NUR401 Exam Questions with Answers
What are the maternal responses to labor? - ✔✔Intermittent contractions of the upper uterus
to push fetus down and maintain placental perfusion; forms a retraction ring
cervix effaces and dilates
What are the fetal responses to labor? - ✔✔placenta maintains reserves for perfusion during
contractions; CV system reacts quickly; fetal lung fluid decreases as thoracic compression
encourages its expulsion
Four P's of Labor - ✔✔Powers
Passage
Passenger
Psyche
What are the two components of Powers of labor? - ✔✔contractions (1st stage) from onset to
dilation
pushing (2nd stage) from dilation to birth
Passage - ✔✔maternal pelvis and soft tissues
pelvis: does not readily yield to the forces of labor; linea terminalis must be wide enough for
fetus to pass through (gynecoid shape) or cephalopelvic disproportion results.
soft tissues: relaxin softens cartilage link of the pelvis and surrounding tissues/ligaments
What is the largest part of the fetus? - ✔✔Head
,Fetal Lie - ✔✔The relationship between fetal maternal spine
Ideal: lateral
Problematic: transverse
Fetal attitude - ✔✔Flexion (preferred) or extension
Presentation - ✔✔Which part of the fetus is closest to the cervis
Ideal: cephalic (vertex) = head down
other:
- brow (forehead against cervix)
- face (face against cervix)
- breech (footling, double footling, frank)
Psyche - ✔✔circumstances/experiences may increase catecholamines which decrease
UC/placental perfusion and increase pain
It's important to promote relaxation
Premonitory signs of labor - ✔✔Braxton-Hicks, Lightening, Bloody Show, Nesting, Spontaneous
Rupture of Membranes (SROM)
True Labor - ✔✔regular and consistent contractions that increase in intensity, duratrion, and
frequency
contraction pain begins in the back and wraps around to the front; worsened by walking
cervix dilates and effaces
False Labor - ✔✔contractions are inconsistent in frequency, duration, and intensity
annoying pain in the abdomen/groin that disappears with walking
, no cervical changes
What is an expectation for multiparous patients? - ✔✔Their labors will be shorter the more
deliveries they have had
Signs of Impending Birth - ✔✔grunting, bearing down, "The Baby is Coming!"
First Stage of Labor - ✔✔Cervix dilates and effaces
Latent: 0-5cm; longer in nullipara
Active: 6-10cm; null = 8-10 hrs and multi = 5-7 hrs
Assessments for the first stage of labor - ✔✔Fetal Monitoring, contractions, sterile cervical
exams, status of membranes, pain, I+Os, support person status
Second Stage of Labor - ✔✔Birth
Assessments for the second stage of labor - ✔✔Signs of complications, maternal/neonatal VS,
Apgar, weight/height of neonate
Third Stage of Labor - ✔✔Delivery of the placenta; may take up to 30 minutes
Assessments for third stage of labor - ✔✔sx of hemorrhage, status of placenta, VS
Fourth stage of labor - ✔✔recovery
Assessments for the fourth stage of labor - ✔✔neonatal assessment, sx of complications
What are the maternal responses to labor? - ✔✔Intermittent contractions of the upper uterus
to push fetus down and maintain placental perfusion; forms a retraction ring
cervix effaces and dilates
What are the fetal responses to labor? - ✔✔placenta maintains reserves for perfusion during
contractions; CV system reacts quickly; fetal lung fluid decreases as thoracic compression
encourages its expulsion
Four P's of Labor - ✔✔Powers
Passage
Passenger
Psyche
What are the two components of Powers of labor? - ✔✔contractions (1st stage) from onset to
dilation
pushing (2nd stage) from dilation to birth
Passage - ✔✔maternal pelvis and soft tissues
pelvis: does not readily yield to the forces of labor; linea terminalis must be wide enough for
fetus to pass through (gynecoid shape) or cephalopelvic disproportion results.
soft tissues: relaxin softens cartilage link of the pelvis and surrounding tissues/ligaments
What is the largest part of the fetus? - ✔✔Head
,Fetal Lie - ✔✔The relationship between fetal maternal spine
Ideal: lateral
Problematic: transverse
Fetal attitude - ✔✔Flexion (preferred) or extension
Presentation - ✔✔Which part of the fetus is closest to the cervis
Ideal: cephalic (vertex) = head down
other:
- brow (forehead against cervix)
- face (face against cervix)
- breech (footling, double footling, frank)
Psyche - ✔✔circumstances/experiences may increase catecholamines which decrease
UC/placental perfusion and increase pain
It's important to promote relaxation
Premonitory signs of labor - ✔✔Braxton-Hicks, Lightening, Bloody Show, Nesting, Spontaneous
Rupture of Membranes (SROM)
True Labor - ✔✔regular and consistent contractions that increase in intensity, duratrion, and
frequency
contraction pain begins in the back and wraps around to the front; worsened by walking
cervix dilates and effaces
False Labor - ✔✔contractions are inconsistent in frequency, duration, and intensity
annoying pain in the abdomen/groin that disappears with walking
, no cervical changes
What is an expectation for multiparous patients? - ✔✔Their labors will be shorter the more
deliveries they have had
Signs of Impending Birth - ✔✔grunting, bearing down, "The Baby is Coming!"
First Stage of Labor - ✔✔Cervix dilates and effaces
Latent: 0-5cm; longer in nullipara
Active: 6-10cm; null = 8-10 hrs and multi = 5-7 hrs
Assessments for the first stage of labor - ✔✔Fetal Monitoring, contractions, sterile cervical
exams, status of membranes, pain, I+Os, support person status
Second Stage of Labor - ✔✔Birth
Assessments for the second stage of labor - ✔✔Signs of complications, maternal/neonatal VS,
Apgar, weight/height of neonate
Third Stage of Labor - ✔✔Delivery of the placenta; may take up to 30 minutes
Assessments for third stage of labor - ✔✔sx of hemorrhage, status of placenta, VS
Fourth stage of labor - ✔✔recovery
Assessments for the fourth stage of labor - ✔✔neonatal assessment, sx of complications
