Labor and Delivery

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  1. List the 4 things of the contraction cycle
    • 1. Frequency
    • 2. Duration
    • 3. Intensity
    • 4. Interval
  2. T or F: The Lower uterine segment does 2/3 of the work, the upper does the other 1/3
  3. Before labor can occur, cervical changes occur. This includes the consistency of the feel going from (soft/firm) to (soft/firm)
    Firm to soft: consistency of a forehead, softens to eventually like a cheek.
  4. Just before labor, will the cervix shorten or lengthen?
  5. State how the maternal response will occur during labor:
    a. Cardiovascular: BV & BP?
    b. Respiratory
    c. GI (early and active labor signs)
    • a. Increase in blood volume by up to 1300ml. Increased BP during contractions
    • b. Increased depth and rate during breaths
    • c. n/v, diarrhea (early). decrease gastric motility (active labor)
  6. What nursing intervention should you do in regards to the woman's urinary system during labor?
    She will have a reduced bladder sensation, so help her to the bathroom to keep bladder empty
  7. State whether these will increase or decrease during labor:
    a. Leukocyte count
    b. Fibrinogen
    c. Fibrinolysis
    d. VT risk
    • a. increase
    • b. increase
    • c. decrease
    • d. increase

    Note: the decreased fibrin will effect blood clots, which will increase risk for DVT
  8. How does blood flow from placenta to uterus become affected during labor?
    Contractions causes intermittent interruption of blood flow during uterine contractions, which decreases perfusion
  9. What are the fetal compensatory characteristics during uterine contractions of labor? List what happens to HCT, O2, and Cardiac
    • To make up for the decreased perfusion:
    • - Elevated HCT levels
    • - Increased O2 capability of fetal hemoglobin
    • - Increased cardiac output of fetus
  10. T or F: a "bloody show" is a good sign during labor
    True: It is a mucusy discharge tinged pink or brown with blood. It means the blood vessels in the cervix are rupturing as it begins to efface and dilate
  11. T or F: After the first baby, fetal descent might not occur until going into labor
  12. After administering an epidural, what is the important step to employ to make sure the mother has enough sensation to push?
    "Laboring down," letting the baby go down the cervix.
  13. This important hormone is produced by the ovary and placenta which prepares the shape and consistency of the pelvis for labor.
    Relaxin: changes ball and socket joint, loosens pelvis, can give discomfort in women
  14. Which Lie or presentatioin might indicate a c-section?
    A face presentation
  15. How can the baby's position in the uterus cause lower back pain to the mom?
    When the occiput of the baby is against the lower back or spine of the mother
  16. This is when the shoulders line up in an anterior/posterior so the baby can be delivered:

    A. extension
    B. expulsion
    C. external rotation
    (this multiple choice question has been scrambled)
  17. Typically two to three weeks before term, the baby begins to drop. This means that its head is lowering in preparation for birth. It is here that we see the first cardinal movement:

    A. Expulsion
    B. Extension
    C. Engagement
    D. Internal Rotation
    (this multiple choice question has been scrambled)
  18. As the fetal head continues its downward passage into the pelvis, it enters the second cardinal movement:

    A. Expulsion
    B. Engagement
    C. Internal Rotation
    D. Descent
    (this multiple choice question has been scrambled)
  19. Why is it important to do a clean catch specimen when admitting to L&D?
    If there's any kind of irritation around the uterus, it can cause labor (like a bladder infection which can spread to the cervix)
  20. This term means contractions are inconsistent in frequency, duration, and intensity. The uterus has not figured it out.
    Prodromal Labor
  21. T or F: to help with Prodromal Labor, changes in activity will help alter the pattern
  22. These are common nursing interventions during labor:
    • Position changes
    • vaginal exams
    • assess for SROM
    • comfort measures
    • Fluids
  23. What must you check before giving pain meds?
    • Vitals
    • Status of labor
    • Fetal status
  24. Will you give IV meds before, during, or after contractions?
  25. The doppler and toco are external or internal fetal monitoring?
  26. The scalp electrode and IUPC are internal or external fetal monitoring
  27. List category I characteristics of FHR patterns
    • Tracings in this category predict normal acid-base status of fetus
    • Obtain baseline rate of 110-160 BPM
    • If Late or variable decelerations are absent
  28. If the baby is in category II of FHR patterns, are interventions needed to bring back to category I?
  29. What do you need to worry about of Category II inderterminate FHR?
    • it is subject to interpretation, which requires close observation
    • May progress to category III, needing emergent delivery
  30. What are characteristics of Category III FHR?
    • tracings show abrnomal acid-base status
    • absent variability 
    • recurrent late decelerations
    • bradycardia
    • Needs emergent delivery
  31. List 4th stage (after delivery) interventions
    • Clear airway
    • monitor color, respirations (blow by O2 prn)
    • Warm and dry
    • skin to skin
    • ID bracelet
    • watch for first void and meconium
Card Set:
Labor and Delivery
2017-08-28 05:41:56
MCN Exam 1
lecture notes
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