Labor and Delivery Overview Quiz
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Questions and Answers

What do the symptoms of a woman who is 38 weeks' pregnant, stating that the baby has dropped and she is having urinary frequency again, describe?

  • Braxton-Hicks contractions
  • Initiation of labor
  • Engagement
  • Lightening (correct)
  • How do Braxton-Hicks contractions differ from labor contractions?

  • Are only mild
  • Are always regular
  • Last several minutes
  • Do not dilate the cervix (correct)
  • Which statement regarding true labor is correct?

  • Contractions may stop with ambulation
  • Discomfort of the contraction is in the fundus
  • Contractions get stronger with ambulation (correct)
  • Contractions do not follow a pattern
  • Why is the size and shape of the true pelvis more important than that of the false pelvis?

    <p>The fetal head must be able to pass through the true pelvis</p> Signup and view all the answers

    What method is used to visualize soft tissue and to determine adequacy of the pelvis?

    <p>Ultrasonography</p> Signup and view all the answers

    What area of the uterus provides the force during a contraction?

    <p>Upper portion</p> Signup and view all the answers

    What is the largest diameter of the fetal skull?

    <p>Biparietal</p> Signup and view all the answers

    What is the reshaping of the skull called when pressure is applied during delivery?

    <p>Molding</p> Signup and view all the answers

    What is the ideal attitude for the fetal body during labor?

    <p>Flexion</p> Signup and view all the answers

    How should the nurse document the fetal position when using Leopold maneuvers and finding a soft rounded prominence at the fundus?

    <p>Right occiput anterior (ROA), vertex</p> Signup and view all the answers

    During the second stage of labor, how often should the nurse monitor the fetal heart rate?

    <p>Every 5 minutes</p> Signup and view all the answers

    Which type of monitor assesses the intensity of contractions?

    <p>Internal monitor</p> Signup and view all the answers

    What does a decrease in fetal heart rate to 120 beats/min at the beginning of a contraction indicate?

    <p>Early deceleration due to head compression</p> Signup and view all the answers

    What would be an appropriate nursing intervention for comfort during the first stage of labor?

    <p>A backrub in the sacral area</p> Signup and view all the answers

    If a woman in active labor has a fetal heart rate of 124 beats/min, what action should the nurse take?

    <p>Reassure the mother the rate is normal</p> Signup and view all the answers

    What is the first priority of the nurse when a patient's membranes have just ruptured?

    <p>Check the fetal heart rate (FHR)</p> Signup and view all the answers

    How should the nurse determine if a patient is in true labor?

    <p>The cervix has softened and effaced</p> Signup and view all the answers

    What immediate action should the nurse take when observing a protruding umbilical cord from the vagina?

    <p>Place the patient in the knee-chest position</p> Signup and view all the answers

    What is the legal responsibility of the nurse when assessing the printout from the fetal monitor?

    <p>Correctly identifying abnormal FHR patterns and notifying the health care provider</p> Signup and view all the answers

    How long does the first stage of labor last?

    <p>The cervix is fully dilated</p> Signup and view all the answers

    Which assessment is the priority when admitting a patient to the labor and delivery unit?

    <p>The timing of contractions</p> Signup and view all the answers

    What would be the most appropriate action for the nurse when a patient screams at her husband to get out of her sight during labor?

    <p>Assure the husband that such behavior is normal</p> Signup and view all the answers

    Which statement is true when a primigravida patient is admitted and the baby is found to be engaged?

    <p>The widest diameter of the presenting part crosses the pelvic inlet</p> Signup and view all the answers

    When should the nurse expect that labor will start after inducing with prostaglandin gel and an amniotomy?

    <p>1 hour</p> Signup and view all the answers

    When does the second stage of labor end?

    <p>With delivery of the baby</p> Signup and view all the answers

    Why is oxytocin administered in the third stage of labor?

    <p>To stimulate uterine contractions</p> Signup and view all the answers

    What is the priority action of the nurse after the delivery of a newborn?

    <p>Suction nose and mouth</p> Signup and view all the answers

    What Apgar score should be assigned to an infant presenting 5 minutes after delivery with a heart rate of 105, some flexion in arms, crying, and a pink body with blue limbs?

    <p>8</p> Signup and view all the answers

    How often should the nurse assess the mother for the first hour following delivery?

    <p>Every 15 minutes</p> Signup and view all the answers

    When the Nitrazine test paper turns yellow on vaginal secretions, what does this indicate?

    <p>Acidic discharge, membranes intact</p> Signup and view all the answers

    Which assessment findings suggest probable fetal distress? (Select all that apply)

    <p>Slow return of FHR to baseline</p> Signup and view all the answers

    Which factors could exclude a pregnant woman from delivering in a birthing center? (Select all that apply)

    <p>The mother has preeclampsia</p> Signup and view all the answers

    Study Notes

    Labor and Delivery Overview

    • Lightening occurs when the baby drops lower into the pelvis, often leading to increased urinary frequency.
    • Braxton-Hicks contractions are non-painful and do not result in cervical dilation.
    • True labor is characterized by contractions that become stronger with movement, while false labor does not follow a regular pattern.

    Pelvis Characteristics

    • The true pelvis is crucial for delivery as the fetal head must pass through it; the false pelvis does not impact birth.
    • Ultrasonography is the preferred method for evaluating pelvis size and soft tissue without harming the fetus.

    Contraction Dynamics

    • The upper portion of the uterus generates the main force during contractions.
    • The biparietal diameter is the largest measurement of the fetal skull.

    Fetal Positioning and Assessment

    • Molding refers to the reshaping of the fetal skull due to pressure during labor.
    • Assessment of fetal position using Leopold maneuvers can indicate a Right Occiput Anterior (ROA) position.
    • Continuous monitoring of fetal heart rate is essential, ideally every 5 minutes during the second stage of labor.

    Monitoring and Interventions

    • An internal monitor assesses contraction intensity effectively.
    • Early deceleration in fetal heart rate indicates head compression during contractions, not fetal distress.
    • Nurses should always check fetal heart rate immediately after membranes rupture.

    Stages of Labor

    • The first stage of labor is the longest and ends when the cervix is fully dilated.
    • The second stage concludes with the delivery of the baby.
    • The use of oxytocin in the third stage helps stimulate uterine contractions.

    Post-Delivery Care

    • Immediately after birth, suctioning the infant's mouth and nose is the first priority.
    • Apgar scores assess the newborn's initial health; a score of 8 indicates generally good condition shortly after birth.

    Maternal Assessment

    • Post-delivery, maternal assessments should occur every 15 minutes.
    • The Nitrazine test differentiates between amniotic fluid status; a yellow result indicates intact membranes.

    Distress Indicators

    • Signs of potential fetal distress include meconium-stained fluid and a slow return of the fetal heart rate to baseline.

    Birthing Center Considerations

    • Certain conditions excluded from birthing center eligibility include planned cesarean delivery and maternal preeclampsia.

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    Description

    Test your knowledge on key concepts related to labor and delivery, including the mechanics of contractions, pelvic characteristics, and fetal positioning. This quiz will help reinforce your understanding of these important aspects in obstetrics and maternity care.

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