Clinical Knowledge Assessment
1. 11.5-14, 30-38: Pregnant HGB, HCT
2. Fetal bradycardia: <110 bpm over 10 minute time period
3. Fetal tachycardia: >160 over 10 minute time period
4. Variability: Represents intactness of fetal CNS
5. Variability (FHR): Most important indicator of fetal well being
6. Variability: Visually detectable FHR oscillations from baseline; defined as
absent, minimal, moderate or marked
7. Acceleration: Visually apparent abrupt increase in FHR above baseline
8. Acceleration: Goal: peak greater or equal to 15 bpm for 15 seconds or more
but under 2 minutes
9. Late deceleration: Visually apparent gradual decrease in FHR below baseline
Onset to nadir greater or equal to 30 seconds and delayed in timing to peak of
contraction with recovery after end of contraction
10. Late deceleration: FHR variability associated with uteroplacental
insufficiency, fetal hypoxia
11. Interventions for late deceleration: Reposition patient, IVF, oxygen, notify
MD, d/c induction or augmentation of labor
12. Early deceleration: Visually apparent gradual decrease in FHR below
baseline Onset to nadir greater or equal to 30 seconds and coincident with
onset, peak, and ending of contractions
13. Early deceleration: FHR variability caused by fetal head compression
14. Variable deceleration: Visually apparent abrupt decrease in FHR below
baseline
Peak greater or equal to 15 bpm for more than 15 seconds but under 2 mins (most
occur with contractions)
15. Variable deceleration: FHR variability caused by cord compression
(interventions to aim to eliminate cord compression and increase fetal
oxygenation)
16. Prolonged deceleration: Visually apparent decrease in FHR below baseline
Decrease by greater than or equal to 15 bpm in greater than or equal to 2 minutes
and under or equal to 1o minutes
17. Normal FHR: 110-160 bpm over 10 minute time period
18. Phases of first stage of labor: latent, active, transition
19. Latent phase: Phase of labor with following contractions:
1/6
, Frequency: 3-30 mins
Duration: 20-40 secs
Intensity: mild to moderate (25-40 mmg Hg IUPC)
20. Active phase: Stage of labor with following contractions:
Frequency: 2-5 mins
Duration: 40-60 secs
Intensity:moderate to strong (50-70 mmg Hg IUPC)
21. Transition phase: Stage of labor with following contractions:
Frequency: 1.5-2 mins
Duration: 60-90 secs
Intensity: strong by palpation (70-90 mmg Hg IUPC)
22. 8.6, 5.3: Length of latent phase for nullipara, multipara (hours)
23. 4.6, 2.4: Length of active phase for nullipara, multipara (hours)
24. 2.6, variable: Length of transition phase for nullipara, multipara (hours)
25. Up to 3 hrs, 0-30 min: Length of second stage for nullipara, multipara (hours)
26. 0-3 cm: Dilation of cervix latent phase
27. 4-7 cm: Dilation of cervix active phase
28. 8-10 cm: Dilation of cervix transition phase
29. 10 cm: Dilation of cervix second stage
30. Back pain relief: hands and knees position, pelvic rocking, lunge, walking,
stair climbing, slow dancing, birthing ball, changing positions
31. Bearing down techniques: Positions: squatting, semi-sitting, hands and
knees, dangling
Spontaneous bearing down: push only with urge, directed using or valsalva
pushing, open-glottis pushing
32. BUBBLE: Breast, uterus, bowel, bladder, lochia, episiotomy/perineum
33. Maternal postpartum assessment: Purpose/use of BUBBLE
34. Maternal postpartum assessment: Purpose/use of HEAVN
35. HEAVN: Homan's sign, emotional bonding and baby, abdomen, vital signs,
nutrition
36. CHESS: Culture/ethnicity/language, health beliefs, economic/educational,
spiritual beliefs, significant others
37. Every 4 hours: Frequency of respiratory, cardiac, and neuromuscular checks
for postpartum mother
2/6
1. 11.5-14, 30-38: Pregnant HGB, HCT
2. Fetal bradycardia: <110 bpm over 10 minute time period
3. Fetal tachycardia: >160 over 10 minute time period
4. Variability: Represents intactness of fetal CNS
5. Variability (FHR): Most important indicator of fetal well being
6. Variability: Visually detectable FHR oscillations from baseline; defined as
absent, minimal, moderate or marked
7. Acceleration: Visually apparent abrupt increase in FHR above baseline
8. Acceleration: Goal: peak greater or equal to 15 bpm for 15 seconds or more
but under 2 minutes
9. Late deceleration: Visually apparent gradual decrease in FHR below baseline
Onset to nadir greater or equal to 30 seconds and delayed in timing to peak of
contraction with recovery after end of contraction
10. Late deceleration: FHR variability associated with uteroplacental
insufficiency, fetal hypoxia
11. Interventions for late deceleration: Reposition patient, IVF, oxygen, notify
MD, d/c induction or augmentation of labor
12. Early deceleration: Visually apparent gradual decrease in FHR below
baseline Onset to nadir greater or equal to 30 seconds and coincident with
onset, peak, and ending of contractions
13. Early deceleration: FHR variability caused by fetal head compression
14. Variable deceleration: Visually apparent abrupt decrease in FHR below
baseline
Peak greater or equal to 15 bpm for more than 15 seconds but under 2 mins (most
occur with contractions)
15. Variable deceleration: FHR variability caused by cord compression
(interventions to aim to eliminate cord compression and increase fetal
oxygenation)
16. Prolonged deceleration: Visually apparent decrease in FHR below baseline
Decrease by greater than or equal to 15 bpm in greater than or equal to 2 minutes
and under or equal to 1o minutes
17. Normal FHR: 110-160 bpm over 10 minute time period
18. Phases of first stage of labor: latent, active, transition
19. Latent phase: Phase of labor with following contractions:
1/6
, Frequency: 3-30 mins
Duration: 20-40 secs
Intensity: mild to moderate (25-40 mmg Hg IUPC)
20. Active phase: Stage of labor with following contractions:
Frequency: 2-5 mins
Duration: 40-60 secs
Intensity:moderate to strong (50-70 mmg Hg IUPC)
21. Transition phase: Stage of labor with following contractions:
Frequency: 1.5-2 mins
Duration: 60-90 secs
Intensity: strong by palpation (70-90 mmg Hg IUPC)
22. 8.6, 5.3: Length of latent phase for nullipara, multipara (hours)
23. 4.6, 2.4: Length of active phase for nullipara, multipara (hours)
24. 2.6, variable: Length of transition phase for nullipara, multipara (hours)
25. Up to 3 hrs, 0-30 min: Length of second stage for nullipara, multipara (hours)
26. 0-3 cm: Dilation of cervix latent phase
27. 4-7 cm: Dilation of cervix active phase
28. 8-10 cm: Dilation of cervix transition phase
29. 10 cm: Dilation of cervix second stage
30. Back pain relief: hands and knees position, pelvic rocking, lunge, walking,
stair climbing, slow dancing, birthing ball, changing positions
31. Bearing down techniques: Positions: squatting, semi-sitting, hands and
knees, dangling
Spontaneous bearing down: push only with urge, directed using or valsalva
pushing, open-glottis pushing
32. BUBBLE: Breast, uterus, bowel, bladder, lochia, episiotomy/perineum
33. Maternal postpartum assessment: Purpose/use of BUBBLE
34. Maternal postpartum assessment: Purpose/use of HEAVN
35. HEAVN: Homan's sign, emotional bonding and baby, abdomen, vital signs,
nutrition
36. CHESS: Culture/ethnicity/language, health beliefs, economic/educational,
spiritual beliefs, significant others
37. Every 4 hours: Frequency of respiratory, cardiac, and neuromuscular checks
for postpartum mother
2/6
