NM 704 EXAM 3 - COMPLETE QUESTIONS
AND DETAILED SOLUTIONS LATEST UPDATE THIS
YEAR JUST RELEASED
Question 1: What occurs hemodynamically during labor?
Answer:
blood volume increases 40-50%, increased in blood volume, Cardiac output
increases by 10-15% in the first stage of labor and 50% in the second stage of
labor due to increased stroke volume. BP and HR increases during contractions
and decreases between contractions
Question 2: What occurs with the respiratory rate during labor?
Answer:
higher requirement for oxygen during labor and decreased total lung capacity.
oxygen consumption increases during uterine contractions, inbetween contractions
it allows for reperfusion and restoration of oxygen to the myometrium. faliure to
restore causes lactic acid buildup and ischemic pain contributing to uterine pain
during labor
Question 3: What occurs hematologically during labor?
Answer:
coagulation factors are enhanced during labor and promote rapid hemostasis after
placental separation.
Peak in WBC does not indicate infection
Question 4: What happens to the GI system during labor?
Answer:
loose stools can occur prior to labor and promote prostaglandin release, during
labor GI motility is delayed, there is increased intra-abdominal pressure which can
cause N/V during the final stages of cervical dilation. Hemorrhoids can develop due
,to pushing and pressure of the fetal presenting part
Question 5: What occurs with pain and physiological response in
labor?
Answer:
anxiety and fear increase pain as well as previous experience
use interventions like massage to interrupt pain pathway, cognitive straities like
distraction and relaxation
Question 6: What is there to know about vaginal exams in labor?
Answer:
exams every 1-2 hours are not justifiable, observe outward signs for labor progress
such as changes in behavior, increase in bloody show, or an urge to push
vaginal exams should be done only if the outcome will change your management
Question 7: Food intake and labor
Answer:
poor nutrition during labor can be associated with longer labor and increase pain in
labor
patient can eat and drink as tolerated (clear liquids, light food, drink fluids low in
acid, sugar and salt)
Question 8: When should IV access and/or IV fluids
Answer:
-tolerate oral fluids or no
-necessary for epidural anesthesia and some antibiotics, pain meds, oxytocin
-saline lock may be beneficial for a birthing person at moderate or high risk of PPH
to allow for rapid use of IV uterotonics during and after the third stage of labor
Question 9: Potential hazard to the newborn of giving dextrose
containing intravenous hydration to laboring people
, Answer:
in large doses IV dextrose can cause fetal lactic acidosis, newborn jaundice and
hypoglycemia
Question 10: Indications for amniotomy
Answer:
Labor induction alone or with oxytocin
Question 11: Contraindications to amniotomy
Answer:
presence of HIV
known vasa previa-blood vessels on membrane
history of uterine rupture
Question 12: Adverse outcomes to amniotomy
Answer:
-risk for infection from prolonged labor and C/S birth
-Known or suspected vasa previa (Velamentous cord insertion and fetal vessel that
run freely overlying the cervix or in close proximity. low lying placenta and resolved
previas at risk too)
-Umbilical cord compression with FHR variable decels
-Umbilical cord prolapse (fetal head unengaged too high in the cervix!!!)
Question 13: Routine amniotomy vs amniotomy done as
intervention for slow labor
Answer:
-evidence show no shortening of the length of the first stage of labor and a possible
increase in C/S
-routine does not shorten labor by very much an average of 20 mins
Question 14: What does ACOG recommend for routine amniotomy?
AND DETAILED SOLUTIONS LATEST UPDATE THIS
YEAR JUST RELEASED
Question 1: What occurs hemodynamically during labor?
Answer:
blood volume increases 40-50%, increased in blood volume, Cardiac output
increases by 10-15% in the first stage of labor and 50% in the second stage of
labor due to increased stroke volume. BP and HR increases during contractions
and decreases between contractions
Question 2: What occurs with the respiratory rate during labor?
Answer:
higher requirement for oxygen during labor and decreased total lung capacity.
oxygen consumption increases during uterine contractions, inbetween contractions
it allows for reperfusion and restoration of oxygen to the myometrium. faliure to
restore causes lactic acid buildup and ischemic pain contributing to uterine pain
during labor
Question 3: What occurs hematologically during labor?
Answer:
coagulation factors are enhanced during labor and promote rapid hemostasis after
placental separation.
Peak in WBC does not indicate infection
Question 4: What happens to the GI system during labor?
Answer:
loose stools can occur prior to labor and promote prostaglandin release, during
labor GI motility is delayed, there is increased intra-abdominal pressure which can
cause N/V during the final stages of cervical dilation. Hemorrhoids can develop due
,to pushing and pressure of the fetal presenting part
Question 5: What occurs with pain and physiological response in
labor?
Answer:
anxiety and fear increase pain as well as previous experience
use interventions like massage to interrupt pain pathway, cognitive straities like
distraction and relaxation
Question 6: What is there to know about vaginal exams in labor?
Answer:
exams every 1-2 hours are not justifiable, observe outward signs for labor progress
such as changes in behavior, increase in bloody show, or an urge to push
vaginal exams should be done only if the outcome will change your management
Question 7: Food intake and labor
Answer:
poor nutrition during labor can be associated with longer labor and increase pain in
labor
patient can eat and drink as tolerated (clear liquids, light food, drink fluids low in
acid, sugar and salt)
Question 8: When should IV access and/or IV fluids
Answer:
-tolerate oral fluids or no
-necessary for epidural anesthesia and some antibiotics, pain meds, oxytocin
-saline lock may be beneficial for a birthing person at moderate or high risk of PPH
to allow for rapid use of IV uterotonics during and after the third stage of labor
Question 9: Potential hazard to the newborn of giving dextrose
containing intravenous hydration to laboring people
, Answer:
in large doses IV dextrose can cause fetal lactic acidosis, newborn jaundice and
hypoglycemia
Question 10: Indications for amniotomy
Answer:
Labor induction alone or with oxytocin
Question 11: Contraindications to amniotomy
Answer:
presence of HIV
known vasa previa-blood vessels on membrane
history of uterine rupture
Question 12: Adverse outcomes to amniotomy
Answer:
-risk for infection from prolonged labor and C/S birth
-Known or suspected vasa previa (Velamentous cord insertion and fetal vessel that
run freely overlying the cervix or in close proximity. low lying placenta and resolved
previas at risk too)
-Umbilical cord compression with FHR variable decels
-Umbilical cord prolapse (fetal head unengaged too high in the cervix!!!)
Question 13: Routine amniotomy vs amniotomy done as
intervention for slow labor
Answer:
-evidence show no shortening of the length of the first stage of labor and a possible
increase in C/S
-routine does not shorten labor by very much an average of 20 mins
Question 14: What does ACOG recommend for routine amniotomy?
