NM 704 Exam 3: Questions With Expert Solutions (A+)
Active management of the third stage of labour Right Ans - consists of
interventions designed to facilitate the delivery of the placenta by increasing
uterine contractions and to prevent PPH by
averting uterine atony.
Within one minute of the delivery of the baby, Right Ans - palpate the
abdomen to rule out the presence of an additional baby or babies and give
oxytocin 10 units intramuscularly (IM).
The usual components of Active management of the third stage of labor
include: Right Ans - • administration of uterotonic agents
• controlled cord traction
• uterine massage after delivery of the placenta, as appropriate
Oxytocin is preferred over other uterotonic drugs because Right Ans - • it is
effective 2 to 3 minutes after injection
• has minimal side effects
• can be used in all women.
3rd stage of labor is definition Right Ans - the period following the birth of
the newborn through the expulsion of the placenta.
maximum safe Lidocaine dosages Right Ans - • 4.5 mg/kg, up to 300 mg
Lidocaine w/o epinephrine
• 7 mg/kg, up to 500 mg Lidocaine w/ epinephrine
the signs of placental separation. Right Ans - • A small gush of blood
• Lengthening of the umbilical cord
• Rise of the uterus into the abdomen
• The uterus becomes firm and rounded
Three Components of AMTSL according to the ICM/FIGO Joint Statement
(2003) are: Right Ans - • Administration of a uterotonic medication within
one minute of the birth of the baby, after ruling out multiple gestation.
Oxytocin is the preferred medication.
• Controlled cord traction to assist with placental expulsion.
• Uterine massage immediately after placental expulsion, and then as needed.
, evidence regarding comparable outcomes with active management versus
expectant of the third stage.
AMTSL has CLEARLY demonstrated the following when AMTSL is used
compared with when expectant management is used to manage third stage of
labor: Right Ans - • A reduced risk of postpartum hemorrhage
• Less overall blood loss
• Less anemia
• Less need for therapeutic uterotonics
Expectant/Physiologic management of third stage labor Right Ans -
noninterventionist approach that involves watchful waiting as third stage
unfolds spontaneously.
includes no routine uterotonic administration, delayed cord-clamping, and
gentle—if any—cord traction.
The placenta is then expelled spontaneously, sometimes with help from
gravity, nipple stimulation, or maternal effort
No uterine massage
The midwife watches for signs of placental separation
physiologic tasks of the third stage: Right Ans - Placental separation
Placental expulsion
Control of bleeding at the placental site
Placental separation Right Ans - the result of an abrupt decrease in size of
the uterine cavity during and following the birth of the neonate.
As the uterus contracts, the placental implantation surface area decreases
without a corresponding change in the placental size.
This sudden disproportion between the area of implantation and placental
size causes the placenta to buckle and separate from the decidua.
Placental expulsion Right Ans - placenta passes through cervix into vaginal
vault and is expelled. It occurs by one of two mechanisms: Shultz or Duncan.
Schultz mechanism Right Ans - results when the placenta separates
centrally; the fetal side of the placenta—the side with a
smooth, shining membrane continuous with the sheath of the chorion (which
also covers the umbilical cord)—drops to the
Active management of the third stage of labour Right Ans - consists of
interventions designed to facilitate the delivery of the placenta by increasing
uterine contractions and to prevent PPH by
averting uterine atony.
Within one minute of the delivery of the baby, Right Ans - palpate the
abdomen to rule out the presence of an additional baby or babies and give
oxytocin 10 units intramuscularly (IM).
The usual components of Active management of the third stage of labor
include: Right Ans - • administration of uterotonic agents
• controlled cord traction
• uterine massage after delivery of the placenta, as appropriate
Oxytocin is preferred over other uterotonic drugs because Right Ans - • it is
effective 2 to 3 minutes after injection
• has minimal side effects
• can be used in all women.
3rd stage of labor is definition Right Ans - the period following the birth of
the newborn through the expulsion of the placenta.
maximum safe Lidocaine dosages Right Ans - • 4.5 mg/kg, up to 300 mg
Lidocaine w/o epinephrine
• 7 mg/kg, up to 500 mg Lidocaine w/ epinephrine
the signs of placental separation. Right Ans - • A small gush of blood
• Lengthening of the umbilical cord
• Rise of the uterus into the abdomen
• The uterus becomes firm and rounded
Three Components of AMTSL according to the ICM/FIGO Joint Statement
(2003) are: Right Ans - • Administration of a uterotonic medication within
one minute of the birth of the baby, after ruling out multiple gestation.
Oxytocin is the preferred medication.
• Controlled cord traction to assist with placental expulsion.
• Uterine massage immediately after placental expulsion, and then as needed.
, evidence regarding comparable outcomes with active management versus
expectant of the third stage.
AMTSL has CLEARLY demonstrated the following when AMTSL is used
compared with when expectant management is used to manage third stage of
labor: Right Ans - • A reduced risk of postpartum hemorrhage
• Less overall blood loss
• Less anemia
• Less need for therapeutic uterotonics
Expectant/Physiologic management of third stage labor Right Ans -
noninterventionist approach that involves watchful waiting as third stage
unfolds spontaneously.
includes no routine uterotonic administration, delayed cord-clamping, and
gentle—if any—cord traction.
The placenta is then expelled spontaneously, sometimes with help from
gravity, nipple stimulation, or maternal effort
No uterine massage
The midwife watches for signs of placental separation
physiologic tasks of the third stage: Right Ans - Placental separation
Placental expulsion
Control of bleeding at the placental site
Placental separation Right Ans - the result of an abrupt decrease in size of
the uterine cavity during and following the birth of the neonate.
As the uterus contracts, the placental implantation surface area decreases
without a corresponding change in the placental size.
This sudden disproportion between the area of implantation and placental
size causes the placenta to buckle and separate from the decidua.
Placental expulsion Right Ans - placenta passes through cervix into vaginal
vault and is expelled. It occurs by one of two mechanisms: Shultz or Duncan.
Schultz mechanism Right Ans - results when the placenta separates
centrally; the fetal side of the placenta—the side with a
smooth, shining membrane continuous with the sheath of the chorion (which
also covers the umbilical cord)—drops to the
