NSG 210
What is a normal fetal heart rate? - 110-160
What drug is used to stimulate uterine contractions? - Oxytocin
What are the desired parameters for uterine contractions? - Lasting 60 seconds or less
Not more often than 2 minutes
What does Terbutaline do & what are its contraindications? - Delays delivery time, but does not stop it.
Contraindicated for gestation 34 weeks or greater & cervical dilation >6 cm.
What does nifedipine do & what is a side effect to watch for? - Helps suppress contractions
Watch for orthostatic hypotension
When does progesterone levels start to drop? - Around 37 weeks. Was previously high because
progesterone relaxes smooth muscle of the uterus
What happens to Estrogen around delivery time? - Remains high. Combination of lower progesterone
and high estrogen makes uterus more responsive to other hormones (oxytocin)
What are Braxton Hick's contractions? - They are false labor contractions which are occurring due to the
decreased levels of progesterone.
Explain dilation and effacement. - Dilation is the opening of the cervix to 10 cm & effacement is the
thinning of the cervical walls expressed in percentage.
Where is relaxin and what does it do? - Produced in the placenta
,What are the stages of labor & what happens in each? - Stage 1 - Cervical dilation
*cervix dilates to about 10 cm
Stage 2 - Expulsion of fetus
*starts when fetal head enters the birth canal and ends when fetus is delivered
Stage 3- Afterbirth
*starts immediately after fetal delivery and ends with delivery of the placenta
Stage 3 - Recovery
Explain an early deceleration - Considered normal
Fetal heart rates drops and mirrors maternal contraction
caused by compression of fetal head on pelvis/soft tissue.
Explain Late Decelerations - Is not normal and requires intervention
Fetal heart rate drops after maternal contraction
Caused by uteroplacental insufficiency (baby not getting enough oxygen?
Explain Variable Deceleration - Not normal and requires intervention
There is not relationship between fetal heart rate drops and maternal contraction
Caused by umbilical cord compression
During Leoupold's Maneuver, you find the fetal lie to be straight up and down. What is this called? -
Longitudinal lie
During Leoupold's Maneuver, you find the fetal lie to be at an angle. What is this called? - Oblique
During Leoupold's Maneuver, you find the fetal lie to be horizontal. What is this called? - Transverse
,During Leoupold's Maneuver, you find one side of the fetus hard & the other side soft. What does this
indicate? - hard - back
soft - front
How can you assess to see if the fetal head has dropped into the pelvis? - Face the mother's feet
Place your fingertips just above the pubic bone
Can you get your fingers between the fetal head and the maternal pubic bone?
Yes - fetal head has not dropped into pelvis
No - fetal head has dropped into pelvis
Where would you expect to find the fundal height of a woman 12 weeks pregnant? - Just above pubic
bone
Where would you expect to find the fundal height of a woman 16 weeks pregnant? - 1/2 way between
pubic bone and umbilicus
Where would you expect to find the fundal height of a woman 20 weeks pregnant? - At umbilicus
Where would you expect to find the fundal height of a woman 24 weeks pregnant? - Finger or two
above umbilicus
Where would you expect to find the fundal height of a woman 36 weeks pregnant? - At the xiphoid
process
Where would you expect to find the fundal height of a woman post 36 weeks pregnant? - Below the
xiphoid process (lightening occurs)
Is it easier to assess a fetal heart beat over the fetal back or fetal chest? - Fetal back
How should a fetus respond when it is stimulated? - Increase in heart rate
, What is the puerperium period? - The period after delivery of baby to 6 weeks postpartum
What is uterine involution? - The return of the uterus to its pre-pregnancy size and condition
What are the types of lochia? - 1. Lochia rubra
2. Lochia serosa
3. Lochia alba
Explain the APGAR - Heart rate:
Absent = 0
<100 = 1
100 or > = 2
Respiratory effort
None = 1
Slow respirations or weak cry = 1
Spontaneous respirations with strong cry = 2
Muscle tone
Limp = 0
Minimal flexion & sluggish movements = 1
Flexed body spontaneous & vigorous movement = 2
Reflex response
None = 0
Minimal response (grimace) = 1
Prompt response = 2
Color
Pale or cyanotic = 0
Bluish hands & feet only = 1
Pink all over = 2
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