Obstetrics Chapter 34 Quiz & Flashcards on Emergencies

Questions and Answers

Preeclampsia MOST commonly occurs after which week of gestation?

24th

20th

12th

30th (correct)

Pregnant women are advised to take iron supplements, such as prenatal vitamins, because?

Iron makes the blood clot faster, which protects the mother from excessive bleeding during delivery.

The blood naturally thins during pregnancy, which predisposes the mother to severe bleeding.

White blood cells decrease during pregnancy, which increases the mother's risk of an infection.

Pregnancy causes a decreased number of red blood cells, which predisposes the mother to anemia. (correct)

Signs and symptoms of preeclampsia include:

Dysuria and constipation

Dyspnea and bradycardia

Marked hypoglycemia

Headache and edema (correct)

Spina bifida is a developmental defect in which:

A portion of the spinal cord or meninges protrudes outside of the vertebrae. Signup and view all the answers

Supine hypotensive syndrome occurs when:

The pregnant uterus compresses the inferior vena cava. Signup and view all the answers

The ONLY indications for placing your gloved fingers in the vagina during delivery are:

Breech presentation and prolapsed umbilical cord. Signup and view all the answers

The onset of labor begins with:

Contractions of the uterus. Signup and view all the answers

When the mother is experiencing a contraction, you should instruct her to:

Take quick short breaths. Signup and view all the answers

Which of the following is a normal physiologic change that occurs in the mother's respiratory system during pregnancy?

Increased respiratory rate and decreased respiratory reserve Signup and view all the answers

Which of the following is NOT generally considered an obstetrical emergency?

Return of contractions following delivery of the baby Signup and view all the answers

Which of the following occurs during true labor?

Uterine contractions become more regular. Signup and view all the answers

Which of the following processes occurs during ovulation?

The inner lining of the uterus thickens in preparation for implantation. Signup and view all the answers

Which of the following statements regarding gestational diabetes is correct?

In some cases, women with gestational diabetes require insulin injections. Signup and view all the answers

Which of the following statements regarding the placenta is correct?

The placenta allows oxygen, carbon dioxide, and other products to transfer between the mother and fetus but does not allow blood to mix between the mother and fetus. Signup and view all the answers

Which of the following statements regarding twins is correct?

Most twins are born within 45 minutes of each other. Signup and view all the answers

While examining a woman in labor, you see the umbilical cord protruding from the vagina. You should:

Push the infant's head away from the cord. Signup and view all the answers

You are assessing a 25-year-old woman who is 39 weeks pregnant. She is experiencing regular contractions that are approximately 3 minutes apart and states that her amniotic sac broke 2 hours ago. After taking the standard precautions, you should:

Assess her for crowning. Signup and view all the answers

You have just delivered a full-term infant. His respirations are rapid and irregular, and he has a strong cry. What should you do next?

Assess the brachial or umbilical pulse. Signup and view all the answers

You have just delivered a premature baby. Your assessment reveals that he is breathing adequately. However, his heart rate is 90 beats/min. You should:

Keep him warm and provide ventilatory assistance. Signup and view all the answers

Your 22-year-old patient is in active labor. Upon visual inspection, you note that the infant's leg is protruding from the vagina. Appropriate management of this situation includes:

Placing the mother supine with her head down and pelvis elevated. Signup and view all the answers

In contrast to abruptio placenta, placenta previa:

May not present with heavy vaginal bleeding. Signup and view all the answers

The vagina and the neck of the uterus comprise the:

Birth canal. Signup and view all the answers

Following delivery of the placenta, the mother is experiencing vaginal bleeding. After massaging the uterine fundus and allowing the mother to breastfeed, the bleeding stops. This occurred because:

These actions simulate the production of oxytocin and cause uterine contraction. Signup and view all the answers

Which of the following statements regarding suctioning of a newborn's mouth and oropharynx is correct?

Suctioning is indicated prior to cutting the cord if respiratory distress is present. Signup and view all the answers

The umbilical cord:

Carries oxygen to the baby via the umbilical vein. Signup and view all the answers

Before assessing the respiratory adequacy of a semiconscious infant or child, you must:

Ensure that the airway is patent and clear of obstructions. Signup and view all the answers

A common cause of shock in an infant is:

Dehydration from vomiting and diarrhea. Signup and view all the answers

The first stage of labor ends when:

The presenting part of the baby is visible. Signup and view all the answers

A 23-year-old woman, who is 24 weeks pregnant, is MOST likely experiencing:

Preeclampsia. Signup and view all the answers

To prevent supine hypotensive syndrome, how should you position a woman who is 8 months' pregnant?

On her left side Signup and view all the answers

Immediately after the delivery of the infant's head, you should:

Check the position of the umbilical cord. Signup and view all the answers

Upon delivery of the baby's head, you note that the umbilical cord is wrapped around its neck. You should:

Make one attempt to slide the cord over the head. Signup and view all the answers

The need for and extent of newborn resuscitation is based on:

Respiratory effort, heart rate, and color. Signup and view all the answers

The 1-minute Apgar score of a newborn reveals that the baby has a heart rate of 90 beats/min. You should assign an Apgar score of:

<ol start="8"> <li></li> </ol> Signup and view all the answers

The MOST effective way to prevent cardiopulmonary arrest in a newborn is to:

Ensure adequate oxygenation and ventilation. Signup and view all the answers

While assisting a woman in labor, you visualize her vaginal area and see an arm protruding from her vagina. You should:

Cover the arm with a sterile towel and transport immediately. Signup and view all the answers

A newborn is considered to be 'term' if it is born after weeks and before weeks.

37; 42 Signup and view all the answers

A newborn infant will usually begin breathing spontaneously within _____ seconds following birth.

15 to 30 Signup and view all the answers

A 26-year-old female who is 34 weeks pregnant is experiencing a seizure. You should:

Place her on her side, administer high-flow oxygen, and transport. Signup and view all the answers

A history of pelvic inflammatory disease or tubal ligations increases a woman's risk for:

An ectopic pregnancy. Signup and view all the answers

A mother who is pregnant with her first baby is typically in the first stage of labor for approximately:

16 hours. Signup and view all the answers

A nuchal cord is defined as an umbilical cord that:

Is wrapped around the baby's neck. Signup and view all the answers

A pregnant trauma patient may lose a significant amount of blood before showing signs of shock because:

Pregnant patients have an overall increase in blood volume. Signup and view all the answers

By the 20th week of pregnancy, the uterus is typically at or above the level of the mother's:

Belly button. Signup and view all the answers

Common interventions used to stimulate spontaneous respirations in the newborn include all of the following, EXCEPT:

Positive-pressure ventilations. Signup and view all the answers

During your visual inspection of a 25-year-old woman in labor, you see the baby's head crowning at the vaginal opening. What should you do?

Apply gentle pressure to the baby's head as it delivers. Signup and view all the answers

Following delivery of a full-term baby, you have clamped and cut the umbilical cord. During transport, you note that the mother is experiencing moderate vaginal bleeding. You should:

Firmly massage the uterine fundus with a circular motion. Signup and view all the answers

From what internal female organ is the fetus expelled during delivery?

Uterus Signup and view all the answers

If a baby is born at 7:52, the second Apgar score should be calculated at:

7:57. Signup and view all the answers

The amniotic fluid serves to:

Insulate and protect the fetus. Signup and view all the answers

The presence of meconium in the amniotic fluid indicates:

That the baby's airway may be obstructed. Signup and view all the answers

Three days after delivering her baby, a 30-year-old woman complains of a sudden onset of difficulty breathing. You should suspect:

Pulmonary embolism. Signup and view all the answers

When determining the frequency of contractions, you should time the contractions from the:

Start of one to the start of the next. Signup and view all the answers

When preparing a pregnant patient for delivery, you should position her:

On a firm surface with her hips elevated 2 to 4 inches. Signup and view all the answers

Which of the following questions is of LEAST pertinence when determining whether a mother will deliver her baby within the next few minutes?

"Have you had a sonogram?" Signup and view all the answers

___________ is heralded by the onset of convulsions, or seizures, resulting from severe hypertension in the pregnant woman.

Eclampsia Signup and view all the answers

Which of the following is not performed immediately following delivery of the infant?

Obtain an Apgar score. Signup and view all the answers

You and your partner are both male and are attending to a 28-year-old female patient complaint. You should:

Respect the patient's wishes, ensure that the appropriate documentation is completed, and transport the patient. Signup and view all the answers

The leading cause of maternal death in the first trimester is internal hemorrhage into the abdomen following rupture of a(n) ___ _.

Ectopic pregnancy Signup and view all the answers

_ _ is a developmental defect in which a portion of the spinal cord protrudes outside the vertebrae.

Spina bifida Signup and view all the answers

Which of the following statements is not true?

The leading cause of abruptly placenta is in an ectopic pregnancy. Signup and view all the answers

By the end of pregnancy, the pregnant patient's heart rate increases up to 20%, or about __________ beats more per minute.

20 Signup and view all the answers

When assisting ventilations in a newborn with a bag-mask device, the rate is ________ breaths/min.

40-60 Signup and view all the answers

A 33-year-old woman who is 36 weeks pregnant is experiencing scant vaginal bleeding. You should:

Place her in a left lateral recumbent position. Signup and view all the answers

A precipitous labor and delivery is MOST common in women who:

Have delivered a baby before. Signup and view all the answers

After the fetus has descended into the pelvis at the end of the third trimester, many mothers experience:

Easier breathing. Signup and view all the answers

An abortion occurs when the fetus and placenta deliver before:

20 weeks. Signup and view all the answers

An infant is considered to be premature if it:

Weighs less than 5 lb or is born before 36 weeks' gestation. Signup and view all the answers

Braxton-Hicks contractions are characterized by:

Alleviation of pain with movement or changing positions. Signup and view all the answers

During delivery of the baby's head, you should suction the mouth before the nose because:

Suctioning the nose first may cause the baby to gasp and aspirate fluid. Signup and view all the answers

During delivery, it is MOST important to position your partner at the mother's head because:

The mother may become nauseated and vomit. Signup and view all the answers

Fetal complications associated with drug- or alcohol-addicted mothers include all of the following, EXCEPT:

Profound tachycardia. Signup and view all the answers

Following delivery of a pulseless and apneic infant who has a foul odor, skin sloughing, and diffuse blistering, you should:

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

General treatment guidelines when caring for a woman with traumatic vaginal bleeding include:

Transporting to an appropriate facility. Signup and view all the answers

If a newborn's heart rate is less than 60 beats/min following delivery, you should:

Provide ventilations for 30 seconds. Signup and view all the answers

If a pregnant patient requires spinal immobilization, you should secure her to the backboard and then:

Elevate the right side of the board with rolled towels or blankets. Signup and view all the answers

In contrast to a full-term infant, a premature infant:

Has an even proportionately larger head. Signup and view all the answers

Most medical models base a pregnant woman's due date:

Two weeks after her last menstrual cycle. Signup and view all the answers

Study Notes

Labor and Delivery

The first stage of labor concludes when the presenting part of the baby is visible.
For a pregnant woman with elevated blood pressure, symptoms like edema and headache suggest preeclampsia.
To avoid supine hypotensive syndrome during transport, position a pregnant patient on her left side.

Neonatal Care

After the infant's head is delivered, checking the position of the umbilical cord is crucial.
If the umbilical cord is nuchal (around the neck), make one attempt to slide it over the baby’s head before proceeding.
Neonatal resuscitation depends on assessing respiratory effort, heart rate, and color.

Apgar Scoring

The 1-minute Apgar score assesses condition: a score of 8 reflects a baby with good vitals but slight cyanosis.
Calculate the second Apgar score exactly one minute after birth.

Post-Delivery Care

Maintaining adequate oxygenation and ventilation is vital to prevent cardiopulmonary arrest in newborns.
Following delivery, if a mother experiences vaginal bleeding, firm massage of the uterine fundus is advised.

Fetal Development

A fetus is "term" if born between 37 and 42 weeks.
A newborn typically begins spontaneous breathing within 15 to 30 seconds after birth.

Patient Care Considerations

Respect cultural constraints regarding patient care to ensure compliance and safety.
Pelvic inflammatory disease history in women increases the risk of ectopic pregnancies.

Complications and Emergencies

Eclampsia is characterized by seizures due to severe hypertension in pregnant women.
The presence of meconium in amniotic fluid raises concerns about airway obstruction.

Specific Conditions and Management

Signs of preeclampsia include headache and swelling, especially of the hands.
During a seizure in a pregnant woman, place her on her side and provide high-flow oxygen.
Pregnant women should take iron to counter anemia risks due to increased blood volume.

Pregnancy Timeline and Changes

By the 20th week of pregnancy, the uterus reaches the level of the belly button.
Braxton-Hicks contractions are irregular and cause relief when changing positions.

Delivery Techniques and Ventilation

During newborn resuscitation, ventilations are needed at a rate of 40-60 breaths per minute.
Suction the mouth before the nose during delivery to prevent aspiration.

Final Notes

A precipitous labor is more common in women who have previously delivered.
Complications like pulmonary embolism can occur post-delivery; monitor for tachycardia and hypotension.
Pregnant patients requiring spinal immobilization should have the right side of the board elevated to prevent hypotension.### Obstetrical Indications
Only indications for gloved finger placement in the vagina during delivery are breech presentation and prolapsed umbilical cord.
Limb presentation and severe vaginal hemorrhage also notable but not for finger placement.

Labor Onset and Management

Onset of labor is marked by contractions of the uterus.
During contractions, instruct the mother to take quick short breaths to manage discomfort effectively.

Physiological Changes during Pregnancy

Normal respiratory change includes increased respiratory rate and decreased respiratory reserve in pregnant women.

Obstetrical Emergencies

Return of contractions after baby delivery is typically not considered an emergency, unlike significant bleeding or failure of placenta delivery.

True Labor Characteristics

Uterine contractions in true labor become more regular and stronger over time.

Ovulation and Uterine Preparation

During ovulation, the inner lining of the uterus thickens in preparation for potential implantation.

Gestational Diabetes Management

Some women with gestational diabetes may require insulin injections for effective management.

Placental Function and Structure

The placenta allows for the exchange of oxygen and carbon dioxide without mixing maternal and fetal blood.

Twin Births

Most twins are born within 45 minutes of each other, differing from the general expectation of single births.

Umbilical Cord Management

If the umbilical cord protrudes from the vagina, push the infant's head away from the cord to avoid compression.

Labor Assessment

In a woman 39 weeks pregnant with regular contractions and a ruptured amniotic sac, assess for crowning prior to other interventions.

Newborn Assessment Post-Delivery

After delivering a newborn, assess the brachial or umbilical pulse to ensure adequate circulation.

Premature Infant Care

For a premature infant with adequate breathing but a low heart rate (90 bpm), maintain warmth and provide ventilatory assistance.

Presentation of Delivery Complications

If an infant’s leg is protruding, position the mother supine with her head down and pelvis elevated to manage the situation.

Abruptio Placenta vs. Placenta Previa

Placenta previa may not present with heavy bleeding, contrasting with abruptio placenta, which can involve severe abdominal pain.

Birth Canal Anatomy

The vagina and cervix collectively form the birth canal.

Management of Postpartum Bleeding

Postpartum vaginal bleeding can stop with uterine massage and breastfeeding due to stimulation of oxytocin production, prompting uterine contraction.

Newborn Suctioning Protocol

Suctioning of a newborn's mouth is indicated if respiratory distress is present before cutting the umbilical cord.

Functions of the Umbilical Cord

The umbilical cord carries oxygen-rich blood to the baby via the umbilical vein.

Airway Assessment in Infants

Ensure the airway is clear and patent before assessing respiratory adequacy in semi-conscious infants or children.

Common Causes of Shock in Infants

Dehydration from vomiting and diarrhea is a frequent cause of shock in infants, highlighting the importance of fluid management.

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Description

Test your knowledge of key concepts in obstetrics and neonatal care with these flashcards. Chapter 34 covers important aspects of labor stages and maternal health during pregnancy. Perfect for students studying for exams or professionals looking to refresh their knowledge.

Obstetrics and Neonatal Care Chapter 34 Flashcards