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Questions and Answers
What is the necessary action when the uterine fundus is found to be boggy during postpartum assessment?
Which lochia color indicates the first stage of postpartum discharge?
What is the recommended assessment frequency for postpartum patients?
What is the correct order of procedures during Stage 2 Delivery of the baby?
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Which statement about Stage 3 Delivery of the placenta is true?
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In assessing a newborn, which condition does not cross suture lines?
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During the fourth stage of recovery, which assessment should be conducted four times per hour?
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What outcome indicates excessive bleeding postpartum?
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What is a normal finding for fundal height in relation to days postpartum?
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What is indicated if the fundus is boggy after delivery?
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If a fetal heart rate shows early decelerations, what does this indicate?
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Which symptom might indicate thrombophlebitis during a postpartum assessment?
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In the case of variable decelerations during fetal monitoring, what is the appropriate treatment?
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Caput succedaneum in newborns is characterized by which of the following?
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Why are uterine contractions important in the third stage of labor?
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What is the priority when assessing a patient's bladder postpartum?
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What abnormal finding immediately after delivery could suggest a risk of hypovolemic shock?
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What is the purpose of uterine contractions postpartum?
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What does a high fetal heart rate variability indicate?
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What should be done if the fetal heart rate is low and under 110?
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What condition describes tiny white spots on a baby’s face caused by distended sebaceous glands?
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Which medication is specifically indicated to stimulate and strengthen labor?
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What risk is associated with the medication Hemabate for pregnant women?
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Which condition involves a benign red papular rash appearing on a baby's torso?
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What is the purpose of administering Betamethasone to a pregnant woman?
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Which medication can cause reflexes to decrease and potentially lead to LOC (level of consciousness) issues in mothers?
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What sign indicates uterine hyperstimulation due to Oxytocin administration?
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Which type of birthmark is described as a nonblanchable port wine stain?
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What does acrocyanosis signify in a newborn?
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What is the primary use of Survanta in neonatal care?
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Study Notes
Fetal Heart Monitoring
- Always monitor fetal heart rate.
- Low heart rate (under 110) indicates concern; implement LION: Left side, IV, O2, notify.
- If Pitocin is administered, discontinue it.
- High heart rate (over 160) is generally acceptable; document and check maternal temperature.
Variability in Fetal Heart Rate
- Low baseline variability is concerning; consistently stable heart rate requires LION.
- High baseline variability is a positive sign; indicates good fetal condition, document findings.
Decelerations
- Late decelerations indicate fetal distress; perform LION.
- Early decelerations are normal if heart rate slows before or during contractions; mark as fine.
- Variable decelerations are very concerning, indicating possible cord prolapse; includes immediate intervention: push head off the cord and maintain position.
Stages of Delivery
- Stage 2: Delivery sequence includes delivering the head, suctioning the mouth then nose, checking for nuchal cord, delivering shoulders and body, and placing ID band on the baby.
- Stage 3: Deliver the placenta; ensure it is intact and that the cord contains two arteries and one vein.
- Stage 4: Recovery begins two hours postpartum; includes four key assessments every hour: vital signs for shock, fundal firmness, bladder status, and physiologic vs. pathologic jaundice.
Neonatal Skin Conditions
- Milia: Tiny white spots on the face from sebaceous glands.
- Epstein's pearls: Small white cysts on gums.
- Mongolian spots: Bluish-black macules on darker-skinned infants.
- Erythema Toxicum Neonatorum: Benign red rash on torso, resolving in a few days.
- Hemangiomas: Benign tumor formed from capillaries.
- Vernix caseosa: Whitish cheese-like substance on skin for first week.
- Acrocyanosis: Normal cyanosis appearing intermittently on hands and feet.
Medications in Obstetrics
- Tocolytics (e.g., Terbutaline, Magnesium Sulfate) are used to halt labor; side effects include tachycardia and respiratory depression.
- Oxytocics (e.g., Oxytocin/Pitocin, Methergine) stimulate contractions; monitor for uterine hyperstimulation and high blood pressure implications.
- Betamethasone: Given to mothers prenatally to facilitate fetal lung maturity.
- Surfactant (Survanta): Administered postnatally to help with lung function.
Postpartum Assessment
- Conducted every 4-8 hours covering breasts, uterine fundus, bladder, bowel, lochia, episiotomy, hemoglobin & hematocrit, extremities, affect, and discomfort.
- Fundus should be firm and midline; if boggy, massage; if displaced, void or catheterize.
- Lochia assessment: Rubra (red), Serosa (pink), Alba (white); normal saturation does not exceed 4-6 inches per hour.
Norms & Variations in Newborns
- Caput succedaneum: Symmetrical swelling crosses sutures, resulting from delivery pressure.
- Cephalohematoma: Non-symmetrical hematoma that does not cross sutures, typically caused by traumatic delivery.
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Description
This quiz covers essential concepts in fetal heart monitoring, focusing on interpreting fetal heart rates and their implications. It includes critical interventions for low and high fetal heart rates, as well as understanding baseline variability. Test your knowledge on best practices in maternal-fetal care.
