Questions and Answers
Preeclampsia MOST commonly occurs after which week of gestation?
Pregnant women are advised to take iron supplements, such as prenatal vitamins, because?
Signs and symptoms of preeclampsia include:
Spina bifida is a developmental defect in which:
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Supine hypotensive syndrome occurs when:
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The ONLY indications for placing your gloved fingers in the vagina during delivery are:
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The onset of labor begins with:
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When the mother is experiencing a contraction, you should instruct her to:
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Which of the following is a normal physiologic change that occurs in the mother's respiratory system during pregnancy?
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Which of the following is NOT generally considered an obstetrical emergency?
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Which of the following occurs during true labor?
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Which of the following processes occurs during ovulation?
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Which of the following statements regarding gestational diabetes is correct?
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Which of the following statements regarding the placenta is correct?
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Which of the following statements regarding twins is correct?
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While examining a woman in labor, you see the umbilical cord protruding from the vagina. You should:
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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:
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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?
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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:
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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:
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In contrast to abruptio placenta, placenta previa:
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The vagina and the neck of the uterus comprise the:
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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:
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Which of the following statements regarding suctioning of a newborn's mouth and oropharynx is correct?
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The umbilical cord:
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Before assessing the respiratory adequacy of a semiconscious infant or child, you must:
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A common cause of shock in an infant is:
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The first stage of labor ends when:
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A 23-year-old woman, who is 24 weeks pregnant, is MOST likely experiencing:
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To prevent supine hypotensive syndrome, how should you position a woman who is 8 months' pregnant?
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Immediately after the delivery of the infant's head, you should:
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Upon delivery of the baby's head, you note that the umbilical cord is wrapped around its neck. You should:
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The need for and extent of newborn resuscitation is based on:
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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:
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The MOST effective way to prevent cardiopulmonary arrest in a newborn is to:
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While assisting a woman in labor, you visualize her vaginal area and see an arm protruding from her vagina. You should:
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A newborn is considered to be 'term' if it is born after ____ weeks and before ____ weeks.
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A newborn infant will usually begin breathing spontaneously within _____ seconds following birth.
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A 26-year-old female who is 34 weeks pregnant is experiencing a seizure. You should:
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A history of pelvic inflammatory disease or tubal ligations increases a woman's risk for:
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A mother who is pregnant with her first baby is typically in the first stage of labor for approximately:
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A nuchal cord is defined as an umbilical cord that:
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A pregnant trauma patient may lose a significant amount of blood before showing signs of shock because:
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By the 20th week of pregnancy, the uterus is typically at or above the level of the mother's:
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Common interventions used to stimulate spontaneous respirations in the newborn include all of the following, EXCEPT:
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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?
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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:
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From what internal female organ is the fetus expelled during delivery?
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If a baby is born at 7:52, the second Apgar score should be calculated at:
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The amniotic fluid serves to:
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The presence of meconium in the amniotic fluid indicates:
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Three days after delivering her baby, a 30-year-old woman complains of a sudden onset of difficulty breathing. You should suspect:
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When determining the frequency of contractions, you should time the contractions from the:
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When preparing a pregnant patient for delivery, you should position her:
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Which of the following questions is of LEAST pertinence when determining whether a mother will deliver her baby within the next few minutes?
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___________ is heralded by the onset of convulsions, or seizures, resulting from severe hypertension in the pregnant woman.
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Which of the following is not performed immediately following delivery of the infant?
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You and your partner are both male and are attending to a 28-year-old female patient complaint. You should:
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The leading cause of maternal death in the first trimester is internal hemorrhage into the abdomen following rupture of a(n) ___________ _________.
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_________ _________ is a developmental defect in which a portion of the spinal cord protrudes outside the vertebrae.
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Which of the following statements is not true?
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By the end of pregnancy, the pregnant patient's heart rate increases up to 20%, or about __________ beats more per minute.
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When assisting ventilations in a newborn with a bag-mask device, the rate is ________ breaths/min.
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A 33-year-old woman who is 36 weeks pregnant is experiencing scant vaginal bleeding. You should:
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A precipitous labor and delivery is MOST common in women who:
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After the fetus has descended into the pelvis at the end of the third trimester, many mothers experience:
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An abortion occurs when the fetus and placenta deliver before:
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An infant is considered to be premature if it:
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Braxton-Hicks contractions are characterized by:
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During delivery of the baby's head, you should suction the mouth before the nose because:
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During delivery, it is MOST important to position your partner at the mother's head because:
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Fetal complications associated with drug- or alcohol-addicted mothers include all of the following, EXCEPT:
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Following delivery of a pulseless and apneic infant who has a foul odor, skin sloughing, and diffuse blistering, you should:
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General treatment guidelines when caring for a woman with traumatic vaginal bleeding include:
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If a newborn's heart rate is less than 60 beats/min following delivery, you should:
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If a pregnant patient requires spinal immobilization, you should secure her to the backboard and then:
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In contrast to a full-term infant, a premature infant:
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Most medical models base a pregnant woman's due date:
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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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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.