The fetal heart beat should be monitored every 15 minutes during the 2nd stage of labor. The characteristic of a normal fetal heart rate is
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Solution
The heart rate will decelerate during a contraction and then go back to its pre-contraction rate after the contraction
The normal fetal heart rate will decelerate (go down) slightly during a contraction because of the compression on the fetal head. However, the heart rate should go back to the pre-contraction rate as soon as the contraction is over since the compression on the head has also ended.
When the bag of waters ruptures spontaneously, the nurse should inspect the vaginal introitus for possible cord prolapse. If there is part of the cord that has prolapsed into the vaginal opening the correct nursing intervention is:
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Solution
Cover the prolapse cord with sterile gauze wet with sterile NSS and place the woman in Trendelenburg position
The correct action of the nurse is to cover the cord with sterile gauze wet with sterile NSS. Observe strict asepsis in the care of the cord to prevent infection. The cord has to be kept moist to prevent it from drying. Don’t attempt to put back the cord into the vagina but relieve pressure on the cord by positioning the mother either on Trendelenburg or Sims position
When the bag of waters ruptures, the nurse should check the characteristic of the amniotic fluiD. The normal color of amniotic fluid is
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Solution
Clear as water
The normal color of the amniotic fluid is clear like water. If it is yellowish, there is probably Rh incompatibility. If the color is greenish, it is probably meconium stained.
When determining the duration of a uterine contraction the right technique is to time it from
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Solution
The beginning of one contraction to the end of the same contraction
Duration of a uterine contraction refers to one contraction. Thus it is correctly measure from the beginning of one contraction to the end of the same contraction and not of another contraction.
The peak point of a uterine contraction is called the
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Solution
Acme
Acme is the technical term for the highest point of intensity of a uterine contraction.
To monitor the frequency of the uterine contraction during labor, the right technique is to time the contraction
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Solution
From the beginning of one contraction to the beginning of the next contraction
The frequency of the uterine contraction is defined as from the beginning of one contraction to the beginning of another contraction.
The proper technique to monitor the intensity of a uterine contraction is
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Solution
Put the tip of the fingers lightly on the fundal area and try to indent the abdominal wall at the height of the contraction
In monitoring the intensity of the contraction the best place is to place the fingertips at the fundal area. The fundus is the contractile part of the uterus and the fingertips are more sensitive than the palm of the hand.
The primary power involved in labor and delivery is
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Solution
Uterine contraction
Uterine contraction is the primary force that will expel the fetus out through the birth canal Maternal bearing down is considered the secondary power/force that will help push the fetus out.
If the labor period lasts only for 3 hours, the nurse should suspect that the following conditions may occur:
1.Laceration of cervix
2.Laceration of perineum
3.Cranial hematoma in the fetus
4.Fetal anoxia
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Solution
1,2,3,4
all the above conditions can occur following a precipitate labor and delivery of the fetus because there was little time for the baby to adapt to the passageway. If the presentation is cephalic, the fetal head serves as the main part of the fetus that pushes through the birth canal which can lead to cranial hematoma, and possible compression of the cord may occur which can lead to less blood and oxygen to the fetus (hypoxia). Likewise, the maternal passageway (cervix, vaginal canal and perineum) did not have enough time to stretch which can lead to a laceration.
The following are signs and symptoms of fetal distress EXCEPT:
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Solution
The pre-contraction FHR is 130 bpm, FHR during contraction is 118 bpm and FHR after uterine contraction is 126 bpm
The normal range of FHR is 120-160 bpm, strong and regular. During a contraction, the FHR usually goes down but must return to its pre-contraction rate after the contraction ends.