Stages/phases of labor
During which phase of the first stage does cervical dilation rapidly progress from 6–10 cm?
Active phase
Which deceleration mirrors uterine contractions and is considered benign?
Early decelerations
What is the expected contraction pattern during active labor?
Every 2–5 minutes lasting 45–60 seconds
Which opioid medication is commonly used for IV labor pain?
Fentanyl
What is uterine tachysystole?
More than 5 contractions in 10 minutes averaged over 30 minutes
What position improves uteroplacental perfusion during fetal distress?
Left lateral side-lying
What medication is used to stop preterm labor?
Tocolytics such as terbutaline or nifedipine
Describe the normal odor of amniotic fluid.
Mild, ocean-like or beach-like
Name the two hormones most responsible for initiating and sustaining labor.
Prostaglandins and oxytocin
What deceleration is caused by umbilical cord compression?
Variable decelerations
What term describes uterine contractions that are too frequent, lasting longer than 90 seconds?
Uterine tachysystole
What is a major nursing concern after administering an epidural?
Maternal hypotension and decreased placental perfusion.
What intrapartum complication is associated with hypertension and decreased placental perfusion?
Preeclampsia
Which medication is given to prevent seizures in preeclampsia?
Magnesium sulfate
What medication is given after delivery to prevent postpartum hemorrhage?
Oxytocin
Identify the test that turns blue in the presence of amniotic fluid.
Nitrazine test
What phase of labor is characterized by intense contractions, shaking, nausea, and irritability?
Transition phase
Which deceleration indicates uteroplacental insufficiency and requires intervention?
Late decelerations
What medication is used to reduce uterine tachysystole?
Terbutaline
Why should butorphanol (Stadol) be avoided in opioid-dependent patients?
It can precipitate acute withdrawal
What are two signs of uterine rupture?
Sudden abdominal pain, loss of fetal station, abnormal fetal heart rate, vaginal bleeding
What are the nursing priorities for amniotic fluid embolism?
Oxygenation, cardiovascular support, emergency response, preparation for CPR
What are two serious side effects of oxytocin?
Uterine tachysystole and fetal distress
Explain why premature rupture of membranes before 34 weeks may be managed expectantly.
To promote fetal lung maturity and reduce prematurity risks
Identify the three components assessed during a sterile vaginal exam.
Dilation, effacement, station
Identify the five components of fetal heart rate interpretation.
Baseline, variability, accelerations, decelerations, contractions
How is contraction frequency measured?
Time from the start of one contraction to the start of the next
Name one nonpharmacologic pain relief method used during labor.
Breathing techniques, position changes, hydrotherapy, massage, relaxation
What complication is indicated by sudden fetal bradycardia after rupture of membranes?
Umbilical cord prolapse
What is the priority action for a prolapsed umbilical cord?
Manual elevation of the presenting part and knee-chest or Trendelenburg position
What medication is used to induce or augment labor?
Oxytocin (Pitocin)
Identify what TACO stands for when assessing amniotic fluid.
Time, Amount, Color, Odor
During which stage is the nurse most concerned with postpartum hemorrhage?
Fourth stage of labor
Name three nursing interventions for recurrent late decelerations.
Turn patient to side, stop oxytocin, administer oxygen, increase IV fluids, notify provider
Why is resting tone important to assess between contractions?
Ensures uterine relaxation and adequate fetal oxygenation
What assessments are required before and after epidural placement?
Baseline vitals, fetal heart rate, platelet count, blood pressure, bladder status
What immediate nursing actions are required for shoulder dystocia?
McRoberts maneuver, suprapubic pressure, call for assistance
What emergency requires manual elevation of the presenting part until delivery?
Umbilical cord prolapse
Which uterotonic medication is contraindicated in patients with asthma?
Carboprost (Hemabate)
Identify the priority nursing assessment after rupture of membranes occurs.
Assess fetal heart rate to check for umbilical cord prolapse