Labor Quiz Guide

stage 1 of labor begins with

contractions

stage 1 ends with

full dilation

stage two begins with

full dilation

stage 2 ends with

delivery of the neonate

stage 3 begins with

delivery of neonate

stage 3 ends with

the delivery of the placenta

stage 4 begins with

the delivery of the placenta

stage 4 ends with

maternal stabilization of vital signsnorma

normal FHR

110-160 BPM

Cause of variable decelerations

cord compression

cause of early decelerations

head compression

cause of acceleration

oxygenation & okay

cause of late decelerations

placental insufficiency

early deceleration nursing care

no intervention required

* includes fetal head compression due to contractions

late deceleration nursing care

place client side-lying, insert IV catheter and increase rate of IV fluids, d/c oxytocin, administer oxygen at 8-10 L/min w/nonrebreather, elevate client’s legs, notify provider, prep for vaginal/csection assisted birth

variable deceleration nursing care

reposition client, d/c oxytocin, administer oxygen 8-10L/min w/nonrebreather, vaginal exam, assist w/amniofusion as prescribed

supine hypotension

occurs when a client lies on her back and the weight of the gravid uterus compresses the vena cava, reducing blood supply to the fetus, gives the client lightheadedness and faintness

* teach the client to lie in a side-lying or semi-sitting position w/knees flexed slightly

placental seperation

placenta partly or completely separates from the inner wall of the uterus before delivery

clinical findings of placental separation

fundus firmly contracting, swift gush of dark blood from introitus, umbilical cord appears to lengthen as the placenta descends, vaginal fullness on exam

placental expulsion

delivery of placenta

VEAL CHOP

variable = cord compression

early = head compression

acceleration = oxygenation

late = placental insufficiency

when palpating the fundus a mild contraction feels like…

the tip of the nose

when palpating the fundus a moderate contraction feels like…

the chin

when palpating the fundus a strong contraction feels like…

the forehead

acceleration

variable transitory increase in FHR above the baseline,

absence of induced accelerations after fetal stimulation

episodic/periodic decelerations

* prolonged FHR deceleration equal or greater than 2 minutes but less than ten
* recurrent variable decelerations w/moderate baseline variability
* recurrent variable decelerations w/minimal or moderate baseline variability
* variable decelerations with additional characteristics, including “overshoots,” “shoulders",” or slow return to baseline FHR

Episodic

not associated with uterine contractions

Periodic

changes that occur with contractions