RNSG 1412 (Ob/Pedi) - Exam 1|Intrapartum Nursing Examination: Amniotomy, Artificial Rupture of Membranes, Fetal Attitude, Crowning, Engagement, Molding, Nuchal Cord, Station Assessment, Uterine Contractions—Coordination, Involuntary, Intermittent, Increme

RNSG 1412 (Ob/Pedi) - Exam 1|Intrapartum Nursing Examination: Amniotomy, Artificial Rupture of Membranes, Fetal Attitude, Crowning, Engagement, Molding, Nuchal Cord, Station Assessment, Uterine Contractions—Coordination, Involuntary, Intermittent, Increment, Peak, Decrement, Intensity, Frequency, Interval, Duration—Fetal Lie, Presentation, Position, Breech Variations, Vertex, Face, Sacrum, Labor Phases, Maternal Vital Signs, Comfort Measures, Pain Management—Nonpharmacologic, Opioid Analgesics, Regional Anesthesia, Epidural, Spinal, Systemic Drug Effects, Medication Safety, Newborn Immediate Care, Postpartum Hemorrhage Prevention, Nursing Interventions During Labor and Delivery Exam Questions Verified and Provided with Complete A+ Graded Rationales Latest Updated 2026 amniotomy artificial rupture of membranes attitude of fetus Relation of the fetal head and limbs to the fetal trunk - (usually flexion) crowning The appearance of the infant's head at the vaginal opening during labor. EDD expected date of delivery engagement (in labor) the fetal presenting part as its widest diameter reaches the level of the ischial spines of the mother's pelvis. Occurs slowly over weeks or rapidly over a couple of hours Engagement occurs when the largest diameter of the fetal presenting part (normally the head) has passed the pelvic inlet and entered the pelvic cavity. Engagement is presumed to have occurred when the station of the presenting part is zero or lower. Engagement often takes place before onset of labor in nulliparous women. In many parous women and in some nulliparas, it does not occur until after labor begins. molding Shaping of the fetal head by overlapping of the cranial bones to facilitate movement through the birth canal during labor. nuchal cord An umbilical cord that is wrapped around the fetus's neck. station Station describes the descent of the fetal presenting part in relation to the level of the ischial spines. The level of the ischial spines is a zero station. Other stations are described with numbers representing the approximate number of centimeters above (negative numbers) or below (positive numbers) the ischial spines. As the fetus descends through the pelvis, the station changes from higher negative numbers (−3, −2, −1) to zero to higher positive numbers (+1, +2, +3, etc.). Sometimes the terms floating or ballotable may describe a fetal presenting part that is so high that it is easily displaced upward during abdominal or vaginal examination, similar to tossing a ball upward. 1. Explain why each characteristic of uterine contractions is important during birth . a. Coordination The uterus can contract and relax in a coordinated way, as can other smooth muscles such as the heart. As the woman approaches full term, contractions become organized and gradually assume a regular pattern of increasing frequency, duration, and intensity during labor. Coordinated labor contractions begin in the uterine fundus and spread downward toward the cervix to propel the fetus through the pelvis. 1. Explain why each characteristic of uterine contractions is important during birth. b. Involuntary Uterine contractions are not under conscious control as are skeletal muscles. The mother cannot cause labor to start or stop by conscious effort. Walking or other activity may stimulate existing labor contractions. Anxiety and excessive stress can diminish them. 1. Explain why each characteristic of uterine contractions is important during birth. c. Intermittent Labor contractions are intermittent rather than sustained, allowing relaxation of the uterine smooth muscle and resumption of blood flow to and from the placenta to permit gas, nutrient, and waste exchange for the fetus. 2. Describe the differences in how the upper and lower uterus contract during labor. Why is it important that the upper and lower parts of the uterus have different contraction characteristics? The upper two-thirds of the uterus contracts actively to push the fetus down. The lower one-third of the uterus remains less active, allowing downward passage of the fetus. The cervix is similar to the lower uterine segment in that it is also passive. The net effect of labor contractions is enhanced because the downward push from the upper uterus is accompanied by reduced resistance to fetal descent in the lower uterus. The opposing characteristics of contractions in the upper and lower uterine segments change the shape of the uterine cavity, which becomes more elongated and narrower as labor progresses. This change in uterine shape straightens the fetal body and efficiently directs it downward in the pelvis. 3. Describe the characteristics of the components of a contraction a. increment The increment occurs as the contraction begins in the fundus and spreads throughout the uterus. 3. Describe the characteristics of the components of a contraction b. peak The peak, or acme, is the period during which the contraction is most intense. 3. Describe the characteristics of the components of a contraction c. decrement The decrement is the period of decreasing intensity as the uterus relaxes. 3. Describe the characteristics of the components of a contraction d. intensity Intensity is the strength of the contractions. The terms "mild," "moderate," and "strong" are used to describe contraction intensity as palpated by the nurse. Mild contractions are often described as feeling like the tip of the nose, moderate contractions like the chin, and firm contractions like the forehead. Different descriptions of intensity may apply when the internal electronic fetal monitor is used to record contractions 3. Describe the characteristics of the components of a contraction e. frequency Frequency is the period from the beginning of one uterine contraction to the beginning of the next; it is usually expressed in minutes and fractions of minutes. For example, the nurse states, "Contractions are 3½ to 4 minutes apart." 3. Describe the characteristics of the components of a contraction f. interval The interval is the period between the end of one contraction and the beginning of the next. The interval is the time when most fetal exchange of oxygen, nutrients, and waste products occurs. This is also called the resting tone. 3. Describe the characteristics of the components of a contraction g. duration Duration is the length of each contraction from beginning to end; it is usually expressed in seconds. For example, the nurse might report, "Her contractions last 55 to 65 seconds." 4. Why should the nurse regularly check the woman's bladder during labor? to make sure it's not full, which will hinder the babies desent. 5. When is the best time to assess the vital signs of a laboring patient? Why? be assess between contractions to get an accurate reading since the contractions will increase everything. early (latent) - every 1-2 hrs active - every 30 min-1 hr transition