NM 704 Exam 3 Module 6 questions with
correct answers
effectiveness *Heat & Cold* for reducing pain & increasing comfort in labor: Answer✔✔ ● Heat applied where fetal head presses (lower back or abdomen) may
decrease pain by causing increased circulation to affected tissue
● Cold application has a numbing effect
● Some find relief w/ cold if heat unsuccessful whereas some find alternating between heat & cold most comforting ● No specific studies for effectiveness
● Multiple contraindications
- areas anesthetized by epidural
- fever
- raynauds
- sickle cell
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
● Vaginal bleeding- differentiated from bloody show; vaginal bleeding is abnormal, contraindicative of digital cervical exam and indicates need for collaboration
● Status of membranes- duration of ROM and characteristics of amniotic fluid (meconium)
● Time of onset of contractions and characteristics (frequency, duration, intensity, aggravating/relieving factors)-helps discriminate true from false labor as well as establishes onset of labor
● Last oral intake- baseline energy and fluid status; useful for anesthesia in case of need for surgery
Components of an admission *physical* when a ♀ is in labor. Answer ✔✔ ● VS (BP, Temp, HR, RR)
● Auscultation of heart and lungs
● Abdominal palpation ○ Determine contraction pattern ○ Assess fetal lie, presentation, position, and engagement ○ Estimated fetal weight and fundal height
● Visual inspection for abdominal scars
● Assessment for presence of peripheral edema
● Cervical Examination ○ Cervical effacement and dilation ○ Position of cervix ○ Station of fetal presenting part ○ Presence of molding or caput succedaneum ○ Fetal lie, presentation, position ○ Tone and elasticity of vagina and perineum ○ Confirmation of membrane status ○ Visual inspection of perineum ○ Assessment of FHR
recommended frequency for the assessment of maternal vital signs in the first stage
of labor. (w/o epidural) Answer ✔✔ BP, HR, RR: q 1 hour
Temp: q2-4 hr when temp normal and membranes intact;
recommended frequency for the assessment of maternal temp Answer ✔✔ q 1-2 hr if temp abnormal &/or after ROM
recommendations for frequency of continuous FHR assessment during 1st stage of labor. Answer✔✔ ● q30min (no complications)
○ Q15min if complications
recommendations for frequency of continuous FHR assessment during 2nd stage of
labor. Answer✔✔ ● q15min (no complications)
○ Q5min if complications
recommendations for frequency of Intermittent Auscultation FHR assessment during 1st stage of labor. Answer ✔✔ ● q15-30min
recommendations for frequency of Intermittent Auscultation FHR assessment during 2nd stage of labor. Answer ✔✔ ● q5-15min
Recommendation for the appropriate use of vaginal exams during the first stage of labor. Answer✔✔ ● No specific scientific evidence to support frequency but
correct answers
effectiveness *Heat & Cold* for reducing pain & increasing comfort in labor: Answer✔✔ ● Heat applied where fetal head presses (lower back or abdomen) may
decrease pain by causing increased circulation to affected tissue
● Cold application has a numbing effect
● Some find relief w/ cold if heat unsuccessful whereas some find alternating between heat & cold most comforting ● No specific studies for effectiveness
● Multiple contraindications
- areas anesthetized by epidural
- fever
- raynauds
- sickle cell
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
● Vaginal bleeding- differentiated from bloody show; vaginal bleeding is abnormal, contraindicative of digital cervical exam and indicates need for collaboration
● Status of membranes- duration of ROM and characteristics of amniotic fluid (meconium)
● Time of onset of contractions and characteristics (frequency, duration, intensity, aggravating/relieving factors)-helps discriminate true from false labor as well as establishes onset of labor
● Last oral intake- baseline energy and fluid status; useful for anesthesia in case of need for surgery
Components of an admission *physical* when a ♀ is in labor. Answer ✔✔ ● VS (BP, Temp, HR, RR)
● Auscultation of heart and lungs
● Abdominal palpation ○ Determine contraction pattern ○ Assess fetal lie, presentation, position, and engagement ○ Estimated fetal weight and fundal height
● Visual inspection for abdominal scars
● Assessment for presence of peripheral edema
● Cervical Examination ○ Cervical effacement and dilation ○ Position of cervix ○ Station of fetal presenting part ○ Presence of molding or caput succedaneum ○ Fetal lie, presentation, position ○ Tone and elasticity of vagina and perineum ○ Confirmation of membrane status ○ Visual inspection of perineum ○ Assessment of FHR
recommended frequency for the assessment of maternal vital signs in the first stage
of labor. (w/o epidural) Answer ✔✔ BP, HR, RR: q 1 hour
Temp: q2-4 hr when temp normal and membranes intact;
recommended frequency for the assessment of maternal temp Answer ✔✔ q 1-2 hr if temp abnormal &/or after ROM
recommendations for frequency of continuous FHR assessment during 1st stage of labor. Answer✔✔ ● q30min (no complications)
○ Q15min if complications
recommendations for frequency of continuous FHR assessment during 2nd stage of
labor. Answer✔✔ ● q15min (no complications)
○ Q5min if complications
recommendations for frequency of Intermittent Auscultation FHR assessment during 1st stage of labor. Answer ✔✔ ● q15-30min
recommendations for frequency of Intermittent Auscultation FHR assessment during 2nd stage of labor. Answer ✔✔ ● q5-15min
Recommendation for the appropriate use of vaginal exams during the first stage of labor. Answer✔✔ ● No specific scientific evidence to support frequency but
