: B Pain is absent with placenta previa and may be agonizing with abruptio placentae.
The nurse caring for pregnant women must be aware that the most common medical complication of pregnancy is:
a.Hypertension b.Hyperemesis gravidarum c.Hemorrhagic complications d.Infections
ANS: A Preeclampsia and eclampsia are two noted deadly forms of hypertension
A primigravida is being monitored in her prenatal clinic for preeclampsia. What finding should concern her nurse?
a. Blood pressure (BP) increase to 138/86 mm Hg
b. Weight gain of 0.5 kg during the past 2 weeks
c. A dipstick value of 3+ for protein in her urine
d. Pitting pedal edema at the end of the day
(ANS: C Proteinuria is defined as a concentration of 1+ or greater via dipstick measurement)
Signs that precede labor include (Select all that apply):
a.Lightening b.Exhaustion c.Bloody show d.Rupture of membranes e.Decreased fetal movement
ANS: A, C, D Signs that precede labor may include lightening, urinary frequency, backache, weight loss, surge of energy, bloody show, and rupture of membranes
Which occurrence is associated with cervical dilation and effacement?
a.Bloody show b.False labor c.Lightening d.Bladder distention
ANS: A. Bloody Show. As the cervix begins to soften, dilate, and efface, expulsion of the mucous plug that sealed the cervix during pregnancy occurs.
To teach patients about the process of labor adequately, the nurse knows that which event is the best indicator of true labor?
a. Bloody show c. Fetal descent into the pelvic inlet
b. Cervical dilation and effacement d. Uterine contractions every 7 minutes
(ANS: B The conclusive distinction between true and false labor is that contractions of true labor cause progressive change in the cervix. )
The factors that affect the process of labor and birth, known commonly as the five Ps, include all except:
a. Passenger. c. Powers.
b. Passageway. d. Pressure.
(ANS: D The five Ps are passenger (fetus and placenta), passageway (birth canal), powers (contractions), position of the mother, and psychologic response.)
The nurse would expect which maternal cardiovascular finding during labor?
a. Increased cardiac output
b. Decreased pulse rate
c. Decreased white blood cell (WBC) count
d. Decreased blood pressure
(ANS: A During each contraction, 400 mL of blood is emptied from the uterus into the maternal vascular system. This increases cardiac output by about 51% above baseline pregnancy values at term.)
