N434: Intrapartum SIE
test questions and
answers 2025
Signs of impending labor
contractions become more regular
presence of bloody show
nesting impulse
GI distress
wt loss (1-3lb)
lightening
Lightening
descent of fetus into birth canal
- occurs two weeks before birth (primi)
When does bloody show usually occur?
cervical mucous with bloody spots.
shows few days before labor or during labor
When having intercourse
Vaginal exam
What is a nesting impulse?
mom feels desire to get everything ready for baby
What is labor confirmed by?
cervical change
- effacement
- dilation
True labor signs and symptoms
contractions (regular and strong; get closer together)
contractions continue through movement
get stronger and increase pain level
False labor Signs and symptoms
,not regular or increase in frequency
stop with resting or change position
usually weak
When do we educate moms to come into the hospital for labor to be
evaluated?
411 rule
- new contraction every 4 minutes
- lasting 1 minute
- occur for 1 hr
Rupture of membranes
Decrease of fetal movement
What are the critical factors affecting labor and delivery?
powers
passageway
passenger
psyche
position
powers: Primary contractions
involuntary contractions
- FERFUSON reflex: baby drop into pelvis; push without knowing
powers: Secondary contractions
voluntary pushing when its time the phase of labor and push baby out
Phases of the contraction
Increment: increase in contraction - beginning
Peak or acme: tip or intense/painful part
Decrement: decline of contraction - end
What are characteristics of contractions?
Coordinated. uterus relaxes and contracts.
Involuntary: woman has no control
intermittent: with rest periods. important for the baby to get some
oxygenated blood flow during resting periods
Duration of contraction
seconds
- beginning to end of one contraction
Frequency of contraction
, beginning of one contraction to the beginning of another
[minutes/fraction of minute]
includes contraction and resting period
Interval of contraction
relaxation of uterus
Intensity of contraction
Nurse should place hands on abdomen to feel intensity
mild, moderate, strong
Mild: nose
Moderate: chin
Strong: forehead
Or measure the intensity with a monitor IUPC
Where do contractions take place?
upper 2/3 of uterus : most of the work
- allow cervix to dilate: cervix is passive factor
Why is it important for contractions to be intermittent?
allow perfusion of baby and uterus
Cervical effacement
thinning and shortening of cervix
Usually before labor the cervix is 2cm thick
represented with %
100% effaced: not feeling at all when
Cervical dilation
opening of cervical os from 0-10 cm
represented in cm.
The cervix is pulled upward and fetus is pushed downward which helps
dilate the cervix when baby's head is repeatedly pushing into the cervix
When do the pregnant woman begin to push for cervical dilation?
10 cm
Not earlier than that
Why is not recommended for woman to push earlier than 10 cm, even
9.5cm not recommended? why?
Because if woman pushes earlier could cause some edema and tearing of
that cervix.
test questions and
answers 2025
Signs of impending labor
contractions become more regular
presence of bloody show
nesting impulse
GI distress
wt loss (1-3lb)
lightening
Lightening
descent of fetus into birth canal
- occurs two weeks before birth (primi)
When does bloody show usually occur?
cervical mucous with bloody spots.
shows few days before labor or during labor
When having intercourse
Vaginal exam
What is a nesting impulse?
mom feels desire to get everything ready for baby
What is labor confirmed by?
cervical change
- effacement
- dilation
True labor signs and symptoms
contractions (regular and strong; get closer together)
contractions continue through movement
get stronger and increase pain level
False labor Signs and symptoms
,not regular or increase in frequency
stop with resting or change position
usually weak
When do we educate moms to come into the hospital for labor to be
evaluated?
411 rule
- new contraction every 4 minutes
- lasting 1 minute
- occur for 1 hr
Rupture of membranes
Decrease of fetal movement
What are the critical factors affecting labor and delivery?
powers
passageway
passenger
psyche
position
powers: Primary contractions
involuntary contractions
- FERFUSON reflex: baby drop into pelvis; push without knowing
powers: Secondary contractions
voluntary pushing when its time the phase of labor and push baby out
Phases of the contraction
Increment: increase in contraction - beginning
Peak or acme: tip or intense/painful part
Decrement: decline of contraction - end
What are characteristics of contractions?
Coordinated. uterus relaxes and contracts.
Involuntary: woman has no control
intermittent: with rest periods. important for the baby to get some
oxygenated blood flow during resting periods
Duration of contraction
seconds
- beginning to end of one contraction
Frequency of contraction
, beginning of one contraction to the beginning of another
[minutes/fraction of minute]
includes contraction and resting period
Interval of contraction
relaxation of uterus
Intensity of contraction
Nurse should place hands on abdomen to feel intensity
mild, moderate, strong
Mild: nose
Moderate: chin
Strong: forehead
Or measure the intensity with a monitor IUPC
Where do contractions take place?
upper 2/3 of uterus : most of the work
- allow cervix to dilate: cervix is passive factor
Why is it important for contractions to be intermittent?
allow perfusion of baby and uterus
Cervical effacement
thinning and shortening of cervix
Usually before labor the cervix is 2cm thick
represented with %
100% effaced: not feeling at all when
Cervical dilation
opening of cervical os from 0-10 cm
represented in cm.
The cervix is pulled upward and fetus is pushed downward which helps
dilate the cervix when baby's head is repeatedly pushing into the cervix
When do the pregnant woman begin to push for cervical dilation?
10 cm
Not earlier than that
Why is not recommended for woman to push earlier than 10 cm, even
9.5cm not recommended? why?
Because if woman pushes earlier could cause some edema and tearing of
that cervix.
