Exam (elaborations)

Exam 2 Nur 141 OB Study Questions and Correct Answers

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Course
NUR 141

Institution
NUR 141

What are the changes a woman may experience prior to the onset of labor? - Braxton hicks contractions -persistent low backache and sacroiliac distress from relaxing of pelvic joints -brownish or blood tinged cirvical mucus(bloody show) -cervix becomes soft (ripens) and partially effaced and may beg...

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exam 2 nur 141 ob study questions and correct answ
what are the changes a woman may experience prior
persistent low backache and sacroiliac distress fr

Institution NUR 141
Course NUR 141

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Exam 2 Nur 141 OB Study Questions
and Correct Answers
What are the changes a woman may experience prior to the onset of labor? ✅-
Braxton hicks contractions
-persistent low backache and sacroiliac distress from relaxing of pelvic joints
-brownish or blood tinged cirvical mucus(bloody show)
-cervix becomes soft (ripens) and partially effaced and may begin to dilate
- membranes may spontaneously rupture
- loss of 1-3.5 pounds in weight caused by water loss resulting from electrolyte shifts
that in turn are produced by changes in estrogen and proesterone levels
-a surge of energy
- less commonly some women have diarrhea, nausea, vomitting, and indigestion
- lightening- In first time pregnancies the uterus sinks downwards and forward about 2
weeks b4 term, when the fetus's presenting part (usually the fetal head) descends into
the true pelvis.
- after lightening- o After lightening, women feel less pressure below the ribcage and
breath more easily, but usually more bladder pressure results from this shift causing
more urinary frequency.
- o In multiparous women, lightening may not occur until after uterine contractions are
established and the labor process begins.

Where are the fontanels on a newborn and when do they close? ✅-Anterior- Larger,
diamond shape, about 3cm X 2cm, lies at the junction of the saggital, coronal, and
frontal sutures. And closes by 18 months after birth

-posterior- Lie at the junction of the sutures of the two parietal bones and the occipital
bone, is triangular, and is about 1cm X 2cm and closes by 6-8 weeks after birth

What conditions must be present for an RN to assume labor has begun? ✅- strong,
regular, rhythmic uterine contractions
-membranes may break or they may wait until the 2nd or 3rd phase of stage 1 in labor

What are the parts of the fetal head and what is molding? ✅Molding- b/c sutures and
fontanels are not firmly united, slight overlapping of the bones or "molding" the shape of
the head accurs during labor. It can be extensive, however, most newborns assume
their normal shape within 3 days after birth.
- Sutures and the fontanels make the skull flexible to accommodate the infant brain,
which continues to grow for some time after birth. Molding occurs to allow the larger
size infant head through the smaller birth canal of the mother.

Fetal Position ✅the relationship of a reference point on the presenting part (Occiput,
sacrum, mentum (chin), or sinciput (deflexed vertex) to the 4 quadrants of the mother's
pelvis. Denoted by a 3 part abbreviation:

, - 1st letter- Location of the presenting part - Right or Left side of the mom's pelvis (R or
L)
- 2nd letter- Stands for specific presenting part of the fetus O for occiput, S for sacrum,
M for mentum (chin), Sc for scapula (shoulders).
- 3rd letter- The location of the presenting part in relation to the anterior (A), posterior
(P), or transverse (T) portion of the mother's pelvis
(i.e. ROA means that the occiput is the presenting part and is in the right anterior
quadrant of the maternal pelvis or LSP means that the sacrum is the presenting part
and is in the left posterior quadrant of the mother's pelvis)

Fetal station ✅- the relationship of the presenting fetal part to an imaginary line drawn
between the maternal ischial spines and is a measure of the degree of descent of the
presenting part of the fetus through the birth canal.
- The placement of the presenting part is measured in centimeters above or below the
ischial spines. Birth is imminent when the presenting part is at +4 to +5. The station of
the presenting part should be determined when labor begins so that the rate of descent
of the fetus during labor can be determined accurately.

Primary powers of labor ✅- involuntary uterine contractions
- Frequency- the time from the beginning of one contraction to the beginning of the next
- Duration- length of contractions
- Intensity- strength of the contraction at its peak
- Responsible for the effacement and dilation of the cervix and descent of the fetus.
- Effacement- the shortening and thinning of the cervix during the first stage of labor.
- Dilation- enlargement or widening of the cervical opening and the cervical canal that
occurs once labor has begun. Full dilation is at 10 cm to allow the birth of a term fetus.
Full cervical dilation marks the end of the first stage of labor and the cervix can no
longer be palpated.
- Ferguson reflex- when the presenting part of the fetus reaches the perineal floor,
mechanical stretching of the cervix occurs. Stretch receptors in the posterior vagina
cause release of endogenous oxytocin that triggers the maternal urge to bear down.

Secondary powers of labor ✅- voluntary bearing down effort
-As soon as the presenting part reaches the pelvic floor, the contractions change in
character and become expulsive. The laboring woman experiences an involuntary urge
to push. She uses secondary powers (bearing-down efforts) to aid in expulsion of the
fetus as she contracts her diaphragm and abdominal muscles and pushes.

Cardiovascular changes that take place in the mother during labor ✅- by the end of the
first stage of labor cardiac output during contractions is increased by 51%
- In general BP systolic and diastolic increase during contractions and decrease in
between
- The woman is at risk for supine hypotension when ascending and descending aorta
are compressed.
- The woman should be discouraged from using the Valsalva maneuver (holding ones
breath and tightening abdominal muscles) for pushing during the second stage because

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