Questions and Answers
What is the purpose of performing an episiotomy?
Completeness of the placenta and its examination is of significant clinical importance.
False
What is the recommended action for the health care provider during the newborn assessment immediately after birth?
Perform the Apgar score assessment at 1 and 5 minutes.
The _ should be placed on the mother's bare chest to promote maternal-infant interaction.
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Match the following terms related to newborn care:
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What should be done to prevent the spread of infection during placenta disposal?
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Decontaminating instruments is unnecessary after placenta disposal.
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How many cotyledons must complete during the placental examination?
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Which maneuver helps to determine the descent of the presenting part of the fetus to the birth canal?
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The Last Menstrual Period (LMP) is important for determining the expected date of confinement (EDC).
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What is the purpose of positioning the client supine with knees slightly flexed during the examination?
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Before performing the procedure, the client should __________ her bladder.
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Match the following items to their purposes in the procedure:
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What is the benefit of using warm water for personal hand hygiene during the procedure?
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Providing privacy for the client is an optional step in the procedure.
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What should be observed on the client’s abdomen during the examination?
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What does a very easily palpated brow indicate about the fetal position?
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Performing Leopold’s Maneuver is recommended before 28 weeks of gestation.
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What should be documented if the absence of fetal heart sounds is detected?
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The _____ position occurs when the occiput is pointing toward a woman's back.
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Match the situation with the required action:
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What indicates a good fetal attitude during examination?
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A hyperextended head indicates a poor fetal attitude.
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When is it advisable to perform Leopold's Maneuver?
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Study Notes
Episiotomy and Aftercare
- An episiotomy is sutured immediately to promote healing, limit damage, and reduce infection risk.
- Immediate examination of the placenta determines its completeness and any abnormalities, regardless of the appearance method (Schultze or Duncan).
- Assessment ensures no placental remnants are left in the uterine cavity.
Postpartum Care
- Clean the mother’s perineum and apply a sanitary pad for hygiene.
- Conduct a brief assessment of the newborn using the Apgar score at 1 and 5 minutes post-birth.
- Assess mother's comfort level and check for uterine contraction.
- Safely dispose of the placenta in a leak-proof container to prevent infection spread.
- Instruments must be decontaminated using a 0.5% chlorine solution for at least 10 minutes before cleaning.
Newborn-Mother Interaction
- Advise skin-to-skin contact immediately after birth to support thermoregulation and enhance maternal-infant bonding.
- Position the newborn prone on the mother’s chest, covered with a blanket to reduce heat loss.
Assessment of Fetal Position
- The third maneuver assesses the descent of the presenting fetal part into the birth canal.
- The fourth maneuver evaluates the degree of fetal head flexion and overall fetal attitude.
Planning and Implementation
- Review the prenatal health record: Last Menstrual Period (LMP), Expected Date of Confinement (EDC), and Age of Gestation (AOG).
- Gather necessary equipment: linen, tape measure, stethoscope/Doppler, pillow, gel, and tissue paper.
- Ensure the client empties her bladder for accurate fetal palpation.
- Wash hands using warm water to avoid uterine stimulation; maintain client privacy during the procedure.
Maternal Positioning
- Position the client supine with slightly flexed knees, using a pillow or towel to alleviate pressure on the vena cava.
- Expose the abdomen to observe fetal positioning through activity and contours.
Fetal Attitude Assessment
- Use fingers to palpate the uterus’ longest diameter and location of fetal movements.
- Assess fetal attitude based on the palpability of the brow and the position of elbows and knees.
Evaluation and Nursing Considerations
- Document findings and notify healthcare providers if fetal heart sounds are absent, if there's a decrease in FHR that does not return to baseline, or if the mother reports decreased fetal movement or abdominal/vaginal issues post-22 weeks.
- Perform Leopold’s Maneuver after 28 weeks gestation, as uterine muscles are more stretched and thin.
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Description
This quiz covers essential procedures and considerations for postpartum care, including episiotomy management, newborn assessment using the Apgar score, and safe disposal of the placenta. It emphasizes the importance of hygiene and maternal-infant bonding through immediate skin-to-skin contact. Test your knowledge on these critical aspects of nursing care following childbirth.
