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Exam (elaborations)

Lamaze Certification Exam COMPLETE SOLUTION 2023

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Oxytocin/prostaglandin before birth - Help ripen the cervix before birth Endorphins - Make contractions more bearable Oxytocin/Prolactin - Help promote breastfeeding and bonding Hormones for baby - Baby's lungs and organs mature before birth Catecholamine ensure baby has enough oxygen during labor/blood supply to heart and brain Pregnancy: Week 6-Week 15 (first trimester) - - General structure of fetus is formed - Amniotic sac and umbilical chords formed Pregnancy: Week 15-27 (second trimester) - - Baby starts growing hair (lanugo) - Meconium is formed in intestines - Vernix covers the body - May start feeling movement or kicks - Braxton Hicks contractions start How are Braxton hicks different from labor contractions? - Braxton Hicks are not consistent and they don't change your cervix Pregnancy: Week 28-38 (Third trimester) - - Baby's lungs mature - Baby recognizes voices and sounds - Baby has periods of sleep and awake GBS - Group B Streptococcus Treatment to Manage Preterm Labor - - Monitor contractions - Less activity (mixed research on bed rest) - Treat it medically Placenta Previa - The placenta lies completely or partially over the cervix Three Types of Breech Presentation - Frank: The baby's butt is over cervix and legs are straight up towards face Complete: The baby is cross-legged over the cervix Footling: One or both of baby's feet are over the cervix How to turn a breech baby - - Breech Tilt Position or Childs Pose position (10 mins 3x a day) - Play sounds at your lower abdomen - Place an ice pack on fundus (top of uterus) - Chiro on sacrum (webster technique) - External version from hospital Diagnostic Test - Test that determines whether or not there is a complication. More invasive and expensive. Screening Test - Look at the probability of there being a complication Bishop Score - The readiness of your cervix to open Continuous Electronic Fetal Monitoring (EFM) - - Provides no benefit to babies - Increases the rate of c-sections - Need it if you have an epidural, used pitocin, or there are health problems - Ask staff to turn off sounds, face the monitor away from you, ask for telemtry monitor (no wires) Intravenous Fluids (IV) - - Decrease movement - ACOG, WHO, and Cochrane reccomend that woman drink orally rather than through fluids - Need it if you have complications, used pitocin/epidural, and antibiotics - Labor/drink at home, walk around with pole, ask for it to be placed in forearm, have tube disconnected between doses Movement Restrictions - - Reduces the effectiveness of contractions, increases pitocin use, prolongs labor - Move often, labor at home as long as possible - Need it if you're having preterm labor, hypertensions, epidural Artificial Rupture of Membranes - - Increase risk of infection - Increase risk for other interventions - Movement and hydration is all that is needed to get a slow labor moving - Be prepared for stronger contractions, avoid vaginal exams - Need if your labor is very difficult or slow to progress Directed Pushing - - Pushing without an urge, breath holding may reduce fetal oxygenation - WHO and American College of Nurse-Midwives recommend not directing women to hold their breath and push when there is an urge - Be patient, change positions, visualization Using Pitocin - - Increases stress on your body - Makes contractions stronger - Necessitates and IV and EFM - Ask questions to your caregiver, stimulate labor naturally, be patient

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