The partograph is a tool used to monitor labor. The maternal parameters measured/monitored are the following EXCEPT:
-
Solution
Fluid intake and output
Partograph is a monitoring tool designed by the World Health Organization for use by health workers when attending to mothers in labor, especially the high risk ones. For maternal parameters all of the above is placed in the partograph except the fluid intake since this is placed in a separate monitoring sheet.
This drug is usually given parentally to enhance uterine contraction:
-
Solution
Pitocin
The common oxytocin given to enhance uterine contraction is Pitocin. This is also the drug given to induce labor.
In a gravido-cardiac mother, the first 2 hours postpartum (4th stage of labor and delivery) particularly in a cesarean section is a critical period because at this stage
-
Solution
There is a fluid shift from the placental circulation to the maternal circulation which can overload the compromised heart.
During the pregnancy, there is an increase in maternal blood volume to accommodate the need of the fetus. When the baby and placenta have been delivered, there is a fluid shift back to the maternal circulation as part of physiologic adaptation during the postpartum period. In a cesarean section, the fluid shift occurs faster because the placenta is taken out right after the baby is delivered giving it less time for the fluid shift to gradually occur.
In vaginal delivery done in the hospital setting, the doctor routinely orders an oxytocin to be given to the mother parenterally. The oxytocin is usually given after the placenta has been delivered and not before because:
-
Solution
Oxytocin can make the cervix close and thus trap the placenta inside
The action of oxytocin is to make the uterus contract as well make the cervix close. If it is given prior to placental delivery, the placenta will be trapped inside because the action of the drug is almost immediate if given parentally.
As soon as the placenta is delivered, the nurse must do which of the following actions?
-
Solution
Inspect the placenta for completeness including the membranes
The placenta must be inspected for completeness to include the membranes because an incomplete placenta could mean that there is retention of placental fragments which can lead to uterine atony. If the uterus does not contract adequately, hemorrhage can occur.
The basic delivery set for normal vaginal delivery includes the following instruments/articles EXCEPT:
-
Solution
Retractor
For normal vaginal delivery, the nurse needs only the instruments for cutting the umbilical cord such as 2 clamps (straight or curve) and a pair of scissors as well as the kidney basin to receive the placenta. The retractor is not part of the basic set. In the hospital setting, needle holder and tissue forceps are added especially if the woman delivering the baby is a primigravida wherein episiotomy is generally done.
When delivering the baby’s head the nurse supports the mother’s perineum to prevent a tear. This technique is called
-
Solution
Ritgen’s technique
Ritgen’s technique is done to prevent the perineal tear. This is done by the nurse by support the perineum with a sterile towel and pushing the perineum downward with one hand while the other hand is supporting the baby’s head as it goes out of the vaginal opening.
When the baby’s head is out, the immediate action of the nurse is
-
Solution
Check if there is cord coiled around the neck
The nurse should check if there is a cord coil because the baby will not be delivered safely if the cord is coiled around its neck. Wiping off the face should be done seconds after you have ensured that there is no cord coil but suctioning of the nose should be done after the mouth because the baby is a “nasal obligate” breather. If the nose is suctioned first before the mouth, the mucus plugging the mouth can be aspirated by the baby.
When the shiny portion of the placenta comes out first, this is called the ___ mechanism.
-
Solution
Schultze
There are 2 mechanisms possible during the delivery of the placenta. If the shiny portion comes out first, it is called the Schultze mechanism; while if the meaty portion comes out first, it is called the Duncan mechanism.
The following are signs that the placenta has detached EXCEPT:
-
Solution
Mother feels like bearing down
Placental detachment does not require the mother to bear down. A normal placenta will detach by itself without any effort from the mother.