Need done By tomorrow morning #2
kerena
DAY_2LABORANDBIRTHANDCOMFORTMEASURES.pdf
DAY #2 OB LABOR & BIRTH and Comfort Measures:
1. _____ Lightening
2. _____ Frequency
3. _____ Cephalic
4. _____ Vertex
5. _____ Effacement
6. _____ Nesting
7. _____ Muslim
8. _____ Frank Breech
9. _____ Dilation
10. _____ Footling Breech
11. ______ Intensity
12. ______ Chinese
13. ______ Duration
14. ______ Leopold’s Maneuver
15. ______ Nitrazine Test
16. ______ Doula
A. Culture that encourages warm broth after birth and avoid “cold foods”.
B. The most favorable fetal presentation for a vaginal delivery.
C. Culture that encourages only female health care personnel take care of laboring woman.
D. The time from the beginning of one uterine contraction to the beginning of the next uterine contraction.
E. The most common fetal presentation where the head is in the down position.
F. Engagement; feels like the baby has dropped. G. Abdominal palpations to determine fetal
position and presentation. H. The strength or intensity of a uterine
contraction. I. The thinning of the cervix measured in
percentage. J. pH paper turns blue-green if amniotic water is
broken. K. The opening of the cervix measured in
centimeters. L. The time from the beginning of one uterine
contraction to the end of the same uterine contraction.
M. The presenting part at the cervix is the fetus’s buttocks.
N. The presenting part at the cervix is the fetus’s feet.
O. One who’s job is provide support and encourage the woman in labor.
P. A sign of impending labor; a sudden burst of energy
Match #1- #16 with A-P
DAY #2 OB LABOR & BIRTH and Comfort Measures:
17. ______ Effleurage
18. ______ Endorphins
19. ______ Pain Threshold
20. ______ Pain Tolerance
21. _______ Gate Control Theory
22. _____ Sacral Pressure
23. ____ Hyperventilation
24. _____ Stadol
25. ___ Narcan (Naloxone)
26. ______ Epidural
27. ______ Spinal
28. ______ Local
29. ______ Pudendal
30. ______ General
31. ______ Blood Patch
32. ______ 100,000
33. _______Maternal Hypotension
A. Least amount of stimulation that a person perceives as painful. B. Stimulation of large fibers by massage, pressure, heat and cold
applications. C. The maximum amount of pain one is willing to endure. D. Firm pressure against the lower back to help relieve back labor
due to fetus in OP (occiput posterior) position. E. Used to reverse respiratory depression, usually seen in infant
caused by opioid drugs F. Stroking of the abdomen, thighs, or other body parts in a
circular movement. G. May occur when woman breathes too fast; complains of
lightheadedness, tingling around the mouth, dizziness, numbness around the mouth. Encourage the patient to breathe slowly into cupped hands or paper bag.
H. Anesthesia that numbs a specific area only; used for repair of episiotomy.
I. Anesthesia given 10-20 minutes prior to delivery; does not block the pain from contractions only the actual delivery of baby.
J. Anesthesia used in emergency surgery or if patient has less than 100,000 platelets; rarely used. Side effects include vomiting and aspiration.
K. Natural body substances similar to morphine. L. Anesthesia usually given to laboring woman when she is at least
4cm; takes some time to take full effect; if given too early in labor may slow down labor. Catheter is left in back to continue drip of medicine via pump through catheter.
M. Anesthesia usually used in cesarean section surgery; numbness is effective immediately from nipples down. No catheter is left in back.
N. Used to relieve headache due to dural puncture; patients own blood is injected into their epidural space.
O. A pain medicine used in labor; do not give if patient may deliver within 1 hour. Crosses the placenta. May cause respiratory depression in neonate.
P. The minimum number of platelets required if patient desires epidural or spinal anesthesia.
Q. Most common side effect of anesthesia; prevent by giving patient IV hydration prior to anesthesia
Match #17- #33 with A-Q
DAY #2 OB LABOR & BIRTH and Comfort Measures:
34. _____ A baseline fetal heart rate of 135bpm during labor should be interpreted as: a) Normal for a term fetus. b) Abnormal if the fetus is preterm. c) High normal when in labor. d) A slow baseline fetal heart rate.
35. _____ The thinning of the cervix during labor is called: a) Dilation b) Effacement c) Station d) Presentation
36. _____ Fetal descent during labor is measured in relation to the mother’s: a) Posterior perineum. b) Sacral promontory. c) Ischial spines. d) Uterine fundus.
37. _____ Which is the priority for nursing care during the second stage of labor? a) Observe the woman’s perineum. b) Encourage pushing with contractions. c) Evaluate labor coping skills. d) Administer ordered analgesia.
38. _____ The priority nursing intervention during the first stage of labor is: a) Offer comfort measures or medication for pain relief. b) Encourage pushing. c) Observe for bleeding. d) Encourage parent-infant bonding.
39. _____ The priority nursing intervention during the second stage of labor is: a) Offer comfort measures or medication for pain relief. b) Encourage pushing. c) Observe for bleeding. d) Encourage parent-infant bonding.
40. _____ The patient is at greatest risk for which of the following during the third stage of labor?
a) Infection b) Bleeding c) Discomfort d) Depression
DAY #2 OB LABOR & BIRTH and Comfort Measures:
41. _____ The patient is at greatest risk for which of the following during the fourth stage of labor?
a) Infection b) Bleeding c) Discomfort d) Depression
42. _____ During Stage 1 of labor, Phase 1, what might a nurse offer the laboring woman to ease labor discomfort?
a) Warm shower, back massage, birthing ball b) Stadol or Demerol IVP c) Epidural anesthesia d) Pudendal anesthesia
43. _____ During Stage 1 of labor, Phase 2, what might a nurse offer the laboring woman to ease labor discomfort?
a) Warm shower, back massage, birthing ball b) Stadol or Demerol IVP c) Epidural anesthesia d) Pudendal anesthesia
44. _____ During Stage 1 of labor, Phase 3, what might a nurse offer the laboring woman to ease labor discomfort?
a) Warm shower, back massage, birthing ball b) Stadol or Demerol IVP c) Epidural anesthesia d) Pudendal anesthesia
45. _____ During Stage 1 of labor, what is the purpose of uterine contractions? a) To push the baby out of the woman’s body b) To prepare the mother for the pain and discomfort of birth c) To efface and dilate the cervix d) To thin the lining of the uterine wall
46. _____ During Stage 2 of labor, what is the purpose of uterine contractions? a) To push the baby out of the woman’s body b) To prepare the mother for the pain and discomfort of birth c) To efface and dilate the cervix d) To thin the lining of the uterine wall
DAY #2 OB LABOR & BIRTH and Comfort Measures:
47. _____ During Stage 1 of labor, what is the nurse’s main concern in regard to the fetus? a) The fetus’s tolerance or intolerance to labor as determined by fetal heart tones. b) The security of the fetus. c) The sex of the fetus. d) Whether or not the mother is going to breastfeed the fetus.
48. _____ During Stage 2 of labor, what is the nurse’s main concern in regard to the fetus? a) The fetus’s tolerance or intolerance to pushing as determined by fetal heart tones. b) Whether or not the dad is going to cut the umbilical cord. c) The sex of the fetus. d) Whether or not the mother is going to breastfeed the fetus.
49. ______ The nurse notes a pattern of variable decelerations on the electronic fetal monitor strip. The initial nursing response should be to:
a) Prepare for delivery. b) Change the laboring woman’s position. c) Do nothing, document, and continue to observe. d) Shut off any infusing Pitocin, turn the patient to her left side, give 8-10L oxygen via
non-rebreather mask, increase IV fluid, and notify CNM or Doctor immediately.
50. ______ The nurse notes a pattern of early decelerations on the electronic fetal monitor strip. The initial nursing response should be to:
a) Prepare for delivery. b) Change the laboring woman’s position. c) Do nothing, document, and continue to observe. d) Shut off any infusing Pitocin, turn the patient to her left side, give 8-10L oxygen via
non-rebreather mask, increase IV fluid, and notify CNM or Doctor immediately.
51. ______ The nurse notes a pattern of late decelerations on the electronic fetal monitor strip. The initial nursing response should be to:
a) Prepare for delivery. b) Change the laboring woman’s position. c) Do nothing, document, and continue to observe. d) Shut off any infusing Pitocin, turn the patient to her left side, give 8-10L oxygen via
non-rebreather mask, increase IV fluid, and notify CNM or Doctor immediately.
52. _____ The nurse notes a pattern of accelerations on the electronic fetal monitor strip. The initial nursing response should be to:
a) Prepare for delivery. b) Change the laboring woman’s position. c) Do nothing, document, and continue to observe. d) Shut off any infusing Pitocin, turn the patient to her left side, give 8-10L oxygen via
non-rebreather mask, increase IV fluid, and notify CNM or Doctor immediately.
DAY #2 OB LABOR & BIRTH and Comfort Measures:
53. _____ The primary means of identifying hemorrhage after vaginal birth is to: a) Assess vital signs frequently. b) Assess the uterine fundus and observe the lochia. c) Keep an ice pack on the perineum. d) Have the woman urinate every 2 hours.
54. _____ The newborn of a woman who receives narcotic analgesics during labor should be observed primarily for:
a) Convulsions b) Slow respirations c) Excess activity d) Constipation
55. _____ The advantage of an epidural block is that it: a) Reduces pain for both labor and birth. b) Has no fetal or maternal risks. c) Supports normal blood pressure. d) Enhances the woman’s urge to push.
56. _____ The disadvantage of an epidural block is that it: a) May cause maternal hypertension. b) Has no fetal or maternal risks. c) Increases pain for both labor and birth. d) May cause maternal hypotension.
57. _____ A blood patch may be done to relieve: a) Low blood pressure b) Respiratory depression c) Postspinal headache d) Prolonged numbness
58. _____ The prepared childbirth technique that is most likely to relieve back pain during labor is:
a) Effleurage b) Sacral pressure c) Thermal stimulation d) Patterned breathing
59. _____ A woman is using prepared childbirth breathing techniques and complains of dizziness and tingling. The nurse should:
a) Have her breathe more rapidly with contractions. b) Ask her if she feels an urge to push or bear down. c) Tell her to exhale slowly into her cupped hands or a brown bag. d) Reassure her that these sensations are normal.
DAY #2 OB LABOR & BIRTH and Comfort Measures:
60. _____ The most effective way to identify adequate maternal oxygenation after administration of a narcotic for cesarean birth is to:
a) Take the blood pressure frequently. b) Observe for cyanosis or restlessness. c) Maintain a side-lying position. d) Observe pulse oximeter readings.
61. _____An epidural is best performed during which phase of labor? a) Latent b) Active c) Transitional d) 4th phase
62. _____ Which assessment finding is most indicative of fetal distress? a) Fetal heart rate of 140 beats/minute b) Presence of fetal heart rate accelerations c) Presence of green amniotic fluid d) Increased amount of bloody show
63. _____ For which complication should the nurse assess the client immediately after the administration of the epidural anesthetic?
a) Maternal hypotension b) Fetal tachycardia c) Spinal headache d) Lower extremity paralysis
64. _____ The nurse medicated the laboring woman with Stadol 2mg IVP for discomfort. Moments later, the woman screamed “ I think the baby is coming!”. Which medication should the nurse have on hand in case the baby is born and experiences respiratory depression?
a) Calcium Gluconate b) Atropine c) Apresoline d) Narcan (naloxone hydrochloride)
65. _____ Which fetal position is most favorable for birth? a) Vertex position b) Direct posterior position c) Frank breech position d) Footling breech position
A
B
C
D
Use the following fetal heart rate strips for questions # 66-79
DAY #2 OB LABOR & BIRTH and Comfort Measures:
66. _____ Which of the following is a reassuring fetal heart rate? a) A b) B c) C d) D
67. _____ Which of the following is a non-reassuring fetal heart rate? a) A b) B c) C d) D
68. _____ Which of the following is a late deceleration of the fetal heart rate? a) A b) B c) C d) D
69. _____Which of the following is an early deceleration of the fetal heart rate? a) A b) B c) C d) D
70. _____ Which of the following is a variable deceleration of the fetal heart rate? a) A b) B c) C d) D
71. _____ Which of the following is an acceleration of the fetal heart rate? a) A b) B c) C d) D
72. _____Which of the following is a normal finding and only documentation and continued observation is required by the nurse?
a) A b) B c) C d) D
DAY #2 OB LABOR & BIRTH and Comfort Measures:
73. _____Which of the following requires the nurse to turn/reposition the laboring woman? a) A b) B c) C d) D
74. _____Which of the following requires the nurse to prepare for delivery? a) A b) B c) C d) D
75. _____Which of the following requires the nurse to reposition the patient, administer oxygen, increase IV fluids, and notify MD immediately?
a) A b) B c) C d) D
76. _____Which of the following is caused by cord compression? a) A b) B c) C d) D
77. _____Which of the following is caused by head compression? a) A b) B c) C d) D
78. _____Which of the following is caused by placental insufficiency? a) A b) B c) C d) D
79. _____Which of the following is a sign of a well-oxygenated fetus? a) A b) B c) C d) D
DAY #2 OB LABOR & BIRTH and Comfort Measures:
80. _____ Using aromatherapy, which scent causes feeling of relaxation, and decreases stress and anxiety?
a) Lavendar b) Citrus c) Geranium d) Peppermint
81. _____Using aromatherapy, which scent may reduce nausea and vomiting as well as help a nursing student think clearly on a test????
a) Lavendar b) Citrus c) Geranium d) Peppermint
82. _____Using aromatherapy, which scent causes feeling of uplifting and reduces depression? a) Lavendar b) Citrus c) Geranium d) Peppermint
83. _____ Which of the following are non-pharmacologic al comfort measures that may be used in labor? (select all that apply)
a) Birthing ball b) Shower, tub or pool c) Guided imagery d) Music e) Stadol f) Epidural g) Aromatherapy h) Massage i) Breathing
DAY #2 OB LABOR & BIRTH and Comfort Measures:
84. _____ Where would an external fetal heart monitor pick up fetal heart tones in a fetus that is cephalic?
a) Above the umbilicus b) Below the umbilicus
85. _____ Where would an external fetal heart monitor pick up fetal heart tones in a fetus that is breech?
a) Above the umbilicus b) Below the umbilicus
86. _____ During a vaginal examination of a client in labor, the obstetrician determines that the fetal head is at the level of the ischial spines. The most accurate documentation of this fetal station would be:
a) -1 b) 0 c) +1
87. _____ During a vaginal examination of a client in labor, the obstetrician determines that the fetal head is above the level of the ischial spines. The most accurate documentation of this fetal station would be:
a) -1 b) 0 c) +1
88. _____ During a vaginal examination of a client in labor, the obstetrician determines that the fetal head is below the level of the ischial spines. The most accurate documentation of this fetal station would be:
a) -1 b) 0 c) +1
DAY #2 OB LABOR & BIRTH and Comfort Measures:
89. _____Which type of anesthesia only numbs the area that is injected? a) Epidural b) Local c) Pudendal d) General
90. _____ Which type of anesthesia requires an IV bolus and minimum of 100,000 platelets prior to, takes 10-20 minutes to take affect, and will require the use of a pump to hook up the medicine drip to?
a) Epidural b) Local c) Pudendal d) General
91. _____ Which type of anesthesia requires is used mainly for emergency purposes and has negative side effects of vomiting and aspiration?
a) Epidural b) Local c) Pudendal d) General
92. _____ Which type of anesthesia does not take away the pain of the contractions but only the discomfort of the actual delivery of the baby?
a) Epidural b) Local c) Pudendal d) General
93. _____ Which type of comfort measure involves massage of the abdomen? a) Imagery b) Effleurage c) Aromatherapy d) Hydrotherapy
94. ______ Which type of comfort measure involves the use of smell? a) Imagery b) Effleurage c) Aromatherapy d) Hydrotherapy
DAY #2 OB LABOR & BIRTH and Comfort Measures:
95. ______ Which type of comfort measure involves the use of smell? a) Imagery b) Effleurage c) Aromatherapy d) Hydrotherapy
96. _____ The nurse realizes that adverse effects of using general anesthesia include: a) Vomiting and pruritus b) Vomiting and diarrhea c) Vomiting and palpitations d) Vomiting and aspiration
97. _____Which medication describes the patient’s ability to self-administer small doses of an analgesic by using a pump programmed for dose and frequency?
a) Demerol IM b) Stadol IVP c) Demerol PCA d) Percocet PO
98. _____ A laboring woman has been given Stadol 1mg IVP for complaints of uterine discomfort. Which maternal assessment by the nurse takes priority?
a) Temperature b) Blood pressure c) Pulse d) Respirations
99. _____ Prior to an epidural, the laboring patient must have a minimum of how many platelets?
a) 50,000 b) 75,000 c) 100,000 d) 150,000
100. _____ A laboring woman has been given an injection of epidural anesthesia. Which maternal assessment by the nurse takes priority?
a) Temperature b) Blood pressure c) Pulse d) Respirations
