Unit 1 - Reproduction

Question 1

Factors Affecting Labor: 5 P’s

Answer 1

• passenger (fetus)
• passageway (fetus)
• powers (physiological focus of labor)
• position (relation between fetus and passage)
• psychological considerations

Question 2

True Labor:

• _____ interval for contractions
• _____ in intensity and frequency
• _____ with rest

Answer 2

• regular interval for contractions
• increase in intensity and frequency
• unrelieved with rest

Question 3

False Labor:

• _____ intervals for contractions
• _____ _____ in durations and frequency
• contractions _____ with rest

Answer 3

• irregular intervals for contractions
• no change in durations and frequency
• contractions relieved with rest

Question 4

nulliparas

Answer 4

contractions 5 min. apart x 1 hour

Question 5

multiparas

Answer 5

contractions 6-8 min. apart x 1 hour

Question 6

contractions: duration

Answer 6

how long

- beginning of 1 contractions to the end of same contraction

Question 7

contractions: frequency

Answer 7

how often

- beginning of one contractions to beginning of next contraction

Question 8

acme

Answer 8

top line of contraction monitor

Question 9

increment

Answer 9

increase of line of contraction monitor

Question 10

decrement

Answer 10

decrease of line of contraction monitor

Question 11

Stages of Labor:

onset of contractions to complete cervical dilation

Answer 11

Stage 1

Question 12

3 phases of stage 1

Answer 12

latent
active
transitional

Question 13

Stages of Labor:

frequent monitoring of pt. & labor progression

Answer 13

Stage 1

Question 14

Stages of Labor:

complete cervical dilation to birth

Answer 14

Stage 2

Question 15

Pushing stage

Answer 15

Stage 2

Question 16

Stages of Labor:

birth to delivery of placenta

Answer 16

Stage 3

Question 17

Stages of Labor:

placenta is guided out as expelled

Answer 17

Stage 3

Question 18

What should you watch for in Stage 3

Answer 18

hemorrhage

Question 19

Stages of Labor:

initial recovery

Answer 19

stage 4

Question 20

Stages of Labor:

monitor VS as scheduled & lacerations degrees

Answer 20

Stage 4

Question 21

Stages of Labor:
will have slight decrease in BP, slight increase in HR, uterus will be midline & firm = normal (uterus will be palpable midline between symphysis pubis & umbilicus)

Answer 21

Stage 4

Question 22

Stage 4:

• slight _____ in BP
• slight _____ in HR
• uterus will be _____ & _____ = normal

Answer 22

• slight decrease in BP
• slight increase in HR
• uterus will be midline & firm = normal

Question 23

Maternal Physiological Responses to Labor and Delivery:

• cardiac output _____
• _____ distribution during a contraction
• BP _____
• BP can _____ due to supine hypotensive crisis, hypovolemia, hemorrhage, dehydration, metabolic acidosis, narcotics, and _____
• temperature _____
• respirations _____
• diaphoresis
• metabolic acidosis _____ by respiratory alkalosis
• metabolic acidosis quickly reverse to normal in the _____ stage because of change in/increased _____ rate
• renal activity _____

Answer 23

• cardiac output increases
• fluid distribution during a contraction
• BP increases
• BP can decrease due to supine hypotensive crisis, hypovolemia, hemorrhage, dehydration, metabolic acidosis, narcotics, and EPIDURALS
• temperature increases
• respirations increase
• diaphoresis
• metabolic acidosis uncompensated by respiratory alkalosis
• metabolic acidosis quickly reverse to normal in the 4th stage because of change in/increased respiratory rate
• renal activity increases

Question 24

What type of pain control is a epidural

Answer 24

regional

Question 25

Pain Control - Analgesia:

short acting, one injection directly into spinal fluid, can last up to 2 hours

Answer 25

spinal block

Question 26

Pain Control - Analgesia:

longer acting, catheter inserted into epidural space to allow continuous anesthesia

Answer 26

Epidural

Question 27

Pain Control - Analgesia:
Uses local anesthetic (lidocaine or bupivacaine), opioid analgesic injection for immediate relief into spinal fluid, and insertion of epidural catheter into epidural space for continuous anesthesia, may be controlled by PCA

Answer 27

*most common

CSE (Combined Spinal/Epidural)

Question 28

Pain Control - Analgesia:

Only for emergencies or if epidural contraindicated

Answer 28

General

Question 29

Normal FHR baseline should be…

Answer 29

110-160 bpm

Question 30

Need at least _____ minutes of monitoring and _____ minutes of consistent baseline tracing to determine baseline

Answer 30

10

2

Question 31

_____ tracing is gold standard for determining if baby is well oxygenated. This is when FHR has normal baseline with moderate variability and 2 or more accelerations in a 20 minute period.

Answer 31

“Reactive”

Question 32

Minimum timeframe for FHR monitoring is _____ minutes if tracing is reactive. Longer if there are alterations in tracings.

Answer 32

20

Question 33

Labor that progresses so rapidly (typically less than 3 hours from onset to delivery)

Answer 33

Precipitous Delivery

Question 34

Head delivers but not the shoulders; can be related to the size of the fetus but does occur in normal-sized fetus. Signs of impending _____ _____ include the slowing of progress or increasing formation of caput succedaneum; treatment is McRobert’s maneuver.

Answer 34

Shoulder dystocia

Question 35

Treatment for Shoulder dystocia

Answer 35

McRobert’s maneuver