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level: Level 1

Questions and Answers List

level questions: Level 1

QuestionAnswer
What are the three primary birthing options to consider?Hospital Birthing center Home
What percentage of births occur outside of a hospital?1.4%
What is an LDRP room, or unit?Labor, delivery, recovery, postpartum room
What is the most common reason for hospitalization of a planned home birth?Failure of the labor to progress
What is lightening?When the fetus settles, or "drops"
When does lightening usually occur?2 weeks before the onset of labor
What kind of paper can distinguish between bodily fluids from the vagina?Nitrazine paper
What color does the nitrazine paper turn if the discharge is amniotic fluid?Blue
At what point does the amniotic sac generally rupture?After labor has begun
Delivery should occur within how many hours of membrane rupture?24 hours
Prolonged rupture of membranes puts the woman and fetus at risk for _________Infection
Blood-tinged mucus is called ______ ______.Bloody show
When do Braxton Hicks contractions start?First trimester
What kind of contractions do not dilate the cervix?Braxton Hicks
Regular, rhythmic contractions that cause progressive cervical dilation of the cervix and effacement is _______ ________.True labor
What kind of precautions should be used during birth?Standard precautions
What are the standard precautions applicable to child birth?Wash hands Don gloves Cover gown/ mask with eye protection Sterile towels to drape woman Gloves and gown when handling newborn Teach partner where to stand/what to touch/protective coverings Use appropriate method of suction for infant's airway
What are the 5 P's of labor and delivery?Passageway Passenger Powers Position Psyche
The true pelvis is divided into 3 segments:Inlet Cavity (midpelvis) Outlet
What methods can the practitioner use to evaluate the size of the pelvis?Palpation Pelvimetry Ultrasound
Which soft tissues undergo changes to allow passage of the fetus?Uterine structures Cervical tissues Vagina Perineum
The delivery of what part of the body is of highest concern?The fetal head
The reshaping of the skull bones in response to pressure of the maternal pelvis is called _____.Molding
Name the major bones of the skull:Two frontal bones Two parietal bones Two temporal bones Occiput
Where sutures meet are larger membranous areas called _______Fontanelles
How many bones form the anterior fontanelle, and what shape is it?Four bones, diamond shaped
How many bones form the posterior fontanelle, and what shape is it?Three bones, triangular
The relationship of two fetal body parts is called _________.Attitude
What is the ideal attitude for the fetal body at full term?Flexion
What is fetal lie?The relationship of the cephalocaudal axis of the fetus to the mother's
Describe longitudinal fetal lieSpine of the fetus is parallel to that of the mother
If the spine of the fetus is perpendicular to that of the mother, it is called _______ lie.Transverse lie
Cephalic presentation is divided into 4 types:Vertex (between fontanelles) Brow Face Mentum (chin)
In what percentage of deliveries is the presentation breech?3%
What is the most common position for delivery?Left occiput anterior (LOA)
What is the second most common position for delivery?Right occiput anterior (ROA)
Fetal position can be determined using which maneuver?Leopold's maneuver
Which position best enables the fetal skull bones to mold as they progress through the maternal pelvis?Longitudinal lie Well-flexed attitude Vertex presentation
Prolonged cord compression will result in what kind of damage to the fetus?Central nervous system damage or death
What completes the third stage of labor?The delivery of the placenta
Involuntary uterine contractions are called ________ powers.Primary powers
What is effacement?Shortening and thinning of the cervix during the first stage of labor
What marks the end of the first stage of labor?Full cervical dilation
The maternal urge to bear down is called the _______ reflexFerguson's reflex
Which position is predominantly used during physician assisted births in the US?Lithotomy
What are primary powers responsible for?Effacement and dilation of the cervix and descent of the fetus
What are secondary powers responsible for?Expelling the infant after the cervix is dilated fully
What are the cardinal movements of labor?Engagement Descent Internal rotation Extension External rotation
What is the longest stage of delivery?The first stage
The first stage of labor lasts an average of how long in nulliparas?10 to 12 hours
How long does the first stage of labor generally last in multiparas?6 to 8 hours
The first stage of labor starts with _____ and ends with _______Starts with regular contractions, ends with complete dilation of cervix
The first stage of delivery is divided into which 3 phases?Latent Active Transitional
Describe contractions in the latent phase of the first stage of deliveryOccur 5 to 8 minutes apart; Last 20 to 35 seconds
During which phase of the first stage of delivery are contractions 3 to 5 minutes apart, lasting 40 to 60 secoonds?Active phase
During the latent phase, dilation of the cervix is the size of a _______.Penny
Describe the contractions during the transitional phase of the first stage of delivery2 to 3 minutes apart, lasting 90 seconds
During the active phase the cervix is at ___ to ___cm dilation4 to 7cm
0 to 3cm dilation occurs during which phase of labor?Latent phase
The cervix is 8 to 10cm dilated during which phase of the first stage of labor?Transitional phase
How long does the second stage of labor/delivery generally last for nulliparas?30 minutes to 2 hours
The second stage of labor/delivery lasts how long in multiparas?20 to 90 minutes
When is an episiotomy performed?End of the second stage of labor
For which 3 reasons is an episiotomy performed?Macrosomic infants Rapid deliveries Abnormal presentations
What is the most common type of episiotomy performed?Midline, or median
What are the complications of an episiotomy?Infection Blood loss Pain Painful sexual intercourse
The second stage of labor/delivery begins with ______ and ends with ______Begins with complete dilation, ends with birth of the baby
Which stage of labor/delivery begins with the delivery of the infant and ends with the delivery of the placenta?Third stage
How long does the third stage of labor/delivery generally last for both primiparas and multiparas?5 to 20 minutes
How much blood is normally lost during the third stage of labor/delivery?200 to 300mL
More than _____mL blood lost during delivery is considered excessive500 mL
What is responsible for producing oxytocin?The pituitary gland
Which 2 medications are commonly administered during the third phase of labor/delivery to stimulate uterine contractions?oxytocin (Pitocin) methylergonovine (Methergine)
How often should assessments be performed during the first hour after delivery?Every 15 minutes
An increase or decrease of __bpm of the fetal heart rate may indicate distress.30 bpm
Why is magnesium sulfate primarily administered?Seizure prevention in preeclampsia and eclampsia
How often should the FHR e auscultated during the first stage of labor?Every 15 to 30 minutes
FHR should be monitored every __ minutes during the second stage of laborEvery 5 minutes
What does a tocotransducer monitor?Uterine activity Frequency and duration of contractions
A tocotransducer cannot assess the intensity of ________.Contractions
What external transducer reflects movement of the fetal heart ventricles ?Ultrasound transducer
Greenish-stained amniotic fluid is the result of ________Meconium
Greenish-stained amniotic fluid due to the presence of meconium is called _______ _______.Meconium staining
The apgar scoring is done at ____ and ____ minutes off age1 and 5 minutes of age
The apgar score includes which 5 criteria?1. Heart rate 2. Respiratory effort 3. Muscle tone 4. Reflex irritability 5. Skin color
What temperature is the environment in utero?99 F
When should enemas NOT be given?If vaginal bleeding or premature labor is present If presenting part is not engaged If presentation is not vertex
How should the woman be positioned if FHR shows late deceleration or if the woman experiences hypotension?Left side
Side-lying positions reduce pressure on the:Vena cava
What does the term doula mean?"Woman servant"
What are 3 therapeutic concepts to convey to the father?1. He is of value and competent 2. He can learn to be a partner in the mother's care 3. Childbearing is a partnership
What are the most commonly used analgesics during labor?meperidine hydrochloride (Demerol) butorphanol tartrate
What are the potential major adverse effects of general anesthesia?Maternal aspiration of gastric contents Respiratory depression Uterine relaxation
What are the measures used to reduce the risk of maternal aspiration?1. Restrict intake to clear fluids or NPO 2. Administer drugs to raise gastric pH 3. Administer drugs to reduce secretions
Labor that lasts less than 3 hours from the onset of contractions to the time of birth is called:Precipitous labor
What scoring tool is used to evaluate the readiness of the mother for induction of labor?Bishop scoring
The artificial rupture of the fetal membrane is called an _________.Amniotomy
When do contractions normally begin after instillation of prostaglandin gel to ripen the cervix?Within one hour
What is performed in conjunction with with prostaglandin gel application?Amniotomy
What is uterone inertia?Absence or weakness of uterine contractions
List some maternal indications for induction of labor?Rupture of membranes greater than 24 hours Hypertensive disorders Diabetes History of stillbirth or fetal demise
What are fetal indications for induction of labor?Intrauterine growth restriction Nonreassuring fetal status Oligohydramnios
List the major maternal indications for cesarean delivery?1. Cephalopelvic disproportion 2. Previous c-section 3. Breech presentation 4. Endangering medical conditions 5. Abnormal conditions of placenta 6. Infections 7. Pelvic abnormalities
What are the five fetal indications for cesarean delivery?1. Fetal oxygen 2. Prolapse of umbilical cord 3. Breech presentation 4. Malpresentations 5. Congenital abnormalities