Quiz #3 - Birth related procedures

Question 1

What is the purpose of an amniotomy?

Answer 1

Enables internal electronic fetal heart monitoring - done usually with induction of labor

Question 2

What are risks of an amniotomy?

Answer 2

Prolapse/compression of umbilical cord, risk for infection because of ROM, abruptio placentae (?)

Question 3

When would induction and augmentation be indicated?

Answer 3

Fetal compromise, SROM, postterm delivery, chorioamnionitis, HTN, fetal death

Question 4

When would induction and augmentation be contraindicated?

Answer 4

Placenta previa, vasa previa, abnormal presentation, umbilical cord prolapse, previous uterine surgery, non-reassuring FHR

Question 5

How can we do cervical ripening?

Answer 5

For induction - medical with prostaglandins or mechanical with a transcervical catheter, laminaria

Question 6

Nursing actions after amniotomy?

Answer 6

Vaginal exam, make sure FHR is still tracking (might see decels or variables)

Question 7

Why oxytocin for induction?

Answer 7

Causes uterus to contract - diluted in isotonic solution & given as secondary infusion

Question 8

What should we note about amniotic fluid?

Answer 8

TACO (time, amount, color, odor)

Question 9

How to recognize tachysystole?

Answer 9

Contractions with no breaks in between

Question 10

What is an external cephalic version?

Answer 10

If baby is not head down, they change position from breech or transverse to cephalic - done w/ ultrasound

Question 11

What is an internal version?

Answer 11

Sometimes used to change second twin position after first twin is born

Question 12

What complications could happen with a version?

Answer 12

Umbilical cord could wrap around fetus

Question 13

What is operative vaginal birth?

Answer 13

Traction applied to fetal head. Forceps used less than vacuum. Also during c-section to pull baby through incision.

Question 14

What trauma can occur to mother with operative delivery?

Answer 14

Laceration or hematoma

Question 15

What trauma can occur to fetus with operative delivery?

Answer 15

Ecchymosis, lacerations, abrasions, facial nerve injury, intracranial hemorrhage

Question 16

What is an episiotomy?

Answer 16

Incision of perineum just before birth

Question 17

What are indications of an episiotomy?

Answer 17

Fetal shoulder dystocia, forceps/vacuum birth, fetus in occiput posterior positio

Question 18

Cesarean birth rates have increased due to what?

Answer 18

Obesity, increased induction rate, delayed childbearing (later years)

Question 19

What are risks that come from C-section?

Answer 19

Infection, blood loss, resp distress in fetus (fluid NOT being squeezed out of lungs)

Question 20

What can happened after a VBAC? (vaginal birth after casarean)

Answer 20

Some mom’s feel inadequate after c-section. Low transverse uterine incisions reduce risk of rupture.

Question 21

Latent phase of labor (cm)

Answer 21

0-3cm

Question 22

Active phase of labor (cm)

Answer 22

3-7cm

Question 23

Transition phase of labor (cm)

Answer 23

7-10cm

Question 24

Pushing phase of labor (considered 2nd stage)

Answer 24

10cm-birth

Question 25

When are pregnant women tested for group B strep?

Answer 25

36-37 weeks

Question 26

1 in __ pregnant women carry GBS in their body.

Answer 26

4

Question 27

How can we prevent most early-onset GBS disease in newborns?

Answer 27

Giving pregnant women antibiotics in labor. Cannot get antibiotics before labor.