Ch.37 Obsterics And Care Of The Newborn

Question 1

Spontaneous Abortion

Answer 1

• AKA miscarriage
• Delivery of fetus and placenta prior to viability
• happens in 1st trimester/ before 12th week gestation

Question 2

Ectopic pregnancy

Answer 2

• Happens in 1st trimester

- Fertilized egg implanted anywhere but the uterus, usually found in the Fallopian tube

Question 3

Placenta Previa

Answer 3

• Happens in 3rd trimester

- placenta implants itself over the cervix

Question 4

Placenta Previa S/Sx

Answer 4

• Lots of bleeding

- No pain

Question 5

Abruptio Placentae

Answer 5

• Abnormal separation of placenta from uterine wall prior to birth of baby
• Happens in 3rd trimester

Question 6

Abruptio Placentae S/Sx

Answer 6

• Lots of pain

- Little to no external bleeding

Question 7

Ruptured Uterus

Answer 7

• Happens in 3rd trimester
• Spontaneous or traumatic rupture of uterine wall
• Releases fetus into abdominal cavity

Question 8

Preeclampsia

Answer 8

• Happens in 3rd trimester
• Condition characterized by high blood pressure and swelling of the extremities
• Pregnancy-induced Hypertension (PIH)

Question 9

Eclampsia

Answer 9

• Happens in 3rd trimester
• When the preeclamptic pt has a seizure and or coma will occur
• LIFE THREATENING EMERGENCY

Question 10

Supine Hypotensive Syndrome

Answer 10

• Happens in 3rd trimester

- Weight of fetus compresses inferior vena cava while woman lays supine

Question 11

Rx Supine Hypotensive Syndrome

Answer 11

-Tilt pt onto left side

Question 12

Preeclampsia S/Sx

Answer 12

• Extremity Swelling
• Elevated BP >140/90
• Persistent Headaches

Question 13

Miscarriage S/Sx

Answer 13

• Abdominal cramping

- Vaginal bleeding

Question 14

Premature Birth

Answer 14

Before 37 weeks and/or < 5lbs in birth weight

Question 15

Post term birth

Answer 15

> 42 weeks

Question 16

Umbilical Cord

Answer 16

• Lifeline for the fetus

- 1 vein and 2 arteries

Question 17

Gravida

Answer 17

How many times have you been pregnant?

Question 18

Para

Answer 18

How many live births have you given?

Question 19

Common assessment questions

Answer 19

• Gravida and Para
• Have you been under doctors care?
• Any complications expected?
• Have you had twins? Triplets?
• Previous C section
• OPQRST investigate pain complaints

Question 20

Stage 1 (Giving Brith)

Answer 20

Beginning of true contractions to full dilation of cervix

Question 21

Braxton Hicks

Answer 21

• “False Labor”

- Contractions thought to condition uterus for labor

Question 22

Stage 2 (Giving Birth)

Answer 22

• AKA expulsion stage
• Crowning
• Complete dilation to delivery of baby
• Make sure to check for the umbilical cord

Question 23

Stage 3 (Giving Birth)

Answer 23

• Following delivery of baby to expulsion of placenta

- 5-20 min following the delivery of baby

Question 24

What do you do if you want to deliver the bottom shoulder of the baby?

Answer 24

Lift up on the head

Question 25

what happens If you push down on the head of the baby while delivery?

Answer 25

Top shoulder would be delivered

Question 26

Prolapsed Cord

Answer 26

- Umbilical cots is the first presenting part - Infant May compress cord cutting off blood supply - True emergency

Question 27

Prolapsed Cord Rx

Answer 27

- insert gloves into vagina and lift baby off the cord if the cord stops pulsating - put wet sterile towel over the cord - Rapid transport

Question 28

Breech Birth

Answer 28

- Butt or lower extremities present first | - If infant delivers , allow it to progress

Question 29

What do you do If the head gets stuck during birth?

Answer 29

Insert gloved index and middle finger into vagina and make an Airway for baby using a V pattern

Question 30

Limb presentation

Answer 30

- One arm or leg is presenting - DO NOT deliver under any circumstances - C-section is needed

Question 31

Multiple Births

Answer 31

- twins to multiple babies | - Deliver as normal

Question 32

Meconium staining

Answer 32

- Fetus has a bowel movement in amniotic sac during delivery - yellow/green/brown color of amniotic fluid

Question 33

Precipitous delivery

Answer 33

-Delivery 3 hours from onset of labor

Question 34

Shoulder Dystocia

Answer 34

Shoulders larger than head

Question 35

Preterm labor

Answer 35

-Labor between 20th and 37th week

Question 36

Premature rupture of membranes

Answer 36

Water breaks before onset of true labor

Question 37

Postpartum hemorrhage

Answer 37

Blood loss greater than 500cc following delivery

Question 38

Rx postpartum hemorrhage

Answer 38

- Massage the fundus - Apply O2 - Put baby to breast of mom

Question 39

Rx Limb Presentation

Answer 39

Transport immediately with mom in knee to chest position

Question 40

APGAR

Answer 40

- Appearance - Pulse - Grimace - Activity - Respirations

Question 41

When should APGAR be done?

Answer 41

1-5 min after birth or as needed after

Question 42

Appearance points

Answer 42

``` -0 points •Entire body is blue -1 points •pink core, blue extremities -2 points •All pink ```

Question 43

Pulse points

Answer 43

``` -0 points •No pulse -1 points •pulse <100 -2 points •pulse >100 ```

Question 44

Grimace

Answer 44

``` -0 points •No flex activity -1 points •Some grimace to stimulation -2 points •Cough, sneeze, cry ```

Question 45

Activity points

Answer 45

``` -0 points •limp -1 points •Flexion without active movement -2 points •Actively moving ```

Question 46

Respiration points

Answer 46

``` -0 points •No respiratory effort -1 points •weak cry -2 points •strong cry ```

Question 47

7-10 points for APGAR

Answer 47

- Within normal range | - only routine care needed

Question 48

4-6 points

Answer 48

- Stimulation | - O2

Question 49

0-3 point APGAR

Answer 49

- Severely depressed - BVM needed - CPR as needed

Question 50

Neonate

Answer 50

Birth to 28 days

Question 51

Loose up to 500cc of Blood during child birth

Answer 51

Is NORMAL