NUR 504 OB Exam 2 Questions With Complete Solutions
5 P's of Labor Correct Answers • Passageway
• Passenger
• Powers
• Psyche
• Position (maternal)
Adbomen postpartum Correct Answers abdominus recti, when
we get pregnant there is thin membrane in between muscles,
uterus enlarges and muscles have to stretch/move/be separated
(diastasis). Diastasis recti is more separation during pregnancy-
during postpartum period this comes back together but this can
take awhile. For some women it never resolves and have to
decide if they want surgery.
((((1-2 fingers are normal, 3 fingers abnormal space
between)))))
...if hasn't resolved within 6 weeks or so it is abnormal. Will still
look pregnant after they deliver because things don't snap back
into place. Don't be alarmed, very normal.
Augmentation Correct Answers Means to add to or supplement,
so basically if a woman's labor is not effective, hypotonic, then
we can do something, procedure/pharmacologic thing, to
increase effectiveness of her labor. This makes sense because if
she goes into labor and not enough on its own we need to help.
Birth Correct Answers Define:Actual expulsion of the products
of conception, the baby and placenta.
• Types
,- Spontaneous vaginal delivery (SVD): where baby comes out
without any mechanical or medical assistance.
- Vacuum assisted vaginal delivery (VAVD): like a big suction
cup, put on baby's head, apply suction and pull baby out. Risk
factors are bruising, cephalohematoma, risk for jaundice after
this.
- Forceps assisted vaginal delivery (FAVD): We cradle baby's
head with those, pull gently, guiding them out.
- Cesarean section (C/S): if vaginal delivery is not possible
Bishop Score Correct Answers • Score categories include the
following:
- Dilation
- Effacement
- Consistency
- Cervical Position
- Fetal station
• Score correlates with whether or not an induction of labor
would be favorable at the current time, based on the conditions
of the cervix. Score tells you if cervix is ripe enough.
• High numbers mean more ripe. Highest score is 13...If dilating
and effacing it is better. Don't need to memorize these numbers
but KNOW what the 5 categories are and that we like high
numbers (means it is soft and ripe). Number ideal to start pitocin
etc is 9 or higher...Anything lower it is more ideal to do a
cervical ripening agent before. Concern for starting Pitocin with
lower score is longer labor, unsuccessful induction, need for a
C-section, not ideal scenarios...Sometimes policies that require
certain Bishop score to start Pitocin.
,Breasts postpartum Correct Answers somewhere at around 3
days the milk will come in whether breast or bottlefeeding, does
work on supply demand situation though and will decrease
supply if not used. Breastfeeding it will keep producing. Will
feel like breasts getting larger, heavier, fuller...it is possible for
breasts to feel lumpy bc ducts are enlarged and this is expected
and is normal finding provided it is not red, tender, painful, etc.
Care of Epesiotomies/Lacerations Correct Answers In first 24
hours, we encourage ice to decrease inflammation. Kinds of
helps with pain too....After 24 hours we encourage use of sitz
bath, promotes circulation, RBCs and WBC that will help area
heal. Sitz baths 2-3-4 times a day 10-15 min each...Keep area
clean and dry too. Give them squirt bottles that can fill with
clean water or soapy water to squirt on and pat dry so don't
injure area badly.
Can use topicals, numbing sprays, creams...can also use tucks
pads, astringent that decrease inflammation in area. Analgesics
for pain also can be given orally if needed. We want to teach
them about proper positioning too. When people have wounds
on bottom it is worse to sit on something squishy because butt
cheeks separate. Tuck buttcheeks under and sit on buttcheeks so
that muscles and fat are supporting it so pressure doesn't go to
perineum or rectum. Easier bowel movements- increase fluids,
fiber, exercise. Stool softeners for most people.
Causes in Variation of Fetal Heart Rate Correct Answers VEAL
CHOP
VEAL, stands for what type of variation
V- variable
, E- early
A- acceleration
L- late
CHOP, causes of specific types of variations
C- cord compression, most common cause of variable
deceleration
H- head compression, corresponds by early deceleration, not as
concerning.
O- okay because we like accelerations
P- placental insufficiency, correspond with late decelerations, if
flow of oxygen insufficient will show up as late decelerations.
Cervical changes postpartum Correct Answers Before labor the
cervix (opening of uterus) is closed...has tiny little pinhole.
During pregnancy the cervix has to open so baby can come out.
We don't want it staying wide open after birth. Starts closing
again. We don't assess for specifically we assume it is
happening...usually checked at 6 weeks visit with
OBGYN...some things never go back completely. Will not go
back to pinhole size, but looks more like a slit.
Cesarean Section Correct Answers Define: birth of baby
through uterine and abdominal incision
• Indications: when we talk about contraindications for induction
we have indication for c-section!
Also maybe labor not progressing/stopped dilating, fetal HR
goes down, if cephalopelvic disproportion, also another very
common reason is a repeat C-section...could have vaginal birth
after C-section but many women would not elect to since uterus
5 P's of Labor Correct Answers • Passageway
• Passenger
• Powers
• Psyche
• Position (maternal)
Adbomen postpartum Correct Answers abdominus recti, when
we get pregnant there is thin membrane in between muscles,
uterus enlarges and muscles have to stretch/move/be separated
(diastasis). Diastasis recti is more separation during pregnancy-
during postpartum period this comes back together but this can
take awhile. For some women it never resolves and have to
decide if they want surgery.
((((1-2 fingers are normal, 3 fingers abnormal space
between)))))
...if hasn't resolved within 6 weeks or so it is abnormal. Will still
look pregnant after they deliver because things don't snap back
into place. Don't be alarmed, very normal.
Augmentation Correct Answers Means to add to or supplement,
so basically if a woman's labor is not effective, hypotonic, then
we can do something, procedure/pharmacologic thing, to
increase effectiveness of her labor. This makes sense because if
she goes into labor and not enough on its own we need to help.
Birth Correct Answers Define:Actual expulsion of the products
of conception, the baby and placenta.
• Types
,- Spontaneous vaginal delivery (SVD): where baby comes out
without any mechanical or medical assistance.
- Vacuum assisted vaginal delivery (VAVD): like a big suction
cup, put on baby's head, apply suction and pull baby out. Risk
factors are bruising, cephalohematoma, risk for jaundice after
this.
- Forceps assisted vaginal delivery (FAVD): We cradle baby's
head with those, pull gently, guiding them out.
- Cesarean section (C/S): if vaginal delivery is not possible
Bishop Score Correct Answers • Score categories include the
following:
- Dilation
- Effacement
- Consistency
- Cervical Position
- Fetal station
• Score correlates with whether or not an induction of labor
would be favorable at the current time, based on the conditions
of the cervix. Score tells you if cervix is ripe enough.
• High numbers mean more ripe. Highest score is 13...If dilating
and effacing it is better. Don't need to memorize these numbers
but KNOW what the 5 categories are and that we like high
numbers (means it is soft and ripe). Number ideal to start pitocin
etc is 9 or higher...Anything lower it is more ideal to do a
cervical ripening agent before. Concern for starting Pitocin with
lower score is longer labor, unsuccessful induction, need for a
C-section, not ideal scenarios...Sometimes policies that require
certain Bishop score to start Pitocin.
,Breasts postpartum Correct Answers somewhere at around 3
days the milk will come in whether breast or bottlefeeding, does
work on supply demand situation though and will decrease
supply if not used. Breastfeeding it will keep producing. Will
feel like breasts getting larger, heavier, fuller...it is possible for
breasts to feel lumpy bc ducts are enlarged and this is expected
and is normal finding provided it is not red, tender, painful, etc.
Care of Epesiotomies/Lacerations Correct Answers In first 24
hours, we encourage ice to decrease inflammation. Kinds of
helps with pain too....After 24 hours we encourage use of sitz
bath, promotes circulation, RBCs and WBC that will help area
heal. Sitz baths 2-3-4 times a day 10-15 min each...Keep area
clean and dry too. Give them squirt bottles that can fill with
clean water or soapy water to squirt on and pat dry so don't
injure area badly.
Can use topicals, numbing sprays, creams...can also use tucks
pads, astringent that decrease inflammation in area. Analgesics
for pain also can be given orally if needed. We want to teach
them about proper positioning too. When people have wounds
on bottom it is worse to sit on something squishy because butt
cheeks separate. Tuck buttcheeks under and sit on buttcheeks so
that muscles and fat are supporting it so pressure doesn't go to
perineum or rectum. Easier bowel movements- increase fluids,
fiber, exercise. Stool softeners for most people.
Causes in Variation of Fetal Heart Rate Correct Answers VEAL
CHOP
VEAL, stands for what type of variation
V- variable
, E- early
A- acceleration
L- late
CHOP, causes of specific types of variations
C- cord compression, most common cause of variable
deceleration
H- head compression, corresponds by early deceleration, not as
concerning.
O- okay because we like accelerations
P- placental insufficiency, correspond with late decelerations, if
flow of oxygen insufficient will show up as late decelerations.
Cervical changes postpartum Correct Answers Before labor the
cervix (opening of uterus) is closed...has tiny little pinhole.
During pregnancy the cervix has to open so baby can come out.
We don't want it staying wide open after birth. Starts closing
again. We don't assess for specifically we assume it is
happening...usually checked at 6 weeks visit with
OBGYN...some things never go back completely. Will not go
back to pinhole size, but looks more like a slit.
Cesarean Section Correct Answers Define: birth of baby
through uterine and abdominal incision
• Indications: when we talk about contraindications for induction
we have indication for c-section!
Also maybe labor not progressing/stopped dilating, fetal HR
goes down, if cephalopelvic disproportion, also another very
common reason is a repeat C-section...could have vaginal birth
after C-section but many women would not elect to since uterus
