Antenatal Care and Assessment Quiz

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Questions and Answers

What is the primary purpose of antenatal assessment?

To offer prenatal vitamins to all patients

To diagnose diseases or complications in presumed healthy pregnant women (correct)

To monitor fetal development exclusively

To conduct regular weight checks

What is the frequency of antenatal visits during the first 28 weeks of pregnancy?

Every month (correct)

Every two weeks

Twice a month

Every week

Which of the following is NOT a component of antenatal assessment?

Assessment of maternal hygiene

Evaluating eligibility for insurance (correct)

Detection of gestational age

Regular blood pressure monitoring

When should more frequent antenatal visits be indicated?

In high-risk pregnancies Signup and view all the answers

What investigation is commonly performed during antenatal visits?

Blood group and Rh typing Signup and view all the answers

What is the main rationale for arranging the antenatal room properly?

To ensure staff convenience and patient comfort Signup and view all the answers

What does Leopold's maneuver help to detect?

Fetal presentation in utero Signup and view all the answers

What is NOT a warning symptom that pregnant women should be instructed about during antenatal visits?

High energy levels Signup and view all the answers

What is the purpose of the fundal grip in Leopold's maneuvers?

To identify the part of the fetus occupying the fundus Signup and view all the answers

When carrying out the lateral grip, what is the clinician primarily trying to locate?

Fetal back location Signup and view all the answers

What does the suprapubic grip help determine regarding the fetus?

The part of the fetus occupying the lower uterus Signup and view all the answers

What characteristic of the fetal back should be assessed during the lateral grip?

Smooth and resistant surface Signup and view all the answers

What indicates that the presenting part of the fetus is engaged during the Pawlik grip?

The presenting part is not movable Signup and view all the answers

Which statement is true about the head of the fetus compared to the breech?

The head is firmer, harder, and round Signup and view all the answers

What is the correct position of the hands during the fundal grip?

Both hands are on the sides of the fundus at the top of the abdomen Signup and view all the answers

What should be felt with the lateral grip of the uterus?

Smoothness and firmness Signup and view all the answers

What is the purpose of making a single clean cut during an episiotomy procedure?

To create more space for fetal presenting part. Signup and view all the answers

What should be done first when repairing an episiotomy?

Locate the apex of the episiotomy. Signup and view all the answers

Which type of suture should be used to close the vaginal tear during episiotomy repair?

No. 1 or zero catgut. Signup and view all the answers

What is done to prevent the spread of infection after episiotomy?

Apply a sterile dressing on the perineal area. Signup and view all the answers

What is the main goal of having perineal care after an episiotomy?

To prevent the spread of infection. Signup and view all the answers

What action should be taken after suturing the episiotomy and before cleaning the wound?

Remove any vaginal pack. Signup and view all the answers

What is an important sign to observe during the management of the third stage of labor?

Signs and symptoms of placental separation. Signup and view all the answers

Which of the following is NOT a step mentioned in the aftercare following an episiotomy?

Providing emotional support to the mother. Signup and view all the answers

What is the first step in making an episiotomy incision?

Infiltrate local anesthesia into the perineum Signup and view all the answers

Why is it important to explain the procedure to the client's mother?

To ensure cooperation and compliance Signup and view all the answers

What is the purpose of putting two fingers between the fetal presenting part and the perineum?

To prevent injury to the fetal scalp Signup and view all the answers

What is the correct angle for injecting local anesthesia into the perineal skin?

20 degrees Signup and view all the answers

How much anesthesia should be injected during the infiltration process?

1-3 ml Signup and view all the answers

What is a critical reason to allow time for the local anesthesia to take effect?

To ensure anesthesia is working before proceeding Signup and view all the answers

What should be done after withdrawing the needle from the perineum?

Redirect it within the perineum for further infiltration Signup and view all the answers

Which is NOT a reason for following up on the mother's labor progress?

To assess the need for an emergency cesarean Signup and view all the answers

What is the primary purpose of instructing a woman to avoid straining after crowning?

To minimize the risk of perineal laceration Signup and view all the answers

What is the correct method to deliver the anterior and posterior shoulders during childbirth?

Lift the fetal head upwards and then downwards Signup and view all the answers

What is the significance of swabbing the eyelid and nose after the head is delivered?

To stimulate the baby's breathing Signup and view all the answers

Why is it recommended to place two clamps on the cord and cut in between after delivery?

To prevent blood from entering the delivery field Signup and view all the answers

What does perineal care primarily involve?

Washing the genitals and surrounding area Signup and view all the answers

What might be a consequence of neglecting proper perineal care post-delivery?

Skin breakdown and infections Signup and view all the answers

What action should be taken if a loop of cord is around the fetal neck?

Slip the loop off if possible and then clamp and cut Signup and view all the answers

What equipment is essential for performing perineal care?

Sterile gloves and antiseptic solution Signup and view all the answers

What is the suggested time frame to postpone vaginal intercourse after giving birth?

2 to 4 weeks Signup and view all the answers

Which of the following is NOT important for post-partum care?

Immediate return to high-intensity workouts Signup and view all the answers

What type of cesarean section involves a vertical incision in the upper uterine segment?

Upper segment cesarean section Signup and view all the answers

Which symptom should prompt a woman to report to her physician post-partum?

Persistent abdominal tenderness Signup and view all the answers

Why is breastfeeding emphasized as important for post-partum women?

It promotes bonding and has health benefits for the baby Signup and view all the answers

What is a common indication for performing an emergency cesarean section?

Immediate threat to the life of the woman or fetus Signup and view all the answers

What is recommended for women to manage post-partum recovery?

Regular light exercise to strengthen muscles Signup and view all the answers

Which dietary recommendation is made for post-partum women to avoid constipation?

Diet rich in fiber Signup and view all the answers

Study Notes

Third Year Maternity & Gynecology Nursing Skills

Course covers antenatal, intrapartum and postnatal assessments, care of the mother and newborn, and family planning.
Students will be able to perform assessments and provide care for expectant and new mothers
Antenatal assessment includes taking patient history, physical examination, and relevant investigations.
Understanding abdominal examination techniques during pregnancy and labour
Monitoring fetal heart rate (FHR)
Performing vaginal examinations during pregnancy and labour
Assessing pitting edema
Providing care for eclamptic patients
Administering magnesium sulfate
Providing care during oxytocin infusions
Monitoring the progress of labour and maternal and fetal condition using partographs
Providing perineal care and episiotomy care
Providing immediate care to the newborn
Assessing the fundus and lochia
Recording and interpreting labor information on partographs
Identifying and interpreting intra-partum electronic fetal monitoring (EFM)
Demonstrating Neonatal assessment and resuscitation
Counseling patients and explaining family planning methods
Determining patient suitability for various family planning methods
Counselling patients making informed choices regarding family planning
Providing follow-up management for family planning methods, including side effects and health problems

Antenatal Assessment

Routine health evaluation of pregnant women.
Aims for early detection, prevention, and treatment of complications (preeclampsia, eclampsia, haemorrhage).
Comprehensive assessment for malpresentations, malpositions, and disproportion influencing labor.
Education on hygiene, diet, and warning symptoms.
Tests for blood group, Rh typing, toxoplasmosis, and syphilis.
Frequency varies by stage of pregnancy (monthly, bi-weekly, weekly).

Role of the Nurse During Antenatal Assessment

Arranging the ante-natal room for efficient and comfortable patient care
Preparing necessary equipment and instruments.
Greeting the patient with respect and kindness.
Taking a complete patient history.
Performing physical and abdominal examinations during visits.
Recording findings in detail.
Detecting abnormalities and referring to relevant specialists where needed.

Components of Antenatal Assessment

Taking complete history from pregnant women
Performing physical examination (general, abdominal, vaginal)
Performing laboratory investigations

Daily Habits and Life Style

Work, transportation, physical activity, rest, diet.
Substances like dirt, clay, smoking, alcohol use
Important for identifying risk factors tied to pregnancy.

Menstrual and Contraceptive History

Age of menarche
Duration, interval, amount of menstruation.
Past contraceptive methods, usage time, and reasons for discontinuation.
LMP (last menstrual period): crucial to calculating estimated date of delivery (EDD).

Antenatal Assessment Return Visits

Assessing for any medical or other concerns that have developed since the last visit.
Assessing for changes in daily habits or lifestyle for identification of underlying situations.

General Examination

Observing general well-being, gait, movement, facial expression, and general cleanliness.
Measuring weight and height.
Measuring blood pressure and pulse
Examining the head's conjunctiva for any relevant conditions.
Examining the eyes
Examining hair and nails
Assessing the mouth and teeth
Checking the neck (including the thyroid gland)
Examining the chest
Examining the breasts, nipples, and areolae
Examination of the genitalia and relevant structures.
Checking the extremities.

Abdominal Examination

Assessing fetal position, presentation, and engagement.
Determining the gestational age through fundal assessment
Determining fetal heart rate tone

Leopold's Maneuver

Series of four maneuvers examining the abdomen to assess fetal position.
It helps understand the position of the fetus in the uterus
Determining the fetal lie, presentation, position, and engagement
Determining fetal heart rate

Various Types of Vaginal Examination

Assessing cervical dilation and effacement to track the progress of labor.
Establishing fetal position, presentation, and station.
Visualizing and examining for presence and type of membranes. Detecting the presence of possible complications.
Assessing the condition of the membranes and cervix.
Determining fetal presentation and station within the pelvis.
Identifying any abnormality in the vagina and cervix.

Administration of Magnesium Sulfate

Indications: Preventing and managing severe preeclampsia. Eclamptic seizures. Hypertension during pregnancy. Constipation.
Contraindications: Hypocalcemia, Myasthenia gravis, kidney diseases, cardiac diseases, and severe respiratory diseases.
Mechanism: Blocks neuromuscular junction activity to prevent excessive uterine muscle contractions and decrease blood pressure.

Management of the First Stage of Labor

Stages of labor: Cervical dilatation and effacement
Duration: 12-16 hours for primiparas, 6-8 hours for multiparas.
Equipments: Vital signs monitoring equipment, fetal heart monitoring devices, speculums, various sized catheters, various fluids, and other supportive supplies.

Management of the Second Stage of Labor

This is the fetal expulsion stage.
Purposes: Fetal delivery, preventing perineal lacerations, and ensuring an uncomplicated delivery.
Equipment: Episiotomy pack, scissors, cord clamp, cotton balls, suction bulb syringe (to prevent inhalation of amniotic fluid).

Management of the Third Stage of Labor

Stages of labor: Placental delivery
Purposes: to ensure the placenta is expelled, maintain uterine contractions to limit blood loss, perform assessment to detect any abnormalities or retained fragments
Equipment: Weighing machine, gloves, trays, dressing.

Management of the Fourth Stage of Labor

Purpose: To ensure the ongoing well-being of mother and child during the post-delivery period.
Aims: placenta and membranes inspection, prevention and control of bleeding, maintaining uterine contractions, assessing maternal comfort, initiating breastfeeding to ensure the continuous well-being of both.
Equipment: IV fluids apparatus, equipment to monitor vital signs (stethoscope, thermometer, sphygmomanometer), cannula, antiseptic solution, cotton swabs, clean pads, and any other necessary materiel.

Cesarean Section

Surgical delivery of a baby through an incision in the mother's abdomen and uterus
Classification: based on the site of incision (classical vs. lower segment).
Indications: Fetal distress, cephalopelvic disproportion, previous C-sections, and other maternal or fetal complications.
Equipment: steril gowns, forceps, scissors, scalpel, other suture materials and dressings, and the required fluids and medications.

Intrapartum Electronic Fetal Monitoring (EFM)

The method of continuously monitoring the fetus during labour to ensure adequate fetal oxygenation.
Types: external and internal
Indications: abnormal fetal heart rate (FHR), increased risk of perinatal morbidity, or specific maternal or fetal conditions.

Perineal Care

Cleaning and care of the perineal area.
Importance during pregnancy and childbirth; prevents skin breakdown, itching, burning, odors.
Equipment: gloves, sponges, basin with warm water, towels, mackintosh, soap with soap dish, toilet paper.

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Description

Test your knowledge on antenatal assessment and care practices critical for monitoring pregnancy. This quiz covers key components such as visit frequency, assessments, and techniques like Leopold's maneuver. Ensure you understand both the purpose and the protocols associated with antenatal visits.