NSPN 7100 (Obstetrics Medicine) STUDY
GUIDE QUESTIONS AND ANSWERS
COMPLETE AND ACCURATE.
Name the three planes of the true pelvis that play a role in labor.
The inlet or brim, the mi pelvis or cavity, and the outlet.
What tissues can be found in the soft pelvis?
The soft pelvis includes the lower uterine segment, the pelvic floor muscles, the
cervix, the vagina, and the introitus.
What are considered the primary powers?
Involuntary uterine contractions
What are considered the secondary powers?
Maternal pushing efforts during uterine contractions
What are the advantages of changing women's position during labour?
Frequent changes of position during labour relieve fatigue, increase comfort,
and improve circulation. Certain positions are anatomically beneficial in
allowing gravity to advance the fetus through the birth canal and may help in
opening the pelvic diameters to allow fetal descent and rotation. In early
labour contractions may also be improved by upright positions and
ambulation.
Name some gravity enhancing positions that can be used during labour?
Gravity enhancing positions could include walking, standing, sitting, and
squatting.
When does the first stage of labour start and end?
Begins with the onset of regular contractions accompanied by cervical changes
and ends when the cervix is fully dilated.
,The First Stage of Labour: When does the latent phase start and end?
starts when contractions become regular and painful and cervical effacement
and dilation commences. Although arbitrary, the latent phase is generally
considered completed when the dilatation of the cervix is 3 cm.
The First Stage of Labour: When does the active phase start and end?
refers to the time when labour is well established, with contractions becoming
more painful and usually more frequent and longer. The cervix thins and
dilates from 4 cm to 7 cm.
The First Stage of Labour: When does the transition phase start and end?
usually occurs when the cervix is 8-10 cm and signals the approach of the
second stage of labour. Contractions during this phase may also take on a
more expulsive nature and the labouring woman may feel that she wants to
bear down.
When does the second stage of labour start and end?
Starts with full dilatation of the cervix and ends with the birth of the baby.
When does the third stage of labour start and end?
Starts with the birth of the baby and lasts until the placenta and membranes
are delivered.
How long does the fourth stage of labour last? What is it?
Fourth stage lasts from one to four hours after birth, although two hours after
birth is the commonly accepted time. The fourth stage of labour is the time for
physiologic adjustment and stabilization for the mother.
What are Leopolds maneuvers?
Four abdominal palpations that can help determine the presentation, lie, and
position of baby
Prior to auscultating the fetal heart (FHR), what assessment should be
done by the perinatal nurse to determine the optimal place to listen?
Leopold's maneuvers
,How frequent should the FHR be auscultated in active labor and second
stage?
Every 15-30 minutes in activefirst stage and every 5 minutes in second stage
What point in the contraction phase is the recommended time to assess the
FHR by auscultation?
Between contractions
How long should you listen to determine FHR by auscultation?
60 seconds
The normal FHR for a term fetus is?
110-160 bpm
Documentation of all of the above assessments is recorded on which
documentation tool?
The partagram
How are contractions assessed?
strength, duration, and frequency are assessed and timed over several
contractions
How can contraction strength be described?
mild, moderate, or strong
How is the duration of a contraction measured?
from the onset to the end of the contraction.
How is the frequency of a contraction measured?
from the onset of one contraction to the onset of another.
Why is it still important to manually palpate the strength of contractions
while using a toco-manometer?
The monitor does not accurately measure the strength of contractions, only the
strength and duration
, How do you determine the frequency of contractions?
From the onset of one contraction to the beginning of the next.
How do you determine the duration of a contraction?
It is the time between the onset and the end of a contraction.
What is meant by the resting tone of the uterus?
The tension of the uterine muscle between contractions.
How would you determine the frequency, duration, resting tone, and
strength of contractions?
By palpating the fundus
What can be assessed in a vaginal exam?
Cervix:
position (posterior/mid/anterior),
consistency (soft/firm), effacement, dilation
-Station of the presenting part.
-Fetal position
-Status of the membranes (e.g. bulging)
-Presence of caput and/or molding.
What should be documented during spontaneous rupture of membranes?
The time of rupture, the color of the fluid, and the amount of fluid draining
How would you complete a vaginal exam if membranes have ruptured
prior to labour starting (PROM)?
Sterile
When can an amniotomy or artificial rupture of the membranes (ARM) be
performed? Why might it be performed?
When fetal head is well engaged and cervix is dilating.
To start labour (induction) or to facilitate progress in labour (augmentation).
GUIDE QUESTIONS AND ANSWERS
COMPLETE AND ACCURATE.
Name the three planes of the true pelvis that play a role in labor.
The inlet or brim, the mi pelvis or cavity, and the outlet.
What tissues can be found in the soft pelvis?
The soft pelvis includes the lower uterine segment, the pelvic floor muscles, the
cervix, the vagina, and the introitus.
What are considered the primary powers?
Involuntary uterine contractions
What are considered the secondary powers?
Maternal pushing efforts during uterine contractions
What are the advantages of changing women's position during labour?
Frequent changes of position during labour relieve fatigue, increase comfort,
and improve circulation. Certain positions are anatomically beneficial in
allowing gravity to advance the fetus through the birth canal and may help in
opening the pelvic diameters to allow fetal descent and rotation. In early
labour contractions may also be improved by upright positions and
ambulation.
Name some gravity enhancing positions that can be used during labour?
Gravity enhancing positions could include walking, standing, sitting, and
squatting.
When does the first stage of labour start and end?
Begins with the onset of regular contractions accompanied by cervical changes
and ends when the cervix is fully dilated.
,The First Stage of Labour: When does the latent phase start and end?
starts when contractions become regular and painful and cervical effacement
and dilation commences. Although arbitrary, the latent phase is generally
considered completed when the dilatation of the cervix is 3 cm.
The First Stage of Labour: When does the active phase start and end?
refers to the time when labour is well established, with contractions becoming
more painful and usually more frequent and longer. The cervix thins and
dilates from 4 cm to 7 cm.
The First Stage of Labour: When does the transition phase start and end?
usually occurs when the cervix is 8-10 cm and signals the approach of the
second stage of labour. Contractions during this phase may also take on a
more expulsive nature and the labouring woman may feel that she wants to
bear down.
When does the second stage of labour start and end?
Starts with full dilatation of the cervix and ends with the birth of the baby.
When does the third stage of labour start and end?
Starts with the birth of the baby and lasts until the placenta and membranes
are delivered.
How long does the fourth stage of labour last? What is it?
Fourth stage lasts from one to four hours after birth, although two hours after
birth is the commonly accepted time. The fourth stage of labour is the time for
physiologic adjustment and stabilization for the mother.
What are Leopolds maneuvers?
Four abdominal palpations that can help determine the presentation, lie, and
position of baby
Prior to auscultating the fetal heart (FHR), what assessment should be
done by the perinatal nurse to determine the optimal place to listen?
Leopold's maneuvers
,How frequent should the FHR be auscultated in active labor and second
stage?
Every 15-30 minutes in activefirst stage and every 5 minutes in second stage
What point in the contraction phase is the recommended time to assess the
FHR by auscultation?
Between contractions
How long should you listen to determine FHR by auscultation?
60 seconds
The normal FHR for a term fetus is?
110-160 bpm
Documentation of all of the above assessments is recorded on which
documentation tool?
The partagram
How are contractions assessed?
strength, duration, and frequency are assessed and timed over several
contractions
How can contraction strength be described?
mild, moderate, or strong
How is the duration of a contraction measured?
from the onset to the end of the contraction.
How is the frequency of a contraction measured?
from the onset of one contraction to the onset of another.
Why is it still important to manually palpate the strength of contractions
while using a toco-manometer?
The monitor does not accurately measure the strength of contractions, only the
strength and duration
, How do you determine the frequency of contractions?
From the onset of one contraction to the beginning of the next.
How do you determine the duration of a contraction?
It is the time between the onset and the end of a contraction.
What is meant by the resting tone of the uterus?
The tension of the uterine muscle between contractions.
How would you determine the frequency, duration, resting tone, and
strength of contractions?
By palpating the fundus
What can be assessed in a vaginal exam?
Cervix:
position (posterior/mid/anterior),
consistency (soft/firm), effacement, dilation
-Station of the presenting part.
-Fetal position
-Status of the membranes (e.g. bulging)
-Presence of caput and/or molding.
What should be documented during spontaneous rupture of membranes?
The time of rupture, the color of the fluid, and the amount of fluid draining
How would you complete a vaginal exam if membranes have ruptured
prior to labour starting (PROM)?
Sterile
When can an amniotomy or artificial rupture of the membranes (ARM) be
performed? Why might it be performed?
When fetal head is well engaged and cervix is dilating.
To start labour (induction) or to facilitate progress in labour (augmentation).
