Obstetrics: Fetal Surveillance and Labor Stages Quiz
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Obstetrics: Fetal Surveillance and Labor Stages Quiz

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Questions and Answers

What is the primary indication for a medically induced preterm birth?

  • Pre-E (correct)
  • Fetal disorders
  • Gestational diabetes
  • Previous C-section
  • What is the primary goal of tocolytics in labor management?

  • To arrest labor after uterine contractions and cervical change (correct)
  • To induce labor
  • To reduce fetal distress
  • To stimulate uterine contractions
  • What is the significance of a +4/+5 cm station in labor?

  • Birth is imminent (correct)
  • Engagement has occurred
  • Uterine contractions are becoming stronger
  • The fetus is in distress
  • What is the primary method of fetal heart rate monitoring?

    <p>External fetal monitoring</p> Signup and view all the answers

    What is the purpose of activity restriction in pregnancy?

    <p>To reduce maternal risk factors</p> Signup and view all the answers

    What is the significance of back labor in pregnancy?

    <p>The baby is in an occiput posterior (OP) position</p> Signup and view all the answers

    What is the primary goal of augmentation of labor?

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

    Why is engagement significant in labor?

    <p>It indicates the largest transverse diameter of the presenting part has passed through the mother's pelvic brim</p> Signup and view all the answers

    What is the recommended management approach for premature preterm premature rupture of membranes (PPROM) occurring at less than 32 weeks of gestation?

    <p>Expectant and conservative management</p> Signup and view all the answers

    What is the primary reason for administering antenatal glucocorticoids to women with preterm PROM between 24 0/7 and 34 0/7 weeks of gestation?

    <p>To accelerate fetal lung maturation</p> Signup and view all the answers

    Which of the following is considered a phase of labor, but is not typically identified based on maternal physical sensations or behavior in women with epidural anesthesia?

    <p>Transition phase</p> Signup and view all the answers

    What is the primary goal of administering magnesium sulfate during labor?

    <p>To provide neuroprotection for the fetus</p> Signup and view all the answers

    Which of the following is NOT a stage of labor?

    <p>Fifth stage</p> Signup and view all the answers

    Which of the following is considered a key aspect of the fourth stage of labor?

    <p>Postpartum observation for complications</p> Signup and view all the answers

    Which of the following is a contributing factor to a prolapsed umbilical cord?

    <p>Long cord (longer than 100 cm)</p> Signup and view all the answers

    Which of the following interventions is NOT typically used to manage tachysystole?

    <p>Administer magnesium sulfate</p> Signup and view all the answers

    What is the significance of meconium-stained amniotic fluid?

    <p>Indicates fetal distress and possible need for immediate intervention</p> Signup and view all the answers

    Which of the following is a possible risk factor for shoulder dystocia?

    <p>Maternal obesity</p> Signup and view all the answers

    What is the primary risk to the mother in a shoulder dystocia delivery?

    <p>Excessive blood loss</p> Signup and view all the answers

    Which of the following is a common intervention for a prolapsed umbilical cord?

    <p>Applying pressure to the presenting part to relieve pressure on the cord</p> Signup and view all the answers

    What is the significance of early decelerations during labor?

    <p>They are a normal response to fetal head compression.</p> Signup and view all the answers

    Which of the following is NOT a typical sign of preeclampsia?

    <p>Increased fetal movement</p> Signup and view all the answers

    What is the primary goal of managing gestational diabetes?

    <p>To maintain tight blood sugar control to prevent complications for both the mother and fetus.</p> Signup and view all the answers

    What is the most common intervention for hypertension in pregnancy?

    <p>Antihypertensive medication</p> Signup and view all the answers

    Study Notes

    Fetal Surveillance

    • Determined individually for each woman
    • PPROM at less than 32 weeks is managed expectantly and conservatively
    • Vigilance for signs of infections
    • Fetal assessment
    • Antenatal glucocorticoids for all women with preterm PROM between 24 0/7 and 34 0/7 weeks of gestation
    • 7-day course of broad-spectrum antibiotics
    • Administering magnesium sulfate for fetal neuroprotection

    Labor Stages

    • First Stage of Labor: onset of regular uterine contractions to full cervix dilation
      • Latent/Early Phase (0-6 cm dilation)
      • Active Phase (6-10 cm dilation)
      • Transition Phase (may not be identified based on maternal physical sensations/behavior in women with epidural anesthesia)
    • Second Stage of Labor: Full cervix dilation to birth of baby
      • Latent phase (passive fetal descent) & Active pushing phase
    • Third Stage of Labor: Birth of baby to placental delivery
    • Fourth Stage of Labor: Placental delivery to first 2 hours after birth
      • Important to observe for complications

    Interventions

    • Prevention (address risk factors) and early recognition
    • Lifestyle modifications: activity restriction (modified bed rest), restrict sexual activity (pelvic rest), and home care (no excessive force)
    • Suppression of uterine activity: tocolytics (meds given to arrest labor after uterine contractions and cervical change have occurred)

    Augmentation of Labor

    • Stimulation of uterine contractions after labor has started spontaneously and progress is unsatisfactory
    • Common augmentation methods include oxytocin infusion and amniotomy
    • Active management of labor
    • Aggressive use of oxytocin so that the woman gives birth within 12 hours of admission to the labor unit

    Fetal Monitoring

    • EFM (external fetal monitoring): monitors FHR and UA
    • Category I: normal
    • Category II: indeterminate
    • Category III: abnormal
    • LTV (long term viability)
    • Early decels (response to fetal head compression)

    Labor Complications

    • Lacerations: interventions such as warm compresses, gentle perineal massage, and stretching can decrease perineal lacerations/trauma
    • Prolapsed cord: occurs when cord lies below the presenting part of the fetus
      • Contributing factors include long cord, malpresentation, transverse lie, and unengaged presenting part
      • Interprofessional Care Management: prompt recognition, pressure off cord, and position change to keep pressure off the cord
    • Meconium-stained amniotic fluid: indicates fetus has passed stool prior to birth
      • Possible causes: normal physiologic function of maturity, breech presentation, hypoxia-induced peristalsis, and umbilical cord compression
      • Interprofessional Care Management: presence of an interprofessional team skilled in neonatal resuscitation is required
    • Shoulder dystocia: head is born, but anterior shoulder cannot pass under pubic arch
      • Newborn more likely to experience birth injuries related to asphyxia, brachial plexus damage, and fracture
      • Mother’s primary risk stems from excessive blood loss from uterine atony or rupture, lacerations, extension of episiotomy, or endometritis
      • Interprofessional Care Management: McRoberts maneuver and suprapubic pressure, Gaskin maneuver

    Cultural Differences in Labor

    • Women may have an idea of the “right” way to behave in labor and may react to the pain experienced in that way
    • Range from total silence to moaning/screaming, does not necessarily indicate the degree of pain being experienced
    • Can influence pt’s choice of birth companion and role of the father (some are present and involved, others are not)
    • Nurse should not perceive it as a lack of concern, caring or interest

    Nursing Intervention

    • If there is tachysystole, stop/lower dose of labor-enhancing drugs
    • Treatments for tachysystole and fetal oxygen deprivation include placing the mother in the left lateral position, giving her oxygen, and increasing her IV fluids

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    N330 Exam 2 Study Guide PDF

    Description

    Test your knowledge on fetal surveillance and labor stages in obstetrics, including preterm PROM management, fetal assessment, and labor stages.

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