Maternity Chapter 10 Quiz

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Questions and Answers

What indicates a negative station in fetal positioning?

Presenting part is engaged at station zero

Presenting part is below the ischial spine

Presenting part is above the ischial spine (correct)

Presenting part is at the ischial spine

Which fetal lie is considered compatible with a natural vaginal birth?

Vertex lie (correct)

Oblique lie

Transverse lie

Breech lie

At what dilation does the active phase of labor begin?

8 cm

0 cm

4 cm

5 cm (correct)

What is the maximum duration for a single uterine contraction to avoid complications?

90 seconds Signup and view all the answers

How often should contractions occur during the transition phase of labor?

2-3 minutes apart Signup and view all the answers

What complication is indicated by LOP and ROP fetal positions?

Painful back labor Signup and view all the answers

Which contraction frequency indicates the latent phase of labor?

5-30 minutes apart Signup and view all the answers

Which option describes how to measure contraction intensity accurately?

Palpating with the pad of fingers over the fundus Signup and view all the answers

Which statement is true regarding the stages of labor?

Dilation and frequency patterns differ across phases Signup and view all the answers

What signifies engagement in fetal positioning?

Station zero at the ischial spine Signup and view all the answers

What is considered a normal hemoglobin level for females during pregnancy?

12-16 Signup and view all the answers

At what point during pregnancy can hemoglobin fall to 10 and still be considered normal?

3rd trimester Signup and view all the answers

Which of the following symptoms is NOT typically associated with the 2nd trimester of pregnancy?

Urinary incontinence Signup and view all the answers

What is an effective treatment for morning sickness during the first trimester?

Eat dry carbohydrates before getting out of bed Signup and view all the answers

How should a pregnant woman position herself to alleviate dyspnea during the 2nd and 3rd trimester?

In the tripod position with feet flat and arms supported Signup and view all the answers

During which trimesters is urinary incontinence commonly experienced?

1st and 3rd Signup and view all the answers

What is the correct dilation of the cervix in centimeters when fully dilated?

10 cm Signup and view all the answers

What is the term for the thinning of the cervix during labor?

Effacement Signup and view all the answers

What strategy is recommended to manage back pain during the 2nd and 3rd trimester?

Pelvic tilt exercises Signup and view all the answers

Which of these statements regarding pregnancy is true?

Morning sickness can be treated by eating before getting out of bed. Signup and view all the answers

How is the ideal weight gain during pregnancy calculated based on the week of gestation?

Week of gestation - 9 Signup and view all the answers

At what week can the fundus typically be palpated for the first time?

Week 12 Signup and view all the answers

What signifies the rapid initial weight gain that might indicate a possible complication during the first trimester?

Gaining more than 3 pounds Signup and view all the answers

Which of the following is a positive sign of pregnancy?

Fetal presence on ultrasound Signup and view all the answers

What is the proper schedule for patient visits in the third trimester of pregnancy?

Once every week until delivery Signup and view all the answers

When should the first auscultation of the fetal heartbeat ideally occur?

At 8-12 weeks Signup and view all the answers

What is the primary purpose of using the knee-chest position during delivery?

To alleviate pressure from the sacrum and coccyx Signup and view all the answers

Which of the following is NOT considered a probable sign of pregnancy?

Quickening Signup and view all the answers

What is the first action to take if a prolapsed cord is identified during delivery?

Push the baby's head back off the cord Signup and view all the answers

What is Chadwick's sign indicative of during pregnancy?

Cervical color change to cyanosis Signup and view all the answers

What does the acronym LION stand for in management of birth complications?

Left side, Increase IV, Oxygen, Notify doctor Signup and view all the answers

What weight gain is typical for the second trimester per week?

1 pound per week Signup and view all the answers

When is quickening most likely to be felt by the mother?

16-20 weeks Signup and view all the answers

In what scenario is it safe to administer systemic pain medication to a woman in labor?

When she is at 5 cm dilation and delivery is unlikely in 15-30 minutes Signup and view all the answers

Why is it essential to stop Pitocin immediately in a crisis during labor?

It can exacerbate the complications being encountered Signup and view all the answers

Which of the following conditions requires immediate notification of the doctor in a laboring patient?

Prolapsed umbilical cord Signup and view all the answers

What is the recommended intervention if a multigravida patient at 8 cm dilation requests IM pain medication?

Do not administer the medication Signup and view all the answers

What position should a laboring mother be placed in if LION is initiated?

Left side position Signup and view all the answers

What are the potential consequences of administering systemic pain medication just before delivery?

Respiratory depression in the newborn Signup and view all the answers

What is the appropriate measure to take when assisting a woman in labor experiencing back pain?

Provide counter pressure on the sacrum Signup and view all the answers

Study Notes

Maternity Care Overview

Due Date Calculation (Nagele’s Rule):
- Start with the first day of the last menstrual cycle, add 7 days, subtract 3 months, and add a year.
Weight Gain During Pregnancy:
- Recommended total gain is 25-31 pounds.
- Ideal weight gain formula: [Week of gestation] - 9 (+ a couple lbs).
- If weight gain exceeds 3 lbs in a month, further assessment is needed.
Fundus Development:
- Fundus of the uterus is not palpable until week 12.
- Reaches umbilical level between weeks 20-22.
- 1st trimester: 1 lb/month (total of 3 lbs). Fundus is not palpable.
- 2nd trimester: 1 lb/week; fundus at umbilicus by week 20-22.
- 3rd trimester: 1 lb/week; fundus above umbilicus, priority shifts to baby.

Pregnancy Signs

Positive Signs:
- Fetal skeleton via X-ray, ultrasound presence, fetal heart auscultation, and examiner palpation of fetal movement.
- Fetal heartbeat detected by 5 weeks, audible between 8-12 weeks.
- Quickening (first fetal movements) occurs around 16-20 weeks.
Probable/Presumptive Signs ("The Maybes"):
- Positive pregnancy test and physical signs such as Chadwick's, Goodell's, and Hegar's signs:
  - Chadwick: Cervical cyanosis.
  - Goodell: Cervical softening.
  - Hegar: Uterine softening.

Patient Care and Teaching

Appointment Schedule:
- Monthly visits until week 28, then bi-weekly until week 36, and weekly until delivery.
Hemoglobin Levels:
- Normal range for females: 12-16.
- 1st trimester normal to drop to 11, 2nd can drop to 10.5, and 3rd can drop to 10, with acceptable low being 9.
Common Symptoms:
- Morning sickness: usually in the first trimester; treat with dry carbs while in bed.
- Urinary incontinence: occurs in the first and third trimesters; void every 2 hours.
- Dyspnea and back pain common during 2nd and 3rd trimesters; treat with tripod position and pelvic tilts, respectively.

Labor and Birth Essentials

Labor Initiation:
- Regular, progressive contractions signal onset.
Cervical Changes:
- Dilation: 0 cm (closed) to 10 cm (fully dilated).
- Effacement: Cervical thinning from thick to 100%.
Fetal Positioning:
- Station indicates fetal head's position in relation to ischial spine, negative (-1, -2) is undesirable, positive (+1, +2) is favorable.
- Vertex lie is ideal for vaginal birth, while transverse lie indicates complications.

Stages of Labor

Stage One Overview:
- Phase 1 (Latent): Dilation 0-4 cm, contractions mild and 5-30 minutes apart.
- Phase 2 (Active): Dilation 5-7 cm, moderate contractions 3-5 minutes apart.
- Phase 3 (Transition): Dilation 8-10 cm, strong contractions 2-3 minutes apart.
Contraction Timing:
- Frequency: Time between consecutive contractions.
- Duration: Length of a single contraction from start to finish.
- Intensity: Strength measured by palpation.

Complications and Pain Management

Complications:
- Back labor due to fetal positioning (LOP, ROP): Treat with knee-chest position and counterpressure on the sacrum.
- Prolapsed cord: Emergency requiring immediate repositioning and maintaining head pressure.
- General interventions: Employ LION approach (Left side, IV increase, O2, Notify doctor) if complications arise.
Pain Management:
- Avoid systemic pain medications if delivery is imminent to prevent adverse effects on the baby.
- Assess likelihood of delivery within the timeframe of medication peak action before administration.

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Description

This quiz covers key concepts related to maternity, specifically calculating due dates using Nagele’s Rule, understanding weight gain during pregnancy, and the anatomy of the fundus. Test your knowledge on important milestones and health assessments in pregnancy.