NM704 FINAL EXAM QUESTIONS 100% Verified
Questions & Answers
Q: What is the current criteria for normal duration of the second stage per ACOG?
Answer:
has not been identified
Q: Prolonged 2nd stage labor: nullip and multip
Answer:
Nullip: >3 hr w/o epidural, >4 hr w/ epidural Multip: >2 hr w/o epidural, >3 hr w/ epidural
Q: Longer durations of second stage may be appropriate as long as
Answer:
progress is being documented
Q: Which birthing positions are associated with more trauma/2nd degree lacs?
Answer:
Lithotomy and squatting
Q: Hands on (flexion of fetal head and guarding perineal body) evidence
Answer:
lower rates of perineal and sphincter tears
Q: Mediolateral epis is
Answer:
less likely to result in 3rd or 4th degree lac compared to midline epis
Q: Higher postpartum pain is associated with which epis
Answer:
mediolateral
Q: Third stage of labor definition
Answer:
begins with birth of baby ends with delivery of placenta
Q: Central separation
Answer:
"shiny"
, Q: membranes are inverted d/t increased placental surface area compared to the placental attachment site more common
Peripheral separation
Answer:
"dirty" buckles at the edge from the margin accompanied by more visible bleeding the maternal surface (rough, textured
side) is the 1st part seen at vaginal opening amniotic sac does not invert, trails behind placenta
Q: signs of placental separation
Answer:
new trickle/gush lengthening of cord uterus changes shape (discoid -> globular) fundus rises slightly
Q: Expectant management of 3rd stage of labor evidence
Answer:
No increased blood loss compared w/ AMTSL general population No increased r/o PPH compared with AMTSL general
population
Q: For moms with RF for PPH, _________ should be the recommended approach for management of 3rd stage
Answer:
AMTSL
Q: Active management of 3rd stage of labor evidence
Answer:
decreased r/o PPH less overall blood loss less PP anemia less need for uterotonics
Q: List some RF for PPH
Answer:
coagulopathies grand multips hx PPH previous uterine incision macrosomia anemia HTN obesity poly IOL/AOL mag
precip birth prolonged labor
Q: the hour following delivery of placenta
Answer:
4th stage of labor
Q: Vital signs during 4th stage labor
Answer:
q 5-15 minutes
Q: 5 B's
Answer:
Brain (psychosocial) Breasts Belly Bladder Bottom
Questions & Answers
Q: What is the current criteria for normal duration of the second stage per ACOG?
Answer:
has not been identified
Q: Prolonged 2nd stage labor: nullip and multip
Answer:
Nullip: >3 hr w/o epidural, >4 hr w/ epidural Multip: >2 hr w/o epidural, >3 hr w/ epidural
Q: Longer durations of second stage may be appropriate as long as
Answer:
progress is being documented
Q: Which birthing positions are associated with more trauma/2nd degree lacs?
Answer:
Lithotomy and squatting
Q: Hands on (flexion of fetal head and guarding perineal body) evidence
Answer:
lower rates of perineal and sphincter tears
Q: Mediolateral epis is
Answer:
less likely to result in 3rd or 4th degree lac compared to midline epis
Q: Higher postpartum pain is associated with which epis
Answer:
mediolateral
Q: Third stage of labor definition
Answer:
begins with birth of baby ends with delivery of placenta
Q: Central separation
Answer:
"shiny"
, Q: membranes are inverted d/t increased placental surface area compared to the placental attachment site more common
Peripheral separation
Answer:
"dirty" buckles at the edge from the margin accompanied by more visible bleeding the maternal surface (rough, textured
side) is the 1st part seen at vaginal opening amniotic sac does not invert, trails behind placenta
Q: signs of placental separation
Answer:
new trickle/gush lengthening of cord uterus changes shape (discoid -> globular) fundus rises slightly
Q: Expectant management of 3rd stage of labor evidence
Answer:
No increased blood loss compared w/ AMTSL general population No increased r/o PPH compared with AMTSL general
population
Q: For moms with RF for PPH, _________ should be the recommended approach for management of 3rd stage
Answer:
AMTSL
Q: Active management of 3rd stage of labor evidence
Answer:
decreased r/o PPH less overall blood loss less PP anemia less need for uterotonics
Q: List some RF for PPH
Answer:
coagulopathies grand multips hx PPH previous uterine incision macrosomia anemia HTN obesity poly IOL/AOL mag
precip birth prolonged labor
Q: the hour following delivery of placenta
Answer:
4th stage of labor
Q: Vital signs during 4th stage labor
Answer:
q 5-15 minutes
Q: 5 B's
Answer:
Brain (psychosocial) Breasts Belly Bladder Bottom
