NM704 QUIZ 3 EXAM QUESTIONS AND VERIFIED ANSWERS
100% GUARANTEED PASS!!!
Initial evaluation
Hx: age, EDD, complications, GBS status, previous pregnancy and delivery
complications, size of babies, FM, vag bleeding, membrane status, ctx onset- present
freq., duration, intensity, aggravating or relieving factors
physical assessment of the laboring woman
VS, heart and lung sounds, abd palpation, Leopold's, visual inspections for abd scars,
peripheral or facial edema, cervical exam (effacement, dilation, position of cervix,
station, caput?), tone and elasticity of the vagina, membranes status, visual inspection
of perineum, assessment of fetal heart rate
labs
CBC, blood type, RH status and antibody, urinalysis, GBS
urinary output
encourage voiding Q2hrs to avoid preventing fetal decent, increased lower abd pain and
poor uterine ctx in 3rd stage; encourage ambulating to toilet when can, with epidurals-
intermittent cath to drain bladder
coping status
fatigue and physical depletion: exhaustion and dehydration can decrease coping
behavior and response to labor: affected by self efficacy, anxiety, fear, and pain
doulas
, provide emotional, physical, non-clinical advice and help make informed decisions; can
be a layperson, nurse or CBE; 26% fewer c/s, 41% operative vag delivery, 28% use in
pain meds, 33% less likely to be distatisfied with birth
oral intake and fluids
contemporary management: limit PO intake and non caloric IVF- to decrease risk of
aspiration if anesthesia needed
modern evidence: no benefit or harm assoc. with oral intake during labor; adequate
hydration- assist in delivery of O2 and nutrietns; nutrition needs during labor- increase
level of ketones may have harmful effects on uterine function
IV access
routine insertion may be eliminated in normal labor and birth; maybe necessary for IV
fluids of not tolerating PO and for meds (GBS, pain or Pitocin)
amniotomy (AROM)
procedure where the amniotic sac if ruptured deliberately for inducing/augmentation or
placing internal monitors; indications: atypical/abnormal FHR, to detect presence of
meconium, internal FSE or IUPC, to induce/augment labor
conditions present before AROM
regular ctx and changes in cervix, at least 3cm dialted, head is fixed in pelvis and
applied to cervix, no active genital HSV infection or high viral load
primary risk with AROM
umbilical cord compression, prolapsed umbilical cord, infection?; informed consent
should be shared with patient prior to amniotomy
risk of regional analgesia
100% GUARANTEED PASS!!!
Initial evaluation
Hx: age, EDD, complications, GBS status, previous pregnancy and delivery
complications, size of babies, FM, vag bleeding, membrane status, ctx onset- present
freq., duration, intensity, aggravating or relieving factors
physical assessment of the laboring woman
VS, heart and lung sounds, abd palpation, Leopold's, visual inspections for abd scars,
peripheral or facial edema, cervical exam (effacement, dilation, position of cervix,
station, caput?), tone and elasticity of the vagina, membranes status, visual inspection
of perineum, assessment of fetal heart rate
labs
CBC, blood type, RH status and antibody, urinalysis, GBS
urinary output
encourage voiding Q2hrs to avoid preventing fetal decent, increased lower abd pain and
poor uterine ctx in 3rd stage; encourage ambulating to toilet when can, with epidurals-
intermittent cath to drain bladder
coping status
fatigue and physical depletion: exhaustion and dehydration can decrease coping
behavior and response to labor: affected by self efficacy, anxiety, fear, and pain
doulas
, provide emotional, physical, non-clinical advice and help make informed decisions; can
be a layperson, nurse or CBE; 26% fewer c/s, 41% operative vag delivery, 28% use in
pain meds, 33% less likely to be distatisfied with birth
oral intake and fluids
contemporary management: limit PO intake and non caloric IVF- to decrease risk of
aspiration if anesthesia needed
modern evidence: no benefit or harm assoc. with oral intake during labor; adequate
hydration- assist in delivery of O2 and nutrietns; nutrition needs during labor- increase
level of ketones may have harmful effects on uterine function
IV access
routine insertion may be eliminated in normal labor and birth; maybe necessary for IV
fluids of not tolerating PO and for meds (GBS, pain or Pitocin)
amniotomy (AROM)
procedure where the amniotic sac if ruptured deliberately for inducing/augmentation or
placing internal monitors; indications: atypical/abnormal FHR, to detect presence of
meconium, internal FSE or IUPC, to induce/augment labor
conditions present before AROM
regular ctx and changes in cervix, at least 3cm dialted, head is fixed in pelvis and
applied to cervix, no active genital HSV infection or high viral load
primary risk with AROM
umbilical cord compression, prolapsed umbilical cord, infection?; informed consent
should be shared with patient prior to amniotomy
risk of regional analgesia
