Podcast
Questions and Answers
Which of the following best describes the primary difference between hypertonic and hypotonic labor dysfunction?
Which of the following best describes the primary difference between hypertonic and hypotonic labor dysfunction?
- Hypertonic labor shows uncoordinated, painful, frequent contractions without cervical change, while hypotonic labor presents as weak, infrequent contractions. (correct)
- Hypertonic labor requires immediate cesarean birth, while hypotonic labor can be managed with pain relief.
- Hypertonic labor involves weak, infrequent contractions, while hypotonic labor is characterized by strong, regular contractions.
- Hypertonic labor is managed with oxytocin augmentation, while hypotonic labor is treated with rest and hydration.
During a shoulder dystocia, which intervention should the nurse perform first?
During a shoulder dystocia, which intervention should the nurse perform first?
- Apply fundal pressure.
- Administer oxygen to the mother.
- Initiate the McRoberts maneuver. (correct)
- Prepare for immediate cesarean section.
A patient with a history of obesity is at a higher risk for which of the following complications during labor and delivery?
A patient with a history of obesity is at a higher risk for which of the following complications during labor and delivery?
- Decreased risk of gestational diabetes.
- Reduced likelihood of cesarean birth.
- Increased risk of thromboembolism. (correct)
- Lower incidence of postpartum complications.
What does a high Bishop score indicate when considering labor induction?
What does a high Bishop score indicate when considering labor induction?
Which of the following findings would indicate tachysystole in a patient undergoing oxytocin induction?
Which of the following findings would indicate tachysystole in a patient undergoing oxytocin induction?
What is the primary risk associated with external cephalic version (ECV)?
What is the primary risk associated with external cephalic version (ECV)?
When performing an amniotomy, what is the most important nursing intervention after the membranes are ruptured?
When performing an amniotomy, what is the most important nursing intervention after the membranes are ruptured?
Which condition is a contraindication for a vaginal birth after cesarean (VBAC)?
Which condition is a contraindication for a vaginal birth after cesarean (VBAC)?
What does the presence of meconium-stained amniotic fluid indicate?
What does the presence of meconium-stained amniotic fluid indicate?
Which intervention is most critical in the immediate management of a prolapsed umbilical cord?
Which intervention is most critical in the immediate management of a prolapsed umbilical cord?
Which of the following is the most likely cause of early postpartum hemorrhage (PPH)?
Which of the following is the most likely cause of early postpartum hemorrhage (PPH)?
A patient had a vaginal delivery 5 days ago. She calls the clinic complaining of heavy bleeding that started suddenly. What is the most likely cause?
A patient had a vaginal delivery 5 days ago. She calls the clinic complaining of heavy bleeding that started suddenly. What is the most likely cause?
Which of the following is included in the first-line management of uterine atony immediately after delivery?
Which of the following is included in the first-line management of uterine atony immediately after delivery?
Which of the following factors increases a woman's risk for thromboembolic disorders in the postpartum period?
Which of the following factors increases a woman's risk for thromboembolic disorders in the postpartum period?
A postpartum patient develops a fever, uterine tenderness, and foul-smelling lochia. Which condition is most likely the cause?
A postpartum patient develops a fever, uterine tenderness, and foul-smelling lochia. Which condition is most likely the cause?
Which assessment finding differentiates postpartum blues from postpartum depression (PPD)?
Which assessment finding differentiates postpartum blues from postpartum depression (PPD)?
A nurse is caring for a postpartum patient with a history of depression. Which intervention is the most important for preventing postpartum depression?
A nurse is caring for a postpartum patient with a history of depression. Which intervention is the most important for preventing postpartum depression?
In the context of postpartum complications, what is the primary role of continuous fetal monitoring during labor?
In the context of postpartum complications, what is the primary role of continuous fetal monitoring during labor?
What is a key nursing responsibility when caring for a patient undergoing induction of labor with oxytocin?
What is a key nursing responsibility when caring for a patient undergoing induction of labor with oxytocin?
Which aspect of nursing care is most important in promoting positive outcomes for women experiencing obstetric emergencies?
Which aspect of nursing care is most important in promoting positive outcomes for women experiencing obstetric emergencies?
Flashcards
Dystocia
Dystocia
Difficult labor arising from issues with the powers of labor, the passenger (fetus), or the passage (maternal pelvis).
Hypertonic labor
Hypertonic labor
Uncoordinated, painful, and frequent contractions without cervical change
Hypotonic labor
Hypotonic labor
Weak, infrequent uterine contractions
Shoulder dystocia
Shoulder dystocia
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McRoberts maneuver
McRoberts maneuver
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Bishop score
Bishop score
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Induction of labor
Induction of labor
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Augmentation of labor
Augmentation of labor
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Version
Version
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Tachysystole
Tachysystole
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Amniotomy
Amniotomy
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Cesarean birth
Cesarean birth
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Postpartum hemorrhage (PPH)
Postpartum hemorrhage (PPH)
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Uterine atony
Uterine atony
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Inversion
Inversion
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Subinvolution
Subinvolution
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Thromboembolic disorders
Thromboembolic disorders
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Endometritis
Endometritis
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Postpartum depression (PPD)
Postpartum depression (PPD)
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Postpartum psychosis
Postpartum psychosis
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Study Notes
- Dystocia is difficult labor resulting from issues with the powers of labor, the passenger (fetus), or the passage (maternal pelvis).
- Dysfunctional labor patterns are categorized as either hypertonic or hypotonic uterine activity.
- Hypertonic labor involves uncoordinated, painful, and frequent contractions without cervical change.
- Management of hypertonic labor includes rest, hydration, and pain relief.
- Hypotonic labor is characterized by weak, infrequent contractions.
- Hypotonic labor may require oxytocin augmentation; cesarean birth may be necessary if augmentation fails.
- Fetal size (macrosomia), malpresentation (breech, transverse lie), and malposition (occiput posterior) can lead to complications
- Shoulder dystocia is an obstetrical emergency where the anterior fetal shoulder impacts behind the maternal pubic bone after delivery of the head.
- McRoberts maneuver (hyperflexion of maternal legs) and suprapubic pressure are interventions for shoulder dystocia.
- Pelvic structure abnormalities or soft tissue obstructions like a full bladder can cause passage problems.
- Maternal obesity increases the risks of gestational diabetes, hypertension, thromboembolism, infection, dysfunctional labor, cesarean birth, and postpartum complications.
- Induction of labor artificially starts labor; augmentation enhances ineffective contractions.
- Bishop score assesses cervical readiness for labor; higher scores indicate a greater likelihood of successful induction.
- Mechanical methods of labor induction use balloon catheters or laminaria to dilate the cervix.
- Chemical methods use prostaglandins (misoprostol, dinoprostone) to ripen the cervix.
- Oxytocin stimulates uterine contractions and requires monitoring to prevent complications.
- Tachysystole (excessively frequent contractions) is a potential adverse effect of oxytocin and can lead to fetal distress.
- Nursing care during induction includes monitoring maternal and fetal responses to interventions.
- Version involves turning the fetus from one presentation to another, like external cephalic version (ECV) for breech presentation.
- ECV presents risks such as placental abruption, umbilical cord entanglement, and fetal distress.
- Amniotomy (artificial rupture of membranes) can induce or augment labor; risks include infection and cord prolapse.
- Forceps-assisted birth and vacuum-assisted birth facilitate vaginal delivery when progress is slow or fetal distress occurs.
- These methods carry risks of maternal lacerations, hematomas, and fetal injuries.
- Cesarean birth involves surgical delivery of the fetus through an incision in the abdomen and uterus.
- Indications for cesarean birth include fetal distress, malpresentation, placental abnormalities, and previous cesarean birth.
- Maternal risks of cesarean birth include infection, hemorrhage, thromboembolism, and complications from anesthesia.
- Fetal risks of cesarean birth are prematurity (if gestational age is inaccurate) and injury during surgery.
- Vaginal birth after cesarean (VBAC) is an option for some women with a prior cesarean delivery.
- VBAC carries a risk of uterine rupture, which is a life-threatening complication.
- Meconium-stained amniotic fluid can indicate fetal distress and may lead to meconium aspiration syndrome in the newborn.
- Shoulder dystocia can cause birth injuries like brachial plexus injury (Erb's palsy) and clavicle fracture in the newborn.
- Prolapsed umbilical cord occurs when the cord precedes the fetus, compromising fetal oxygenation.
- Management of prolapsed cord includes elevating the presenting part to relieve pressure on the cord and immediate cesarean delivery.
- Rupture of the uterus is rare but catastrophic, often associated with VBAC or previous uterine surgery.
- Amniotic fluid embolism (AFE) occurs when amniotic fluid enters the maternal circulation, causing cardiorespiratory collapse.
- Disseminated intravascular coagulation (DIC) is a life-threatening complication involving abnormal blood clotting and hemorrhage.
- Postpartum hemorrhage (PPH) is excessive bleeding after childbirth, often caused by uterine atony (failure of the uterus to contract).
- PPH can be in the antepartum period.
- Early PPH happens within 24 hours of birth; late PPH is more than 24 hours after birth, up to 6 weeks postpartum.
- Uterine atony means the uterus fails to contract adequately after delivery.
- Risk factors for uterine atony include overdistended uterus, multiple gestation, hydramnios, grandmultiparity, prolonged or rapid labor, use of oxytocin, and magnesium sulfate.
- Management of uterine atony includes fundal massage, medications (oxytocin, misoprostol, methylergonovine, carboprost tromethamine), and bimanual compression.
- Lacerations of the genital tract can cause significant bleeding after birth.
- Retained placental fragments can lead to late PPH.
- Hematomas can form in the vulva, vagina, or retroperitoneal space after delivery.
- Inversion indicates the uterus is turned inside out after birth.
- Subinvolution means the uterus does not return to its normal size after birth.
- Thromboembolic disorders include superficial thrombophlebitis, deep vein thrombosis (DVT), and pulmonary embolism (PE).
- Risk factors for thromboembolism include hypercoagulability of pregnancy, venous stasis, and vessel injury during childbirth.
- Postpartum infections include endometritis (infection of the uterine lining), wound infections, urinary tract infections (UTIs), and mastitis (breast infection).
- Endometritis is often associated with cesarean birth and prolonged rupture of membranes.
- Postpartum depression (PPD) is a mood disorder that can affect women after childbirth.
- Risk factors for PPD include history of depression, stressful life events, and lack of social support.
- Postpartum psychosis is a severe mental illness that can occur after childbirth, characterized by hallucinations and delusions.
- Postpartum depression or psychosis can impact parental attachment.
- Nurses play a crucial role in assessing, preventing, and managing complications during labor and birth.
- Continuous fetal monitoring helps detect fetal distress and guide interventions.
- Early identification and prompt treatment of complications can improve maternal and fetal outcomes.
- Emotional support and education are essential components of nursing care for women experiencing complications.
- Collaboration with the healthcare team ensures comprehensive and coordinated care.
- Documentation of assessments, interventions, and patient responses is critical for legal and quality assurance purposes.
- Adherence to safety protocols and evidence-based practices minimizes risks and promotes positive outcomes.
- Cultural sensitivity and individualized care are essential to meet the unique needs of each woman and her family.
- Nurses advocate for the rights and well-being of women and their newborns.
- Continuing education and professional development enhance nurses' knowledge and skills in managing obstetric emergencies.
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