Obstetrics Partograph Quiz
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Questions and Answers

What describes a multipara?

  • A woman who has not given birth at all.
  • A woman who is currently pregnant without previous births.
  • A woman who has given birth to live babies at least twice. (correct)
  • A woman who has multiple pregnancies but no live births.

How often should the Fetal Heart Rate be recorded on the partograph?

  • Every 30 minutes (correct)
  • Every 4 hours
  • Every hour
  • Every 10 minutes

What should be recorded in the Liquor section of the partograph?

  • The fetal heart rate.
  • The number of contractions.
  • Cervical dilatation.
  • The color of the amniotic fluid if membranes are ruptured. (correct)

What does the term 'Moulding' refer to in the partograph?

<p>The extent of overlapping of the fetal skull bones. (B)</p> Signup and view all the answers

How is cervical dilatation recorded on the partograph?

<p>With a simple number and letter notation. (C)</p> Signup and view all the answers

Which of the following is monitored for contractions on the partograph?

<p>The frequency of contractions per 10 minutes. (C)</p> Signup and view all the answers

What is the purpose of recording the elapsed time since monitoring began on the partograph?

<p>To determine the progress of labor. (B)</p> Signup and view all the answers

What does the Descent of Head measure on the partograph?

<p>The progress of the baby's head in the birth canal. (D)</p> Signup and view all the answers

What is indicated when cervical dilatation remains on or to the left of the alert line during labor?

<p>Labor progress is satisfactory. (B)</p> Signup and view all the answers

What should you avoid doing if the membranes have ruptured and the woman has no contractions?

<p>Performing a digital vaginal examination. (C)</p> Signup and view all the answers

What symbol is used to plot the descent of the fetal head on the partograph?

<p>O (B)</p> Signup and view all the answers

At what station is the fetal head considered to be at the same level as the ischial spines?

<p>Station 0 (C)</p> Signup and view all the answers

What does a negative station number indicate about the position of the fetal head?

<p>The fetal head is floating. (D)</p> Signup and view all the answers

What occurs at station +3 during labor?

<p>The fetal head is crowning. (A)</p> Signup and view all the answers

What happens at station -4 or -3 regarding the fetal head?

<p>The fetal head is floating. (D)</p> Signup and view all the answers

What is a common way to determine the station of the fetal head?

<p>Vaginal examination using gloved fingers. (C)</p> Signup and view all the answers

What is the primary purpose of the woman lying in a supine position during abdominal examination?

<p>To relax the abdominal muscles (A)</p> Signup and view all the answers

Why is it important to expose only the area of the abdomen needed for palpation?

<p>To maintain the patient's modesty and privacy (D)</p> Signup and view all the answers

What might happen if the woman's bladder is not empty before the examination?

<p>It might cause discomfort and affect fundal height accuracy (A)</p> Signup and view all the answers

Which of the following is NOT part of the methods used in abdominal examination?

<p>Blood sampling (A)</p> Signup and view all the answers

What does inspection of the abdomen help to determine?

<p>Uterine size and fetal lie (A)</p> Signup and view all the answers

What is the significance of the linea negra observed during inspection?

<p>It is a sign of hormonal changes during pregnancy (C)</p> Signup and view all the answers

What technique should be used during palpation to avoid discomfort?

<p>Gentle and smooth movements with warm hands (A)</p> Signup and view all the answers

Which skin condition indicates previous surgeries, especially a cesarean section?

<p>Scar formation (C)</p> Signup and view all the answers

What does an Apgar score of 0 to 2 indicate for a newborn infant?

<p>Severe distress requiring resuscitation (A)</p> Signup and view all the answers

At what times is the Apgar score assessed after birth?

<p>At 1 minute and 5 minutes (A)</p> Signup and view all the answers

What is the maximum possible total score in the Apgar scoring system?

<p>10 (C)</p> Signup and view all the answers

Which of the following scores corresponds to a heart rate of ≥ 100 b.p.m in the Apgar score?

<p>2 (D)</p> Signup and view all the answers

What is the ideal length of the umbilical cord mentioned in the procedures?

<p>50 cm (B)</p> Signup and view all the answers

What does the reflex irritability score of '1' indicate in the Apgar assessment?

<p>Grimace (A)</p> Signup and view all the answers

When should the umbilical cord be clamped and divided?

<p>As soon as pulsations have ceased (B)</p> Signup and view all the answers

Which of the following statements about the Apgar scoring system is NOT true?

<p>A score of 7 to 10 indicates severe distress. (A)</p> Signup and view all the answers

What event would NOT result in a point being subtracted from the scoring system?

<p>Every previous vaginal delivery (D)</p> Signup and view all the answers

Which situation is considered a contraindication for conducting a vaginal examination?

<p>Undiagnosed vaginal bleeding (D)</p> Signup and view all the answers

Which criteria are NOT included in the assessment during a vaginal examination?

<p>Fetal heart rate monitoring (B)</p> Signup and view all the answers

What is the purpose of the Bishops score in a clinical procedure?

<p>To evaluate cervical conditions before induction (B)</p> Signup and view all the answers

When should a vaginal examination be conducted after observing a non-reassuring fetal heart rate?

<p>Immediately upon observation (D)</p> Signup and view all the answers

What is one objective of perineal care?

<p>To relieve edema and soreness (A)</p> Signup and view all the answers

When should perineal care be performed after delivery?

<p>After urination and defecation during the post-partum period (B)</p> Signup and view all the answers

What is indicated by pain and swelling around the vagina?

<p>Stretching from childbirth (D)</p> Signup and view all the answers

Which of the following should be done first in the perineal care procedure?

<p>Wash the hands thoroughly (A)</p> Signup and view all the answers

How should the cleaning of the perineum be performed?

<p>From the symphysis pubis upward to the umbilicus (A)</p> Signup and view all the answers

What type of discharge is expected after childbirth?

<p>Initially bloody, turning pink, then yellow (D)</p> Signup and view all the answers

What is the correct positioning of the woman during perineal care?

<p>In a lithotomy position with legs elevated (A)</p> Signup and view all the answers

What is the final step in the perineal care procedure?

<p>Record the time of procedure (A)</p> Signup and view all the answers

Flashcards

Multipara

A woman who has given birth to at least two live babies previously.

Fetal Heart Rate

The heart rate of the fetus, measured in beats per minute (bpm).

Liquor (Amniotic Fluid)

The fluid surrounding the fetus in the amniotic sac.

Moulding

Overlapping of fetal skull bones as the head moves through the birth canal.

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Cervical Dilatation

The opening of the cervix, measured in centimeters.

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Descent of Head

How far the baby's head has progressed down the birth canal.

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Contractions per 10 minutes

The frequency of uterine contractions, measured every 10 minutes.

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Partograph

A chart used to record key information during labor.

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Supine Position

Lying flat on the back with knees slightly bent and separated. This position helps relax abdominal muscles and reduces the risk of low blood pressure.

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Abdominal Examination

A physical assessment of the abdomen during pregnancy, using techniques like inspection, palpation, and auscultation.

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Inspection in Abdominal Examination

Visual observation of the abdomen to assess its shape, size, skin conditions, and fetal movements.

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Palpation

Using gentle touch to feel the abdomen for the size and position of the uterus, fetus, and other structures.

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Linea Negra

A dark line that appears on the abdomen during pregnancy, running from the belly button to the pubic bone.

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Striae Gravidarum

Stretch marks that appear on the abdomen, breasts, thighs, and buttocks due to skin stretching during pregnancy.

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Fetal Movements

The baby's movements felt by the mother through the abdominal wall.

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Warm Relaxed Hands

Using warm, relaxed hands during palpation to avoid discomfort for the pregnant woman and prevent any uterine contractions.

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Cervical dilation alert line

A line on a partograph used to track the progress of cervical dilation during labor. Satisfactory progress is indicated if the cervical dilation remains on or to the left of the line.

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PROM (Premature Rupture of Membranes)

The premature rupture of the amniotic sac that surrounds the fetus

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Fetal Descent

The movement of the fetal head through the birth canal during labor, plotted on the partograph with the symbol 'O'.

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Station 0

The point where the presenting part of the fetal head is at the same level as the ischial spines. Key position for fetal descent track.

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Negative Station

Indicates that the fetal head is positioned higher than the ischial spines in the mother's pelvis.

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Positive Station

Indicates the fetal head, as it descends, is lower than the ischial spines in the mother's pelvis.

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Crowning

The stage of labor where the baby's head is fully visible at the vaginal opening. This is usually an indication that the cervix is fully dilated.

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Digital vaginal examination

Manual examination of the vagina to assess fetal position,station, and other factors during labor, But not needed if the membranes rupture and woman has no contractions due to the risk of infection.

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Apgar Score

A scoring system used to assess a newborn's heart rate, breathing, muscle tone, reflexes, and skin color 1 minute and 5 minutes after birth.

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Normal Apgar Score

A score of 7 to 10 indicates a healthy newborn with good cardiopulmonary function.

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Mild to Moderate Distress Apgar Score

A score of 3 to 6 suggests some difficulties with breathing and/or heart rate.

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Severe Distress Apgar Score

A score of 0 to 2 indicates serious problems with breathing and/or heart rate, requiring immediate resuscitation and intensive care.

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Umbilical Cord

The cord connecting the baby to the placenta, containing two arteries and one vein, and covered by Wharton's jelly.

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Clamping and Cutting the Cord

Two clamps are applied to the umbilical cord, 8-10 cm from the baby's belly button, and the cord is cut between them once pulsations cease.

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Wharton's Jelly

A gelatinous substance that surrounds the blood vessels in the umbilical cord, protecting them.

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Bradypnea

Slow breathing rate in a baby, less than 15 breaths per minute.

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Bishop Score

A scoring system used to predict the likelihood of successful vaginal delivery. It assesses cervical dilation, effacement, consistency, position, and fetal station.

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Cervical Effacement

The thinning and shortening of the cervix, measured as a percentage of its original length.

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Presenting Part

The part of the fetus that enters the birth canal first, usually the head (vertex) but can be the buttocks (breech) or other parts.

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Perineal Care

Cleaning and caring for the vulva and perineum, especially after childbirth.

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Purpose of Perineal Care

To maintain hygiene, promote healing, prevent infection, reduce swelling and discomfort, and provide comfort.

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When is Perineal Care done?

Before vaginal exams and catheterization, after shaving, upon admission and at intervals during labor, after urination and defecation, before dressing episiotomy wounds, and pre/post perineal and vaginal surgeries.

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Signs of Perineal Changes After Childbirth

Pain and swelling around the vagina, vaginal discharge (bloody, pink, yellow), possible vaginal tear.

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Perineal Care Procedure

Steps include: hand washing, preparing equipment, explaining the procedure, draping the woman, positioning with a bed pan, removing soiled perineal pad, cleaning with forceps and sponges, drying, applying a sterile perineal pad, repositioning patient, removing soiled equipment, removing gloves, and washing hands.

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Cleaning Direction

Clean from the symphysis pubis upward to the umbilicus, then the far thigh, then the near thigh, then far labia from above downward, then near labia, and finally from the clitoris downward to the perineum and rectum.

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Charting Perineal Care

Record the time of the procedure, temperature of the cleaning solution, and the type of solution used.

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Lithotomy Position

Position where the woman lies on her back with her hips and knees flexed and her feet placed in stirrups.

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Study Notes

Clinical Procedures of Obstetrics and Gynecological Nursing Part 2

  • Topics covered in this part include:
    • The Partograph
    • Abdominal examination
    • Immediate Care of the Newborn Baby
    • Breast self-Examination
    • Examination of the placenta
    • IUD insertion
    • Fundus and lochia examination
    • Pap test
    • Perineal care
    • Bishop score
    • Vaginal Examination

Introduction

  • Maternal mortality in developing countries is often linked to prolonged labor, hemorrhage, infection, obstructed labor, and unsafe abortion.
  • A partograph is a chart used to monitor labor progress and identify potential problems like prolonged or obstructed labor and fetal distress.
  • The partograph helps track key indicators like cervical dilation, fetal head descent, contractions, and vital signs.

The Partograph

  • The partograph is a graphical tool for monitoring labor progress and fetal/maternal well-being.
  • Correct use of the partograph is crucial in recognizing abnormal labor and potential distress in the mother or baby.
  • The partograph plots key measurements such as fetal heart rate, contractions, and cervical dilation over time.

Identifying Fetal Distress

  • Fetal distress is indicated by abnormal fetal heart rate patterns (either constantly low or high).
  • The color of amniotic fluid (e.g., meconium-stained) can suggest potential problems.

Finding Your Way Around the Partograph

  • The partograph has specific sections for recording time, patient details, and measurements.
  • Key measurements like fetal heart rate, uterine contractions, and cervical dilation are recorded on specific parts of the graph.

Cervical Dilation and Descent

  • Cervical dilation is measured in centimeters (cm).
  • Fetal descent is measured as the station of the presenting part of the fetus relative to the ischial spines.

Moulder and Caput

  • Measurements of moulding and caput formation are recorded on the partograph.
  • These are indicators that reflect the degree of overlapping or swelling of the fetal skull bones during birth.
  • Assessment of moulding and caput is important for evaluating potential disproportion between the maternal pelvis and the fetal head size.

Recording and Interpreting Progress of Labour

  • Normal cervical dilatation during active labour progresses at 1 cm per hour, however this differs between multipara's and primiparas'
  • Fetal heart rate should be checked every 30 minutes.
  • The uterine contractions should be checked every 30 minutes.

Maternal Wellbeing

  • Maternal vital signs (blood pressure, pulse, temperature, and urine output) are monitored.
  • Abnormal values indicate potential issues that necessitate referral to a higher level facility.

Vaginal and Cervical Examination

  • Procedures for performing vaginal/cervical examinations for relevant information about maternal progression and fetal wellbeing.
  • Important aspects to note on the examination, such as the status of membranes, the position of the cervix, and the fetus's position and station will all be recorded on the graph.
  • The findings are reported on the partograph.

Fetal Heart Rate

  • Normal fetal heart rate is typically between 120-160 beats per minute.
  • Persistent deviations from this range are cause for concern and may indicate fetal distress.
  • Frequent checks are required when the rate falls outside this range.

Amniotic Fluid

  • Amniotic fluid assessment is crucial during labor.
  • Its clarity and appearance can indicate important aspects of maternal and fetal health.
  • Meconium-stained amniotic fluid is cause for concern, requiring immediate referral.

Components of Examination

  • The process of placental evaluation and all the observations that need to be made will be recorded.
  • The different types of placental characteristics, such as size shape, and completeness of cotyledons.
  • The assessment of the umbilical cord, which involves the length, insertion point and presence of knots or thrombi.
  • Recording of abnormal observations or other relevant findings for the proper assessment of the mother or fetus

IUD Insertion

  • Introduction of an intrauterine device (IUD) to prevent pregnancy.
  • Details on contraindications and advantages of using an IUD.
  • The procedure outlines for insertion includes detailed preparation, patient positioning, and steps to follow.

Perineal Care

  • Perineal care after childbirth focuses on maintaining the health and comfort of the perineal area.
  • Cleaning and observation for signs of trauma, infection, or other complications.

Bishop Score

  • Bishop score is used to predict likelihood of a successful vaginal delivery in situations where induction may be necessary.
  • The score accounts for various factors, including cervical ripening, cervical dilation, consistency, station, and effacement.

Vaginal Examination

  • This procedure assesses dilatation, effacement, and station of the cervix, as well as presenting part of the fetus in conjunction with other assessments.
  • Indication and contraindications for this examination are explained.

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Description

Test your knowledge on the usage and interpretation of the partograph in obstetrics. This quiz covers key aspects such as fetal heart rate monitoring, cervical dilatation, and the descent of the fetal head. Perfect for medical students and healthcare professionals.

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