NM 704 Exam 3 Module 6 Graded A+
*side effects of epidural analgesia include* - ANSWER-*fever & hypotension (postdural
puncture headache, pruritus, & transient fetal heart rate decels)*
*the traditional, biomedical definition of second stage labor is* - ANSWER-*the time
from complete dilation of the cervix to the birth of the baby*
*the use of epidural anesthesia is associated with* - ANSWER-*an ↑'ed rate of operative
vaginal births*
*water immersion during labor is associated with a* - ANSWER-*↓ in epidural use*
39 yo nullipara @ 41 weeks w/ an unremarkable medical, surgical, ob & prenatal hx is in
active labor. she is 7cm/100%/0 station & has had no meds. she has progressed 3cms
in the past 3 hours. what is her best plan for oral intake - ANSWER-diet as tolerated
a multipara @ 39 wks in active labor is 4cm/90%/0 station. she asks you to break her
water. you should explain that - ANSWER-routine amniotomy may ↑ risk of c-section
a multipara @ 40 weeks in active labor. her temp is 101.9*F. this is most likely caused
by - ANSWER-an infectious process
a nullipara @ 40 weeks is in active labor. her urine dipstick shows 3+ ketones. this
indicates - ANSWER-inadequate caloric intake
a nullipara @ 40 weeks is in active labor. she is 7cm/100%/0 station. a urine dipstick
shows 3+ ketones. What question is relevant - ANSWER-can she tolerate oral intake?
a nulliparous ♀ @ 40 weeks is in labor. @ 3pm she is 6cm/100%/-1 station. @ 7pm she
is 7cm/100/-1. she is not experiencing any back pain. the anterior fontanel is palpated in
the right anterior portion of the pelvis. what is correct? - ANSWER-prolonged labor &
vaginal exam findings suggest a posterior position
According to the evidence on labor support, the greatest benefit came from use of:
A. A hospital staff member
B. A non-hospital staff member (ie doula)
C. a member of the woman's social/support network - ANSWER-B. A non-hospital staff
member (ie doula)
Amniotomy effect on cesarean birth - ANSWER-The evidence showed a possible
increase in caesarean section.
Amniotomy effect on fetal & neonatal status - ANSWER-- cord compression
- FHR decels
, - cord prolapsed
- increased risk for infection
- ruptured fetal vessels --> rare
Amniotomy effect on labor duration - ANSWER-The evidence showed:
● Reduction in *2nd stage* for primiparous ♀
● no shortening of the length of *1st stage* of labour
Amniotomy effect on perception of pain - ANSWER-maternal discomfort
Amniotomy effect on rates of analgesia use - ANSWER-● no difference (though data did
not differentiate between types of analgesia)
amniotomy procedure - ANSWER-● confirm cephalic presentation & engagement,
● assess fetal station & ensure fetal head is well applied to the cervix
● keep fingers in the cervix, gently disrupt the membranes with the amniohook, ideally
during a contraction, avoid scratching the fetal head
● leave fingers in place during the initial gush of fluid to ensure no prolapsed cord.
● Monitor fetal heart rate during procedure & for a short time after.
amniotomy risks - ANSWER-- cord compression
- FHR decels
- cord prolapsed
- maternal discomfort
- increased risk for infection
- ruptured fetal vessels --> rare
- possible increased risk for c/s
associated w/a reduced c-section birth rate - ANSWER-continuous one-to-one labor
support
Components of an admission *history* when a ♀ is in labor. - ANSWER-● Age-
extremes associated with increased risk for adverse outcomes
● Parity- influences labor progress and duration
● EDD and gestational weeks- Identifies potential newborn complications. Allows for
evaluating fetal size r/t gestational age
● Complications of current pregnancy including GBS status- identifies existing and/or
potential problems
● Major complications w/ previous pregnancies- identifies potential recurring problems
● Previous labor experiences including duration- influences expectations and identifies
potential coping strategies
● Mode of previous births/deliveries- identifies operative, vaginal, and c-section;
influences management
● Size of previous babies- estimate of pelvic adequacy
● Fetal movement pattern- fetal well-being
*side effects of epidural analgesia include* - ANSWER-*fever & hypotension (postdural
puncture headache, pruritus, & transient fetal heart rate decels)*
*the traditional, biomedical definition of second stage labor is* - ANSWER-*the time
from complete dilation of the cervix to the birth of the baby*
*the use of epidural anesthesia is associated with* - ANSWER-*an ↑'ed rate of operative
vaginal births*
*water immersion during labor is associated with a* - ANSWER-*↓ in epidural use*
39 yo nullipara @ 41 weeks w/ an unremarkable medical, surgical, ob & prenatal hx is in
active labor. she is 7cm/100%/0 station & has had no meds. she has progressed 3cms
in the past 3 hours. what is her best plan for oral intake - ANSWER-diet as tolerated
a multipara @ 39 wks in active labor is 4cm/90%/0 station. she asks you to break her
water. you should explain that - ANSWER-routine amniotomy may ↑ risk of c-section
a multipara @ 40 weeks in active labor. her temp is 101.9*F. this is most likely caused
by - ANSWER-an infectious process
a nullipara @ 40 weeks is in active labor. her urine dipstick shows 3+ ketones. this
indicates - ANSWER-inadequate caloric intake
a nullipara @ 40 weeks is in active labor. she is 7cm/100%/0 station. a urine dipstick
shows 3+ ketones. What question is relevant - ANSWER-can she tolerate oral intake?
a nulliparous ♀ @ 40 weeks is in labor. @ 3pm she is 6cm/100%/-1 station. @ 7pm she
is 7cm/100/-1. she is not experiencing any back pain. the anterior fontanel is palpated in
the right anterior portion of the pelvis. what is correct? - ANSWER-prolonged labor &
vaginal exam findings suggest a posterior position
According to the evidence on labor support, the greatest benefit came from use of:
A. A hospital staff member
B. A non-hospital staff member (ie doula)
C. a member of the woman's social/support network - ANSWER-B. A non-hospital staff
member (ie doula)
Amniotomy effect on cesarean birth - ANSWER-The evidence showed a possible
increase in caesarean section.
Amniotomy effect on fetal & neonatal status - ANSWER-- cord compression
- FHR decels
, - cord prolapsed
- increased risk for infection
- ruptured fetal vessels --> rare
Amniotomy effect on labor duration - ANSWER-The evidence showed:
● Reduction in *2nd stage* for primiparous ♀
● no shortening of the length of *1st stage* of labour
Amniotomy effect on perception of pain - ANSWER-maternal discomfort
Amniotomy effect on rates of analgesia use - ANSWER-● no difference (though data did
not differentiate between types of analgesia)
amniotomy procedure - ANSWER-● confirm cephalic presentation & engagement,
● assess fetal station & ensure fetal head is well applied to the cervix
● keep fingers in the cervix, gently disrupt the membranes with the amniohook, ideally
during a contraction, avoid scratching the fetal head
● leave fingers in place during the initial gush of fluid to ensure no prolapsed cord.
● Monitor fetal heart rate during procedure & for a short time after.
amniotomy risks - ANSWER-- cord compression
- FHR decels
- cord prolapsed
- maternal discomfort
- increased risk for infection
- ruptured fetal vessels --> rare
- possible increased risk for c/s
associated w/a reduced c-section birth rate - ANSWER-continuous one-to-one labor
support
Components of an admission *history* when a ♀ is in labor. - ANSWER-● Age-
extremes associated with increased risk for adverse outcomes
● Parity- influences labor progress and duration
● EDD and gestational weeks- Identifies potential newborn complications. Allows for
evaluating fetal size r/t gestational age
● Complications of current pregnancy including GBS status- identifies existing and/or
potential problems
● Major complications w/ previous pregnancies- identifies potential recurring problems
● Previous labor experiences including duration- influences expectations and identifies
potential coping strategies
● Mode of previous births/deliveries- identifies operative, vaginal, and c-section;
influences management
● Size of previous babies- estimate of pelvic adequacy
● Fetal movement pattern- fetal well-being
