Answers.
What is the first stage of labor? correct answers Begins with the onset of uterine contractions that
result in cervical change ends with complete cervical effacement and dilation.
What is effacement? correct answers Shortening and thinning of the cervix during the first stage
of labor, and dilation of the cervix is the enlargement of cervical opening.
What is the latent stage of first stage of labor? correct answers Defined as a cervix that is found
to be 0 to 3cm dilated and less than 1 cm. Contractions become more regular and painful. 6 to 8
hours. Morphine and Gravol are used.
What is the active stage of labor? correct answers Defined as beginning when the cervix is 4cm
dilated in a nullparous patient and 4 to 8 cm dilated in a parous patient. Contractions become
more painful, frequent, longer and closer together. 3 to 6 hours. Opioids, epidurals, and
anesthesias used here.
Difference between prelabour and true labour. correct answers Prelabour:
Contractions occur irregularly or become regular only temporarily. Often stop with walking or
position change.
Labour: Occur regularly, become stronger, last longer, become more intense with walking.
Continue despite use of comfort measures.
Analysis of a urine specimen. correct answers Ketones - Nutritional status is shown.
Specific gravity - color and amount
Leukocytes - infection
Protein - preeclampsia
Nurses responsibility in assessment of labour correct answers Monitoring uterine contractions
Determine frequency and intensity
Any unit-specific documentation
When does fetal heart rate (FHR) need to be assessed? correct answers Immediately after ROM,
due to an increased risk for the umbilical cord to prolapse
After any change in the contraction pattern or patient status
Before and after administering medication or performing a procedure
, Who can do vaginal examinations? When should they be performed? correct answers Done by
specially trained nurses or the physician
Should be performed only when absolutely required by patient or fetus
On admission
When significant changes occur, patient perception of perineal pressure or the urge to bar down
When labouring patient requests pain medication
When abnormal FHR present
Perineal lacerations types correct answers First degree laceration - extends through the skin and
structures superficial to muscles
Second degree - extends through muscles of perineal body
Third degree - continues through anal sphincter muscle
Fourth degree - extends completely through the anal sphincter and the rectal mucosa
What is the third stage of labour? correct answers Assessment:
Contracting fundus
Change in uterus from a discoid to a globular ovular shape as the placenta moves into the lower
uterine segment
What interventions can be done in the third-stage of labour? correct answers Assist labouring
patient to bear down, to facilitate expulsion of the separated placenta.
Administer oxytoxic medication
Perform hygiene cleansing measures
Introduce patient to baby and facilitate attachment process
What is the fourth stage of labour? correct answers The fourth stage of labours begins with
expulsion of the placenta and lasts until the patient is stable in the immediate postpartum period.
1-2 hours post delivery.
This is when the patients undergo readjustment to their non-pregnant body and function.
What are beta-endorphins? correct answers Endogenous opioids secreted by the pituitary gland
that act on the CNS and PNS to reduce pain. The pain threshold may rise as beta-endorphins
increase, enabling patients in labour to tolerate acute pain.