Chapter 31: Obstetrics and Neonatal Care

Question 1

Discuss

How long does the ovum have after ovulation to be fertilized?

Answer 1

36-48 hrs

Question 2

Discuss

What’s a bloody show?

Answer 2

Mucus plug that blocks uterus is discharged before birth.

Question 3

Discuss

Do fetus and mother share the same blood?

Answer 3

No, separated by membrane in the placenta

Question 4

Discuss

What’s the blood vessel composition of the umbilical cord?

Answer 4

Two arteries and one vein (vein returning oxygenated blood from placenta)

Question 5

Discuss

the amniotic sac

Answer 5

Contains 500-1000 ml of amniotic fluid that cushions baby in uterus.

Question 6

Discuss

What are the three general stages of labor?

Answer 6

Dilation of cervix, delivery of infant, delivery of placenta

Question 7

Discuss

Describe the first stage of labor

Answer 7

Goes from onset of contractions to fully dilated cervix. Usually 16 hours for primigravida. Contractions become more regular, lasting 30-60s. Included in this stage is lightening, the feeling of the head moving down into the pelvis.

Question 8

Discuss

What’s false labor?

Answer 8

When contractions don’t increase in frequency or intensity. Pain is alleviated by changing position.

Question 9

Discuss

Describe the second stage of labor

Answer 9

Goes from fetus entering birth canal to birth. Pt will feel urge to push.

Question 10

Discuss

Describe the third stage of labor

Answer 10

Delivery of placenta takes up to 30 minutes.

Question 11

Discuss

What’s preeclampsia?

Answer 11

Pregnancy induced hypertension. After the 30th week of pregnancy, with headache, seeing spots, edema, anxiety.

Question 12

Discuss

What’s eclampsia?

Answer 12

Seizures as a result of hyptertension from pregnancy.

Question 13

Discuss

What’s supine hypotensive syndrome?

Answer 13

When vena cava is compressed by fetus. Placing pt on her left side will relieve this pressure.

Question 14

Discuss

What’s an ectopic pregnancy and S/S?

Answer 14

When fertilized egg lands in fallopian tube instead of uterus. Big emergency.

Question 15

Discuss

What might vaginal bleeding early in pregnancy suggest?

Answer 15

Possible spontaneous abortion or ectopic pregnancy.

Question 16

Discuss

What does vaginal bleeding in later stages of pregnancy suggest?

Answer 16

Possible abruptio placenta.

Question 17

Discuss

What’s abruptio placenta?

Answer 17

When the placenta separates prematurely usually from hypertension or trauma.

Question 18

Discuss

What’s gestational diabetes?

Answer 18

Diabetes during pregnancy

Question 19

Discuss

What’s nuchal cord?

Answer 19

When the umbilical cord is wrapped around the neck. Always check for this as the head emerges.

Question 20

Discuss

What are three emergency situations to worry about during birth?

Answer 20

1. More than 30 min and still no placenta. 2. More than 500 ml bleeding before placenta. 3. Significant bleeding after placenta.

Question 21

Discuss

What to expect with infant breathing after birth?

Answer 21

Usually begins breathing 15-30s after birth. HR 120 or higher. If not breathing, flick feet or rub back. If no breathing still after 10-15 s, begin resuscitation.

Question 22

Discuss

What’s the APGAR score stand for and when is it administered? What scores expected?

Answer 22

Appearance, pulse, grimace, activity, respiration. Calculated at 1 min and 5 min. Usually 7-8 at 1 min and 8-10 at 5 min.

Question 23

Discuss

How to determine APGAR score?

Answer 23

Area of Activity 2 1 0

Appearance Body pink Blue hands/feet Blue body

Pulse >100 <100 None

Grimace Cries, withdraws Weak cry No cry

                     from flicked foot

Activity Resists Weak Limp

                   straightening           resistance

Resp. Rapid Slow None

Question 24

Discuss

What rate should an infant be BVM’d at?

Answer 24

40-60 breaths/min