NR 327 EDAPT OPERATIVE DELIVERY 2024

EDAPT OPERATIVE DELIVERY The process of labor and delivery typically results in good outcomes for the mother and newborn. However, it is a very complex process consisting of multiple factors that impact outcomes. Sometimes, medical intervention is necessary. The size and shape of the woman’s pelvis determine the ease with which the fetal head can pass through for vaginal delivery to occur. Four different types of the pelvis can be assessed to determine if the pelvis is an adequate passageway: gynecoid, android, anthropoid, and platypelloid. The gynecoid pelvis is the most common and favorable for vaginal birth. Which statements are true of the cardinal movements of labor? Select all that apply. The cardinal movements of labor are the maneuvers, adjustments, and turns the fetal head normally makes as it descends in the pelvis. The largest diameter of the fetal head aligns with the largest diameter of the pelvis (called internal rotation). As the occiput of the fetal head passes under the symphysis pubis, the head extends to accommodate the fetal head. Cardinal movements do not decrease labor pains or induce uterine contractions. Which appearance in amniotic fluid requires follow up by the nurse? Select all that apply. Amniotic fluid should be clear, pale, watery, free of strong odor, and be around 1000 mL in amount. Amniotic fluid that is bloody, has a strong odor, or has a yellow or green color is considered abnormal and requires a follow-up. Labor is a diverse and individualized process with interacting, complex factors. Let’s review the five factors of the labor and delivery process that must act in harmony with one another to produce positive outcomes: passageway, passenger, powers, position, and psyche. So, what happens when one or more of the five Ps is dysfunctional and impacts the others? Labor may or may not progress safely and negative outcomes can result. There are several medical interventions that may be used to overcome dysfunctional labor and delivery. A woman in labor whose uterine contractions have slowed and weakened, whose fetus is in an occiput posterior position, and who is crying is experiencing issues with which processes of labor and delivery? Select all that apply.  Passenger: The fetus is in an occiput posterior position.  Powers: Uterine contractions have slowed and weakened.  Psyche: The client is crying. The obstetrician or certified nurse-midwife may determine that the amniotic membranes need to be ruptured artificially for various reasons. This procedure is called an amniotomy or an artificial rupture of membranes