NSPN 7100 EXAM STUDY QUESTIONS AND
ANSWERS ACCUARTE AND VERIFIED RATED
A.
who should be offered a trial of labour after cesarean (TOLAC)?
woman w/ previous transverse low-segment uterine incisions and no
contraindications for c-section
what is the major concern during TOLAC?
uterine rupture
contraindications for trial of labour after c-section (TOLAC)?
- previous suspected classic/inverted T or low vertical incision
- previous major uterine reconstruction that includes hysterectomy or
myomectomy
- previous uterine rupture
- contraindication to labour (placenta previa, malpresentation)
- requested repeat c-section
signs and symptoms of uterine rupture
- atypical or abnormal FHR pattern
- cessation of contractions
- constant abdominal pain
- vaginal bleeding
- hematuria
- signs of maternal shock
what is the most critical adaptation for the newborn to make to
extrauterine life?
establishment of effective respirations
how is the initiation of respirations triggered in neonates?
,combination of chemical, mechanical, thermal, and sensory factors
what are chemical factors to stimulate the respiratory center in a neonate?
progressive decline in pO2 during labour, drop in prostaglandins resulting
from cord clamping
what are mechanical factors to stimulate the respiratory center in a
neonate?
squeezing of chest during vaginal delivery
what are thermal factors to stimulate the respiratory center in a neonate?
warm intrauterine environment to cooler room temp. stimulates respiratory
center in the medulla
what are sensory factors to stimulate the respiratory center in a neonate?
drying the baby to stimulate respiratory center
what is the APGAR scoring abbreviation?
Appearance (color)
Pulse (HR)
Grimace (reflexes, response to stimulation)
Activity (muscle tone)
Respirations
what APGAR score causes us to be worried at 5 minutes?
anything 7 or less
what APGAR score indicates that the infant is making good adjustment @
1 minute?
7 or more
what APGAR score indicates that the infant is having a little difficulty @ 1
minute?
4-6
,what APGAR score indicates that the infant is in severe distress @ 1
minute?
3 or less
when is the first period of reactivity?
within minutes after birth-30 minutes
what happens during the first period of reactivity?
quiet alert state (eyes open, capable of responding to environment). optimal
state for meeting parents. HR 160-180 then settles to 100-120 at 30 mins.
Resps irregular, crackles normal, nasal flaring and chest retractions may
happen
what is the time period of the "sleep" period of transition after birth?
following initial period of reactivity (birth-30 mins), deep sleep occurs for 60-
100 minutes
what changes happen during the "sleep" period of reactivity?
deep sleep. physiologic needs stabilize, such as temp regulation,
oxygenation/circulation, resps rapid but not laboured
when is the second period of reactivity?
between 2-8 hours after birth
how long is the "sleep" period of reactivity?
60-100 minutes
how long is the second period of reactivity?
lasts from 10 mins-several hours
what happens during the second period of reactivity?
brief periods of tachycardia and tachypnea, increased muscle tone, skin color
changes, meconium usually passed
what is one of the most effective ways to support physiologic transition?
, with skin-to-skin contact with mother
what are neonatal benefits of skin to skin?
- stabilizes respirations and oxygen saturations
- thermal regulation
- reduces apnea and bradycardia
- reduces stress and crying
- improves infant state organization and self-regulation
- facilitates neurodevelopment
- accelerated weight gain
- decreases pain response to painful procedures
- increased incidence and duration of breastfeeding
what are maternal benefits of skin to skin?
- increased self-confidence, competence, self-esteem
- enhanced parent-infant attachment
- positively effects maternal mood/behaviour
- increased incidence/duration of breastfeeding
- increased milk supply
- increased confidence in meeting infants needs
what is organization?
infant's ability to regulate physiologic functioning, maintain good tone,
modulate states, and interact with their environment
what is the ability to regular sleep/wake states for an infant essential for?
neurodevelopment
what is the ability to regulate sleep/wake states (organization) and move
between them (modullation) affected by?
gestational age and health status
what is state modulation?
ability to transition smoothly between states
ANSWERS ACCUARTE AND VERIFIED RATED
A.
who should be offered a trial of labour after cesarean (TOLAC)?
woman w/ previous transverse low-segment uterine incisions and no
contraindications for c-section
what is the major concern during TOLAC?
uterine rupture
contraindications for trial of labour after c-section (TOLAC)?
- previous suspected classic/inverted T or low vertical incision
- previous major uterine reconstruction that includes hysterectomy or
myomectomy
- previous uterine rupture
- contraindication to labour (placenta previa, malpresentation)
- requested repeat c-section
signs and symptoms of uterine rupture
- atypical or abnormal FHR pattern
- cessation of contractions
- constant abdominal pain
- vaginal bleeding
- hematuria
- signs of maternal shock
what is the most critical adaptation for the newborn to make to
extrauterine life?
establishment of effective respirations
how is the initiation of respirations triggered in neonates?
,combination of chemical, mechanical, thermal, and sensory factors
what are chemical factors to stimulate the respiratory center in a neonate?
progressive decline in pO2 during labour, drop in prostaglandins resulting
from cord clamping
what are mechanical factors to stimulate the respiratory center in a
neonate?
squeezing of chest during vaginal delivery
what are thermal factors to stimulate the respiratory center in a neonate?
warm intrauterine environment to cooler room temp. stimulates respiratory
center in the medulla
what are sensory factors to stimulate the respiratory center in a neonate?
drying the baby to stimulate respiratory center
what is the APGAR scoring abbreviation?
Appearance (color)
Pulse (HR)
Grimace (reflexes, response to stimulation)
Activity (muscle tone)
Respirations
what APGAR score causes us to be worried at 5 minutes?
anything 7 or less
what APGAR score indicates that the infant is making good adjustment @
1 minute?
7 or more
what APGAR score indicates that the infant is having a little difficulty @ 1
minute?
4-6
,what APGAR score indicates that the infant is in severe distress @ 1
minute?
3 or less
when is the first period of reactivity?
within minutes after birth-30 minutes
what happens during the first period of reactivity?
quiet alert state (eyes open, capable of responding to environment). optimal
state for meeting parents. HR 160-180 then settles to 100-120 at 30 mins.
Resps irregular, crackles normal, nasal flaring and chest retractions may
happen
what is the time period of the "sleep" period of transition after birth?
following initial period of reactivity (birth-30 mins), deep sleep occurs for 60-
100 minutes
what changes happen during the "sleep" period of reactivity?
deep sleep. physiologic needs stabilize, such as temp regulation,
oxygenation/circulation, resps rapid but not laboured
when is the second period of reactivity?
between 2-8 hours after birth
how long is the "sleep" period of reactivity?
60-100 minutes
how long is the second period of reactivity?
lasts from 10 mins-several hours
what happens during the second period of reactivity?
brief periods of tachycardia and tachypnea, increased muscle tone, skin color
changes, meconium usually passed
what is one of the most effective ways to support physiologic transition?
, with skin-to-skin contact with mother
what are neonatal benefits of skin to skin?
- stabilizes respirations and oxygen saturations
- thermal regulation
- reduces apnea and bradycardia
- reduces stress and crying
- improves infant state organization and self-regulation
- facilitates neurodevelopment
- accelerated weight gain
- decreases pain response to painful procedures
- increased incidence and duration of breastfeeding
what are maternal benefits of skin to skin?
- increased self-confidence, competence, self-esteem
- enhanced parent-infant attachment
- positively effects maternal mood/behaviour
- increased incidence/duration of breastfeeding
- increased milk supply
- increased confidence in meeting infants needs
what is organization?
infant's ability to regulate physiologic functioning, maintain good tone,
modulate states, and interact with their environment
what is the ability to regular sleep/wake states for an infant essential for?
neurodevelopment
what is the ability to regulate sleep/wake states (organization) and move
between them (modullation) affected by?
gestational age and health status
what is state modulation?
ability to transition smoothly between states
