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68 Cards in this Set
- Front
- Back
CHAPTER FOURTEEN
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(Ignore this card)
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How often should VS be taken in the latent phase
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every 30-60 minutes
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How often should VS be taken in the active phase
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every 30 minutes
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How often should VS be taken in the transition phase
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every 15-30 minutes
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Assess temperature how often during labor
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every 4 hours
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How often should contractions be monitored in the latent phase
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every 30-60 minutes
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How often should contractions be monitored in the active phase
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every 15-30 minutes
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How often should contractions be monitored in the transition phase
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every 10-15 minutes
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How often should FHR be monitored in the latent phase
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every 30-60 minutes
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How often should FHR be monitored in the active phase
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every 15-30 minutes
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How often should FHR be monitored in the transition phase
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every 15-30 minutes
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Encourage voiding every ___ during labor
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2 hours
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How often should VS be taken in the second stage
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every 5-30 minutes
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How often should FHR be monitroed in the second stage
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every 15 minutes and STAT after birth
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first degree laceratoin
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extends through skin of perineum and does not involve the muscles
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second degree laceration
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extends through skin and muscles of perineum
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third degree laceration
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extends through skin, muscles, perineum, and anal sphincter
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fourth degree laceration
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extends through skin, muscles, perineum, anal sphincter, and anterior rectal wall
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During the third stage, gently cleanse the vulvar area with what
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warm water or 0.9% sodium chloride, then apply perineal pad or ice pack
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CHAPTER FIFTEEN
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(Ignore this card)
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What is ECV
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External Cephalic Version - attempt to manipulate the abdominal wall to direct a malpositioned fetus into a normal vertex cephalic presentation
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When should ECV be performed?
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after 37 weeks gestation
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ECV caries a high risk of
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prolapsed cord
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Contraindications to ECV include
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uterine anomalies, previous C-section, cephalopelvic disproportion, placenta previa, multifetal gestatoin, and/or oligohydramnios
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What mother needs to take RhoGAM at 28 weeks?
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the Rh-negative mother
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Bishop Score
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used to determine the maternal readiness for labor by evaluating if the cervix is favorable
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What is rated on the Bishop score?
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cervical dilation, effacement, consistency, position, and presenting part station
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How does the Bishop Score work
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the five factors are assigned a numerical value of 0 to 3, the total score is calculated, and a score is assigned
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ON the bishop score, what number do nulliparas need to indicate readiness for labor?
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9
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ON the bishop score, what number do multiparas need to indicate readiness for labor?
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5 or more
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What does cervical ripening do to the dosage of oxytocin needed for induction
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lowers the dosage needed
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Give three examples of prostaglandin gel used to ripen the cervix
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Cytotec, Cervidil, Prepidil
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What are prostaglandin gels used for
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Ripen the cervix
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Can balloon catheters be used to ripen the cervix
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Yes - inserted into the intracervical canal
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How do hydroscopic dilators and sponges ripen the cervix
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absorb fluid from the surroudning tissues and then enlarge
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What cervical ripening method is made from dessicated seaweed
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laminaria tents
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Synthetic dilators and sponges which ripen the cervix contain what
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Magnesium sulfate (lamicel)
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When are synthetic dilators and sponges used, and what do they do
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They ripen the cervix, used before ROM
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How do synthetic dilators and sponges ripen the cervix
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absorb fluid and expand causing cervical dilation
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When cervical ripening is performed, hyperstimulation of the uterus may occur. What is the Tx?
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administer terbutaline (Brethine) sub-Q
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If there is fetal distress and the mother is placed laterally, which side should she be on?
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left side
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Labor should be induced with what maternal medication complications?
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Rh-isoimmunization; DM; pulmonary disease; PIH
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Should labor be induced with fetal demise or with chorioamnionitis?
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With both
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When inducing labor, the nurse may initiate oxytocin how long after the administration of prostaglandin
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6-12 hours
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What must the nurse ensure has happened before the administration of oxytocin
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ensure that the fetus is engaged at a minimum station of 0
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When administering oxytocin via piggyback, which infusion port should be used
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the one closest to the client
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What should uterine resting tone be
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10-15 mm Hg
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there is a problem if uterine contraction frequency is more often than every
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2 minutes
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There is a problem if uterine contraction duration is longer than
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90 seconds
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There is a problem if uterine contraction intensity is greater than
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90 mm Hg
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If a nonreassuring FHR is noted, the IV fluid rate may be increased up to
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200 mL/hour
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When inducing labor and noting a nonreassuring FHR, describe the medicataion to be administeed
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tocolytic terbutaline (Brethine) 0.25 mg Sub-Q to diminish uterine activity
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Augmentation of labor
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the stimulation of hypotonic contractions once labor has spontaneously begun, but progress is inadequate
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What instrument is used to perform an Amniotomy
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Amnihook
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Labor typically begins within how many hours of ROM?
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12 hours
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There is an increased risk of what with ROM?
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cord prolapse
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In order to reduce the risk of infection or malposition of fetus following AROM, what should be limited?
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maternal activity
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When an amnioinfusion is performed, what is instilled and how?
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0.9% sodium chloride or LR solution thorugh a transcervical catheter
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In a vacuum-assisted delivery, when is the vacuum released and removed?
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preceding delivery of the fetal body but after the delivery of the head
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What position is the mother in during a vacuum-assisted delivery
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lithotomy
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What neonatal S/S is a normal occurrence with a vacuum-assisted delivery?
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caput succedaneum
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How long does it take for caput to resolve?
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24 hours
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Is an episiotomy used to prevent cerebral hemorrhage?
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Yes, in a fragile preterm infant
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Which type of episiotomy is easier to repair?
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midline (Median)
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Which type of episiotomy is associated with lower blood loss
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midline (Median)
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Which type of episiotomy is associated with a higher incidence of 3rd and 4th degree lacerations
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midline (Median)
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Which type of episitiomy is sometimes associted with 3rd degree lacerations
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mediolateral
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A tender uterus and foul-smelling lochia may indicate
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endometritis
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