Maternity Chapter 10

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Questions and Answers

What is the normal hemoglobin level for females during pregnancy?

9-11

12-16 (correct)

13-18

10-14

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

Eat dry carbohydrates before getting out of bed (correct)

Take vitamin supplements before meals

Avoid all carbohydrates in the morning

Drink ginger tea before breakfast

During which trimesters can urinary incontinence occur?

Throughout the entire pregnancy

Only during the second trimester

First and third trimesters (correct)

Only during the first trimester

What position is recommended to alleviate dyspnea in the second and third trimesters?

Tripod position with arms leaning forward Signup and view all the answers

What does cervical effacement refer to during labor?

Thinning of the cervix Signup and view all the answers

What is the first action to take in the event of a prolapsed cord?

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

What does the acronym LION stand for in managing birth complications?

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

Under what condition should systemic pain medication NOT be administered to a woman in labor?

If the baby is expected to be born when the medication peaks. Signup and view all the answers

Which position is recommended for a woman with a prolapsed cord?

Knee-chest position with butt and head elevated. Signup and view all the answers

What is the first priority action if Pitocin is being administered during a crisis?

Stop the Pitocin infusion. Signup and view all the answers

What does a negative station indicate in relation to the fetal presenting part?

The presenting part is above the ischial spine. Signup and view all the answers

Which lie is most compatible for a natural vaginal birth?

Vertex lie Signup and view all the answers

During which phase of the first stage of labor is the cervical dilation 5-7 cm?

Active phase Signup and view all the answers

What is the contraction frequency during the transition phase of labor?

2-3 minutes apart Signup and view all the answers

What should be the maximum contraction duration to avoid uterine hyperstimulation?

90 seconds Signup and view all the answers

In order to time contractions, what does duration refer to?

Time from beginning to end of one contraction Signup and view all the answers

What is a common complication related to fetal positioning during labor?

Painful back labor Signup and view all the answers

Which station indicates that the fetal presenting part is at the ischial spine?

0 station Signup and view all the answers

What is the ideal total weight gain during pregnancy?

25-31 pounds Signup and view all the answers

At which week of gestation should the fundus first become palpable?

12 weeks 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

When is quickening typically felt by the mother?

16-20 weeks Signup and view all the answers

At 20-22 weeks of pregnancy, where should the fundus be located?

At the level of the umbilicus Signup and view all the answers

When should a patient first auscultate a fetal heart rate?

8 weeks Signup and view all the answers

Which of the following signs is NOT considered a positive sign of pregnancy?

Cervical softening Signup and view all the answers

How often should a patient visit their healthcare provider from week 28 to week 36 of pregnancy?

Every 2 weeks Signup and view all the answers

At what hemoglobin level can a female in her second trimester be considered normal?

10.5 Signup and view all the answers

What is a common non-pharmacological treatment for morning sickness?

Eating dry carbohydrates Signup and view all the answers

Which trimester is characterized by a significant drop in urinary incontinence complaints?

2nd trimester Signup and view all the answers

What is the maximum acceptable hemoglobin level during the third trimester?

10 Signup and view all the answers

What position is recommended to relieve dyspnea during pregnancy?

Tripod position Signup and view all the answers

Which of the following describes a valid sign of labor?

Onset of regular contractions Signup and view all the answers

What should a pregnant individual do to manage back pain during the second trimester?

Perform pelvic tilt exercises Signup and view all the answers

Which of the following is true regarding cervical dilation during labor?

10 cm indicates full dilation Signup and view all the answers

How often should a postpartum individual manage urinary incontinence?

Every 2 hours Signup and view all the answers

Which statement best describes the process of effacement during labor?

Thinning of the cervix Signup and view all the answers

What is the expected total weight gain during pregnancy?

25-31 pounds Signup and view all the answers

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

12 weeks Signup and view all the answers

Which sign is associated with cervical softening during pregnancy?

Goodell sign Signup and view all the answers

How often should a patient visit their healthcare provider during the third trimester?

Every week Signup and view all the answers

When is quickening typically experienced by the mother?

16-20 weeks Signup and view all the answers

What is the most common time frame to first auscultate a fetal heart using a Doppler?

8-12 weeks Signup and view all the answers

What alteration does Nagele’s Rule require to calculate a due date from the first day of the last menstrual cycle?

Add 7 days and subtract 3 months Signup and view all the answers

Which of the following is NOT a positive sign of pregnancy?

Absence of menstruation Signup and view all the answers

During which trimester should the fetus be prioritized over the mother in terms of health considerations?

3rd trimester Signup and view all the answers

What is the weight gain expectation during the 1st trimester (weeks 1-12)?

3 lbs total Signup and view all the answers

What does a positive station indicate concerning the fetal presenting part?

It is below the ischial spine. Signup and view all the answers

What is the main purpose of uterine contractions during the first stage of labor?

To dilate and efface the cervix. Signup and view all the answers

During which phase of the first stage of labor is the contraction frequency 3-5 minutes apart?

Phase 2 (Active) Signup and view all the answers

What is indicated by a transverse lie regarding fetal presentation?

Fetal presentation is not compatible for vaginal delivery. Signup and view all the answers

What is the maximum contraction duration to avoid uterine hyperstimulation?

90 seconds Signup and view all the answers

What does the term 'engagement' refer to in the context of fetal position?

Fetal head is at the ischial spine. Signup and view all the answers

What should be done if contractions are longer than 90 seconds and closer than every two minutes?

Stop Pitocin and assess the situation. Signup and view all the answers

What does the term 'frequency' refer to when timing contractions?

The interval between contractions. Signup and view all the answers

Which fetal positioning commonly leads to painful back labor?

LOP Signup and view all the answers

Which phase of the first stage of labor is characterized by a dilation of 8-10 cm?

Phase 3 (Transition) Signup and view all the answers

What is the primary goal of placing the mother in a knee-chest position during labor?

To alleviate pain by repositioning the baby Signup and view all the answers

What immediate action should be taken if a prolapsed cord is identified?

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

In the acronym LION for managing birth complications, what does the 'O' represent?

Oxygenate the mother Signup and view all the answers

Under what circumstance should systemic pain medication be withheld from a woman in labor?

If the baby is likely to be born before the medication takes effect Signup and view all the answers

What is the preferred action if a contraction is too strong and causes fetal distress?

Stop the Pitocin infusion immediately Signup and view all the answers

Which position is primarily used to relieve pain during contractions in labor?

Knee-chest position Signup and view all the answers

What is the primary intervention for complications during labor involving uterine hypotony?

Increasing IV fluids and turning the mother to the left side Signup and view all the answers

When should a multigravida woman in labor be denied IM pain medication?

If she is likely to deliver in the next 30-60 minutes Signup and view all the answers

What should be avoided when a woman is in labor if the baby’s delivery is anticipated shortly?

Administering systemic pain medications Signup and view all the answers

Which response indicates a correct understanding of the purpose of counter pressure during labor?

It provides comfort by relieving back pain Signup and view all the answers

Study Notes

Maternity Overview

Nagele’s Rule calculates due date: first day of last menstrual cycle, add 7 days, subtract 3 months, add a year.
Recommended weight gain during pregnancy is 25-31 pounds; ideal weight gain formula: [Week of gestation] - 9 (+ a couple pounds).
Monitor for excessive weight gain (>3 lbs) which may indicate complications.

Fundus Development

Fundus not palpable until 12 weeks; reaches umbilical level around 20-22 weeks.
First trimester (1-12 weeks): weight gain is approximately 1 lb/month (total ~ 3 lbs).
Second trimester (13-27 weeks): weight gain is about 1 lb/week with fundus at umbilicus level.
Third trimester (28-40 weeks): consistent weight gain of 1 lb/week; fundus rises above umbilicus.

Signs of Pregnancy

Positive signs include fetal skeleton on X-ray, presence on ultrasound, Doppler fetal heart rate auscultation, and palpable fetal movement.
Fetal heart rate detectable at 8-12 weeks; first kicks (quickening) felt at 16-20 weeks.

Pregnancy Signs and Symptoms

Probable signs include positive pregnancy tests and signs of Chadwick, Goodell, and Hegar.
Chadwick: bluish cervical coloration; Goodell: softening of the cervix; Hegar: softening of the lower uterus.

Prenatal Visits

Schedule: once/month until 28 weeks, then biweekly until 36 weeks, and weekly until delivery.
Hemoglobin levels can drop in pregnancy: normal for females is 12-16; may be 11 in the first trimester, 10.5 in the second, and down to 10 in the third.

Common Issues During Pregnancy

Morning sickness typically starts in the first trimester; treat with dry carbohydrates before getting out of bed.
Urinary incontinence common in the first and third trimester; recommend voiding every 2 hours postpartum.
Dyspnea appears in second and third trimesters; manage with a tripod position.
Back pain prevalent in second and third trimesters; relieved through pelvic tilt exercises.

Labor and Birth

Valid sign of labor is onset of regular, progressive contractions.
Dilation measures cervix opening (0-10 cm); effacement is the thinning of the cervix to 100%.
Engagement denotes station zero, where the fetal presenting part is at the ischial spine.

Labor Stages

First stage contractions serve to dilate and efface the cervix; three phases defined by dilation (Latent: 0-4 cm, Active: 5-7 cm, Transition: 8-10 cm).
Important to monitor for uterine tetany; contractions max out at 90 seconds and should occur no closer than every two minutes.

Complications

Painful back labor indicates a fetal position issue (ROP, LOP); position change to knee-chest and apply counter pressure for relief.
Prolapsed umbilical cord is a critical emergency; push the presenting part back and position patient in knee-chest until delivery.
LION intervention: Left side positioning, Increase IV fluids, Oxygen, Notify doctor in emergencies.

Pain Management

Avoid systemic pain medications in labor if delivery is imminent; assess delivery likelihood based on dilation progress.
Timing important for administering pain relief; prioritize maternal and fetal safety.