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NM 704 EXAM 3 MODULE 6 QUESTIONS AND ANSWERS 2024
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NM 704 EXAM 3 MODULE 6 QUESTIONS AND ANSWERS 2024
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NM 704 EXAM 3 MODULE 6effectiveness *Heat & Cold* for reducing pain & increasing comfort in labor: -
ANSWERS-● Heat applied where fetal head presses (lower back or abdomen) may
decrease pain by causing increased circulation to affected tissue
● Cold application has a numbing effect
● Some find relief w/ cold if heat unsuccessful whereas some find alternating
between heat & cold most comforting
● No specific studies for effectiveness
● Multiple contraindications
- areas anesthetized by epidural
- fever
- raynauds
- sickle cell
Components of an admission *history* when a ♀ is in labor. - ANSWERS-● Age-
extremes associated with increased risk for adverse outcomes
● Parity- influences labor progress and duration
● EDD and gestational weeks- Identifies potential newborn complications. Allows
for evaluating fetal size r/t gestational age
● Complications of current pregnancy including GBS status- identifies existing
and/or potential problems
,● Major complications w/ previous pregnancies- identifies potential recurring
problems
● Previous labor experiences including duration- influences expectations and
identifies potential coping strategies
● Mode of previous births/deliveries- identifies operative, vaginal, and c-section;
influences management
● Size of previous babies- estimate of pelvic adequacy
● Fetal movement pattern- fetal well-being
● Vaginal bleeding- differentiated from bloody show; vaginal bleeding is
abnormal, contraindicative of digital cervical exam and indicates need for
collaboration
● Status of membranes- duration of ROM and characteristics of amniotic fluid
(meconium)
● Time of onset of contractions and characteristics (frequency, duration,
intensity, aggravating/relieving factors)-helps discriminate true from false labor as
well as establishes onset of labor
● Last oral intake- baseline energy and fluid status; useful for anesthesia in case of
need for surgery
Components of an admission *physical* when a ♀ is in labor. - ANSWERS-● VS
(BP, Temp, HR, RR)
● Auscultation of heart and lungs
● Abdominal palpation
○ Determine contraction pattern
○ Assess fetal lie, presentation, position, and engagement
, ○ Estimated fetal weight and fundal height
● Visual inspection for abdominal scars
● Assessment for presence of peripheral edema
● Cervical Examination
○ Cervical effacement and dilation
○ Position of cervix
○ Station of fetal presenting part
○ Presence of molding or caput succedaneum
○ Fetal lie, presentation, position
○ Tone and elasticity of vagina and perineum
○ Confirmation of membrane status
○ Visual inspection of perineum
○ Assessment of FHR
recommended frequency for the assessment of maternal vital signs in the first
stage of labor. (w/o epidural) - ANSWERS-BP, HR, RR: q 1 hour
Temp: q2-4 hr when temp normal and membranes intact;
recommended frequency for the assessment of maternal temp - ANSWERS-q 1-2
hr if temp abnormal &/or after ROM
recommendations for frequency of continuous FHR assessment during 1st stage
of labor. - ANSWERS-● q30min (no complications)
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