Podcast
Questions and Answers
What degree of rotation does the fetal head require during internal rotation from a posterior position?
What degree of rotation does the fetal head require during internal rotation from a posterior position?
- 180 degrees
- 90 degrees
- 135 degrees (correct)
- 45 degrees
Which position is NOT recommended to aid rotation from a posterior fetal position?
Which position is NOT recommended to aid rotation from a posterior fetal position?
- Standing upright (correct)
- Squatting
- Lying on the right side
- Assuming a hands and knees position
What labor pattern suggests the fetus is in a posterior presentation?
What labor pattern suggests the fetus is in a posterior presentation?
- Decreased fetal heart rate
- Frequent contractions
- Prolonged active phase (correct)
- Rapid descent
How does a posteriorly presenting fetal head affect the fit within the cervix?
How does a posteriorly presenting fetal head affect the fit within the cervix?
What symptom may a woman experience due to sacral nerve compression during labor?
What symptom may a woman experience due to sacral nerve compression during labor?
What is a recommended method to relieve back pain caused by fetal head rotation against the sacrum?
What is a recommended method to relieve back pain caused by fetal head rotation against the sacrum?
What factor could hinder fetal rotation through the pelvis?
What factor could hinder fetal rotation through the pelvis?
Why is it essential to confirm the position of a fetus presenting in a posterior position?
Why is it essential to confirm the position of a fetus presenting in a posterior position?
What is the primary aim of therapeutic management during a cord prolapse?
What is the primary aim of therapeutic management during a cord prolapse?
Which position can be used to aid in relieving pressure from the cord?
Which position can be used to aid in relieving pressure from the cord?
What should be done if the cord is exposed to room air?
What should be done if the cord is exposed to room air?
When is it appropriate to use forceps during the delivery process with cord prolapse?
When is it appropriate to use forceps during the delivery process with cord prolapse?
What intervention may be prescribed to reduce uterine activity in a cord prolapse scenario?
What intervention may be prescribed to reduce uterine activity in a cord prolapse scenario?
Why are twins more often delivered by cesarean birth?
Why are twins more often delivered by cesarean birth?
What complication is more likely to occur in multiple gestations?
What complication is more likely to occur in multiple gestations?
What factor increases the risk of cord prolapse during multiple pregnancies?
What factor increases the risk of cord prolapse during multiple pregnancies?
What is a common complication associated with large babies at birth?
What is a common complication associated with large babies at birth?
What maternal condition is most frequently associated with the birth of large babies?
What maternal condition is most frequently associated with the birth of large babies?
What is a potential consequence of fetal pelvic disproportion?
What is a potential consequence of fetal pelvic disproportion?
Which condition may lead to umbilical cord prolapse during labor?
Which condition may lead to umbilical cord prolapse during labor?
During assessment, what indicates a possible cord prolapse?
During assessment, what indicates a possible cord prolapse?
What fetal presentation is likely to increase the risk of umbilical cord prolapse?
What fetal presentation is likely to increase the risk of umbilical cord prolapse?
What is the preferred birth method if an oversized infant cannot be delivered vaginally?
What is the preferred birth method if an oversized infant cannot be delivered vaginally?
What is a common finding during an examination that may indicate cord prolapse?
What is a common finding during an examination that may indicate cord prolapse?
What is a common risk associated with breech presentation?
What is a common risk associated with breech presentation?
Which of the following is NOT a type of vertex malpresentation?
Which of the following is NOT a type of vertex malpresentation?
What can occur if the fetal position is occipitoposterior?
What can occur if the fetal position is occipitoposterior?
Which nursing intervention is critical in addressing fetal distress?
Which nursing intervention is critical in addressing fetal distress?
Which condition is classified as a problem with the powers during labor?
Which condition is classified as a problem with the powers during labor?
What is a consequence of an immature fetus during labor?
What is a consequence of an immature fetus during labor?
Which nursing assessment is crucial for managing umbilical cord prolapse?
Which nursing assessment is crucial for managing umbilical cord prolapse?
What factor can contribute to cephalopelvic disproportion during labor?
What factor can contribute to cephalopelvic disproportion during labor?
What condition is characterized by difficulty in uterine contractions due to overstretching from multiple gestations?
What condition is characterized by difficulty in uterine contractions due to overstretching from multiple gestations?
What can be determined by external abdominal palpation or ultrasound after the birth of the first infant?
What can be determined by external abdominal palpation or ultrasound after the birth of the first infant?
Which statement accurately describes the most common presentation of twins during birth?
Which statement accurately describes the most common presentation of twins during birth?
What is a potential risk associated with prolonged labor or birth in multiple gestations?
What is a potential risk associated with prolonged labor or birth in multiple gestations?
Which intervention may be initiated to assist uterine contractions if vaginal birth is planned after the first infant?
Which intervention may be initiated to assist uterine contractions if vaginal birth is planned after the first infant?
What occurs as a result of a disproportion between the size of the fetal head and the pelvic diameters?
What occurs as a result of a disproportion between the size of the fetal head and the pelvic diameters?
What can be used to relax the uterus if uterine relaxation is necessary?
What can be used to relax the uterus if uterine relaxation is necessary?
After the birth of the first child in a multiple gestation, what should be done with the baby’s cord?
After the birth of the first child in a multiple gestation, what should be done with the baby’s cord?
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Study Notes
Vertex Malpresentation
- Brow Presentation: Occurs when the fetal forehead is the presenting part.
- Face Presentation: Fetal face is the presenting part; can complicate delivery.
- Sincipital Presentation: The fetal vertex presents with the brow, between brow and forehead.
Breech Presentation
- Types: Include complete, incomplete, and frank breech.
- Maternal Risks: Higher risk for perineal tearing and c-section requirement.
- Vaginal Delivery of Breech: Can be complex, requiring skilled assistance.
- External/Podalic Version: A maneuver to turn the fetus into a cephalic position before delivery.
Other Presentations
- Shoulder Presentation: Occurs when the shoulder is the presenting part; often necessitating c-section.
- Compound Presentation: Involves presenting limbs alongside the fetal head.
Nursing/Medical Care of Clients with Malpresentation
- Care involves monitoring fetal heart rate and positioning strategies to encourage optimal fetal positioning.
Fetal Distress
- Causes: Include umbilical cord compression, placental insufficiency, and fetal hypoxia.
- Signs/Symptoms: Changes in fetal heart rate patterns, decreased fetal movement.
- Nursing Interventions: Position changes, oxygen supplementation, and continuous fetal monitoring.
Prolapse Umbilical Cord
- Cause: Happens when the umbilical cord slips ahead of the presenting fetal part.
- Contributing Factors: Include premature rupture of membranes and abnormal fetal presentations.
- Assessment & Nursing Diagnoses: Detectable during vaginal examination; assess fetal heart rate.
- Nursing Interventions: Elevate fetal head, change maternal position, cover exposed cord with sterile compress.
Problems with the Passageway
- Abnormal Pelvic Size/Shape: Can result in cephalopelvic disproportion and shoulder dystocia.
Problems with the Powers
- Dystocia: Refers to ineffective labor progression.
- Hypertonic Uterine Dysfunction: Characterized by frequent, ineffective contractions.
- Hypotonic Uterine Dysfunction: Occurs when the contractions are inadequate.
- Uterine Rupture: A severe complication involving tearing of the uterine wall.
Placental Problems
- Lower Uterine Segment Implantation: Can lead to complications such as placenta previa.
- Premature Detachment of Placenta: Risk of fetal distress and maternal bleeding.
Additional Notes on Fetal Positions
- Occipitoposterior Position: Fetal occiput is directed posteriorly; can complicate labor.
- Signs of Dysfunctional Labor: May include prolonged phases of labor and abnormal fetal heart patterns.
- Management Strategies: Include maternal positioning to encourage rotation of the fetus.
Multiple Gestations
- Delivery Risks: Increased likelihood of cesarean delivery due to fetal distress.
- Post-delivery Assessment: Careful monitoring for uterine atony and hemorrhage risk, especially after multiple births.
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