Test 4

Question 1

Know what the bishop score is

Answer 1

it helps determine the cervical readiness for labor
⭐️Consists of 5 factors: Cervical consistency; position, dilation, effacement, and fetal station

Question 2

Oxytocin nursing considerations & complications

Answer 2

Induces labor, helps delivery of the placenta, and post partum hemorrhage, monitor for contractions >90 seconds as they may cause uterine rupture.
⭐️Complications: higher risk for c-section, hyper stimulation of the uterus with possible rupture, water retention, and fetal distress

Question 3

Gate control theory

Answer 3

⭐️ It involves distracting the women with nonpharmalogical pain relief methods such as staring at a painting they enjoy, breathing techniques (in hopes they can forget or minimize their pain)

Question 4

4. Decelerations nursing considerations and causes pg 194

Answer 4

• Early decelerations are caused by pressure on the fetal head as it meets resistance from the structures from the birth cancel, and requires normal continuous monitoring.
• Late decelerations are associated with uteroplacental insufficiency, indicating diminished blood flow to the uterus and placenta, intervention would be to position the women on her R/L side to relieve compression on the maternal abdominal aorta & inferior vena cava.
• Variable decelerations indicate acute umbilical cord compression, and require careful monitoring as cord compression can stress the fetus

Question 5

5. Reasons for episiotomies

Answer 5

⭐️Shoulder dystocia might lead to an episiotomy

Question 6

Nursing considerations during the second stage of labor and concerns

Answer 6

⭐️Full dilation of the Cervix marks the beginning of 2nd stage, the nurse should monitor length of contractions 90< second poses increase risk of rupture, expected findings: bloody show, pelvic pressure, early decelerations.

Question 7

7. Epidural anesthesia nursing considerations

Answer 7

⭐️If it is given to early it can prolong labor
HYPOTENSION is our priority with anesthesia and a nursing intervention would be to turn them on their left side to relieve pressure off of the vena cava.

Question 8

8. Cervical ripening

Answer 8

They include membrane stripping and mechanical dilation of the cervix with either a catheter or a laminaria

Question 9

Terbutaline K,H,K

Answer 9

⭐️It HALTS uterine contractions delaying labor, used to prevent labor, monitor for orthostatic hypotension, and increases HR > 130

Question 10

10. Admitted mom for preeclampsia nursing considerations

Answer 10

Initiate seizure precautions, monitor respirations, given magnesium sulfate, monitor neurological status, bed rest (side lying), accurate BP, daily weights, monitor fetal status.
⭐️ monitor for signs of Eclampsia

Question 11

Station, presentation, position, attitude (see slide)

Answer 11

⭐️Presentation- cephalic: will be below umbilicus, Breech: will be above umbilicus, fetal sacrum: R anterior quadrant
Position- R & L relation of the present in part of the maternal pelvis
Attitude- fetal parts in relation to each other
Station- position of the baby’s presenting part in relation to the ischial spines in the pelvis

Question 12

. VBAC contraindications

Answer 12

⭐️If they’ve had a classical uterine incision, placenta Previa , and a previous uterine rupture

Question 13

13. PROM nursing considerations

Answer 13

⭐️Monitor for infection, will be prescribed prophylactic antibiotics, pelvic rest in between contractions, and monitor fetal kick counts.

Question 14

True labor

Answer 14

⭐️True labor results in progressive effacement and dilation of the cervix

Question 15

15. Magnesium sulfate K,H,K

Answer 15

⭐️If they’ve dilated more than 3-4 cm they can not receive mag sulf.
Prevents & controls seizures, always given by iv infusion, keep calcium gluconate available in case of overdose, monitor for s/s of toxicity (decreased DTR, decrease LOC, Decrease RR)

Question 16

. Prolapsed cord nursing considerations

Answer 16

⭐️Place the client in a knee-chest or trendelenburg position, move the fetal presenting part off the cord with 2 fingers, cover part with warm, sterile, saline soaked towel.

Question 17

Ruptured uterus s/s

Answer 17

Dramatic onset of fetal bradycardia, “ popping” sensation on abdomen, excessive maternal pain (may radiate to the chest), unrelenting uterine contraction, vaginal bleeding is increased or bloody show, easily palpable fetal parts through abdominal wall, signs of maternal shock.

Question 18

18. Transition stage of labor

Answer 18

⭐️It is the most intense stage, and the nurse may assist the women to rest between contractions and pant to avoid pushing until the cervix is fully dilated

Question 19

Other NTK

Answer 19

Anticipatory signs of labor:
Burst of energy- they have that feeling that something is coming and begin to gain in energy in a sense of preparing themselves (nesting)

• Fetal HR 110 - 160 BPM
• relaxation techniques (gate control)- massage and deep breathing

• complications during the labor process
A) breech: FH tones above the clients umbilicus at midline
B) fetal distress: FHR below 110 or above 160. No variability or little
* turn them on their left, administer oxygen, d/c oxytocin
C) PTL: after 20 weeks and before 37, terbutaline will increase HR and weaken contractions