NU 332 Exam #2 Questions With
Correct Solutions
Bones of Fetal Skull - ANSWER Sutures - made up of connective tissue, separate to mold
shape
Fontanelles - soft spots, frontal close within 18 months, posterior close 6-8 weeks old
Molding - after birth, allows for brain growth
Fetal Presentation - ANSWER Part entering pelvis first
Cephalic or vertex: Occiput (O)
Breech: Sacrum (S) - butt or feet first
Shoulder: Scapula (Sc)
Chin or face: Mentum (M)
Factors determining presenting part include fetal lie, fetal attitude, fetal position
Determine once head delivers
Fetal Lie - ANSWER Longitudinal - vertical, parallel with mom's spine, occipital or breach
Transverse - cannot deliver vaginally, always c-section
Fetal Attitude - ANSWER General flexion
Chin tucked down, arms to abdomen, legs crossed
Fetal Position - ANSWER 3 letter abbreviation
1st denotes R or L side of mom's pelvis
2nd presenting part of fetus (O, S, Sc, M)
3rd location of presenting part A, P, T
Fetal Station - ANSWER Ischial spine is 0, use cms
Above is -
Below is +
Engagement - baby comes down to ischial spine, station 0
,Pelvis Types - ANSWER Gynecoid - classic female
Platypelloid - flat, oval
Android - similar to male
Anthropoid - oval, long
Primary Powers - ANSWER Involuntary contractions - start at fundus and work their way
down
Frequency - start of one to the start of next one
Duration - how long they last, start to end of same one
Intensity - strength - mild, moderate, strong
Effacement - shortening and thinning of cervix, use 0-100%
Dilation - 1-10cm
Secondary Powers - ANSWER Involuntary urge to bear down - Ferguson reflex, natural
oxytocin
Push with urge to do so
Closed glottis - hold breath, diaphragm will push on fundus to help
No effect on effacement, dilation
Position of Mother - ANSWER Frequent changes relieve fatigue, increase comfort,
improve circulation (deceleration, relieve pressure on cord)
Upright position uses gravity to assist
Signs Preceding Labor - ANSWER Lightening - uterus settling downward, forward, more
pressure on pelvis, urinary frequency, 2wk before onset
Increase in Braxton-Hicks contractions - discomfort, no change in cervix
Burst of energy - nesting
Low backache
Bloody show, SROM - cervical mucus
Loss of 1-2 pounds - water loss, decreased progesterone, increased estrogen
GI symptoms - nausea
Loss of mucus plug, cervical changes
Onset of Labor - ANSWER Increased estrogen and prostaglandins, decreased
, progesterone
Uterine distention and pressure
Aging placenta - deliver by 42 wks, breaking down can start labor
Fetal fibronectin found in plasma - keeps placenta intact and attached to uterus
Cervical secretions - collect specimen. If positive, amniotic sac breaking down, go into
labor
First Stage of Labor - ANSWER Dilation 0-10
Latent - effacement
Active - dilation to 10cm
Second Stage of Labor - ANSWER Full dilation until birth
Can take 5 min-3 hours for pushing
Third Stage of Labor - ANSWER Birth to delivery of placenta
Placenta usually separates from uterus with the 3rd-4th contraction after the infant is
born then will be delivered with the next uterine contraction
Uterus size decreases, volume decreases
Watch for signs of spontaneous detachment
Active management - pitocin started before placenta comes out, fundal massage, risk
for placental fragments to remain inside
Monitor - hemorrhage, fluid shifts
Lacerations repaired - lights, sutures, cleanse perineum, ice pack
Fourth Stage of Labor - ANSWER Lasts 2 hours after placenta delivery
Mechanisms of Labor - ANSWER Turns and adjustments of fetus to fit
7 cardinal movements of vertex - engagement/descent, flexion, internal rotation,
extension, restitution and external rotation, expulsion
Expulsion - head and shoulders lifted, trunk follows
Correct Solutions
Bones of Fetal Skull - ANSWER Sutures - made up of connective tissue, separate to mold
shape
Fontanelles - soft spots, frontal close within 18 months, posterior close 6-8 weeks old
Molding - after birth, allows for brain growth
Fetal Presentation - ANSWER Part entering pelvis first
Cephalic or vertex: Occiput (O)
Breech: Sacrum (S) - butt or feet first
Shoulder: Scapula (Sc)
Chin or face: Mentum (M)
Factors determining presenting part include fetal lie, fetal attitude, fetal position
Determine once head delivers
Fetal Lie - ANSWER Longitudinal - vertical, parallel with mom's spine, occipital or breach
Transverse - cannot deliver vaginally, always c-section
Fetal Attitude - ANSWER General flexion
Chin tucked down, arms to abdomen, legs crossed
Fetal Position - ANSWER 3 letter abbreviation
1st denotes R or L side of mom's pelvis
2nd presenting part of fetus (O, S, Sc, M)
3rd location of presenting part A, P, T
Fetal Station - ANSWER Ischial spine is 0, use cms
Above is -
Below is +
Engagement - baby comes down to ischial spine, station 0
,Pelvis Types - ANSWER Gynecoid - classic female
Platypelloid - flat, oval
Android - similar to male
Anthropoid - oval, long
Primary Powers - ANSWER Involuntary contractions - start at fundus and work their way
down
Frequency - start of one to the start of next one
Duration - how long they last, start to end of same one
Intensity - strength - mild, moderate, strong
Effacement - shortening and thinning of cervix, use 0-100%
Dilation - 1-10cm
Secondary Powers - ANSWER Involuntary urge to bear down - Ferguson reflex, natural
oxytocin
Push with urge to do so
Closed glottis - hold breath, diaphragm will push on fundus to help
No effect on effacement, dilation
Position of Mother - ANSWER Frequent changes relieve fatigue, increase comfort,
improve circulation (deceleration, relieve pressure on cord)
Upright position uses gravity to assist
Signs Preceding Labor - ANSWER Lightening - uterus settling downward, forward, more
pressure on pelvis, urinary frequency, 2wk before onset
Increase in Braxton-Hicks contractions - discomfort, no change in cervix
Burst of energy - nesting
Low backache
Bloody show, SROM - cervical mucus
Loss of 1-2 pounds - water loss, decreased progesterone, increased estrogen
GI symptoms - nausea
Loss of mucus plug, cervical changes
Onset of Labor - ANSWER Increased estrogen and prostaglandins, decreased
, progesterone
Uterine distention and pressure
Aging placenta - deliver by 42 wks, breaking down can start labor
Fetal fibronectin found in plasma - keeps placenta intact and attached to uterus
Cervical secretions - collect specimen. If positive, amniotic sac breaking down, go into
labor
First Stage of Labor - ANSWER Dilation 0-10
Latent - effacement
Active - dilation to 10cm
Second Stage of Labor - ANSWER Full dilation until birth
Can take 5 min-3 hours for pushing
Third Stage of Labor - ANSWER Birth to delivery of placenta
Placenta usually separates from uterus with the 3rd-4th contraction after the infant is
born then will be delivered with the next uterine contraction
Uterus size decreases, volume decreases
Watch for signs of spontaneous detachment
Active management - pitocin started before placenta comes out, fundal massage, risk
for placental fragments to remain inside
Monitor - hemorrhage, fluid shifts
Lacerations repaired - lights, sutures, cleanse perineum, ice pack
Fourth Stage of Labor - ANSWER Lasts 2 hours after placenta delivery
Mechanisms of Labor - ANSWER Turns and adjustments of fetus to fit
7 cardinal movements of vertex - engagement/descent, flexion, internal rotation,
extension, restitution and external rotation, expulsion
Expulsion - head and shoulders lifted, trunk follows
