Podcast
Questions and Answers
What is the main management approach for Premature Rupture of Membranes (PPROM) at less than 32 weeks?
What is the main management approach for Premature Rupture of Membranes (PPROM) at less than 32 weeks?
- Begin labor induction immediately
- Administer high-dose antibiotics only
- Immediate delivery of the baby
- Expectant and conservative management (correct)
What is a key intervention for fetal neuroprotection during preterm premature rupture of membranes?
What is a key intervention for fetal neuroprotection during preterm premature rupture of membranes?
- Magnesium sulfate administration (correct)
- Antenatal glucocorticoids only
- Immediate cesarean delivery
- Continuous fetal monitoring
What characterizes the Active Phase of the First Stage of Labor?
What characterizes the Active Phase of the First Stage of Labor?
- Fetal monitoring becomes less important
- Cervical dilation from 6 to 10 cm (correct)
- Cervix is fully dilated and pushing begins
- Cervical dilation from 0 to 6 cm
Which stage of labor follows the birth of the baby?
Which stage of labor follows the birth of the baby?
Which statement about the Fourth Stage of Labor is true?
Which statement about the Fourth Stage of Labor is true?
What is recommended for all women with preterm PROM between 24 0/7 and 34 0/7 weeks of gestation?
What is recommended for all women with preterm PROM between 24 0/7 and 34 0/7 weeks of gestation?
What is the purpose of an External Cephalic Version (ECV)?
What is the purpose of an External Cephalic Version (ECV)?
At what gestational age is the success rate for ECV approximately 65%?
At what gestational age is the success rate for ECV approximately 65%?
Which of the following is NOT a characteristic of preterm labor (PTL)?
Which of the following is NOT a characteristic of preterm labor (PTL)?
What is the diagnostic test used for determining preterm labor?
What is the diagnostic test used for determining preterm labor?
Which factor is NOT considered a risk factor for spontaneous preterm birth?
Which factor is NOT considered a risk factor for spontaneous preterm birth?
What is the primary purpose of ultrasound scanning during an ECV?
What is the primary purpose of ultrasound scanning during an ECV?
Which of the following statements about cervical length is true concerning preterm birth?
Which of the following statements about cervical length is true concerning preterm birth?
Which of the following best describes indicated preterm birth?
Which of the following best describes indicated preterm birth?
What is considered fetal tachycardia?
What is considered fetal tachycardia?
Which of the following can be a cause of fetal tachycardia?
Which of the following can be a cause of fetal tachycardia?
Which medication is associated with causing fetal tachycardia?
Which medication is associated with causing fetal tachycardia?
Which measure is NOT part of intrauterine resuscitation?
Which measure is NOT part of intrauterine resuscitation?
Fetal cardiac arrhythmias can lead to which condition?
Fetal cardiac arrhythmias can lead to which condition?
What is the primary aim of intrauterine resuscitation?
What is the primary aim of intrauterine resuscitation?
What marks the end of the first stage of labor?
What marks the end of the first stage of labor?
How is effacement expressed during labor?
How is effacement expressed during labor?
Which of the following represents the degree of descent of the presenting fetal part?
Which of the following represents the degree of descent of the presenting fetal part?
What is the typical range for cervical dilation during labor?
What is the typical range for cervical dilation during labor?
Which factor is NOT considered one of the 5 P's affecting the labor process?
Which factor is NOT considered one of the 5 P's affecting the labor process?
What usually happens to effacement and dilation in a first pregnancy?
What usually happens to effacement and dilation in a first pregnancy?
What is a critical reason for performing an emergency C-section?
What is a critical reason for performing an emergency C-section?
Which procedure helps to estimate fetal size and assess fetal position, presentation, and lie?
Which procedure helps to estimate fetal size and assess fetal position, presentation, and lie?
What is the target blood glucose level to maintain during labor?
What is the target blood glucose level to maintain during labor?
What should be assessed at 6 to 12 weeks postpartum for women who had gestational diabetes?
What should be assessed at 6 to 12 weeks postpartum for women who had gestational diabetes?
What is the primary goal of antepartum care for women requiring insulin during pregnancy?
What is the primary goal of antepartum care for women requiring insulin during pregnancy?
Which of the following is NOT a component of postpartum care after gestational diabetes?
Which of the following is NOT a component of postpartum care after gestational diabetes?
What should be done if tachysystole occurs when using labor-enhancing drugs?
What should be done if tachysystole occurs when using labor-enhancing drugs?
Which element is NOT part of the DM counseling for pregnant women?
Which element is NOT part of the DM counseling for pregnant women?
Study Notes
Labor and Delivery Overview
- Dilation: Widening of cervical opening; measured from 0-10 cm. Full dilation signifies end of first labor stage.
- Effacement: Thinning and shortening of the cervix; expressed as 0-100%. Typically progresses faster during first pregnancies.
- Station: Measures descent of fetal part in relation to ischial spines; +4 or +5 cm indicates imminent birth.
Fetal Monitoring
- Tachycardia: Defined as fetal heart rate > 160 bpm for over 10 minutes. Common causes include fetal hypoxemia, maternal fever, medications (e.g., atropine, terbutaline), and arrangements like fetal cardiac arrhythmias.
- Intrauterine Resuscitation: Methods to enhance oxygen flow to placenta; includes proper positioning, IV fluid administration, and maternal oxygen supply.
Stages of Labor
- First Stage: Begins with contractions, ends at full dilation; consists of Latent (0-6 cm) and Active phases (6-10 cm).
- Second Stage: Full dilation to baby’s birth; includes both passive fetal descent and active pushing phases.
- Third Stage: Delivery of placenta following birth.
- Fourth Stage: Observational period lasting two hours post-delivery to monitor for complications.
Labor Induction Techniques
- External Cephalic Version (ECV): Procedure to turn a fetus from a breech or shoulder position to vertex, usually performed at 36-37 weeks with a success rate around 65%.
- Internal Version: Rarely used; safety is uncertain.
Preterm Labor (PTL)
- Diagnosis relies on regular contractions and cervical changes before 37 weeks. Preterm birth occurs between 20 0/7 and 36 6/7 weeks.
- Spontaneous PTB: Accounts for 75% of cases. Risk factors include infections, multifetal gestation, and socioeconomic status.
- Fetal Fibronectin (fFN) Test: Glycoprotein test with high predictive accuracy for assessing the risk of imminent preterm labor.
HELLP Syndrome
- Variant of preeclampsia characterized by hemolysis, elevated liver enzymes, and low platelets.
Pregnancy Insulin Management
- Antepartum Care: Strict glucose control through dietary modifications, monitoring, and pharmacologic therapy. Regular fetal surveillance needed.
- Intrapartum Care: Hourly glucose monitoring during labor, maintaining levels between 80-110 mg/dl.
- Postpartum Care: Normal glucose levels typically return, but women are at a higher risk for gestational diabetes in future pregnancies.
Fetal Assessment Techniques
- Leopold's Maneuvers: Abdominal palpation to determine fetal position, presentation, and engagement.
- Continuous Lumbar Epidural (CLE): Common pain relief method during labor, with specific contraindications and side effects.
Monitoring and Interventions
- Continuous vigilance for signs of infection in cases of Preterm Premature Rupture of Membranes (PPROM) especially under 32 weeks.
- Use of antenatal glucocorticoids and antibiotics to manage conditions associated with preterm labor.
Summary of Care Goals
- Maintain optimal maternal and fetal health through monitoring, adequate medical interventions, and careful tracking of labor progression and complications.
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Prepare for your N330 Exam 2 with this comprehensive study guide focused on Nursing Medical Surgical Care of Adults at California State University San Marcos. Review key concepts, essential nursing practices, and critical patient care skills to excel in your exam.
