Obstetrical Patients

Question 1

What are the hallmark signs of abruptio placentae?

Answer 1

Abdominal pain, contractions, dark vaginal bleeding

Question 2

What serum laboratory test is used to determine pregnancy?

Answer 2

Beta human chorionic gonadotropin (b-HCG)

Question 3

What intrauterine resuscitation measures can be taken during fetal distress?

Answer 3

High-flow 100% oxygen administration, left lateral recumbent positioning, IV fluid boluses for hypotension

Question 4

Preterm labor is determined by what criteria?

Answer 4

Frequent uterine contractions and cervical dilation or effacement between the 20th and 37th weeks of gestation

Question 5

When evaluating fetal heart rate monitoring, what should the critical care paramedic evaluate for?

Answer 5

Baseline fetal heart rate, changes in fetal heart rate, variability in the baseline, changes in trending patterns

Question 6

What is the appropriate administration of oxytocin in postpartum hemorrhage?

Answer 6

20-40 units in 1000 mL at 100 mL/hr IV

Question 7

What is a D & C?

Answer 7

Dilation of the cervix and curettage of the endometrial tissue used to treat abnormal vaginal bleeding or for retained products of conception.

Question 8

Is amniotic fluid acidic, alkalotic, or neutral?

Answer 8

Alkalotic

Question 9

What lab value is of importance upon delivery of the neonate?

Answer 9

Blood glucose

Question 10

What are maternal complications of gestational diabetes mellitus?

Answer 10

Preeclampsia, preterm labor, pyelonephritis, need for cesarean section

Question 11

What should contractions be monitored for?

Answer 11

Length of contraction, intensity, and time elapsed between contractions

Question 12

A pregnant female presents with altered mental status, tachycardia, and pale, diaphoretic skin. What do you suspect is the cause?

Answer 12

Hypoglycemia, gestational diabetes mellitus

Question 13

What is the biggest risk factor with preterm labor?

Answer 13

Premature rupture of membranes

Question 14

How is an umbilical cord prolapse managed?

Answer 14

Insertion of two fingers into the vagina to prevent the presenting portion of the fetus from occluding the cord. The patient may also be placed in the knee-chest position.

Question 15

Reoccurrence or prolonged seizure activity in the eclamptic patient should be treated with what dose of magnesium sulfate?

Answer 15

2-4 grams IV or IM

Question 16

What are the classic signs of placenta previa?

Answer 16

Painless, bright red vaginal bleeding

Question 17

In a typical vaginal delivery, the fetus presents in what position?

Answer 17

Vertex position

Question 18

Nitrazine paper will turn what color in the presence of amniotic fluid?

Answer 18

Blue

Question 19

What does HELLP syndrome stand for?

Answer 19

Hemolysis, Elevated Liver function tests, Low Platelets

Question 20

Name tocolytic agents used in preterm labor.

Answer 20

Terbutaline, magnesium sulfate, calcium channel blockers, beta-adrenergic agonists

Question 21

List findings indicative of severe preeclampsia.

Answer 21

SBP>160, DBP>110, proteinuria, oliguria, pulmonary edema, RUQ pain, elevated LFTs

Question 22

Ominous signs of fetal distress include what?

Answer 22

Fetal bradycardia, recurrent variable decelerations, absence of variability in fetal heart rate

Question 23

What does the mnemonic G/P T-P-A-L stand for when evaluating an obstetric patient?

Answer 23

Gravida, Para, Full-Term Infants, Preterm Infants, Abortions, Living Children

Question 24

An intrauterine pressure-monitoring catheter utilized to detect and record uterine contractions is known as what?

Answer 24

Tocodynamometer

Question 25

During a final assessment prior to transferring a patient in labor to another facility, you observe crowning. What changes are made regarding the transfer?

Answer 25

Hold the transfer and prepare for delivery