OB Exam 2 Study Guide with Complete Solutions

OB Exam 2 Study Guide with Complete Solutions There are 4 stages of labor, describe the 1st stage - Answer️️ -*dilation and effacement of the cervix* 1. Latent phase: 0-4 cm dilation -Longest phase of labor -Contractions feel like period cramps and are mild to palpation 2. Active phase: 5-7 cm dilation -Women become more focused anxious or restless -Contractions become more regular and painful 3. Transition phase: 8-10cm dilation -Contractions are strong and closer together -Woman feels out of control, irritable or dependent -Shortest lasting phase of labor There are 4 stages of labor, describe the 2nd stage - Answer️️ -*pushing started with the cervix completely dilated and ends with the birth of the baby* ©SOPHIABENNETT@ Monday, August 26, 2024 6:09 AM 2 a. May last 20 minutes to 2 hours long b. As the fetus descends through the birth canal the fetus head rotates for optimal delivery: 1. Engagement: fetal head reaches level of the ischial spines 2. Descent: fetus moves past the ischial spines 3. Flexion: fetal chin touches chest in response to pressure from maternal tissue 4. Extension: fetal chin comes off the chest and the neck arches are the head is born 5. External rotation: fetal heal rotates as the shoulders move into position for delivery 6. Expulsion: body of the fetus is born There are 4 stages of labor, describe the 3rd stage - Answer️️ -*begins with the birth of the baby and ends with delivery of the placenta* a. Complete within 5-30 minutes b. Failure to contract is called uterine atony and is a primary cause of postpartum hemorrhage There are 4 stages of labor, describe the 4th stage - Answer️️ -*begins with the delivery of the placenta and ends after 4 hours or when the mother becomes clinically stable* ©SOPHIABENNETT@ Monday, August 26, 2024 6:09 AM 3 a. During this stage the nurse should assess uterine position, vaginal bleeding (lochia), and vital signs. b. Administer pain meds as needed c. The nurse should assist the patient with skin to skin contact and initiating breastfeeding When assessing the fetal heart rate you dont want to see oxygen deprivation, describe some characteristics of oxyegn deprivation - Answer️️ --Fetal monitoring is the assessment of the fetal heart rate for patterns that indicate fetal compromise -Abnormal patterns are associated with hypoxemia and may lead to hypoxia -Intermittent monitoring generally includes auscultation of the fhr every 15-30 minutes during the active phase of labor and every 5 to 15 minutes in the second stage of labor -Continuous fetal monitoring a nurse evaluates monitoring every 30 minutes during the first stage of a low risk woman and every 15 during the second stage. High risk woman, the fetal monitor strips are reviewed more frequently Characteristics of FHR monitoring include - Answer️️ --A baseline heart rate is assessed over a 10 minute period and is normally between 110-160 bpm ©SOPHIABENNETT@ Monday, August 26, 2024 6:09 AM 4 -Variability is the irregular fluctuations in the baseline fetal heart rate -Moderate variability has an amplitude of 6-25 minutes and ia assessed over a 10 minute period -Accelerations are an increase in baseline of at least 15 beats and lasting at least 15 seconds in a term fetus -Decelerations are decreases in the fetal heart rate from baseline *We want it to be 6-25 moderate* Absent - 0-2 Minimal- 2-25 Moderate 6-25 Marked 25 FHR decelerations include - Answer️️ --Late decelerations caused by poor placental perfusion -Variable decelerations caused by cord compression