MCCN SDAP X - OB Exam 2 Questions with Complete Solutions, Rated A+

Normal VS in PP period - cORRECT sOLUTION BP, Resp, Temp all normal but temp may be slightly increased in 1st 24 hours (not above 100.4F). HR= 50-70BPM, MAP should be greater than 60 Periodic Fetal Heart Tones - cORRECT sOLUTION Early decelerations, late decel, variable decel Indicators of subinvolution - cORRECT sOLUTION excessive lochia, foul odor, uterine pain, uterine atony (boggy), uterus position higher than expected Risk factors for hemorrhage - cORRECT sOLUTION large baby, multiple fetuses, polyhydramnios (any excessive stretching), prolonged labor w/ pitocin, precipitous labor, delivery under general anesthesia Preterm labor - cORRECT sOLUTION 21st week to 36 weeks + 6 days, problem only if it progresses to birth 5 P's of Labor - cORRECT sOLUTION What impacts the timeliness and effectiveness of labor; passageway, passenger, powers, psyche, and position of mother Passageway - cORRECT sOLUTION bony pelvis: is shape favorable for vaginal birth?; soft tissues of pelvis: vaginal canal, pelvic muscles (perineal floor), cervix Passenger - cORRECT sOLUTION Fetus. Size, angle, presenting body part Powers - cORRECT sOLUTION Uterine contractions. Forces that propel baby thru birth canal, dilate cervix, then pushing force of mom Psyche - cORRECT sOLUTION disposition of mom which greatly effects how mom labors. fear/tension pulls blood away from uterus, less effective labor Position of Mother - cORRECT sOLUTION position influences characteristics of labor. sitting or semi fowlers= more frequent, less intense contractions; side lying= more intense, less frequent. For baby that is facing upwards to mom's pelvis, flip position from side to side every hour to help rotate. Fetal Positioning - cORRECT sOLUTION want OA (occiput anterior)= baby facing sacrum. Can be left or right (LOA or ROA). If baby is facing pelvis=OP (occiput posterior) How to determine fetal positioning - cORRECT sOLUTION locate fetal occipital bone (feel for posterior fontanel) Dystocia - cORRECT sOLUTION Abnormal labor, ex= staying too long at a stage/dilation Tocolytics - cORRECT sOLUTION meds that stop contractions/ labor Uterine stretch theory - cORRECT sOLUTION when uterus gains a certain capacity, then it is going to try to empty itself. So anything that causes extra stretch (big baby, etc) might have earlier labor Hormone changes at labor - cORRECT sOLUTION Change in balance of progesterone and estrogen, progest drops and estrogen is able to promote contraction. Prostoglandin levels increase, also cause contractions Premonitory/ preliminary signs of labor - cORRECT sOLUTION Signal that LABOR is coming soon. Lightening (1-3 weeks prior), Braxton-Hicks (soften/ripen cervix), discharge of mucous plug (~1 week), Energy spurt ("nesting", 24-48 hours), ROM (baby delivered in 24 hrs), Diarrhea (~24hrs), Weight loss (fluid loss) False labor UC characteristics - cORRECT sOLUTION UCs: remain consistent interval apart, painless tightening w/o intensity increase, located in lower abd, usually go away w/ activity, no bloody show, can dilate 2-3cm True labor UC characteristics - cORRECT sOLUTION UCs: increase in frequency, getting stronger, felt 1st in low back radiating to lower abd, intensify with activity, bloody show (pink tinged mucous), ongoing cervical change (this is absolute distinction), change in fetal station Stage 1 of labor - cORRECT sOLUTION Dilatation stage. phase I= latent- 0-3cm; phase II=active- 4-7cm; phase III= transition- 8-10cm. typical primipara= 12-14 hours in this stage, multipara= 6-8hrs