NUR 166 Exam 2 Hondros Family-Centered Nursing for the Practical Nurse | Comprehensive Questions with Verified Answers and Detailed Rationales | LPN Maternal-Child and Family Health Exam

INSTANT PDF DOWNLOAD — This comprehensive exam preparation resource for NUR 166 Exam 2 at Hondros College of Nursing covers Family-Centered Nursing for the Practical Nurse (LPN) program. It features verified questions and answers with detailed rationales in multiple-choice, select-all-that-apply (SATA), ordered response, and clinical scenario formats aligned with the Ohio Board of Nursing LPN scope of practice. This resource focuses on maternal-newborn nursing, intrapartum care, postpartum care, newborn assessment and care, breastfeeding, and complications of pregnancy, labor, and delivery. MATERNAL-NEWBORN NURSING (EXAM 2 FOCUS) INTRAPARTUM CARE (LABOR AND DELIVERY) Stages of Labor Stage 1: Cervical Dilation (Onset of True Labor to Full Dilation at 10 cm) – Subdivided into three phases: Latent Phase (0-6 cm) – Cervical dilation 0-6 cm, contractions mild to moderate (frequency 5-30 minutes, duration 15-45 seconds, intensity mild), lasts approximately 6-8 hours (nulliparous) or 4-6 hours (multiparous). Nursing interventions: encourage rest, ambulation if no contraindications, provide comfort measures (back rub, breathing techniques), offer clear liquids, encourage voiding q2h. Active Phase (6-8 cm) – Cervical dilation 6-8 cm, contractions moderate to strong (frequency 3-5 minutes, duration 45-60 seconds, intensity moderate), lasts approximately 2-4 hours (nulliparous) or 1-3 hours (multiparous). Nursing interventions: coach with breathing techniques (slow-paced breathing, modified-paced breathing), provide pain relief, monitor FHR q15-30 minutes, position changes. Transition Phase (8-10 cm) – Cervical dilation 8-10 cm, contractions strong to very strong (frequency 1.5-2.5 minutes, duration 60-90 seconds, intensity strong), lasts approximately 1-3 hours (nulliparous) or 30-60 minutes (multiparous). Nursing interventions: intense support, coach with patterned-paced breathing, provide encouragement, avoid pushing until fully dilated, monitor FHR q15 minutes (q5 minutes if high risk), prepare for delivery. Stage 2: Expulsion (Full Dilation 10 cm to Birth of Fetus) – Cervix fully dilated, descent of presenting part, Ferguson reflex (urge to push). Contractions: frequency 1.5-2.5 minutes, duration 60-90 seconds, intensity strong. Duration: nulliparous 30 minutes-3 hours, multiparous 5-30 minutes. Nursing interventions: coach effective pushing (open glottis pushing, avoid prolonged breath-holding), assess perineum for crowning, assist provider, monitor FHR q5 minutes. Positioning for labor: upright positions (sitting, squatting, side-lying, hands-and-knees) improve pelvic outlet diameter, gravity assists descent. Stage 3: Placental Delivery (Birth of Fetus to Delivery of Placenta) – Signs of placental separation: umbilical cord lengthens, uterus becomes firm and globular, sudden gush of blood, uterus rises in abdomen. Duration: typically 5-30 minutes. Normal blood loss: 500 mL vaginal delivery. Nursing interventions: administer Pitocin (oxytocin) 10 units IM after delivery of placenta (if ordered), massage fundus, inspect placenta for completeness (all cotyledons and membranes), monitor for hemorrhage. Stage 4: Immediate Postpartum Recovery (1-4 Hours Postpartum) – Maternal stabilization: monitor vital signs q15 minutes x1 hour, then q30 minutes x1 hour, then q1 hour. Assess fundus (should be firm, midline, at umbilicus), lochia (rubra, moderate flow, no clots 1 cm), bladder (encourage voiding within 4 hours), perineum (REEDA: redness, edema, ecchymosis, discharge, approximation). Newborn transition (first 2 hours of life): skin-to-skin contact, initiate breastfeeding, monitor respiratory status, temperature, blood glucose. Signs of True Labor vs. False Labor True Labor False Labor (Braxton Hicks) Regular contractions increasing in frequency, duration, intensity Irregular contractions, no pattern Contractions become closer together (e.g., every 5 min → 3 min → 2 min) Contractions remain irregular (e.g., 10 min, then 15 min, then 20 min) Contractions progressively longer (30 sec → 45 sec → 60+