97 Questions
Which of the following is NOT an impending labor sign or symptom?
Cervical dilation and effacement
Which of the following is a reassuring fetal heart rate pattern?
Moderate variability with accelerations
What is the recommended nursing intervention for late decelerations in the fetal heart rate pattern?
Lift the baby's head off the cord, change maternal position, and consider amnioinfusion
Which of the following is a sign to go to the hospital or birth center during impending labor?
Ruptured membranes
What is the recommended nursing intervention for variable decelerations in the fetal heart rate pattern?
Lift the baby's head off the cord and change maternal position
Which of the following is NOT a method of fetal monitoring?
Phenaphthazine (nitrazine) test
What is the recommended nursing intervention for fetal bradycardia (heart rate below 110 bpm)?
Increase maternal IV fluids to address placental insufficiency
Which of the following is a sign or symptom of true labor?
Bloody show
What is the recommended nursing intervention for early decelerations in the fetal heart rate pattern?
No specific intervention is required, as early decelerations are generally benign
Which of the following is a nonreassuring fetal heart rate pattern?
Sustained bradycardia
Which of the following is a sign of impending labor associated with vaginal discharge?
Expulsion of the mucus plug
What is the significance of weight loss of 1 to 3 pounds as a sign of impending labor?
Reflects body's preparation for labor
Which sign is NOT a symptom of impending labor?
Cervical dilation and effacement
What should be the cause for concern during impending labor if not related to contractions or membranes?
Decreased fetal movement
Which statement accurately describes the fetal heart rate baseline?
Normal range between 110-160 BPM
In fetal monitoring, what does the term 'Nadir' refer to?
Lowest point of fetal heart rate between contractions
What is the recommended nursing intervention for placental insufficiency due to maternal hypotension?
IV fluids to raise blood pressure
When assessing the Fetal Heart Rate, what characteristic is associated with nonreassuring patterns?
Tachycardia sustained over 160 BPM
VEAL CHOP is a mnemonic used for interpreting fetal heart rate patterns. What does 'VEAL' represent in this context?
'Variable decelerations = Early decelerations'
Which of the following is the most appropriate nursing intervention when fetal bradycardia and decreased variability are observed?
Reposition the mother and provide supplemental oxygen
In the context of fetal monitoring, what does the term 'nadir' refer to?
The lowest point or depth of a variable deceleration
Which of the following is the most appropriate nursing intervention when late decelerations are observed in the fetal heart rate pattern?
Administer intravenous fluids and consider amnioinfusion
What is the significance of the 'VEAL' component in the 'VEAL CHOP' mnemonic for interpreting fetal heart rate patterns?
It represents variable decelerations, early decelerations, accelerations, and late decelerations
Which of the following is the most appropriate nursing intervention when a lack of accelerations is observed in the fetal heart rate pattern?
Assess for potential placental insufficiency and consider interventions
Which of the following is the most appropriate nursing intervention when fetal tachycardia (heart rate above 160 bpm) is observed?
Assess for potential causes and consider interventions
Which of the following is the most appropriate nursing intervention when a prolonged late deceleration is observed in the fetal heart rate pattern?
Prepare for an emergency cesarean delivery
Which of the following is the most appropriate nursing intervention when recurrent variable decelerations are observed in the fetal heart rate pattern?
Encourage the mother to change positions frequently
Which of the following is the most appropriate nursing intervention when a sinusoidal fetal heart rate pattern is observed?
Assess for potential causes and consider interventions
Which of the following is the most appropriate nursing intervention when fetal heart rate decelerations are observed in conjunction with uterine hyperstimulation (contractions too close together)?
Administer tocolytics to reduce uterine contractions
What is the significance of the 'CHOP' component in the 'VEAL CHOP' mnemonic for interpreting fetal heart rate patterns?
It represents cord compression, which can lead to late decelerations in the fetal heart rate.
Which of the following is the most appropriate nursing intervention when a sinusoidal fetal heart rate pattern is observed?
Monitor the fetal heart rate closely and prepare for potential resuscitation measures.
Which of the following is the most appropriate nursing intervention when fetal tachycardia (heart rate above 160 bpm) is observed?
Monitor the fetal heart rate closely and prepare for potential resuscitation measures.
What is the recommended nursing intervention for late decelerations in the fetal heart rate pattern?
Lift the baby's head off the cord and change the mother's position.
Which of the following is the most appropriate nursing intervention when fetal bradycardia (heart rate below 110 bpm) and decreased variability are observed?
Monitor the fetal heart rate closely and prepare for potential resuscitation measures.
Which of the following is the most appropriate nursing intervention when fetal heart rate decelerations are observed in conjunction with uterine hyperstimulation (contractions too close together)?
Administer tocolytics to address uterine hyperactivity.
What is the recommended nursing intervention for placental insufficiency due to maternal hypotension?
Administer IV fluids to address the maternal hypotension.
Which of the following is a sign to go to the hospital or birth center during impending labor?
Decreased fetal movement.
Which of the following is a reassuring fetal heart rate pattern?
Stable fetal heart rate with moderate variability.
What is the significance of weight loss of 1 to 3 pounds as a sign of impending labor?
It indicates the baby has dropped into the pelvis, a sign of impending labor.
What is the most likely cause of pulmonary edema and shortness of breath during labor?
Maternal drug administration
Which of the following is the most significant risk factor for preterm labor?
Prior premature birth
What is the most appropriate nursing intervention for a prolapsed umbilical cord?
Insert fingers into the vagina to apply pressure on the baby's head to keep it off the cord
What is the most likely cause of uterine rupture during labor?
Both a and b
What is the most common cause of polyhydramnios (excessive amniotic fluid) during pregnancy?
Gestational diabetes
What is the most appropriate nursing intervention for fetal tachycardia (heart rate above 160 bpm) during labor?
Monitor the fetal heart rate closely
What is the recommended nursing intervention for late decelerations in the fetal heart rate pattern?
Place the mother on her left side to promote circulation
What is the most appropriate nursing intervention when fetal heart rate decelerations are observed in conjunction with uterine hyperstimulation (contractions too close together)?
Reposition the mother to her side to improve uteroplacental perfusion
What is the recommended nursing intervention for placental insufficiency due to maternal hypotension?
Administer fluids to increase maternal blood pressure
What is the significance of the 'CHOP' component in the 'VEAL CHOP' mnemonic for interpreting fetal heart rate patterns?
Signifies the occurrence of late decelerations
Which of the following is a sign of impending labor associated with vaginal discharge?
Increased vaginal discharge with a clear, watery appearance
What is the recommended nursing intervention for late decelerations in the fetal heart rate pattern?
Reposition the mother to her side to improve uteroplacental perfusion
Which of the following is a nonreassuring fetal heart rate pattern?
Fetal heart rate with a baseline of 140-150 bpm and late decelerations with contractions
Which of the following is NOT a method of fetal monitoring?
Magnetic resonance imaging (MRI)
Which complication during labor is characterized by fetal distress, maternal shock, and necessitates immediate C-section among other treatments?
Abruptio placentae
What is the main cause of dystocia during labor related to maternal factors?
Uterine inertia
Which condition during labor involves the placenta reaching within 2 to 3 cm of the cervical opening?
Placenta previa
What medical intervention is commonly used to induce labor when contractions are weak or labor is not progressing?
Oxytocin
In cases of dystocia caused by fetal factors in labor, what condition involves the head being too large for a safe vaginal delivery?
Cephalopelvic disproportion
What does oxytocin commonly cause as a side effect during labor induction?
Congestive heart failure
Which obstetrical procedure setting allows the woman to undergo labor, delivery, and recovery all in the same room?
Modern hospital setting
What nursing intervention is appropriate when a woman undergoes an episiotomy to alleviate pain and swelling?
Provide ice packs and analgesic sprays
What is the primary goal of using Oxytocin, Prostaglandin E1 (misoprostol), or E2 (dinoprostol) suppository vaginally for cervical softening?
To soften the cervix
What is the purpose of an episiotomy in obstetrical procedures?
To enlarge the vaginal outlet for delivery
Which indication may necessitate the use of forceps during labor?
Maternal fatigue or exhaustion
In obstetric procedures, what is the purpose of administering warm or cool sitz baths post-episiotomy?
To alleviate perineal pain and swelling
What is the role of a double-bladed curved forceps in obstetrics?
To increase traction during delivery
In the context of obstetric procedures, what does 'mediolateral' refer to in relation to an episiotomy?
A specific location for surgical incision
What is the significance of green-stained amniotic fluid during labor?
It may lead to fetal compromise.
During the transition phase of labor, what is the primary role of the healthcare provider?
Provide firm coaching on breathing and relaxation techniques.
If a woman in labor is experiencing crowning, what should be the immediate nursing action?
Report the crowning to the healthcare provider.
What is the recommended frequency for monitoring contractions and fetal heart rate during the second stage of labor?
Every 5 minutes
In case of retained placenta during the third stage of labor, what complication can arise?
Hemorrhage
What is the role of performing an Apgar score evaluation immediately after birth?
To evaluate newborn's respiratory status and overall condition
Why is it essential to maintain a firm contraction of the uterus in the immediate postpartum period?
To minimize blood loss and prevent postpartum hemorrhage
What might indicate chronic fetal hypoxemia due to prolonged maternal hypoxia?
Oligohydramnios
What is a complication during labor characterized by fetal distress, maternal shock, and necessitates immediate C-section among other treatments?
Abruptio placentae
Which condition during labor involves the placenta reaching within 2 to 3 cm of the cervical opening?
Marginal placenta previa
What causes uterine contractions when they are not strong enough or labor is not progressing?
Oxytocin
Which type of placenta previa involves the placenta completely covering the cervical opening?
Total placenta previa
Which procedure involves starting labor by medical intervention often due to large or post-term baby, diabetes mellitus, or worsening PIH?
Induction & Augmentation of Labor
What is a condition caused by an excessively large abdomen, striae gravidarum, and can be the cause of prolapsed cord?
Dystocia
What is the purpose of an episiotomy in obstetrical procedures?
To facilitate delivery by enlarging the vaginal outlet
Which nursing intervention is appropriate post-episiotomy to alleviate pain and swelling?
Use ice packs (first 8 hours) and warm or cool sitz baths
What is the role of forceps in obstetric extractions?
To facilitate delivery by increasing traction and assisting in rotating the baby's head
When is amniotomy indicated during labor?
When there are signs of maternal or fetal distress
What is the primary goal of using Oxytocin, Prostaglandin E1, or E2 suppository vaginally for cervical softening?
To soften the cervix and prepare for labor induction
What is the significance of maternal or fetal distress during amniotomy?
It requires immediate emergency intervention
What is the purpose of using warm or cool sitz baths post-episiotomy?
To reduce pain and swelling in the perineal area
Why might forceps be used during delivery according to obstetric procedures?
Due to maternal exhaustion or heart disease
Which nursing action is appropriate during Amniotomy?
Monitor BP every 10-15 minutes and after rupture of waters for any sign of maternal or fetal distress.
Which of the following is a potential cause of polyhydramnios (excessive amniotic fluid) during pregnancy?
Neural tube defects like spina bifida or anencephaly
What is the most appropriate nursing intervention when a prolapsed umbilical cord is identified during labor?
All of the above
Which of the following is a potential cause of uterine rupture during labor?
All of the above
Which of the following is the most appropriate nursing intervention when fetal bradycardia (heart rate below 110 bpm) and decreased variability are observed?
All of the above
Which of the following is a potential risk factor for preterm labor?
All of the above
What is the most appropriate nursing intervention when a sinusoidal fetal heart rate pattern is observed?
All of the above
Which of the following is a potential complication of precipitate labor (very brief labor, less than 3 hours)?
All of the above
Study Notes
- Impending labor signs include lightening, increased vaginal mucus discharge, softening of the cervix, Braxton Hicks contractions, burst of energy, weight loss of 1 to 3 pounds, and rupture of membranes.
- True labor signs consist of cervical dilation and effacement, contractions at regular intervals increasing in duration and intensity, back pain radiating to the abdomen, bloody show, and expulsion of the mucus plug.
- Reasons to go to the hospital or birth center during impending labor include contractions, ruptured membranes, bleeding other than bloody show, decreased fetal movement, or any other concerns.
- Fetal monitoring methods include fetoscope, Doppler, external monitoring, and internal monitoring.
- Fetal heart rate baseline is 110-160 BPM, with variations like bradycardia, decreased variability, accelerations, early decelerations, variable decelerations, and late decelerations.
- VEAL CHOP is a mnemonic for interpreting fetal heart rate patterns, helping identify causes like cord compression or placental insufficiency.
- Reassuring fetal heart rate patterns include stable FHR, moderate variability, accelerations, and appropriate uterine contraction frequency; non-reassuring patterns involve tachycardia or bradycardia.
- Complications during labor can include abruptio placentae, which may be partial or total, with causes like hypertension, cocaine use, poor nutrition, or previous history.
- Dystocia in labor can be caused by maternal factors like uterine inertia or passageway issues, or fetal factors like cephalopelvic disproportion.
- Inducing labor can be done using oxytocin or dinoprostone to stimulate contractions or ripen the cervix, with considerations for monitoring fetal distress and potential side effects.
Test your knowledge on the signs and symptoms of impending labor, such as lightening, Braxton Hicks contractions, and weight loss, as well as the signs of true labor, which include cervical dilation, regular contractions, and expulsion of the mucus plug.
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