Intrapartum 1
Which type of Contractions are Coordinated, Involuntary and Intermittent
A. True
B. False
C. Braxton Hicks
D. Regular
True Contractions are Coordinated: Contracts and relaxes similar to other smooth muscles.
Involuntary: Inability to start and stop however actions may increase and decrease contractions such as walking. Anxiety/Stress can cause the contractions to lessen (due to adrenalin)
Intermittent: Allows for relaxation of the muscle and blood flow to resume
Braxton Hicks or false:
Contractions are considered regular when the duration and frequency are stable over a period of time.
A nurse is assigned to care for a client with hypotonic uterine dysfunction and signs of a slowing labor. The nurse is reviewing the physician's orders and would expect to note which of the following prescribed treatments for this condition?
A. Medication that will provide sedation
B. Increased hydration
C.Oxytocin (Pitocin) infusion
D.Administration of a tocolytic medication
C. Pitocin
Dropping in pregnancy is also known as _________
Lightening: At the end of the third trimester, the baby settles, or drops lower, into the mother's pelvis.
The beginning of one contraction to the beginning of the next is known as:
A. Frequency
B. Duration
C. Intensity
D. Recurrence
Correct: Frequency
Duration: Beginning of one contraction to the end of that contraction.
Intensity: Strength of the contraction
Recurrence: Another word for Frequency but not correct
A nurse is caring for a client in labor. The nurse determines that the client is beginning in the 2nd stage of labor when which of the following assessments is noted?
A.The client begins to expel clear vaginal fluid
B.The contractions are regular
C.The membranes have ruptured
D.The cervix is dilated completely
B. The contractions are regular
A nurse is performing an assessment of a client who is scheduled for a cesarean delivery. Which assessment finding would indicate a need to contact the physician?
A.Fetal heart rate of 180 beats per minute
B.White blood cell count of 12,000
C.Maternal pulse rate of 85 beats per minute
D.Hemoglobin of 11.0 g/dL
A. Fetal HR of 180 may indicate fetal distress
A client arrives at a birthing center in active labor. Her membranes are still intact. and the nurse-midwife prepares to perform an amniotomy. A nurse who is assisting the nurse-midwife explains to the client that after this procedure. she will most likely have:
A. Less pressure on her cervix
B. Increased efficiency of contractions
C. Decreased number of contractions
D. The need for increased maternal blood pressure monitoring
Increased efficiency of contractions
What is the most common presentation?
A. Head first
B. Facing rearward
C. Face and body angled toward the left
D. Transverse lie
E. Chin tucked in
A. Head first AKA Cephalic
Sunny side up is actually known as which presentation?
The occiput posterior presentation (also called sunny-side up), the fetus is head-first but is facing up (toward the mother's abdomen). It is the most common abnormal position or presentation.
A nurse explains the purpose of effleurage to a client in early labor. The nurse tells the client that effleurage is:
A. A form of biofeedback to enhance bearing down efforts during delivery
B. Light stroking of the abdomen to facilitate relaxation during labor and provide tactile stimulation to the fetus
C. The application of pressure to the sacrum to relieve a backache
D. Performed to stimulate uterine activity by contracting a specific muscle group while other parts of the body rest
Light stroking of the abdomen to facilitate relaxation during labor and provide tactile stimulation to the fetus
A nurse in the labor room is caring for a client in the active phases of labor. The nurse is assessing the fetal patterns and notes a late deceleration on the monitor strip. The most appropriate nursing action is to:
A. Place the mother in the supine position
B. Document the findings and continue to monitor the fetal patterns
C. Administer oxygen via face mask
D. Place the mother in a 45 degree angle E. Increase the rate of the Pitocin
C. Administer oxygen via face mask Late decelerations are due to uteroplacental insufficiency This causes hypoxemia; therefore, oxygen is necessary.
Place the mother in a lateral position
This could put the fetus at risk
45 degrees is not indicated
Hold the Pitocin
What hormone has the strongest effect promoting smooth muscle relaxation for contractions (secreted from lower aspect of fetal membranes).
A. Oxytocin
B. Estrogen
C. Progesterone
D. Prostaglandins
Prostaglandins
Oxytocin stimulates uterine contractions
progesterone slows down contractions
Estrogen loosens the ligaments and connective tissue of the birth canal during the last stage of pregnancy.
A nurse is assigned to care for a client with hypotonic uterine dysfunction and signs of a slowing labor. The nurse is reviewing the physician's orders and would expect to note which of the following prescribed treatments for this condition?
A. Medication that will provide sedation
B. Increased hydration
C. Oxytocin (Pitocin) infusion
D.Administration of a tocolytic medication
C Pitocin
Why are intermittent versus sustained contractions important?
intermittent allows the fetus and mother to rest
Increases blood flow to the placents
Sustained contributes to fetal distress. Greater than 90 seconds=tetanic contraction.