MCN 273 FINAL Latest Update -

MCN 273 FINAL Latest Update - Exam from Credible Source with 680 Questions and 100% Verified Detailed Correct Answers Guaranteed A+ Approved by Professor

"Powers" of Labor: Primary - CORRECT ANSWER: Uterine muscular contractions (myometrial activity - frequency, duration, intensity) Causes cervical change (dilation, effacement, station) "Laboring down" (allow for 2-3hrs)

"Powers" of Labor: Secondary - CORRECT ANSWER: Pushing during the second stage of labor Coordinate the primary force

1st: Systemic Analgesia - CORRECT ANSWER: Goal is to provide maximum relief with minimal risk Medications can cross placenta - safer to give earlier in labor Consider labor progress and women's medical status IV or IM, not PO May cause decreased GI motility, vomiting up of PO medications Safety first - bedrest, assisted ambulation Monitor VS, especially respirations, FHR Typically given opioids, antiemetics, benzodiazepines FHR may show minimal variability Only takes the edge off Works for about 12 hours Consider where mom is in the labor process

2nd: Regional Analgesia - CORRECT ANSWER: Temporary reversible loss of sensation 1 / 4

Prevents transmission of nerve impulses Less risk than general anesthesia - visitor can be present for C/S delivery Pain relief, not pressure release Does not cross placenta Types - epidural, spinal, pudendal block Small catheter stays in place to re-dose analgesia, can also be used for C/S

3rd: Un-medicated Labor - CORRECT ANSWER: Nursing/doula labor support Water-birth/hydrotherapy Ambulation/position change Birthing aids - squat bar, birthing ball, birthing stool Massage Heat/cold Visualization Breathing techniques Sterile water injections (provide 1-2hrs of relief, helpful for back labor) Advantages - patient autonomy and empowerment, least pharmaceutical transfer to fetus, natural experience, most mobile during labor, family involvement Disadvantages - requires preparation and support

Abruptio Placentae - CORRECT ANSWER: Premature separation fo placenta from

uterine wall after 20 weeks prior to birth Caused by decreased blood flow/degenerative changes in placenta vessels = retroplacental clots of possible rupture = separation

Abruptio Placentae: Classifications - CORRECT ANSWER: Partial or complete Partial apparent Partial concealed Complete concealed 2 / 4

Grade 1-3 depending on severity (grade 3 more emergent) Can also be chronic, slow bleed

Abruptio Placentae: Fetal Complications - CORRECT ANSWER: Prematurity Anemia Hypoxia Mortality with greater placental separation

Abruptio Placentae: Maternal Complications - CORRECT ANSWER: Depends on severity of bleed and time between separation and birth Disseminated intravascular coagulation (DIC) = large amounts of clotting factors used up at placental site = not enough everywhere else Shock resulting from moderate to severe hemorrhage Possible hysterectomy if can't control the bleeding

Abruptio Placentae: Risk Factors - CORRECT ANSWER: Maternal HTN Trauma Uterine over distention PPROM Cocaine abuse Chorio

Abruptio Placentae: S/S - CORRECT ANSWER: Painful, dark red bleeding

Abruptio Placentae: Therapy - CORRECT ANSWER: Coagulation tests Maintain cardiovascular status of mother - hemodynamic monitoring, urine output, labs, IV x2, type and cross match EFM for uterine pattern (tachysystole present) Birth method depends on maternal/fetal condition - NSVD if mom is dilating and baby can withstand it, otherwise emergency C/S, fluid/volume replacement 3 / 4

Accelerations - CORRECT ANSWER: 15x15

Accelerations - CORRECT ANSWER: Abrupt increase at least 15bpm above FHR

baseline for at least 15sec May be associated with fetal movement Sign of fetal wellbeing and adequate oxygenation

After Sperm Entry - CORRECT ANSWER: Zone pellucida blocks more sperm from

entering Sex of zygote is determined

Afterpains - CORRECT ANSWER: Intermittent UCs that cause involution

More common in multiparas Multips have a larger uterus from multiple babies Lost muscle tone can cause severe pain Oxytocic agents are released when breastfeeding which may make afterpains worse Tx with ibuprofen, warm water bottle

Alcohol Use in Pregnancy: Fetal Effects - CORRECT ANSWER: Withdrawal FASD Physical, behavioral, and cognitive effects Long term complications include delay in oral feeding, CNS dysfunction, learning disabilities, impulsivity, cognitive and speech impairment

Alcohol Use in Pregnancy: Maternal Effects - CORRECT ANSWER: Maternal Effects: malnutrition, bone-marrow suppression, increased infections, liver disease, withdrawal/DTs There is *no known safe amount of alcohol for pregnancy*

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