COMPLETE QUESTIONS AND ANSWERS FOR MATERNITY AND PEDIATRIC NURSING CH 8 & 9

COMPLETE QUESTIONS AND ANSWERS FOR MATERNITY AND PEDIATRIC NURSING CH 8 & 9 Immediately after birth the cardiac output reaches what percent? - CORRECT ANSWER-80% A patient comes to the hospital in active labor at 4:30AM. She has not eaten since dinner the night before, which was at 6PM. She has a gynecoid pelvis, and this will be her fourth child; the first three were delivered vaginally. It is now 8AM and she is 80% effaced and dilated 3 cm. What nourishment should the nurse allow her upon request? - CORRECT ANSWER-ice chips, clear liquids Patient is dilated to 10cm, feel the urge to push, but refuses due to the pain. What can be given to get this patient through the pain and allow her to push? - CORRECT ANSWER-puedendal block What causes pain in the first stage of labor? - CORRECT ANSWER-stretching of the cervix (dilation) What are the 4 ways the cervix can change - CORRECT ANSWER-passively distends, becomes engaged, retracts into uterus, becomes shorter and thinner When during a labor can a patient have a puedendal block - CORRECT ANSWER-just before labor What dilation would you expect in a patient in transition phase - CORRECT ANSWER8-10cm Explain "zero station" - CORRECT ANSWER-presenting part is at the level of the ischial spines Explain the following vaginal exam to the patient... 10cm, 100%, and +1 - CORRECT ANSWER-10 cm dilated, 100% effaced, and +1 station What are the 4 essential components - CORRECT ANSWER-4 Ps Passageway, Passenger, Powers, Psyche What is the difference between tolerance and threshold - CORRECT ANSWERtolerance- how much high intensity pain you can withstand threshold- lowest intensity of painful stimulus at which a patient perceives pain False pelvis - CORRECT ANSWER--the flared upper portion of the bony pelvis -not part of the bony passageway True pelvis - CORRECT ANSWER--the portion of the pelvis below the linea terminalis -consists of the inslet, midpelvis, and outlet Gynecoid pelvis - CORRECT ANSWER-*most favorable for a vaginal birth -rounded shape Anthropoid pelvis - CORRECT ANSWER-elongated shape Android pelvis - CORRECT ANSWER-heart-shaped- male Platypelloid pelvis - CORRECT ANSWER-flat in its dimensions Soft tissues - CORRECT ANSWER--Cervix- changes during pregnancy/ labor: *passively distends *becomes engaged *retracts into the uterus *becomes shorter and thinner -Vagina Fetal lie - CORRECT ANSWER--Longitudinal lie: long axis of the fetus is parallel to maternal long axis -Oblique lie: between longitudinal and transverse lie -Transverse lie: long axis of fetus is perpendicular to maternal long axis Fetal presentation - CORRECT ANSWER-foremost part of the fetus that enters the pelvic inlet 3 main presentations -Head: cephalic presentation -Feet or buttock: breech presentation -Shoulder: shoulder presentation Fetal attitude - CORRECT ANSWER-Relationship of fetal parts to one another *Flexion (ovoid shape)- most favorable for vaginal delivery *Military (no flexion or extension) *Brow or frontum (partial extension) *Face (full extension) Fetal position - CORRECT ANSWER-Relationship of reference point on presenting part to quadrants of maternal pelvis *First letter/ designation: refers to side of maternal pelvis toward which presenting part is facing *Second letter/ designation: reference point on presenting part *Third letter/ designation: specifies direct presenting part is facing -Anterior; posterior; transverse (ex. ROA) Fetal station - CORRECT ANSWER-relationship of presenting part to ischial spines *Zero station -Presenting part is at the level of the ischial spines (at the true pelvis) *Minus station -Presenting part is above the ischial spines *Plus station -Presenting part is below the ischial spines Phases of involuntary uterine contraction - CORRECT ANSWER-*Increment-building up of contraction (longest phase) *Acme- peak *Decrement- letting-up phase *Relaxation period- resting period between contractions Descriptors of contractions - CORRECT ANSWER--Frequency: How often the contractions are occurring *Measured by counting time interval from beginning of one contraction to beginning of following contraction. -Duration: Interval from beginning of a contraction to its end -Intensity: Strength of the contraction Factors impacting the psyche of a laboring woman - CORRECT ANSWER-*current pregnancy experience (planned/unplanned) *previous birth experience *expectations for current birth experience *type of preparation for birth (classes/birth plan) *Support person involvement *Culture (superstition/ beliefs) -BE AWARE! Anxiety can SLOW DOWN the labor process.. Onset of Labor -Theories regarding labor onset - CORRECT ANSWER--Progesterone withdrawal theory -Oxytocin theory -Prostaglandin theory Anticipatory signs of labor - CORRECT ANSWER--Lightening or sense that the baby has "dropped"