NUR215 LAB EXAM QUESTIONS AND ANSWERS A+
GRADED
What are 5 premonitory signs of labor?
1. Lightening (descent of fetus in true pelvis)
2. Braxton-Hicks contractions (irregular uterine contractions that do not result in cervical
change)
3. Cervical changes (soft cervix, partially effaced, begins to dilate)
4. Surge in energy
5. Backache
What are the 4 Ps essential in the outcome of labor and delivery?
1. Powers (involuntary uterine contractions + voluntary pushing)
2. Passage (bony pelvis + soft tissues of the cervix, pelvic floor, vagina and introitus)
3. Passenger (fetus)
4. Psyche (response of the woman during the intrapartum period)
What is GPTAL and what does each term mean?
GPTAL is a comprehensive set of terms describing a woman's obstetrical status
G= gravidity= number of times the woman has been pregnant
P= number of preterm births
T= number of term births
A= number of abortions/miscarriages
L= number of children currently living
Name and briefly describe the stages of labor
First stage: begins with onset of labor and ends with complete cervical dilation
Second stage: begins with dilation of cervix and ends with delivery of baby
Third stage: begins after delivery of baby and ends with delivery of placenta
Fourth stage: begins after delivery of the placenta and is completed 4 hours later
Which stage of labor is the longest?
First stage. Typically lasts 12 hours for primigravidas and 8 hours for multigravadas
What 3 phases make up the first stage of labor?
Latent phase (0-3 cm)
Active phase (4-7 cm)
Transition phase (8-10 cm)
What is the frequency/duration/intensity of contractions in the 3 phases of stage
1 labor?
Frequency:
5-15 min (latent)
3-5 min (active)
1-2 min (transition)
Duration:
10-30 sec (latent)
30-45 sec (active)
, 40-60 sec (transition)
Intensity:
mild (latent)
moderate/strong (active)
strong (transition)
Dilation
The enlargement or opening of the cervical os
How many cm is considered completely dilated?
10 cm (can no longer be palpated on vaginal examination)
When do the membranes rupture?
Either active/transition phase of stage 1
Effacement
The shortening and thinning of the cervix
How is degree of effacement measured?
Percentage (0-100%)
Station
The relationship of the ischial spines to the presenting part of the fetus
Ranges from -3 to +3
What is the narrowest diameter the fetus must pass through during a vaginal
birth?
0
What is GBS?
Group B streptococci
10-30% of pregnant women are colonized with it in the vagina or rectum
Can be transmitted to fetus during delivery and cause invasive infection
What drug(s) is used to treat GBS?
Penicillin- drug of choice
Ampicillin- alternative
When is intrapartum GBS prophylaxis indicated?
-Previous infant with GBS disease
-Positive GBS vaginal-rectal screening culture during current pregnancy
-Unknown GBS status at onset of labor < 37 weeks, ROM > 18 hours, temperature >
100.4 degrees F
Describe the purpose of Leopold's maneuvers
Purpose: to inspect and palpate the maternal abdomen to determine the fetal position,
station and size
What are the types/characteristics of Leopold's maneuvers?
First maneuver: determine what part of the fetus is located in the fundus of the uterus
Second maneuver: determine location of fetal back
Third maneuver: determine the presenting part
Fourth maneuver: determine the location of the cephalic prominence
List important nursing actions during the active phase of labor
-Monitor FHR and contractions every 15-30 min
-Monitor maternal vital signs every 2 hours; every 1 hour if ROM
-Perform intrapartal vaginal exam as needed to assess cervical changes and fetal
GRADED
What are 5 premonitory signs of labor?
1. Lightening (descent of fetus in true pelvis)
2. Braxton-Hicks contractions (irregular uterine contractions that do not result in cervical
change)
3. Cervical changes (soft cervix, partially effaced, begins to dilate)
4. Surge in energy
5. Backache
What are the 4 Ps essential in the outcome of labor and delivery?
1. Powers (involuntary uterine contractions + voluntary pushing)
2. Passage (bony pelvis + soft tissues of the cervix, pelvic floor, vagina and introitus)
3. Passenger (fetus)
4. Psyche (response of the woman during the intrapartum period)
What is GPTAL and what does each term mean?
GPTAL is a comprehensive set of terms describing a woman's obstetrical status
G= gravidity= number of times the woman has been pregnant
P= number of preterm births
T= number of term births
A= number of abortions/miscarriages
L= number of children currently living
Name and briefly describe the stages of labor
First stage: begins with onset of labor and ends with complete cervical dilation
Second stage: begins with dilation of cervix and ends with delivery of baby
Third stage: begins after delivery of baby and ends with delivery of placenta
Fourth stage: begins after delivery of the placenta and is completed 4 hours later
Which stage of labor is the longest?
First stage. Typically lasts 12 hours for primigravidas and 8 hours for multigravadas
What 3 phases make up the first stage of labor?
Latent phase (0-3 cm)
Active phase (4-7 cm)
Transition phase (8-10 cm)
What is the frequency/duration/intensity of contractions in the 3 phases of stage
1 labor?
Frequency:
5-15 min (latent)
3-5 min (active)
1-2 min (transition)
Duration:
10-30 sec (latent)
30-45 sec (active)
, 40-60 sec (transition)
Intensity:
mild (latent)
moderate/strong (active)
strong (transition)
Dilation
The enlargement or opening of the cervical os
How many cm is considered completely dilated?
10 cm (can no longer be palpated on vaginal examination)
When do the membranes rupture?
Either active/transition phase of stage 1
Effacement
The shortening and thinning of the cervix
How is degree of effacement measured?
Percentage (0-100%)
Station
The relationship of the ischial spines to the presenting part of the fetus
Ranges from -3 to +3
What is the narrowest diameter the fetus must pass through during a vaginal
birth?
0
What is GBS?
Group B streptococci
10-30% of pregnant women are colonized with it in the vagina or rectum
Can be transmitted to fetus during delivery and cause invasive infection
What drug(s) is used to treat GBS?
Penicillin- drug of choice
Ampicillin- alternative
When is intrapartum GBS prophylaxis indicated?
-Previous infant with GBS disease
-Positive GBS vaginal-rectal screening culture during current pregnancy
-Unknown GBS status at onset of labor < 37 weeks, ROM > 18 hours, temperature >
100.4 degrees F
Describe the purpose of Leopold's maneuvers
Purpose: to inspect and palpate the maternal abdomen to determine the fetal position,
station and size
What are the types/characteristics of Leopold's maneuvers?
First maneuver: determine what part of the fetus is located in the fundus of the uterus
Second maneuver: determine location of fetal back
Third maneuver: determine the presenting part
Fourth maneuver: determine the location of the cephalic prominence
List important nursing actions during the active phase of labor
-Monitor FHR and contractions every 15-30 min
-Monitor maternal vital signs every 2 hours; every 1 hour if ROM
-Perform intrapartal vaginal exam as needed to assess cervical changes and fetal
