Download N112 LABOR AND DELIVERY PART 2 WITH COMPLETE SOLUTIONS!! and more Exams Advanced Education in PDF only on Docsity!
N112 LABOR AND DELIVERY PART 2 WITH
COMPLETE SOLUTIONS!!
fetoscope a stethoscope for listening to fetal heart tones
doptone Hand held ultrasonic device used to listen to fetal heart tones. Must be used with a conductive gel
When is it important to listen to fetal heart sounds?
- during contractions and for 30 seconds after contraction
- in the first stage, Q 15-30 minutes
- in the second stage, Q 5 minutes
- immediately after rupture of membranes
Tocodynamometer (toco) pressure strain gauge in a disc
- applied around the abdomen
- disc is pressed by abdominal P changes
Intrauterine Pressure Catheter (IUPC) A catheter that can be placed through the cervix into the uterus to measure uterine
pressure during labor. Some types of catheters may be inserted for the purpose of infusing warmed saline to add additional intrauterine fluid when oligohydramnios is present.
Tachycardia in a fetus can be sign of: prematurity, maternal fever, fetal activity, fetal hypoxia/infection, medication
- if persists for more than 10 minutes, or with late decelerations, fetal distress
Bradycardia in a fetus can be a sign of: fetal hypoxia, maternal drugs/hypotension, prolonged cord compression, congenital heart lesions
- if persistent or more than 20 below baseline, may indicate cord compression or separation of placenta
a ______________ fluctuation in fetal heart rate is 6-25 bpm and is considered normal moderate
fetal heart accelerations normal elevation of fetal heart rate of more than 15 bpm over baseline for at least 15 seconds (but less than 2 minutes)
fetal heart decelerations Abrupt decrease in HR; normal response to head compression; returns to normal after contraction ends. Only worry about late deceleration when it drops and doesn't recover until 30+ s after contraction (distress!)
- ominous if repetitive, prolonged, severe, slow return to baseline
During labor, the nurse notes that there are no accelerations in the fetal heart rate. What does this indicate, and what action should the nurse take?
Fetal distress. Have mom change position and notify the HCP
During labor, the nurse notes that there are early decelerations in the fetal heart rate. What does this indicate, and what action should the nurse take?
None. This is an indication of fetal head compression, which is normal.
During labor, the nurse notes that there are late or variable decelerations in the fetal heart rate. What does this indicate, and what action should the nurse take?
Late: UPI Variable: CC
- position mom on the left side & notify HCP
- oxygen by mask at 10L
- increase rate of IV fluid
- may stop oxytocin
a progressive increase or decrease in baseline heart rate, or a progressive decrease in baseline variability are considered ________________ FHR patterns, and may be signs of
hypoxia. nonreassuring
normal meconium staining: pale, straw-colored with white flecks
abnormal meconium staining: pea-green or brown, yellow, port-wine
breathing patterns of first stage of labor: slow breathing: in thru nose, out thru mouth light accelerated: in/out thru mouth, 1 sec breaths variable breathing: "hee-hee-who" with occasional longer "puh" exhale
breathing patterns of second stage of labor: expulsion breathing: take a breath, bear down, hold it as long as comfortable grunting and moaning - slowly release air and open glottis 3-5 brief (4-6 second) pushes with each contraction
Intra-uterine growth restriction IUGR
- Station
- Consistency
- Cervix Position (tips forward when ready for labor)
amniotomy artificial rupture of membranes
Prostaglandin gel is used to: ripen or soften the cervix
caput succedaneum diffuse edema of the fetal scalp that crosses the suture lines. re-absorbes within 1 to 3 days
vaginal birth after cesarean (VBAC) Giving birth vaginally after having had a previous cesarean birth
Trial of Labor After Cesarean (TOLAC) An attempt to have a vaginal birth after a previous cesarean birth.
To determine fetal lie, presentation, and position, the caregiver uses which assessment technique?
palpation of contractions
The fetal position is ROA. Where is the fetal presenting part in relation to the maternal pelvis? The occiput is facing the right side and the front of the maternal pelvis.
To assess the frequency of a woman's labor contractions, the nurse would time: The start of one contraction to the start of the next.
At what point during labor can an internal fetal monitor be applied? when the cervix is 2-3cm dilated and membranes have ruptured
a woman tells the nurse she believes her membranes have ruptured. What is the best way to validate ROM? Nitrazine test
As the woman's labor progresses, which assessment finding indicates that the second stage of labor has begun? Bearing-down reflex
