NR 327 Maternal Exam 1 Questions and Answers;
Chamberlain College of Nursing
5ps of labor - ANSPassage
Powers
Psyche
Passenger
Position
Abnormal CST - ANSPositive
Presence of decels
-Baby cannot tolerate labor
Abruptio placenta - ANSPremature separation of placenta from uterine wall
-Will cause bleeding
Abruptio placetae - ANSPlacenta separating from uterine wall prematurely
-Causes problems with oxygenation
-US is done to detect separation
May be sudden onset
Sudden severe pain
Rigid abdomen
Signs of shock
Accel - ANSAbrupt increase of 15bpm lasting for 15 seconds
-Want to see 3-4 in a 30 minute period
Accels and Decels - ANSVEAL CHOP
Variable = cord
Early = head
Acceleration = oxygenated (ok)
Late = placenta
Active labor - ANS-Lasts on average 3-5 hours
-Nurse checks pelvic exam
-Contractions stronger, regular 45-90 seconds long
-Cervical dilation 4-7cm
-Up to 100% effacement
-Pt may have spotting
-Pt may have pain
Adverse effects of pharmacological pain management - ANSNeonate respiratory
depression
Adverse effects of spinal anesthesia - ANSHypotension
Fetal bradycardia
Spinal headache d/t leakage of cerebrospinal fluid
Loss of bearing down reflex
,NR 327 Maternal Exam 1 Questions and Answers;
Chamberlain College of Nursing
Inability to feel urge to void
After completion of version - ANSEFM for 4 hours
Assess contractions
Can be discharged once contractions have subsided
If not in labor, pt may go home
-If unsuccessful, pt scheduled for c/s
Amniocentesis - ANSDone after 14 weeks
US guided, invasive, needs consent
-Looks at protein levels in amniotic fluid to detect abnormalities
Amniotic fluid - ANSProtects growing fetus
Maintains stable temp
Provides cushion
Promotes normal fetus development
Amniotic fluid volume - ANSPresent: 1 vertical pocket >2cm, AFI >5cm
Absent: Absent pockets; large pocket ≤2cm, AFI <5
Amniotomy - ANSBaby has to be at 0 station to prevent umbilical cord prolapse
-Done by provider
-Must be on EFM continuously
-Priority if fetal HR followed by TACO
Analgesia - ANSOptions for managing pain during stage 1
-Reduce anxiety
-Promote sleep
-Early latent phase of labor
-Sedative hypnosis
AROM - ANSArtificial rupture of membranes
-Done by provider
-Best time is when baby is at ischial spine (station: 0)
-If head is too high, risk for umbilical cord prolapse
Assessing incision - ANSREEDA
Redness
Edema
Ecchymosis
Drainage
Approximation of edges
Assessing rupture of membranes - ANSTACO
T: time
, NR 327 Maternal Exam 1 Questions and Answers;
Chamberlain College of Nursing
A: amount
C: color (cloudy, clear)
-Green (meconium)
-Yellow (urine)
O: odor (earthy, semen like)
-Stinky (infection)
-Ammonia (urine)
Augmentation - ANSPatient is contracting, cervix is dilated, soft, bag of water is
ruptured
Candidates: SROM, True labor
Ballotement - ANSuterus will rebound when pushed
Baseline fetal HR - ANS110-160bpm
-Pt should be on EFM for 20 mins in order to determine baseline
Beta HCG - ANSBlood draw
Urine HCG: may give false positive
Betamethasone - ANSSteriod
Prevents respiratory depression
-1 dose Q24 hours for 2 days
-12mg IM x 2 doses
Bicornate uterus - ANSMore likely to start contracting early, will not accommodate
growing baby
Biophysical profile - ANSDone by ultrasound
8 is normal
10 possible
-Fetal breathing (2)
-Fetal movements (2)
-Fetal tone (2)
-AFI volume (2)
-Fetal accelerations (2)
Bleeding in early pregnancy - ANSMiscarriage (SAB)
-<20 weeks
-<500g
-50% genetic
Bonding-Kangaroo care - ANSSkin on skin
Bonding-Kangaroo care and breastfeeding - ANSPromotes contractions
Chamberlain College of Nursing
5ps of labor - ANSPassage
Powers
Psyche
Passenger
Position
Abnormal CST - ANSPositive
Presence of decels
-Baby cannot tolerate labor
Abruptio placenta - ANSPremature separation of placenta from uterine wall
-Will cause bleeding
Abruptio placetae - ANSPlacenta separating from uterine wall prematurely
-Causes problems with oxygenation
-US is done to detect separation
May be sudden onset
Sudden severe pain
Rigid abdomen
Signs of shock
Accel - ANSAbrupt increase of 15bpm lasting for 15 seconds
-Want to see 3-4 in a 30 minute period
Accels and Decels - ANSVEAL CHOP
Variable = cord
Early = head
Acceleration = oxygenated (ok)
Late = placenta
Active labor - ANS-Lasts on average 3-5 hours
-Nurse checks pelvic exam
-Contractions stronger, regular 45-90 seconds long
-Cervical dilation 4-7cm
-Up to 100% effacement
-Pt may have spotting
-Pt may have pain
Adverse effects of pharmacological pain management - ANSNeonate respiratory
depression
Adverse effects of spinal anesthesia - ANSHypotension
Fetal bradycardia
Spinal headache d/t leakage of cerebrospinal fluid
Loss of bearing down reflex
,NR 327 Maternal Exam 1 Questions and Answers;
Chamberlain College of Nursing
Inability to feel urge to void
After completion of version - ANSEFM for 4 hours
Assess contractions
Can be discharged once contractions have subsided
If not in labor, pt may go home
-If unsuccessful, pt scheduled for c/s
Amniocentesis - ANSDone after 14 weeks
US guided, invasive, needs consent
-Looks at protein levels in amniotic fluid to detect abnormalities
Amniotic fluid - ANSProtects growing fetus
Maintains stable temp
Provides cushion
Promotes normal fetus development
Amniotic fluid volume - ANSPresent: 1 vertical pocket >2cm, AFI >5cm
Absent: Absent pockets; large pocket ≤2cm, AFI <5
Amniotomy - ANSBaby has to be at 0 station to prevent umbilical cord prolapse
-Done by provider
-Must be on EFM continuously
-Priority if fetal HR followed by TACO
Analgesia - ANSOptions for managing pain during stage 1
-Reduce anxiety
-Promote sleep
-Early latent phase of labor
-Sedative hypnosis
AROM - ANSArtificial rupture of membranes
-Done by provider
-Best time is when baby is at ischial spine (station: 0)
-If head is too high, risk for umbilical cord prolapse
Assessing incision - ANSREEDA
Redness
Edema
Ecchymosis
Drainage
Approximation of edges
Assessing rupture of membranes - ANSTACO
T: time
, NR 327 Maternal Exam 1 Questions and Answers;
Chamberlain College of Nursing
A: amount
C: color (cloudy, clear)
-Green (meconium)
-Yellow (urine)
O: odor (earthy, semen like)
-Stinky (infection)
-Ammonia (urine)
Augmentation - ANSPatient is contracting, cervix is dilated, soft, bag of water is
ruptured
Candidates: SROM, True labor
Ballotement - ANSuterus will rebound when pushed
Baseline fetal HR - ANS110-160bpm
-Pt should be on EFM for 20 mins in order to determine baseline
Beta HCG - ANSBlood draw
Urine HCG: may give false positive
Betamethasone - ANSSteriod
Prevents respiratory depression
-1 dose Q24 hours for 2 days
-12mg IM x 2 doses
Bicornate uterus - ANSMore likely to start contracting early, will not accommodate
growing baby
Biophysical profile - ANSDone by ultrasound
8 is normal
10 possible
-Fetal breathing (2)
-Fetal movements (2)
-Fetal tone (2)
-AFI volume (2)
-Fetal accelerations (2)
Bleeding in early pregnancy - ANSMiscarriage (SAB)
-<20 weeks
-<500g
-50% genetic
Bonding-Kangaroo care - ANSSkin on skin
Bonding-Kangaroo care and breastfeeding - ANSPromotes contractions
