1
Q
What is the single most important indicator of the progress of labor?
A
Cervical dilation is the single most important indicator of the progress of labor.
2
Q
When should vaginal examinations be avoided during labor assessment?
A
Vaginal examinations should be avoided in the presence of vaginal bleeding or until placenta previa or abruptio placentae is ruled out.
3
Q
List three factors that can affect the progress of labor.
A
Size of fetal head, fetal presentation, fetal lie, fetal attitude, and fetal position.
4
Q
In the first stage of labor, what are the cervical dilation parameters for the latent/early phase?
A
The latent or early phase is characterized by cervical dilation from 0 cm to 5 cm.
5
Q
In the first stage of labor, what are the cervical dilation parameters for the active phase?
A
The active phase is characterized by cervical dilation from 6 cm to 10 cm.
6
Q
What is the immediate first nursing assessment after a suspected rupture of membranes?
A
The first assessment should be the Fetal Heart Rate (FHR) to check for nonreassuring status due to a possible umbilical cord prolapse.
7
Q
A positive nitrazine paper test for amniotic fluid will turn what color, indicating what pH range?
A
The nitrazine paper will turn blue, indicating an alkaline pH of 6.5 to 7.5.
8
Q
When viewed under a microscope, amniotic fluid will exhibit what characteristic pattern?
A
Amniotic fluid will exhibit a frond-like ferning pattern.
9
Q
Why is it important for a laboring client to void every 2 hours?
A
A distended bladder can impede fetal descent through the birth canal and cause trauma to the bladder.
10
Q
A gentle circular stroking of the abdomen in rhythm with breathing during contractions is a nonpharmacological comfort measure known as _____.
A
effleurage
11
Q
During the transition phase of labor, a client’s statement about needing to have a bowel movement is often an indication of what?
A
This sensation is a finding of complete cervical dilation and fetal descent.
12
Q
The second stage of labor begins with _____ and ends with the birth of the fetus.
A
complete dilation and effacement of the cervix
13
Q
A first-degree perineal laceration extends through what tissues?
A
It extends through the skin of the perineum and does not involve the muscles.
14
Q
A second-degree perineal laceration extends through which tissues?
A
It extends through the skin and muscles into the perineum but not the anal sphincter.
15
Q
What structures are involved in a fourth-degree perineal laceration?
A
It extends through the skin, muscles, anal sphincter, and the anterior rectal wall.
16
Q
The appearance of the fetal head at the perineum is known as _____.
A
crowning
17
Q
The third stage of labor begins with the birth of the fetus and ends with what event?
A
The delivery of the placenta.
18
Q
List three clinical findings that indicate placental separation.
A
Fundus firmly contracting, a swift gush of dark blood from the introitus, and the umbilical cord appearing to lengthen.
19
Q
What is the primary focus of nursing care during the fourth stage of labor?
A
The focus is to maintain uterine tone and to prevent hemorrhage.
20
Q
During the first 2 hours of the fourth stage of labor, how often should the nurse assess maternal blood pressure and pulse?
A
Maternal blood pressure and pulse should be assessed every 15 minutes for the first 2 hours.
21
Q
What is an external cephalic version (ECV)?
A
It is an ultrasound-guided, hands-on procedure to externally manipulate the fetus into a cephalic lie, typically performed at 37 to 38 weeks.
22
Q
What is a major risk associated with an external cephalic version (ECV)?
A
There is a high risk of placental abruption, umbilical cord compression, and emergent cesarean birth.
23
Q
What is the purpose of a Bishop score?
A
A Bishop score is used to determine maternal readiness for labor by evaluating if the cervix is favorable for induction.
24
Q
A Bishop score of _____ or more for a client at 39 weeks of gestation is indicative of a successful induction.
A
8
25
What is the purpose of cervical ripening?
Cervical ripening increases cervical readiness for labor by promoting cervical softening, dilation, and effacement.
26
Name two chemical agents based on prostaglandins used for cervical ripening.
Misoprostol (prostaglandin E1) and Dinoprostone (prostaglandin E2).
27
What medication is administered to treat uterine tachysystole caused by cervical ripening agents?
A subcutaneous injection of terbutaline is administered.
28
Before administering oxytocin for labor induction, the nurse must confirm the fetus is engaged in the birth canal at a minimum of what station?
The nurse must confirm the fetus is at a minimum of station 0.
29
When administering oxytocin, how often should the FHR and contraction pattern be monitored during the second stage of labor?
The FHR and contraction pattern should be monitored every 5 minutes in the second stage of labor.
30
The oxytocin infusion should be discontinued if uterine contractions have a duration longer than how many seconds?
The infusion should be discontinued if the contraction duration is longer than 70 seconds.
31
What is the difference between induction and augmentation of labor?
Induction is the deliberate initiation of contractions before spontaneous onset, while augmentation is the stimulation of hypotonic contractions that have already begun spontaneously.
32
What is an amniotomy?
An amniotomy is the artificial rupture of the amniotic membranes (AROM) by a provider.
33
Prior to performing an amniotomy, what must be ensured to prevent cord prolapse?
The presenting part of the fetus must be engaged.
34
What is the primary purpose of an amnioinfusion?
An amnioinfusion is used to supplement the amount of amniotic fluid to reduce the severity of variable decelerations caused by cord compression.
35
What are two indications for an amnioinfusion?
Oligohydramnios and fetal cord compression.
36
What is caput succedaneum, which can occur after a vacuum-assisted birth?
Caput succedaneum is a swelling of the scalp in a newborn that usually disappears within 3 to 5 days.
37
A potential complication for a neonate after a forceps-assisted birth is facial nerve _____.
palsy
38
What is an episiotomy?
An episiotomy is an incision made into the perineum to enlarge the vaginal opening to facilitate birth and minimize soft tissue damage.
39
Which type of episiotomy is associated with a higher incidence of third- and fourth-degree lacerations?
The median (midline) episiotomy.
40
During a cesarean birth, why is a wedge placed under one of the client's hips?
A wedge is placed under a hip to prevent compression of the vena cava.
41
A tender uterus and foul-smelling lochia after a cesarean birth can indicate what complication?
These findings can indicate endometritis.
42
What is a major criterion for a client to be a candidate for a vaginal birth after cesarean (VBAC)?
The client must have one or two previous low transverse cesarean births with no other uterine scars.
43
What is a prolapsed umbilical cord?
It occurs when the umbilical cord is displaced, preceding the presenting part of the fetus, or protruding through the cervix.
44
What is the first and most critical nursing intervention for a prolapsed umbilical cord?
Using a sterile-gloved hand, insert two fingers into the vagina and apply pressure on either side of the cord to elevate the fetal presenting part off the cord.
45
What client position is recommended to relieve pressure on a prolapsed umbilical cord?
A knee-chest, Trendelenburg, or a modified lateral semi-prone recumbent position.
46
What type of FHR decelerations are characteristic of a prolapsed umbilical cord?
Variable or prolonged decelerations.
47
The passage of meconium into the amniotic fluid is often a result of fetal _____ that stimulates the vagal nerve.
hypoxia
48
If meconium-stained amniotic fluid is observed, what team should be notified to be present at the birth?
The neonatal resuscitation team should be notified.
49
Nonreassuring fetal status is present when the FHR is below _____/min or above _____/min.
110; 160
50
What is the recommended maternal position to improve uteroplacental perfusion in cases of nonreassuring fetal status?
A left side-lying position is recommended.
51
What is dystocia?
Dystocia is a difficult or abnormal labor related to the five P's of labor (passenger, passageway, powers, position, and psychologic response).
52
_____ uterine contractions are weak and inefficient, while _____ uterine contractions are excessively frequent, uncoordinated, and strong.
Hypotonic; hypertonic
53
In a persistent occiput posterior presentation, the client often reports greater _____ pain.
back
54
What maternal position can help a fetus rotate from a posterior to an anterior position?
Positioning the client on both hands and knees.
55
What is precipitous labor?
Precipitous labor is defined as labor that lasts 3 hours or less from the onset of contractions to the time of birth.
56
During a precipitous labor, how can a nurse control a rapid birth to prevent trauma?
By applying light pressure to the perineal area and fetal head, gently pressing upward toward the vagina.
57
What is a major maternal complication of precipitous labor?
Postpartum hemorrhage, uterine rupture, or cervical/vaginal/perineal lacerations.
58
What is a major fetal complication of precipitous labor?
Fetal hypoxia or fetal intracranial hemorrhage.
59
What classic symptom might a client report during a uterine rupture?
The client may report a sensation of "ripping," "tearing," or sharp pain.
60
What happens to fetal station during a complete uterine rupture?
There is a cessation of contractions and loss of fetal station.
61
What is an anaphylactoid syndrome of pregnancy, or amniotic fluid embolism?
It occurs when amniotic fluid infiltrates maternal circulation, travels to and obstructs pulmonary vessels, causing respiratory distress and circulatory collapse.
62
What are the three hallmark signs of an amniotic fluid embolism?
Indications of respiratory distress, coagulation failure, and circulatory collapse.
63
What is the single most important indicator of the progress of labor?
Cervical dilation.
64
A nurse should avoid vaginal examinations in the presence of vaginal bleeding until what two conditions are ruled out?
Placenta previa or abruptio placentae.
65
What are the five factors that affect the progress of labor?
Size of fetal head, fetal presentation, fetal lie, fetal attitude, and fetal position.
66
The first stage of labor lasts from the onset of regular uterine contractions to _____.
full effacement and dilation of the cervix.
67
What is the priority nursing assessment immediately after a suspected rupture of membranes?
Assess the Fetal Heart Rate (FHR) to check for umbilical cord prolapse.
68
Nitrazine paper used to verify ruptured membranes will turn what color in the presence of alkaline amniotic fluid?
Blue (indicating a pH of 6.5 to 7.5).
69
When viewed under a microscope, amniotic fluid will exhibit what characteristic pattern?
A frond-like ferning pattern.
70
Why should a laboring client be encouraged to void every 2 hours?
A distended bladder can impede fetal descent and cause trauma to the bladder.
71
During the active phase of the first stage of labor, how often should the nurse perform a temperature assessment if membranes have ruptured?
Every 2 hours.
72
Cervical dilation during the latent/early phase of the first stage of labor ranges from _____ to _____ cm.
0 to 5 cm.
73
Cervical dilation during the active phase of the first stage of labor ranges from _____ to _____ cm.
6 to 10 cm.
74
A client's statement expressing the need to have a bowel movement during the transition phase of labor often indicates what?
Complete cervical dilation and fetal descent.
75
What defines the second stage of labor?
It lasts from the time the cervix is fully dilated to the birth of the fetus.
76
During the second stage of labor, how frequently should the FHR be monitored?
Every 5 to 15 minutes, depending on fetal risk status.
77
Term: Crowning
Definition: The appearance of the fetal head at the perineum, when the vaginal area bulges.
78
A _____ degree perineal laceration extends through the skin and muscles into the perineum but not the anal sphincter.
second
79
A fourth-degree perineal laceration extends through the skin, muscles, anal sphincter, and the _____.
anterior rectal wall.
80
What defines the third stage of labor?
It lasts from the birth of the fetus until the placenta is delivered.
81
List three clinical findings that indicate placental separation.
Fundus firmly contracting, swift gush of dark blood from introitus, and the umbilical cord appears to lengthen.
82
What is the primary purpose of administering oxytocics during the third stage of labor?
To stimulate the uterus to contract and thus prevent hemorrhage.
83
What defines the fourth stage of labor?
It begins with the delivery of the placenta and includes at least the first 2 hours after birth.
84
During the first 2 hours of the fourth stage of labor, how often should the nurse assess maternal blood pressure and pulse?
Every 15 minutes.
85
What is the primary focus of nursing care during the fourth stage of labor?
To maintain uterine tone and to prevent hemorrhage.
86
Term: External cephalic version (ECV)
Definition: An ultrasound-guided, hands-on procedure to externally manipulate a malpositioned fetus into a cephalic lie.
87
An external cephalic version is typically performed at what gestational age?
37 to 38 weeks of gestation.
88
What medication is administered during an external cephalic version to relax the uterus?
Tocolytics.
89
What is a Bishop score used to determine?
Maternal readiness for labor by evaluating if the cervix is favorable for induction.
90
A Bishop score of _____ or more for a client at 39 weeks of gestation is indicative of a successful induction.
8
91
What is the purpose of cervical ripening?
To increase cervical readiness for labor through promotion of cervical softening, dilation, and effacement.
92
What are two chemical agents based on prostaglandins used for cervical ripening?
Misoprostol (prostaglandin E1) and Dinoprostone (prostaglandin E2).
93
If uterine tachysystole occurs after administration of a cervical-ripening agent, what medication should the nurse be prepared to administer?
Subcutaneous injection of terbutaline.
94
Prior to administering oxytocin for labor induction, the nurse must confirm the fetus is engaged in the birth canal at a minimum of what station?
Station 0.
95
When administering oxytocin, how often should the nurse monitor the FHR and contraction pattern during the first stage of labor?
Every 15 minutes.
96
Oxytocin should be discontinued if uterine contraction duration is longer than _____ seconds.
70
97
What is the primary nursing action for a nonreassuring FHR pattern during oxytocin infusion?
Position the client in a side-lying position to increase uteroplacental perfusion.
98
Term: Augmentation of labor
Definition: The stimulation of hypotonic contractions once labor has spontaneously begun, but progress is inadequate.
99
Term: Amniotomy
Definition: The artificial rupture of the amniotic membranes (AROM) by the provider.
100
Before performing an amniotomy, the provider must ensure the presenting part of the fetus is engaged to prevent what complication?
Cord prolapse.
101
Term: Amnioinfusion
Definition: The instillation of normal saline or lactated Ringer’s into the amniotic cavity to supplement amniotic fluid.
102
What are the two primary indications for an amnioinfusion?
Oligohydramnios and fetal cord compression causing variable decelerations.
103
What is a major risk associated with operative vaginal birth using a vacuum extractor?
Scalp lacerations, subdural hematoma, or cephalohematoma of the neonate.
104
A potential complication for a neonate after a forceps-assisted birth is injury to which cranial nerve?
Facial nerve (causing facial nerve palsy).
105
A _____ episiotomy extends from the vaginal outlet toward the rectum and is the most commonly used type.
median (midline)
106
When preparing a client for a cesarean birth, a wedge should be placed under one hip to prevent what condition?
Compression of the vena cava (supine hypotension).
107
A tender uterus and foul-smelling lochia after a cesarean birth can indicate what complication?
Endometritis.
108
What is a primary criterion for a client to be a candidate for a vaginal birth after cesarean (VBAC)?
One or two previous low transverse cesarean births with no other uterine scars.
109
Term: Prolapsed umbilical cord
Definition: When the umbilical cord is displaced, preceding the presenting part of the fetus, or protruding through the cervix.
110
What FHR pattern is characteristic of a prolapsed umbilical cord?
Variable or prolonged decelerations.
111
What is the immediate, priority nursing intervention for a prolapsed umbilical cord?
Using a sterile-gloved hand, insert two fingers into the vagina and apply pressure to the fetal presenting part to elevate it off the cord.
112
What client position change is recommended to relieve pressure on a prolapsed umbilical cord?
A knee-chest, Trendelenburg, or a modified lateral semi-prone recumbent position.
113
What is the underlying cause of meconium-stained amniotic fluid in a mature fetus?
Fetal hypoxia stimulates the vagal nerve, which induces peristalsis and relaxation of the anal sphincter.
114
Stained amniotic fluid accompanied by _____ or _____ decelerations in FHR is considered an ominous finding.
variable or late
115
Nonreassuring fetal status is present when the FHR is below _____/min or above _____/min.
110; 160
116
Term: Dystocia
Definition: A difficult or abnormal labor related to the five P's of labor (passenger, passageway, powers, position, psychologic response).
117
How does a hypotonic uterus feel upon palpation during a contraction?
It is easily indentable, even at the peak of contractions.
118
A client with a fetus in the persistent occiput posterior position will likely report greater pain in what area?
The back, as the fetus presses against the maternal sacrum.
119
What maternal position can help a fetus rotate from a posterior to an anterior position?
Hands and knees position.
120
Term: Precipitous labor
Definition: Labor that lasts 3 hours or less from the onset of contractions to the time of birth.
121
What type of uterine dysfunction is a major risk factor for precipitous labor?
Hypertonic uterine dysfunction.
122
During a precipitous labor, what instruction should the nurse give the client to help control the urge to push?
Encourage the client to pant with an open mouth between contractions.
123
What is a major maternal complication of a precipitous labor?
Cervical, vaginal, or perineal lacerations, uterine rupture, or postpartum hemorrhage.
124
A client reporting a sensation of "ripping" or "tearing" accompanied by cessation of contractions and loss of fetal station is likely experiencing what emergency?
Uterine rupture.
125
What are the classic manifestations of hypovolemic shock that can occur with a uterine rupture?
Tachypnea, hypotension, pallor, and cool, clammy skin.
126
Term: Anaphylactoid syndrome of pregnancy
Definition: An amniotic fluid embolism that occurs when amniotic fluid enters maternal circulation, obstructing pulmonary vessels and causing circulatory collapse.
127
What are the initial signs of an amniotic fluid embolism?
A sudden report of chest pain and/or sudden shortness of breath.
128
What severe coagulation problem can occur as a result of an amniotic fluid embolism?
Disseminated intravascular coagulopathy (DIC).
129
To assist with a prolapsed cord, the nurse applies a warm, sterile, _____-soaked towel to the visible cord.
saline
130
In which stage of labor are Apgar scores assigned to the newborn?
The third stage.
131
For a client with hypertonic contractions, the nurse should promote rest and place the client in what position?
A lateral position.
132
Is oxytocin administered for hypertonic contractions?
No, oxytocin is not administered for hypertonic contractions; it is used to augment hypotonic contractions.
133
For a client in the first stage of labor with intact membranes, how often should temperature be assessed?
Every 4 hours.
134
What is the single most important indicator of the progress of labor?
Cervical dilation.
135
When should vaginal examinations be avoided during labor assessment?
In the presence of vaginal bleeding or until placenta previa or abruptio placentae is ruled out.
136
What is the nurse's priority assessment when there is a suspected rupture of membranes?
Assess the Fetal Heart Rate (FHR) to check for nonreassuring status from a possible umbilical cord prolapse.
137
Why is it important for a laboring client to void every 2 hours?
A distended bladder can impede fetal descent through the birth canal and cause trauma to the bladder.
138
The first stage of labor lasts from the onset of regular uterine contractions until what event?
Full effacement and dilation of the cervix.
139
In the latent/early phase of the first stage of labor, the cervix dilates from 0 cm to _____ cm.
5
140
In the active phase of the first stage of labor, the cervix dilates from 6 cm to _____ cm.
10
141
What type of breathing pattern should be encouraged if a client has not learned a particular pattern during the active phase of labor?
A rapid pant-pant-blow breathing pattern.
142
A client's statement expressing the need to have a bowel movement during the active phase of labor is a finding of what?
Complete dilation and fetal descent.
143
What does a positive nitrazine paper test indicate, and what color does it turn?
It indicates the presence of alkaline amniotic fluid, and the paper turns blue.
144
Under a microscope, amniotic fluid will exhibit what characteristic pattern?
A frond-like ferning pattern.
145
What are the expected findings for normal amniotic fluid color and odor?
The fluid should be clear, the color of water, and free of odor.
146
How often should a laboring client's temperature be assessed after the membranes have ruptured?
Every 2 hours.
147
The second stage of labor lasts from the time the cervix is fully dilated until what event?
The birth of the fetus.
148
Term: Crowning
Definition: The appearance of the fetal head at the perineum, where the vaginal area bulges.
149
A first-degree perineal laceration extends through the skin of the perineum but does not involve the _____.
muscles
150
A third-degree perineal laceration extends through the skin, muscles, perineum, and the _____.
external anal sphincter muscle
151
A fourth-degree perineal laceration extends through the skin, muscles, anal sphincter, and the _____.
anterior rectal wall
152
During the second stage of labor, how often should FHR be monitored?
Every 5 to 15 minutes, depending on fetal risk status.
153
The third stage of labor lasts from the birth of the fetus until what event?
The placenta is delivered.
154
List two clinical findings that indicate placental separation from the uterus.
A swift gush of dark blood from the introitus and lengthening of the umbilical cord.
155
During the third stage of labor, why are oxytocics administered?
To stimulate the uterus to contract and thus prevent hemorrhage.
156
When does the fourth stage of labor begin and how long does it typically last?
It begins with the delivery of the placenta and includes at least the first 2 hours after birth.
157
During the first 2 hours of the fourth stage of labor, how often should the nurse assess maternal blood pressure and pulse?
Every 15 minutes.
158
What is the primary focus of nursing care during the fourth stage of labor?
To maintain uterine tone and to prevent hemorrhage.
159
What is an external cephalic version?
An ultrasound-guided, hands-on procedure to externally manipulate the fetus into a cephalic lie.
160
What medication is administered to relax the uterus before an external cephalic version?
Tocolytics.
161
What is the purpose of a Bishop score?
To determine maternal readiness for labor by evaluating whether the cervix is favorable.
162
List three of the five factors rated in a Bishop score.
Cervical dilation, cervical effacement, cervical consistency, cervical position, and station of the presenting part.
163
What is the goal of cervical ripening?
To increase cervical readiness for labor through promotion of cervical softening, dilation, and effacement.
164
Name one chemical agent based on prostaglandins used for cervical ripening.
Misoprostol (prostaglandin E1) or Dinoprostone (prostaglandin E2).
165
If uterine tachysystole occurs after administration of a cervical-ripening agent, what medication should the nurse administer?
A subcutaneous injection of terbutaline.
166
Before administering oxytocin for labor induction, the nurse must confirm that the fetus is engaged in the birth canal at a minimum of station _____.
0
167
What is the desired contraction frequency when titrating oxytocin for labor induction?
A frequency of 2 to 3 minutes.
168
The nurse should discontinue an oxytocin infusion if the contraction duration is longer than _____ seconds.
70
169
What is a key nursing action if a nonreassuring FHR pattern occurs during an oxytocin infusion?
Position the client in a side-lying position to increase uteroplacental perfusion.
170
Term: Augmentation of labor
Definition: The stimulation of hypotonic contractions once labor has spontaneously begun, but progress is inadequate.
171
What is an amniotomy?
The artificial rupture of the amniotic membranes (AROM) by the provider.
172
Prior to an amniotomy, the nurse must ensure that the presenting part of the fetus is _____ to prevent cord prolapse.
engaged
173
What is an amnioinfusion?
The instillation of normal saline or lactated Ringer's into the amniotic cavity to supplement the amount of amniotic fluid.
174
An amnioinfusion is primarily indicated to reduce the severity of variable decelerations caused by what issue?
Cord compression.
175
What neonatal complication is a risk associated with an operative vaginal birth with a vacuum extractor?
Scalp lacerations, subdural hematoma, or cephalohematoma.
176
Term: Caput succedaneum
Definition: Swelling of the scalp in a newborn that usually disappears within 3 to 5 days, often seen after vacuum-assisted birth.
177
Compression of the umbilical cord between the fetal head and forceps will cause what change in the FHR?
A decrease in the FHR.
178
What is a median (midline) episiotomy?
An incision that extends from the vaginal outlet toward the rectum.
179
During a cesarean birth, why is the client positioned with a wedge under one hip?
To prevent compression of the vena cava.
180
A tender uterus and foul-smelling lochia after a cesarean birth can indicate what complication?
Endometritis.
181
What is a key criterion for a client to be a candidate for a vaginal birth after cesarean (VBAC)?
One or two previous low transverse cesarean births with no other uterine scars.
182
What is a prolapsed umbilical cord?
An event where the umbilical cord is displaced, preceding the presenting part of the fetus, or protruding through the cervix.
183
What is the nurse's immediate, priority action upon discovering a prolapsed umbilical cord?
Using a sterile-gloved hand, insert two fingers into the vagina and apply pressure on either side of the cord to the fetal presenting part to elevate it off of the cord.
184
What maternal position is used to relieve pressure on a prolapsed umbilical cord?
A knee-chest, Trendelenburg, or a modified lateral semi-prone recumbent position.
185
A prolapsed umbilical cord often causes what type of FHR decelerations?
Variable or prolonged decelerations.
186
Meconium-stained amniotic fluid is often associated with fetal hypoxia, which stimulates the _____ nerve in mature fetuses.
vagal
187
What is the appropriate nursing action if a newborn is crying vigorously immediately after birth despite meconium-stained fluid?
Place the newborn skin to skin with the mother and continue to assess.
188
What FHR is considered nonreassuring?
A rate below 110/min or above 160/min.
189
Term: Dystocia
Definition: A difficult or abnormal labor related to the five P's of labor (passenger, passageway, powers, position, and psychologic response).
190
A hypotonic uterus is easily indentable, even at the _____ of contractions.
peak
191
In the case of a persistent occiput posterior position, what maternal position can help the fetus rotate to an anterior position?
The hands and knees position.
192
Term: Precipitous labor
Definition: Labor that lasts 3 hours or less from the onset of contractions to the time of birth.
193
Hypertonic uterine dysfunction involves contractions that are too frequent and long, and do not allow for _____ of the uterine muscle between contractions.
relaxation
194
During a precipitous labor, what should the nurse encourage the client to do to control the urge to push?
Pant with an open mouth between contractions.
195
To control a rapid birth and prevent trauma, the nurse should apply light pressure to the perineal area and the _____.
fetal head
196
What is a uterine rupture?
A tear in the wall of the uterus, which can be complete (involving the uterine wall and peritoneal cavity) or incomplete (dehiscence at a prior scar).
197
What clinical finding is a classic sign of a complete uterine rupture?
Cessation of contractions and loss of fetal station.
198
A client with a uterine rupture may report a sensation of "ripping" or "_____."
tearing
199
What is an anaphylactoid syndrome of pregnancy, also known as an amniotic fluid embolism?
A rupture in the amniotic sac or maternal uterine veins causes infiltration of amniotic fluid into the maternal circulation, leading to respiratory distress and circulatory collapse.
200
An amniotic fluid embolism can lead to serious coagulation problems such as _____.
disseminated intravascular coagulopathy (DIC)
201
What is the primary nursing intervention for a client experiencing an amniotic fluid embolism?
Administer oxygen, assist with intubation and mechanical ventilation, and perform CPR if necessary.
202
What is the expected FHR range?
110 to 160 beats per minute.
203
What is effleurage?
Gentle circular stroking of the abdomen in rhythm with breathing during contractions to provide comfort.
204
What is a major risk of an amniotomy?
An increased risk for cord prolapse or infection.
205
Post-cesarean birth, what nursing intervention helps prevent thrombus formation?
Encouraging ambulation.
206
For a client receiving oxytocin, the nurse should monitor maternal blood pressure, pulse, and respirations every _____ minutes and with every change in dose.
30 to 60
207
A client receiving oxytocin has a uterine resting tone greater than 15 mm Hg between contractions. What should the nurse do?
Discontinue the oxytocin infusion.
208
What fetal presentation is a contraindication for an operative vaginal birth with a vacuum extractor?
Any presentation other than vertex.
209
A fetus in a breech or transverse position is a potential indication for what procedure at 37-38 weeks gestation?
External cephalic version.
210
Failure of the cervix to dilate and efface or failure of labor to progress are indications for what procedure?
Cervical ripening.
OB Proctor Exam ATI
flashcards
Decks in class (11)
# Cards
