Labor and Birth Complication
What is a prolapsed umbilical cord?
The umbilical cord descends through the cervix alongside or ahead of the presenting fetal part
What are the Five Ps of labor?
Passenger, passageway, powers, position, and psyche.
Name one nonpharmacologic method of labor pain relief.
Breathing and relaxation, massage, position changes, hydrotherapy when appropriate, or continuous support.
In VEAL CHOP, what does VEAL stand for?
Variable, Early, Accelerations, Late — the fetal heart rate patterns.Hide answer
What is one important assessment when a patient arrives in labor?
Maternal vital signs, contraction pattern, fetal heart rate, labor history, and signs of complications.
After membrane rupture, the fetal heart rate suddenly drops and the cord is visible. What emergency should the nurse suspect?
Umbilical cord prolapse.
What is the difference between fetal lie and fetal presentation?
Lie is the relationship of the fetal spine to the maternal spine. Presentation is the fetal part entering the pelvis first.
What type of anesthesia is commonly used for an epidural during labor?
Regional anesthesia that reduces pain sensation in the lower body.
An early deceleration mirrors the contraction. What is its usual cause?
Fetal head compression. It is usually a benign pattern when the rest of the assessment is reassuring.
Why should the nurse ask whether a patient has felt fetal movement and whether the membranes have ruptured?
These findings help assess fetal well-being, labor status, and risks such as infection or umbilical cord prolapse.
After delivery, a patient has heavy vaginal bleeding and a boggy uterus. What is the likely cause?
Uterine atony. The uterus is not contracting effectively to compress placental-site blood vessels.
What are the three phases of the first stage of labor traditionally taught in nursing?
Latent, active, and transition phases.
After an epidural, the patient's blood pressure drops and the fetal heart rate decreases. What complication may be occurring?
Maternal hypotension that can reduce uteroplacental perfusion and affect fetal oxygenation.
A variable deceleration occurs. What is the most common cause?
Umbilical cord compression.
A laboring patient says, 'I cannot do this anymore.' What is a therapeutic nursing response?
Offer calm reassurance, assess coping and pain, provide specific coaching, and support the patient's preferences
During birth, the fetal head delivers but retracts against the perineum and the shoulders do not deliver. What complication is this?
Shoulder dystocia. Call for help and prepare for maneuvers such as McRoberts positioning and suprapubic pressure; never use fundal pressure.
The cervix is 10 cm dilated. What stage of labor is the patient entering?
The second stage: complete cervical dilation through birth of the baby.
What is an important nursing assessment before and after administering an opioid analgesic during labor?
Assess maternal respiratory status, sedation, vital signs, pain, and fetal status; consider proximity to birth and newborn respiratory-depression risk.
Late decelerations occur repeatedly with contractions. What is the primary concern?
Uteroplacental insufficiency and reduced fetal oxygenation.
After rupture of membranes, what assessment is especially urgent?
Assess fetal heart rate promptly to detect possible cord prolapse, then assess fluid color, odor, and time of rupture.
Immediately after rupture of membranes, the fetal heart rate drops to 60/min. What should the nurse prioritize while urgently summoning the obstetric team?
Suspect cord prolapse, relieve cord compression by positioning the patient knee-chest or hips elevated as appropriate, and if the cord is palpable, elevate the presenting part with a gloved hand. Do not push the cord back in. Prepare for emergency birth.Hide answer
A laboring patient's contractions are strong, but the cervix stops dilating. Name two possible factors the nurse should assess.
Ineffective powers or contractions, fetal position or size, pelvic adequacy, and maternal position or other contributing factors. The cause requires clinical assessment.
A patient receiving an epidural reports difficulty breathing and develops severe hypotension. What is the priority?
Call for immediate assistance, assess airway and breathing, support circulation, monitor fetal status, and initiate emergency interventions per protocol.
A patient receiving oxytocin has contractions every minute with recurrent late decelerations. What should the nurse do first?
Stop oxytocin, reposition laterally, call for assistance, assess maternal status, and initiate appropriate intrauterine resuscitation measures.
A patient has an urge to push, but the cervix is not fully dilated. What should the nurse do?
Assess labor progress and coach the patient to pant or breathe through the urge as appropriate while notifying the care team; avoid directed pushing until complete dilation unless a clinician directs otherwise.