Jeopardy again?
Immediately following delivery, what should the nurse do to care for the infant?
Suction the mouth then nose
The client's last period was on March 17th. What will be her EDD/EDB?
December 24th
Your client is currently pregnant. She has a 5 year old daughter who was born at 39 weeks, a son that is 2 born at 32 weeks. In between those two pregnancies she had a spontaneous abortion at 10 weeks, and then she gave birth to twin girls at 34 weeks. What is her GTPAL?
G=6
T=1
P=2
A=1
L=4
Why is oxytocin given?
To help contract the uterus -both in intrapartum and then postpartum
Describe Supine Hypotensive Syndrome to me and what interventions are appropriate?
It is where the gravid uterus puts pressure on the major blood vessels when the client lays flat. This can cause decreased blood flow and the patient may complain of dizziness when she sets up. Place a wedge or rolled up towel under one hip.
What differentiates false labor from true labor?
Cervical change
How many of each (veins and arteries) are in the umbilical cord?
2 arteries and 1 vein
What are the 5 P's that affect labor?
Powers
Passage
Passenger
Psyche
Position
Why do we not want contractions lasting longer than 90 seconds?
The uterus needs time to relax and the infant needs time to hyper-oxygenate between contractions
The patient's birth plan request intermittent fetal monitoring. What is the nurse's best response to this question?
A. As long as we have a healthy baseline, intermittent fetal monitoring is allowed.
B. This can put your baby in danger. Are you sure you want to do this?
C. Intermittent fetal monitoring is only allowed when you are up walking in the room/halls.
D. Where did you find the information to support intermittent fetal monitoring?
A. As long as we have a healthy baseline, intermittent fetal monitoring is allowed.
When should RhoGAM be given?
When the mother is Rh -
How is the duration of a contraction measured?
In seconds from the beginning of one contraction to the end of contraction
What is an amniotomy?
Artificial rupture of the sac of membranes
What should be assessed when SROM occurs?
FHR
Amniotic fluid color, amount, and odor
How is frequency of contractions measured?
In minutes, time from beginning of one contraction to the beginning of another.
This refers to the long axis (spine) of the fetus in relationship to the long axis (spine) of the mother.
Fetal Lie
Give me at least 3 signs of impending labor
•Lightening
•Braxton-Hicks
•Cervical Changes
•Nesting
•Weight Loss
•Low Backache
•Mucus Plug/Bloody Show
Why is amniotic fluid important? What does it do? Give me at least 2
Cushions impact to the abdomen
Provides stable temperature for infant
The infant is lying head down in utero with the head flexed and chin tucked to its chest. What am I describing?
Fetal Attitude
Give me at least 3 common discomforts of pregnancy
Nausea/Vomiting
Heartburn
Urinary frequency
Backache
Constipation
Leg Cramps
The client report states that she is 5cm, 70% and -1 station. Explain this to me.
The client's cervix is 5cm dilated and 70% effaced or thinned out. The infant is at -1 station so is still above the ischial spine.
Give me at least 3 physiological changes that happen in pregnancy.
Plasma volume increases quicker than RBC's
Relaxation of ligaments - low back pain
Linea Nigra
Chloasma
Striae - stretch marks
Increase in cardiac output
Displacement of intestines by gravid uterus
Your laboring patient is requesting NOT to have an epidural during this delivery. She asks if she can move around the room freely. What is your answer?
Yes, walking is encouraged as long as the epidural has not been placed. Walking can help speed up labor.
What are three actions/labs that will be done at the initial prenatal visit?
Ultrasound
UA
Blood type and Rh Factor
STI screenings
Education on feelings during the 1st trimester
Weight
Vitals
Give me at least two reasons a vaginal delivery would be contraindicated.
Cephalopelvic disproportion
Breech presentation
Active herpes outbreak
Previous classical uterine incision