NM 704 Exam 2 questions and answers
What is arrest of descent? ✔✔No descent in an hour
According to Friedan, when does active phase of labor begin? ✔✔When rate of
progress increases
According to Friedman, when does the second stage of labor begin? ✔✔Complete
dilation
According to Friedman, when does the second stage of labor end? ✔✔Birth of
baby
What did Friedman find with women who had protracted or arrested descents?
✔✔52.5% still gave birth vaginally
According to Friedman, what is the time limit for the latent phase for a nulliparous
mother? ✔✔Less than 20 hours
According to Friedman, what is the time limit for the latent phase for a
multiparous mother? ✔✔Less than 14 hours
According to Friedman, what is the rate of dilation during active phase for a
nulliparous mother? ✔✔1.2 cm/hour
,According to Friedman, what is the rate of dilation during active phase for a
multiparous mother? ✔✔1.5 cm/hour
What are some theories about why labor takes longer now than before? ✔✔(1)
bigger babies (2) greater BMIs
When waiting for a longer labor progression, what was there no difference in?
✔✔(1) PPH (2) PP fever (3) neonatal resuscitation (4) 5 min APGAR (5)
neurological abnormalities
What is increased labor a risk for? ✔✔(1) Cesarean sections (2) increased 3-4th
degree tears (3) increased instrumental delivery
Per ACOG/SMFM, when should a cesarean section be performed for longer labor?
✔✔(1) 4 hours of adequate labor and no change in dilation (2) 6 hours of
adequate labor could not be achieved with use of oxytocin
What are indications for an induction of labor? ✔✔(1) gHTN (2)
preeclampsia/eclampsia (3) IUGR (4) cholestasis (5) DM (6) fetal demise (7) intra-
amniotic infection (8) intra-amniotic infection (9) oligo (10) nonreassuring fetal
status
When can an elective induction be scheduled? ✔✔Before 39 weeks
, What are some reasons for an elective induction? ✔✔(1) maternal or provider
convenience (2) history of fast labors (3) relief of physiologic pregnancy
discomforts (4) avoidance of certain calendar dates or holidays (5) patient
satisfaction
What are some issues with the antidiuretic effect of oxytocin? ✔✔(1) fluid
restriction (2) pulmonary edema
What are some problems with giving oxytocin as a bolus? ✔✔(1) hypotension (2)
tachycardia (3) transient myocardial ischemia
What is the most common side effect of oxytocin? ✔✔Tachysystole
What should you do with oxytocin if there are any signs of fetal compromise?
✔✔Discontinue
When can you start oxytocin after fetal well-being is established? ✔✔15-30
minutes
What does oxytocin increase the risk for? ✔✔(1) PPH (2) uterine rupture
If a woman is in stable condition and is not yet in active labor, what can you do?
✔✔Shut it off to correct downregulation
What is arrest of descent? ✔✔No descent in an hour
According to Friedan, when does active phase of labor begin? ✔✔When rate of
progress increases
According to Friedman, when does the second stage of labor begin? ✔✔Complete
dilation
According to Friedman, when does the second stage of labor end? ✔✔Birth of
baby
What did Friedman find with women who had protracted or arrested descents?
✔✔52.5% still gave birth vaginally
According to Friedman, what is the time limit for the latent phase for a nulliparous
mother? ✔✔Less than 20 hours
According to Friedman, what is the time limit for the latent phase for a
multiparous mother? ✔✔Less than 14 hours
According to Friedman, what is the rate of dilation during active phase for a
nulliparous mother? ✔✔1.2 cm/hour
,According to Friedman, what is the rate of dilation during active phase for a
multiparous mother? ✔✔1.5 cm/hour
What are some theories about why labor takes longer now than before? ✔✔(1)
bigger babies (2) greater BMIs
When waiting for a longer labor progression, what was there no difference in?
✔✔(1) PPH (2) PP fever (3) neonatal resuscitation (4) 5 min APGAR (5)
neurological abnormalities
What is increased labor a risk for? ✔✔(1) Cesarean sections (2) increased 3-4th
degree tears (3) increased instrumental delivery
Per ACOG/SMFM, when should a cesarean section be performed for longer labor?
✔✔(1) 4 hours of adequate labor and no change in dilation (2) 6 hours of
adequate labor could not be achieved with use of oxytocin
What are indications for an induction of labor? ✔✔(1) gHTN (2)
preeclampsia/eclampsia (3) IUGR (4) cholestasis (5) DM (6) fetal demise (7) intra-
amniotic infection (8) intra-amniotic infection (9) oligo (10) nonreassuring fetal
status
When can an elective induction be scheduled? ✔✔Before 39 weeks
, What are some reasons for an elective induction? ✔✔(1) maternal or provider
convenience (2) history of fast labors (3) relief of physiologic pregnancy
discomforts (4) avoidance of certain calendar dates or holidays (5) patient
satisfaction
What are some issues with the antidiuretic effect of oxytocin? ✔✔(1) fluid
restriction (2) pulmonary edema
What are some problems with giving oxytocin as a bolus? ✔✔(1) hypotension (2)
tachycardia (3) transient myocardial ischemia
What is the most common side effect of oxytocin? ✔✔Tachysystole
What should you do with oxytocin if there are any signs of fetal compromise?
✔✔Discontinue
When can you start oxytocin after fetal well-being is established? ✔✔15-30
minutes
What does oxytocin increase the risk for? ✔✔(1) PPH (2) uterine rupture
If a woman is in stable condition and is not yet in active labor, what can you do?
✔✔Shut it off to correct downregulation
