VEAL, CHOP,LION PIT
FHR drops suddenly at random times, unrelated to contractions. What’s happening?
Variable decelerations — Cord compression
This prostaglandin gel is used to ripen the cervix before induction.
Dinoprostone (Prepidil)
The stage that begins with onset of contractions and ends with complete dilation.
First stage of labor
You see a sudden drop in FHR after AROM, and you feel the cord. What’s your priority?
Call for help, relieve pressure on cord, knee-chest position, O₂, prep for C-section
A nurse documents FHR baseline 140, moderate variability, no decels, with accelerations. What’s the plan?
Continue to monitor — normal tracing
FHR slows with contractions and returns to baseline before contraction ends.
Early deceleration — Head compression (expected)
This vaginal insert should be removed with onset of labor, ROM, or tachysystole.
Dinoprostone (Cervidil)
This phase is from 0–6 cm, contractions are mild, and mom is excited.
Latent phase
What are the risks of forceps or vacuum-assisted delivery?
Maternal lacerations, bleeding; neonatal bruising, cephalohematoma, facial nerve injury
Prolonged second stage, maternal exhaustion, and fetal distress — what intervention might be needed?
Forceps or vacuum delivery
FHR drops after contractions begin and returns to baseline after it ends.
Late deceleration — Placental insufficiency
This med ripens cervix and treats postpartum hemorrhage.
Misoprostol (Cytotec)
This phase (8–10 cm) is the shortest, hardest, and mom may be irritable and lose control.
Transition phase
After AROM, what must the nurse always check first?
Fetal heart rate
What does a high Bishop score of 3 (≥80% effaced) mean?
Cervix is favorable for induction
What should the nurse do for late decelerations?
LION PIT (Left lateral, IV fluids, O₂, Notify provider, Stop Pitocin)
What is the main risk of all uterine stimulants?
Excessive uterine activity (tachysystole) with or without abnormal FHR
Stage that ends with the birth of the baby.
Second stage
When should a prostaglandin NOT be used?
Nonreassuring FHR, previous C-section, placenta previa
Define and give an example of the 4 Ps
Psyche: moms emotional state and mental attitude toward labor.
Example: If the mother is anxious, fearful, or tense, her stress hormones (like adrenaline) can interfere with uterine contractions and reduce the effectiveness of pushing.
Power: the uterine contractions and the maternal pushing efforts.
Passenger: fetus and its ability to move through the birth canal.
Passage: the maternal pelvis and birth canal through which the baby passes.
Example: A small or abnormally shaped pelvis can prevent descent of the fetus
What FHR pattern is reassuring and needs no intervention?
Accelerations — “Okay” pattern
What are the contraindications for oxytocin (Pitocin)?
Abnormal presentation, CPD, placenta previa, active herpes, fetal distress
In the fourth stage, what are your top nursing priorities?
Maternal stabilization, fundal checks, lochia, bonding, and hemorrhage watch
What’s the main contraindication for performing AROM?
Fetal head not engaged or abnormal lie (breech/transverse)
Fast 5....
1. Normal pelvis shape?
2. How long is precipitous labor?
3. Uterine rupture RF?
4. Management of uterine inversion?
5. Sign of shoulder dystocia
1. Gynecoid
2. 3hrs or less
3. uterine surgery, way to much amnionic fluid, multipara
4. bed rest, no barring down, get it contracting once back in
5. turtling