Nursing of the Childbearing Family
Exam 1 Comprehensive Questions
(Frequently Tested) with Verified
Answers
Define what is occurring during the third stage of labor - Answer: This stage of labor starts after
the baby is born until the placenta is expelled. Delivering the placenta may cause the woman to
feel some increased cramping then a feeling of relief.
Define what is occurring during the fourth stage of labor and how long it lasts - Answer: This
stage of labor starts after the placenta is expelled until 2-4 hours after birth. Taking vital signs,
checking bleeding and fundus, transitioning newborn, and bonding occurs.
Performing mobility and neurologic checks is important with patients who have had what type
of pain management during labor? - Answer: This is done for patients that have received an
epidural to make sure that they can move and support themselves. This is also important with
patients that have had spinal.
During the fourth stage of labor a woman can experience shaking/shivering, is this normal or
abnormal finding, and what are the interventions that you can implement? - Answer: This is a
normal finding due to vascular changes. Giving the patient warm blankets and reassurance that
it will stop are the interventions that should be implemented.
Uterine involution is the return of the uterus to the pregnancy size, shape and location. Identify
components of an assessment for uterine involution - Answer: The nurse would assess the
location, position, and tone of the uterus. The nurse would also need to look at the lochia's
color and amount
rubra - Answer: Lochia that is bright red; lasts 1-3 days postpartum
,serosa - Answer: pink or brown in color and lasts for 4-10 days post-partum
alba - Answer: yellow-whitish in color and lasts 10 days-6 weeks postpartum
outline how you would assess a perineal/abdominal incision - Answer: REEDA
R-Redness
E-edema in the labia
E-ecchymosis
D-discharge (not from vagina, from laceration repair)
A-approximation
Kegal exercises - Answer: strengthen pelvic floor muscles
Stadol (butorphanol) and Nubain - Answer: -used for Pain management
-narcan DOES NOT reverse Stadol effects
-Can be used throughout labor [should not be given within 1 hour before delivery as it can lead
to resp.depression of the newborn]
Which type of regional anesthesia has the greatest risk of headaches as a post-anesthesia
complication? - Answer: Spinal is related to the leaking of cerebral spinal fluid. With an epidural,
it can sometimes be inadvertently inserted into the subarachnoid space with the larger bore
needle then there is an increased change of a headache due to the wet tap.
What is the most successful intervention for a woman experiencing a spinal headache? -
Answer: Interventions for this include laying the patient down flat, drinking fluids and/or IV
fluids, and analgesia. A blood patch is done if the previous measures do not work.
, List the first two interventions that are appropriate if you enter a room and discover a
postpartum hemorrhage - Answer: If this were to happen, the nurse should immediately begins
a fundal massage, stay with the patient, and call for help. After this, you can proceed to start an
IV and administer uterotonic meds (such as Pitocin), assess vital signs, assess hemoglobin and
hematocrit, and you may need to administer blood. Encourage breastfeeding of the infant if the
mother's condition allows her to do so.`
Identify women who have an increased risk of having a postpartum hemorrhage - Answer:
Women who have an increased risk of having a postpartum hemorrhage includes a full bladder
(especially if they have had an epidural, they may need to be catheterized), uterine atony (due
to a larger baby, multiple gestation, multipara), retained placental parts or placental accreta
(placenta does not detach) that leads to subinvoluntion, vaginal wall or cervical lacerations,
coagulopathy, and inversion of the uterus (uterus turns inside out).
What is the most common anesthesia that is administered for an emergency cesarean delivery?
- Answer: General anesthesia would be used during this procedure
What is the most common anesthesia that is administered during vaginal delivery? - Answer: An
epidural is the most common anesthesia that is administered in this situation
What is the most common anesthesia that would be administered during a scheduled or
planned cesarean delivery? - Answer: Spinal anesthesia is the most common type of anesthesia
that is used during this procedure
If a woman has no pain management during labor and during stage 3 she asks for something for
her perineal repair, what options are available to her and which one would have the lowest risk
for complications and long term effects? - Answer: A local anesthetic would be utilized for this
suture repair. Local infiltration has the lowest risk for complications, has an immediate onset,
and is short acting. It is effective as the sutures are being placed to repair the laceration or
episiotomy. Once the repair is done, then use the topical interventions such as ice, tucks,
hydrocortisone creams, analgesics. Sitz bath after 24 hours. The pudendal can also be used
when the patient is crowning and then in place and working for episiotomy repair.
Exam 1 Comprehensive Questions
(Frequently Tested) with Verified
Answers
Define what is occurring during the third stage of labor - Answer: This stage of labor starts after
the baby is born until the placenta is expelled. Delivering the placenta may cause the woman to
feel some increased cramping then a feeling of relief.
Define what is occurring during the fourth stage of labor and how long it lasts - Answer: This
stage of labor starts after the placenta is expelled until 2-4 hours after birth. Taking vital signs,
checking bleeding and fundus, transitioning newborn, and bonding occurs.
Performing mobility and neurologic checks is important with patients who have had what type
of pain management during labor? - Answer: This is done for patients that have received an
epidural to make sure that they can move and support themselves. This is also important with
patients that have had spinal.
During the fourth stage of labor a woman can experience shaking/shivering, is this normal or
abnormal finding, and what are the interventions that you can implement? - Answer: This is a
normal finding due to vascular changes. Giving the patient warm blankets and reassurance that
it will stop are the interventions that should be implemented.
Uterine involution is the return of the uterus to the pregnancy size, shape and location. Identify
components of an assessment for uterine involution - Answer: The nurse would assess the
location, position, and tone of the uterus. The nurse would also need to look at the lochia's
color and amount
rubra - Answer: Lochia that is bright red; lasts 1-3 days postpartum
,serosa - Answer: pink or brown in color and lasts for 4-10 days post-partum
alba - Answer: yellow-whitish in color and lasts 10 days-6 weeks postpartum
outline how you would assess a perineal/abdominal incision - Answer: REEDA
R-Redness
E-edema in the labia
E-ecchymosis
D-discharge (not from vagina, from laceration repair)
A-approximation
Kegal exercises - Answer: strengthen pelvic floor muscles
Stadol (butorphanol) and Nubain - Answer: -used for Pain management
-narcan DOES NOT reverse Stadol effects
-Can be used throughout labor [should not be given within 1 hour before delivery as it can lead
to resp.depression of the newborn]
Which type of regional anesthesia has the greatest risk of headaches as a post-anesthesia
complication? - Answer: Spinal is related to the leaking of cerebral spinal fluid. With an epidural,
it can sometimes be inadvertently inserted into the subarachnoid space with the larger bore
needle then there is an increased change of a headache due to the wet tap.
What is the most successful intervention for a woman experiencing a spinal headache? -
Answer: Interventions for this include laying the patient down flat, drinking fluids and/or IV
fluids, and analgesia. A blood patch is done if the previous measures do not work.
, List the first two interventions that are appropriate if you enter a room and discover a
postpartum hemorrhage - Answer: If this were to happen, the nurse should immediately begins
a fundal massage, stay with the patient, and call for help. After this, you can proceed to start an
IV and administer uterotonic meds (such as Pitocin), assess vital signs, assess hemoglobin and
hematocrit, and you may need to administer blood. Encourage breastfeeding of the infant if the
mother's condition allows her to do so.`
Identify women who have an increased risk of having a postpartum hemorrhage - Answer:
Women who have an increased risk of having a postpartum hemorrhage includes a full bladder
(especially if they have had an epidural, they may need to be catheterized), uterine atony (due
to a larger baby, multiple gestation, multipara), retained placental parts or placental accreta
(placenta does not detach) that leads to subinvoluntion, vaginal wall or cervical lacerations,
coagulopathy, and inversion of the uterus (uterus turns inside out).
What is the most common anesthesia that is administered for an emergency cesarean delivery?
- Answer: General anesthesia would be used during this procedure
What is the most common anesthesia that is administered during vaginal delivery? - Answer: An
epidural is the most common anesthesia that is administered in this situation
What is the most common anesthesia that would be administered during a scheduled or
planned cesarean delivery? - Answer: Spinal anesthesia is the most common type of anesthesia
that is used during this procedure
If a woman has no pain management during labor and during stage 3 she asks for something for
her perineal repair, what options are available to her and which one would have the lowest risk
for complications and long term effects? - Answer: A local anesthetic would be utilized for this
suture repair. Local infiltration has the lowest risk for complications, has an immediate onset,
and is short acting. It is effective as the sutures are being placed to repair the laceration or
episiotomy. Once the repair is done, then use the topical interventions such as ice, tucks,
hydrocortisone creams, analgesics. Sitz bath after 24 hours. The pudendal can also be used
when the patient is crowning and then in place and working for episiotomy repair.
