NM 704 FINAL *MINE* STUDY!! EXAM QUESTIONS AND
ANSWERS WITH COMPLETE SOLUTIONS VERIFIED GRADED A++
1st stage maternal vs -- b/p, hr, rr
every 1 hr
1st stage maternal normal temp & intact membranes vs
every 2-4 hrs
1st stage maternal abnormal temp &/or ruptured membranes vs
every 1-2 hrs
2nd stage maternal b/p
every 15 min btwn contractions
2nd stage maternal temp, hr, rr
every 1 hr
maternal b/p during pushing
- increased 10 mmHg
maternal hr during contraction
- increased
ACOG cont FHR 1st stage without complications
every 30 min
ACOG cont FHR 1st stage with complications
every 15 min
ACOG cont FHR 2nd stage without complications
,every 15 min
ACOG cont FHR 2nd stage with complications
every 5 min
ACNM FHR active phase
every 15-30 min
ACNM FHR pushing phase
every 15 min
AWHONN FHR active phse
every 15-30 min
AWHONN FHR 2nd stage
every 5-15 min
ACOG intermittent FHR labor without complications
no recommendations
ACOG intermittent FHR 1st stage with complications
every 15 min
ACOG intermittent FHR 2nd stage with complications
every 5 min
FHR monitoring in final phase
every 2-3 contractions
2nd stage assessment for acidemia in low risk fetus
every 15 min
2nd stage assessment for acidemia in high risk fetus
every 5 min
,old vag exam checks
every 2 hrs d/t friedmans arrest of labor if no change in 2 hrs
vag exams not needed if
watching for outward signs of labor progress
outward signs of labor progress
- changes in behavior
- increase in bloody show
- urge to push
vag exams needed if
not showing outward signs of labor progress
vag exams during later part of active labor
may need more d/t labor progressing more quickly
vag exams & interventions
closly linked --> if no progress then intervene
PO intake & 1st stage
encouraged --> mom needs energy d/t increased cardiac output, work of resp, & uterine
muscles
PO intake & 2nd stage
increase in energy demand d/t work of pushing
hypoglycemia in labor
- r/t fasting
- can cx production of lactate & ketones
ketonuria
, - occurs d/t lack of caloric intake
excess ketones has a _______ effect on uterine function
negative
ketonuria in 3rd trimester
- d/t accelerated starvation cxing rapid rise in ketones & fall in plasma glucose --> to
conserve glucose for fetus
ACNM & PO intake
- should NOT restrict
ACOG & PO intake
- clear liquids only
- no solids
ACNM & PO intake restriction
- if mom gets opiods
- if mom develops likelihood of receiving general anesthetic
empty stomach
- makes contents more acidic = increased aspiration risk
IV access if
- need for meds --> antibiotics, pain, oxytocin
- inability to tolerate PO intake
- fluid bolus prior to epidural
IV dextrose & newborn effects
- cxes hyperglycemia in mom --> which cxes hypoglycemia in baby
- cxes jaundice in baby r/t hypoglycemia cxing lethargy leading to poor feeding
ANSWERS WITH COMPLETE SOLUTIONS VERIFIED GRADED A++
1st stage maternal vs -- b/p, hr, rr
every 1 hr
1st stage maternal normal temp & intact membranes vs
every 2-4 hrs
1st stage maternal abnormal temp &/or ruptured membranes vs
every 1-2 hrs
2nd stage maternal b/p
every 15 min btwn contractions
2nd stage maternal temp, hr, rr
every 1 hr
maternal b/p during pushing
- increased 10 mmHg
maternal hr during contraction
- increased
ACOG cont FHR 1st stage without complications
every 30 min
ACOG cont FHR 1st stage with complications
every 15 min
ACOG cont FHR 2nd stage without complications
,every 15 min
ACOG cont FHR 2nd stage with complications
every 5 min
ACNM FHR active phase
every 15-30 min
ACNM FHR pushing phase
every 15 min
AWHONN FHR active phse
every 15-30 min
AWHONN FHR 2nd stage
every 5-15 min
ACOG intermittent FHR labor without complications
no recommendations
ACOG intermittent FHR 1st stage with complications
every 15 min
ACOG intermittent FHR 2nd stage with complications
every 5 min
FHR monitoring in final phase
every 2-3 contractions
2nd stage assessment for acidemia in low risk fetus
every 15 min
2nd stage assessment for acidemia in high risk fetus
every 5 min
,old vag exam checks
every 2 hrs d/t friedmans arrest of labor if no change in 2 hrs
vag exams not needed if
watching for outward signs of labor progress
outward signs of labor progress
- changes in behavior
- increase in bloody show
- urge to push
vag exams needed if
not showing outward signs of labor progress
vag exams during later part of active labor
may need more d/t labor progressing more quickly
vag exams & interventions
closly linked --> if no progress then intervene
PO intake & 1st stage
encouraged --> mom needs energy d/t increased cardiac output, work of resp, & uterine
muscles
PO intake & 2nd stage
increase in energy demand d/t work of pushing
hypoglycemia in labor
- r/t fasting
- can cx production of lactate & ketones
ketonuria
, - occurs d/t lack of caloric intake
excess ketones has a _______ effect on uterine function
negative
ketonuria in 3rd trimester
- d/t accelerated starvation cxing rapid rise in ketones & fall in plasma glucose --> to
conserve glucose for fetus
ACNM & PO intake
- should NOT restrict
ACOG & PO intake
- clear liquids only
- no solids
ACNM & PO intake restriction
- if mom gets opiods
- if mom develops likelihood of receiving general anesthetic
empty stomach
- makes contents more acidic = increased aspiration risk
IV access if
- need for meds --> antibiotics, pain, oxytocin
- inability to tolerate PO intake
- fluid bolus prior to epidural
IV dextrose & newborn effects
- cxes hyperglycemia in mom --> which cxes hypoglycemia in baby
- cxes jaundice in baby r/t hypoglycemia cxing lethargy leading to poor feeding
