Presentation Material

Question 1

Shoulder Dystocia

Answer 1

Failure of the anterior fetal shoulders to deliver after the fetal head

Question 2

Two biggest risk factors for shoulder dystocia?

Answer 2

Abnormalities in maternal pelvis and macrosomia

Question 3

What are some signs of shoulder dystocia?

Answer 3

Slow second stage of labor and fetal head emerging and retracting (turtle sign)

Question 4

What is a top cause of malpractice claims?

Answer 4

Shoulder dystocia that results in permanent fetal injury

Question 5

The McRoberts manuever

Answer 5

moves the sacrum and synthesis pubis to decrease the angle of inclination

Question 6

What is the preferred method of shoulder dystocia?

Answer 6

Done with epidural anesthesia

Question 7

How do you dislodge fetal shoulders from the pubic bone in the McRoberts manuever?

Answer 7

Apply suprapubic pressure directly above the symphasis pubis

Question 8

Fetal Non-Stress Test

Answer 8

a normal fetus prouces characteristic heart rate patterns in response to fetal movement, uterine contractions, or stimulation

Question 9

What is the most common reason for the absence of FHR accelerations?

Answer 9

quiet fetal sleep state

Question 10

How will a woman be placed for a NST?

Answer 10

In a relining chair to allow optimal uterine perfusion and to prevent supine hypotension

Question 11

What is a NST looking for?

Answer 11

signs of fetal activity and a concurrent acceleration of FHR

Question 12

A reactive test means

Answer 12

there were two accelerations of their heart rate in a 20-minute period

Question 13

A non-reactive test interventions may include

Answer 13

Giving the mother orange juice, vibroacoustic stimulation, and music

Question 14

The disadvantage of Fetal non stress test is that there is a

Answer 14

high rate of false positive nonreactive tests

Question 15

What is Rh?

Answer 15

A protein on the surface of RBC’s

Question 16

What are Rh- blood types?

Answer 16

O+, O-, A-, B-, AB-

Question 17

What is one way a mom may have the antibodies?

Answer 17

If Rh- mom has previously had a Rh+ baby

Question 18

What is necessary to test for mother to know if there may be an incompatability?

Answer 18

Mothers blood type and if mother has antibodies to Rh protein

Question 19

How can a Rh+ baby cause a mother to produce antigens?

Answer 19

Baby’s Rh blood can enter mother’s circulation and cause mother’s body to produce antibodies that attach Rh+ RBCs

Question 20

What is the biggest worry in a first pregnancy incompatability?

Answer 20

Rh sensitization in future pregnancies

Question 21

What is Rh sensitization?

Answer 21

Occurs when mother’s antibodies cross the placenta and attack Rh+ RBC’s in baby

Question 22

What does Rhogam do?

Answer 22

prevents maternal blood from producing antibodies that attack Rh+ RBC’s by binding to Rh+ and removing them from circulation

Question 23

When should Rhogam be given?

Answer 23

28 weeks and within 72 hours of delivery

Question 24

What is circumcision?

Answer 24

the removal of all or part of the foreskin of the penis

Question 25

Health benefits of NMC:

Answer 25

prevention of UTI, reduced risk for penile cancer, and reduced risk for STI's, particularly HIV

Question 26

What are some reasons parents choose to have NMC?

Answer 26

hygiene, religious conviction, tradition, culture, social norms

Question 27

Why is NMC not performed immediately after birth?

Answer 27

danger of cold stress and decreased clotting factors

Question 28

How do you prepare for a NMC?

Answer 28

penis is cleaned with soap and water or antiseptic solution, draped to provide warmth and sterile field

Question 29

Gomco clamp

Answer 29

surgical removal, minimizes blood loss., ned petroleum gauze dressing for 24 hours after

Question 30

PlastiBell

Answer 30

fitted over glans, suture tied around rim of bell, and excess foreskin is cut away; plastic rim falls off when it heals, petroleum gauze is not necessary

Question 31

How often do you check for bleeding in NMC?

Answer 31

Every 15 - 30 minutes for first hour and then hourly for next 4 - 6 hours. Then with every diaper change thereafter

Question 32

What do you do if bleeding occurs in NMC?

Answer 32

apply gentle pressure with a folded sterile gauze square

Question 33

How often should an infant have a wet diaper after NMC?

Answer 33

2 - 6 times per 24 hours the first 1 - 2 days, then 6 - 8 times per 24 hours after 3 - 4 days

Question 34

How to keep area clean after NMC?

Answer 34

Change diaper and inspect every 4 hours, wash penis with just water (no soap or baby wipes), apply petroleum with each diaper change, apply diaper loosely

Question 35

What is the goal of cord care?

Answer 35

prevent or decrease the risk for hemorrhage and infection

Question 36

The cord should be kept

Answer 36

clean and dry

Question 37

The umbilical cord consists of

Answer 37

two arteries and one vein

Question 38

How do you clean the cord?

Answer 38

Give sponge baths, cleanse with water at the base of the cord where it joins the skin

Question 39

How frequently does cord get assessed and cleaned?

Answer 39

Every diaper change; if cord is soiled clean it with water and dry it thorougly

Question 40

When is the cord clamp taken off?

Answer 40

when the cord is dried; about 24 - 48 hours

Question 41

When should the cord fall off?

Answer 41

10 - 14 days to 3 weeks

Question 42

What happens to the cord about day 3?

Answer 42

It becomes black, dry, and shriveled

Question 43

What might happen when the cord separates?

Answer 43

There may be a few drops of blood from the umbilicus

Question 44

What should a woman do for lactation suppression?

Answer 44

wear w well-fitted support bra continuously for the first 72 hours

Question 45

What should the mother avoid when suppressing lactation?

Answer 45

breast stimulation, running warm water over breasts, newborn suckling, expressing milk

Question 46

How can a woman manage engorgement of breasts?

Answer 46

application of ice packs, cabbage leaves, a mild analgesic or anti-inflammatory medication