Chapter 24

Question 1

Accomplished through an abdominal incision into the uterus

Answer 1

Cesarean Birth

Question 2

Is the artificial rupturing of membranes during labor

Answer 2

Amniotomy

Question 3

Is a surgical incision of the perineum

Answer 3

Episiotomy

Question 4

What is the advantage of mediolateral episiotomy over midline episiotomy?

Answer 4

Decreasing chance of rectal mucosal tear

Question 5

Surgical opening of the labia

Answer 5

Defibulation

Question 6

Is the most precise method for assessing FHR and uterine contractions.

Answer 6

Internal Electronic Monitoring

Question 7

It is most often used to assess whether contractions are strong enough to cause cervical change in the case of a prolonged labor course.

Answer 7

Internal Electronic Monitoring

Question 8

It is inserted into the uterine cavity and alongside the fetus

Answer 8

Internal Electronic Monitoring

Question 9

What can be evaluated in the Internal Electronic Monitoring

Answer 9

Frequency, duration, baseline strength, and peak strength of contractions

Question 10

This is done by applying pressure with the fingers to the fetal scalp through the dilated cervix.

Answer 10

Scalp stimulation

Question 11

This causes a tactile response in the fetus that momentarily increases the FHR

Answer 11

Scalp stimulation

Question 12

Is an assessment of acid-base balance in a fetus in labor

Answer 12

Scalp stimulation

Question 13

Cesarean Birth is used most often as a prophylactic measure to alleviate problems of birth such as:

Answer 13

*Cephalopelvic disproportion
*breech or multiple fetus births
*failure to progress in labor

Question 14

Are planned and there is time for thorough preparation for the experience throughout the antepartal period.

Answer 14

Scheduled Cesarean Birth

Question 15

Scheduled cesarean births are ideally done at

Answer 15

39 weeks or after full fetal development has occured.

Question 16

Reasons for scheduled cesarean births are when there is a physical indication such as

Answer 16

Transverse presentation, infection that could be contracted by the fetus, or cephalopelvic disproportion

Question 17

Births that are done for reasons that arise suddenly in labor

Answer 17

Emergent cesarean birth

Question 18

Reasons for emergent cesarean birth:

Answer 18

*placenta previa
*premature separation of the placenta
*fetal distress
*failure to progress

Question 19

Increases the heart rate, causes bronchial dilatatio, and elevates blood glucose level.

Answer 19

Epinephrine

Question 20

The _____ serves as the primary line of defense against bacterial invasion

Answer 20

Skin

Question 21

To ensure protection against postsurgical endometritis, medications are given such as

Answer 21

Prophylactic antibiotic, Ampicillin (omnipen)
Cephalosporin such as cefazolin (ancef)

Question 22

During a vaginal birth, a patient loses how much blood

Answer 22

300 to 500 mL of blood.

Question 23

Loss of blood increases how much with a cesarean birth

Answer 23

500 to 1000 mL

Question 24

Effects of surgery on a pregnant patient:

Answer 24

*stress response
*interference with body defenses
*interference with circulatory function
*interference with body organ function
*interference with self-image or self-esteem

Question 25

For preoperative interview, include questions like

Answer 25

*what the procedure will entail
*length of hospitalization anticipated
If they’ve been told about any postsurgical equipment to be used
*any special precautions that are being planned for the infant

Question 26

Opening or rupture of the incision

Answer 26

Dehiscence

Question 27

Operative risk for a pregnant patient

Answer 27

*poor nutritional status
*age variations
*altered general health status
*fluid and electrolyte imbalance
*fear

Question 28

Common device used three to four times a day postoperatively to encourage deep breathing

Answer 28

Incentive spirometer

Question 29

Gastric emptying agent

Answer 29

Metoclopramide (reglan)

Question 30

Speed up stomach emptying or a histamine blocker

Answer 30

Ranitidine (zantac)

Question 31

Acts to neutralize acid stomach secretions

Answer 31

Citric acid and sodium citrate (bicitra)

Question 32

Preoperative diagnostic procedures:

Answer 32

*vital sign determination
*urinalysis
*complete blood count
*coagulation profile
*serum electrolytes and pH
*blood typing and cross-matching

Question 33

Immediate preoperative care measures:

Answer 33

*Informed consent
*overall hygiene
*baseline intake and output determinations
*hydration
*preoperative medication
*patient chart and presurgery checklist

Question 34

Is a form of morphine commonly used in addition to a local anesthesia in epidurals

Answer 34

Duramorph

Question 35

The effects of duramorph lasts for

Answer 35

24 hours

Question 36

What should be done after administering duramorph

Answer 36

Assess respirations every 2 hours postsurgery

Question 37

Surgical site infections at the lower abdomen decreases with the use of

Answer 37

Chlorhexidine wipes

Question 38

Incision is made vertically through both the abdominal skin and the uterus

Answer 38

Classic cesarean section