OB Exam 2
Know FHR range - 110 to 160 bpm
Homan's sign - pain behind the knee upon forced dorsiflexion of the foot.
Main disadvantage of narcotic analgesics if given late in labor - neonatal respiratory depression
Narcotic antagonist- know example - NARCAN
7 powers of birth process- list - passage, passenger, powers, position, psyche, pain management, and
patience.
Station - refers to the position of the fetal head relative to the ischial spines
Engagement - refers to the entrance of the widest diameter of the presenting part of the fetus into
the mother's pelvis.
Signs of hyperventilation - include feelings of anxiety, a feeling that she cannot get enough air, an
elevated heart rate, light-headedness or vertigo, numbness or tingling of the fingers, and chest
tightness.
To manage hyperventilation - encourage the patient to do one of the following: (1) slow down
breathing and breathe through pursed lips, as if blowing out a candle; (2) close her mouth and one
nostril and breathe through one nostril only; or (3) cover her nose and mouth with a paper bag and
breathe in and out into the bag for a few breaths only or for about 15 seconds.
Only 2 perineal pads should be saturated per hour and interventions if excessive lochia is noted - -
Ask the patient when her pad was last changed. This provides a better indication of the amount of
lochia noted.
- Report any abnormal amount, color, or odor.
- Teach the patient about the progression of lochia.
- Alert the health-care provider if more than two peripads are soaked with blood during the first
hour.
, Variable decelerations- what does it indicate & nursing interventions if noted - - An abrupt decrease
in FHR of 15 beats or more.
- Can be caused by cord compression, which disrupts the oxygenation of the fetus.
- Change the patient's position to decrease cord compression.
- Discontinue oxytocin to decrease uterine activity, if applicable.
- Administer oxygen by tight face mask at 10 L/min.
- Assess maternal hydration and increase IV fluids if appropriate.
- Notify the health-care provider.
- Consider an internal FSE for more accurate data about the fetal condition.
- Perform amnioinfusion, if ordered, to correct umbilical cord compression.
- Provide support to the patient and her family to manage anxiety.
Nonpharmacological methods of pain management- know examples - - Creating a relaxing
environment with low lighting, warmth, and quiet
- Displaying a picture of a relaxing scene or baby's first outfit for the woman to view during labor
- Playing relaxing music or sounds, such as a bubbling stream or birds singing
- Using aromatherapy with lavender, sage, or jasmine
- Stimulating the skin with massage to the lower back or light fingertip massage of the abdomen;
stroking of the arm to shoulder or knee to thigh is also relaxing
- Talking the woman through progressive relaxation by having her focus on relaxing her neck and
shoulders, and then progressing the relaxation throughout her body
- Positioning pillows under the uterus to relieve some of the strain on the lower back during labor
- Walking, swaying, or rolling on a birthing ball to help her to relax and to ease labor pain
- Using diversion and distraction methods, such as counting or focusing on a task during a
contraction
- Applying a cool washcloth to the forehead, which is comforting when she is tired and hot from the
work of labor
- Providing ice chips or clear liquids, if permitted by the health-care provider, to soothe her dry
mouth and throat
- Assisting her to use breathing techniques, which are a tool that promotes relaxation and diversion
in labor
Know FHR range - 110 to 160 bpm
Homan's sign - pain behind the knee upon forced dorsiflexion of the foot.
Main disadvantage of narcotic analgesics if given late in labor - neonatal respiratory depression
Narcotic antagonist- know example - NARCAN
7 powers of birth process- list - passage, passenger, powers, position, psyche, pain management, and
patience.
Station - refers to the position of the fetal head relative to the ischial spines
Engagement - refers to the entrance of the widest diameter of the presenting part of the fetus into
the mother's pelvis.
Signs of hyperventilation - include feelings of anxiety, a feeling that she cannot get enough air, an
elevated heart rate, light-headedness or vertigo, numbness or tingling of the fingers, and chest
tightness.
To manage hyperventilation - encourage the patient to do one of the following: (1) slow down
breathing and breathe through pursed lips, as if blowing out a candle; (2) close her mouth and one
nostril and breathe through one nostril only; or (3) cover her nose and mouth with a paper bag and
breathe in and out into the bag for a few breaths only or for about 15 seconds.
Only 2 perineal pads should be saturated per hour and interventions if excessive lochia is noted - -
Ask the patient when her pad was last changed. This provides a better indication of the amount of
lochia noted.
- Report any abnormal amount, color, or odor.
- Teach the patient about the progression of lochia.
- Alert the health-care provider if more than two peripads are soaked with blood during the first
hour.
, Variable decelerations- what does it indicate & nursing interventions if noted - - An abrupt decrease
in FHR of 15 beats or more.
- Can be caused by cord compression, which disrupts the oxygenation of the fetus.
- Change the patient's position to decrease cord compression.
- Discontinue oxytocin to decrease uterine activity, if applicable.
- Administer oxygen by tight face mask at 10 L/min.
- Assess maternal hydration and increase IV fluids if appropriate.
- Notify the health-care provider.
- Consider an internal FSE for more accurate data about the fetal condition.
- Perform amnioinfusion, if ordered, to correct umbilical cord compression.
- Provide support to the patient and her family to manage anxiety.
Nonpharmacological methods of pain management- know examples - - Creating a relaxing
environment with low lighting, warmth, and quiet
- Displaying a picture of a relaxing scene or baby's first outfit for the woman to view during labor
- Playing relaxing music or sounds, such as a bubbling stream or birds singing
- Using aromatherapy with lavender, sage, or jasmine
- Stimulating the skin with massage to the lower back or light fingertip massage of the abdomen;
stroking of the arm to shoulder or knee to thigh is also relaxing
- Talking the woman through progressive relaxation by having her focus on relaxing her neck and
shoulders, and then progressing the relaxation throughout her body
- Positioning pillows under the uterus to relieve some of the strain on the lower back during labor
- Walking, swaying, or rolling on a birthing ball to help her to relax and to ease labor pain
- Using diversion and distraction methods, such as counting or focusing on a task during a
contraction
- Applying a cool washcloth to the forehead, which is comforting when she is tired and hot from the
work of labor
- Providing ice chips or clear liquids, if permitted by the health-care provider, to soothe her dry
mouth and throat
- Assisting her to use breathing techniques, which are a tool that promotes relaxation and diversion
in labor
