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Learning Guide
Complications of Labor and Delivery
Chaper 27
Dysfunctional Labor
Problems of the Powers
Hypotonic Dyfunction
1. What are the characteristics of hypotonic contractions?
2. What are the causes/ risk factors of hypotonic uterine contractions?
3. What interventions might the nurse use when caring for a woman
experiencing hypotonic uterine contractions?
Hypertonic Dysfunction
4. What are the characteristics of hypertonic uterine contractions?
5. What are the causes/risk factors of hypertonic uterine contractions?
6. What interventions would the nurse implement when caring for a woman
experiencing hypertonic uterine contractions?
Ineffective Maternal Pushing
7. What intervention can the nurse use to assist a woman who is having
difficulty pushing effectively?
Problems with the Passenger
Fetal Size
8. Define macrosomia.
9. What methods may be used by the nurse to relieve impacted fetal
shoulders?
Abnormal Presentation or position
10.How do each of the following relate to a complicated labor?

Rotation abnormalities

Deflexion abnormalities

Breech presentation

Multifetal Pregnancy
11.What nursing interventions are appropriate to assist with abnormal
presentation or position?
Problems with the Passage
12. What are the signs of a small or abnormally shaped pelvis?
13. How does a full bladder impede fetal descent?
Problems of the Psyche
14. How does the body respond to stress?
15. What nursing interventions can be used to help a woman relax while in
labor?
Abnormal Labor Duration
Prolonged Labor
16. What are the potential problems associated with a prolonged labor?
17. What nursing interventions should be employed for a prolonged labor?
Precipitate Labor
18.What is precipitous labor? What are the risks associated with a precipitous
labor?
19. What is the nursing care for a precipitous labor?
20. What is the nursing care for a precipitous delivery and potential
complications?
Premature Rupture of the Membrane
21. What is premature rupture of membranes (PROM)?
a. What conditions are associated with PROM?
b. What assessments should the nurse make in the case of PROM?
c. What patient teaching is needed if a woman returns home after
PROM?
Preterm Labor
22. What is Preterm labor?
23. What conditions are associated with preterm labor?
24. What are the actions, nursing implications, and side effects of the following
medications used for treating preterm labor?
a. Magnesium Sulfate
b. Nifedipine – calcium antagonist
c. Terbutaline – beta-adrenergic
25. Why are corticosteroids given to a woman in preterm labor?
26. How long should labor be delayed after administration of Betamethasone
(Celestone) to realize the greatest benefit from this drug?
27. What nursing interventions are used to assist a woman in preterm labor?
Intrapartum Emergencies
Prolapsed Umbilical Cord
28. Define prolapse of the umbilical cord.
a. What is conditions are associated with a prolapse of the umbilical
cord?
b. What are specific nursing interventions for the woman with a
prolapsed umbilical cord?
Uterine Rupture
29. What conditions are associated with rupture of the uterus?
30. What are the signs and symptoms of a uterine rupture?
Anaphylactoid Syndrome (AFE)
31. What is the cause of an amniotic-fluid embolism?
32. What does the therapeutic management involve?
Chapter 20
Nursing Care During Obstetric Procedures
Amniotomy
1. Define the term amniotomy.
2. What are the risks associated with an amniotomy?
3. What nursing care is required after this procedure?
4. When is this procedure contraindicated?
Induction and Augmentation of Labor
5. What are some reasons that labor may be induced?
6. When is augmentation of labor employed?
7. What are the risks associated with the induction and augmentation of labor?
8. What are the techniques used to induce or augment labor?
9. How does the Bishop's Score determine readiness for labor?
10. What is cervical ripening?
11. What medications are used in this process?
12. What precautions should be taken when administering Oxytocin?
13. What observations of the fetal response to Oxytocin should be made?
14. What observations of the maternal response to Oxytocin should be made?
Version
15. What is an external version?
16. What is an internal version?
17. What are the nursing considerations for a woman undergoing an external
version?
Operative Vaginal Birth
18. What are the indications for the use of forceps or vacuum extractor?
19. What are the risks of using these devices?
20. What are the nursing considerations?
Episiotomy
21. What is an episiotomy?
22. What are nursing considerations in reducing the need for an episiotomy?
Cesarean Birth
23. Discuss the nursing considerations related to the woman having a cesarean
birth.
24. What is a VBAC?
25. What risk is associated with an attempted VBAC?