Podcast
Questions and Answers
What characterizes an incompetent cervix?
Which of the following is a potential consequence of an untreated ectopic pregnancy?
In which type of abortion is the cervix closed with no passage of tissue?
During which trimester can molar pregnancy occur?
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What distinguishes a missed abortion from other types?
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What is the typical early sign of an ectopic pregnancy?
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Which labor pain cause is associated with cervical effacement and dilation?
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Which type of abortion involves malodorous tissue and varies in cramps and bleeding?
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What is a key risk factor for uterine rupture during labor?
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Which of the following is not a manifestation of pre-eclampsia/eclampsia?
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What should be the immediate nursing goal in the case of cord prolapse during labor?
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Which statement about shoulder dystocia is true?
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What is the primary concern during an amniotomy?
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What does Rh isoimmunization primarily affect?
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Which of the following is a common intervention for amniotic fluid embolism?
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Which symptom is associated with increased risk of gestational diabetes?
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Which of the following accurately describes a characteristic of postpartum blues?
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What is a typical feature of the 'Taking Hold' phase in Rubin's Phases?
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Which of the following is NOT a cause of postpartum hemorrhage?
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Which statement is true regarding the hormone changes postpartum?
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Which symptom is associated with postpartum psychosis?
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Study Notes
Postpartum Assessment (BUBBLE)
- Breasts: Evaluate temperature, color, nipple condition, and pain levels.
- Uterus: Assess firmness (should be firm, not boggy) and location, decreasing 1 cm below umbilicus daily; inspect surgical incisions if present.
- Bladder: Ensure the patient can void 6-8 hours post-delivery; assess ability to empty bladder completely.
- Bowel: Monitor for flatus and distention; auscultate bowel sounds.
- Lochia: Record color and odor of lochia as appropriate for gestational age.
- Episiotomy: Check for redness, edema, ecchymosis, drainage, and tissue approximation.
Basic Hormone Changes
- Hormonal fluctuations occur post-delivery affecting mood and physiological processes.
Postpartum Hemorrhage
- Physiology: Myometrium compresses dilated uterine blood vessels to halt bleeding.
- Causes: Uterine atony, genital tract trauma, retained products of conception (POC), coagulopathy.
Postpartum Depression (Types)
- Postpartum Blues: Temporary sadness, sleep disturbances, feelings of inadequacy, increased tearfulness.
- Postpartum Psychosis: Severe mood disturbance, disorientation, paranoia, self-harm thoughts.
- Postpartum Depression: Guilt, anxiety, fatigue, mood swings, potential rejection of the infant.
Rubin's Phases of Adjustment
- Taking In Phase: 1-2 days postpartum; mother centers on self-needs and discusses birth experience.
- Taking Hold Phase: 2-3 days postpartum; focus shifts to infant and bodily functions, mood swings prominent.
Incompetent Cervix
- Characterized by painless cervical dilation and effacement, typically in the second trimester, leading to spontaneous abortion or premature birth.
- Cerclage Band: Surgical intervention can reinforce the cervix to prevent preterm birth.
Ectopic Pregnancy
- Occurs when a fertilized egg implants outside the uterus, commonly in the fallopian tube.
- Causes: Previous trauma, scar tissue, inflammation, or anatomical abnormalities.
- Symptoms: Light vaginal bleeding, pelvic pain, potential for ruptured tube creating a life-threatening situation.
Types of Abortion
- Spontaneous Abortion: Non-induced pregnancy loss before 20 weeks gestation.
- Threatened: Mild cramps, slight spotting, cervix closed.
- Inevitable: Moderate cramps, moderate bleeding, cervix dilated.
- Incomplete: Severe cramps, heavy bleeding, tissue in canal, cervix dilated.
- Complete: Minimal bleeding post-tissue passage, cervix closed.
- Missed: No symptoms, cervix closed.
- Septic: Varied cramps and bleeding, malodorous tissue.
- Recurrent: Similar to septic with varied symptoms.
Hydatidiform Mole (Molar Pregnancy)
- Abnormal growth in the uterus where tissue resembles a sperm-egg fusion, lacking typical fetal development.
- Risks: Membrane rupture can cause significant hemorrhage; contraindicated activities include sex and heavy lifting.
Uterine Rupture
- Risk Factors: Prior cesarean deliveries or uterine anomalies; presents as loss of fetal heart tones, abdominal pain, cessation of contractions.
- Interventions: Rapid medical response, IV fluids, oxygen, preparation for cesarean section.
Amniotic Fluid Embolism
- Occurs when amniotic fluid or fetal cells enter the maternal circulation, potentially leading to respiratory distress.
- Prognosis: High mortality rate (60-80%); prepare for emergency code.
Pre-Eclampsia/Eclampsia/HELLP Syndrome
- Pathophysiology: Narrowing of placenta's spiral arteries causes poor perfusion, leading to hypertension and proteinuria.
- Risk Factors: Nulliparity, extremes of age, multiple gestations, obesity, and history of hypertension.
- Symptoms: High blood pressure, proteinuria, oliguria, and severe edema; immediate delivery often required.
Cord Prolapse
- Occurs when the umbilical cord slips ahead of the baby during labor, leading to potential compression and fetal hypoxia.
- Symptoms: Visible or palpable cord; often requires cesarean delivery.
- Nursing Action: Positioning (knee-chest) can alleviate pressure off the cord.
Shoulder Dystocia
- Fetus's shoulder becomes lodged during delivery, risking injury.
- Intervention: McRoberts maneuver helps to dislodge shoulder.
Amniotomy
- Procedure for rupturing the amniotic sac to induce labor; involves monitoring the fetal heart rate and maternal condition closely.
Vacuum & Forceps
- Used to expedite labor in cases of maternal or fetal distress; associated risks include facial trauma and hemorrhage.
Gestational Diabetes
- Increases risks for both the mother and the newborn; involves monitoring and management plans.
Rh Isoimmunization
- RhoGAM is administered to Rh-negative women during potential sensitization events; education on the importance of follow-up and monitoring.
Infections
- Group Beta Strep: Common bacteria that may affect pregnant women; 35% prevalence in lower GI and genital tract; relevant considerations for maternal and fetal care during labor.
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Description
Test your knowledge on postpartum assessments including the BUBBLE method. This quiz covers important observations regarding the breasts, uterus, bladder, bowel, lochia, and episiotomy. Ideal for nursing students and healthcare professionals.
