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NM 704 Exam 3 Module 6 Questions and Correct Answer
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Elscores 8/18/2024 6:16:34 PMNM 704 Exam 3 Module 6
Questions and Correct Answer
effectiveness *Heat & Cold* for reducing pain & increasing comfort in labor:
~: ● 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.
~: ● 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
, Elscores 8/18/2024 6:16:34 PM
● 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.
~: ● 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
, Elscores 8/18/2024 6:16:34 PM
● 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)
~: BP, HR, RR: q 1 hour
Temp: q2-4 hr when temp normal and membranes intact;
recommended frequency for the assessment of maternal temp
~: q 1-2 hr if temp abnormal &/or after ROM
recommendations for frequency of continuous FHR assessment during 1st stage of labor.
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