NURS 145 Exam 5 Study Questions and Correct Answers
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Course
NUR 145
Institution
NUR 145
Pudendal Block - local anesthetic trans-vaginally injected; "ring of fire" - administered during late second stage of labor (10-20 min. before labor) ADVERSE: vaginal hematoma, abscess
Epidural Block - local anesthetic into the epidural space (4-5th lumbar vertebrae) - eliminates all sensation of ...
NURS 145 Exam 5 Study Questions and
Correct Answers
Pudendal Block ✅- local anesthetic trans-vaginally injected; "ring of fire"
- administered during late second stage of labor (10-20 min. before labor)
ADVERSE: vaginal hematoma, abscess
Epidural Block ✅- local anesthetic into the epidural space (4-5th lumbar vertebrae)
- eliminates all sensation of umbilicus-thighs
- administered w/ client in active labor and dilation to 4cm
- not administered if platelets low
ADVERSE: maternal hypotension, urine retention
RISK: infection, hypovolemia
Spinal Anesthesia (block) ✅- local anesthetic injected into the subarachnoid space ->
spinal fluid (3rd-5th lumbar vertebrae)
- eliminates all sensation nipples to feet
- common for c-section
ADVERSE: maternal hypotension, fetal bradycardia, urine retention, loss of bearing
down reflex
Augmentation of Labor ✅- stimulation to hypotonic contractions once labor begins
Amniotomy ✅- artificial rupture of amniotic membranes
- increased risk of cord prolapse
MONITOR: fetal HR outside of 110-160, observe color, odor, amount and character of
amniotic fluid, maternal temperature every 2hrs to monitor for infection
C-Section ✅- delivery through the trans-abdominal incision of uterus
C-Section Indications ✅abnormal labor
inability of fetus to pass mother's pelvis
gestational HTN or diabetes
active maternal herpes
previous surgery to uterus
fetal compromise
placenta previa or abruption
C-Section Risks ✅anesthesia to mother and fetus
respiratory complications
hemorrhage
blood cots
injury to urinary tract
, delayed intestinal peristalsis
infection
C-Section: Preprocedure ✅CBC, coagulation studies, blood typing
clinical lab: anemia and blood clotting abnormalities
baseline vital signs & FHR
position for comfort
indwelling catheter
IV
C-Section Postprocedure ✅VS (identify hemorrhage or shock)
IV site
fundus (firmness, height, and midline position)
dressing (assess for drainage)
lochia (quantity, color, and clots)
urine output
always assess fundus for firmness and at the U
mothers may need more emotional support
C-Section Incisions ✅Low Transverse: not likely to rupture during another birth, VBAC
is possible
Low Vertical: more likely to rupture during another birth
Classic: more blood loss, most likely to rupture during another pregnancy
Nonpharmalogical Stimulation of Contractions ✅Walking: stimulates contractions,
eases pressures of fetus on mother and adds gravity to downward force of a contraction
Prostaglandin E2: dinoprostone ✅intravaginally, sustained release, easily removed
with a string
Prostaglandin E1: misoprostol ✅PO or intravaginal pill, effective in achieving vaginal
delivery w/in 24hrs
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