Quiz 1- Wk1-4 Flashcards
You are faced with a non-imminent birth however the umbilical cord is visible, aspects of patient management include?
Select one:
a. Minimise cord handling, ensure the cord is pulsating, place mother in Exaggerated Sims position
b. Handle the cord with warm saline packs, ensure that that it is kept warm and moist and make sure that the presenting part is not putting pressure on the cord.
c. Transport without intervention and advise the hospital of your expected arrival time
d. Minimise cord handling and ensure that that it is kept warm and moist
You are faced with a non-imminent birth however the umbilical cord is visible, aspects of patient management include?
a. Minimise cord handling, ensure the cord is pulsating, place mother in Exaggerated Sims position
Paramedics are assessing a woman who is in her eighth month of pregnancy and discover that her blood pressure is 100/70, her heart rate is 90, and her respiratory rate is 20. What do these vital signs most likely indicate?
Select one:
a. Normal changes during pregnancy
b. Severe dehydration
c. The patient is hypoxic.
d. Moderate hypovolemia at this stage of pregnancy
Paramedics are assessing a woman who is in her eighth month of pregnancy and discover that her blood pressure is 100/70, her heart rate is 90, and her respiratory rate is 20. What do these vital signs most likely indicate?
a. Normal changes during pregnancy
When assessing a patient with possible pre-eclampsia a common patient complaint may be:
Select one:
a. Itchy abdomen
b. Headache
c. Increased urge to urinate
d. Blurred vision in isolation
When assessing a patient with possible pre-eclampsia a common patient complaint may be:
b. Headache
What paramedic management is required to assist the delivery of the placenta in the pre-hospital environment?
Select one:
a. Perform fundal massage to assist with the deliver of the placenta, administer uterotonic drugs and storage of the placenta into a clinical waste bag for review at hospital
b. Administration of uterotonic drugs, active cord traction and storage of the placenta into a clinical waste bag for review at hospital
c. Active cord traction, administration of uterotonic drugs and storage of the placenta into a clinical waste bag for review at hospital
d. Let the placenta deliver without active intervention, monitor the women for ongoing blood loss and storage of the placenta into a clinical waste bag for review at hospital and monitor the woman for ongoing blood loss
What paramedic management is required to assist the delivery of the placenta in the pre-hospital environment?
d. Let the placenta deliver without active intervention, monitor the women for ongoing blood loss and storage of the placenta into a clinical waste bag for review at hospital and monitor the woman for ongoing blood loss
In the setting of a footling breech presentation the paramedic should (multiple answers):
Select one or more:
a. Undertake a ‘hands-off’ approach
b. Attempt to deliver using the Lovset’s maneouvre
c. Prepare a polyethylene bag regardless of gestation age.
d. Use the McRobert’s position
In the setting of a footling breech presentation the paramedic should (multiple answers):
a. Undertake a ‘hands-off’ approach
b. Attempt to deliver using the Lovset’s maneouvre
During the assessment of a pregnant woman, paramedics discover the baby is crowning. The contractions are 1 minute apart. The patient is a gravida 3, para 2. How should the paramedics proceed?
Select one:
a. Stay on scene and prepare to assist with the birth of the baby
b. Reassure the mother that she will not birth her baby for at least an hour
c. Transport immediately
d. Prepare for delivery, while traveling to hospital under emergency driving conditions
During the assessment of a pregnant woman, paramedics discover the baby is crowning. The contractions are 1 minute apart. The patient is a gravida 3, para 2. How should the paramedics proceed?
a. Stay on scene and prepare to assist with the birth of the baby
How does the McRobert’s position work to assist the delivery in a suspected shoulder dystocia?
a. Opens the pelvis diameter
b. Allows the mother to push harder with contractions
c. Allows the baby’s pelvis and legs to restitute in the correct position.
d. Prevents nuchal cord
How does the McRobert’s position work to assist the delivery in a suspected shoulder dystocia?
a. Opens the pelvis diameter
Signs of shoulder dystocia may include (select all that apply):
a. Post partum haemorrhage
b. Failure of shoulders to descend
c. A ‘footling’ presentation
d. Failure of the baby to undergo restitution
e. Prolonged delivery time of body > 1 min
Signs of shoulder dystocia may include (select all that apply):
b. Failure of shoulders to descend
d. Failure of the baby to undergo restitution
e. Prolonged delivery time of body > 1 min
Third stage labour should last no longer than…
Select one:
a. Ten hours
b. Three hours
c. One hour
d. Six hours
Third stage labour should last no longer than…
Select one:
c. One hour
The definition of an antepartum haemorrhage is:
Select one:
a. Any significant blood loss occurring within six weeks post birth
b. Any internal or external bleeding occurring throughout a pregnancy prior to birth/labour
c. Greater than 500mls of blood loss within 24 hours post birth
d. The rupture of membranes
The definition of an antepartum haemorrhage is:
Select one:
b. Any internal or external bleeding occurring throughout a pregnancy prior to birth/labour
The first manoeuvre to use when faced with a should dystocia is?
Select one:
a. McRobert’s
b. Lovset’s
c. All-fours
d. Mauriceau-Smellie-Viet
The first manoeuvre to use when faced with a should dystocia is?
Select one:
a. McRobert’s
At what gestation age do you need to use a polyethylene bag with a preterm baby to keep them warm?
Select one:
a. <30
b. <32
c. <34
d. <28
At what gestation age do you need to use a polyethylene bag with a preterm baby to keep them warm?
d. <28
When assessing visible blood loss, what volume needs to be present for a paramedic to confirm primary post-partum haemorrhage:
Select one:
a. >250mls
b. >500mls
c. <500mls
d. >1000mls
When assessing visible blood loss, what volume needs to be present for a paramedic to confirm primary post-partum haemorrhage:
b. >500mls
You are attempting to manage an imminent birth with a breech presentation. The mother is resting with her buttocks on the edge of the bed and the baby’s buttocks are visible as the presenting part. To safely facilitate the birth from this position the baby’s back should be:
Select one:
a. Maintained in a lateral but neutral position until the nape of the neck is visible
b. Uppermost toward the paramedic with the baby’s face toward the sacrum
c. Maintained in a lateral position until the nape of the neck is visible
d. Back facing away from the treating paramedic with the baby’s face toward the mothers abdomen
You are attempting to manage an imminent birth with a breech presentation. The mother is resting with her buttocks on the edge of the bed and the baby’s buttocks are visible as the presenting part. To safely facilitate the birth from this position the baby’s back should be:
b. Uppermost toward the paramedic with the baby’s face toward the sacrum
If during a breech presentation the baby’s arms don’t birth by themselves, the paramedic should perform the:
Select one:
a. Gaskin manoeuvre
b. Lovsetts manoeuvre
c. Suprapubic pressure
d. McRobert’s manoeuvre
If during a breech presentation the baby’s arms don’t birth by themselves, the paramedic should perform the:
b. Lovsetts manoeuvre
Fill the blanks- Positioning the pregnant patient supine should be avoided, as this can lead to obstruction of the _____ causing a ____ in cardiac output and subsequent _____
Positioning the pregnant patient supine should be avoided, as this can lead to obstruction of the inferior vena cava causing a decrease in cardiac output and subsequent hypotension
Fundal massage should be applied to:
Select one:
a. A firm, compacted and central fundus associated with visible blood loss
b. To assist the delivery of the placenta post birth of the baby
c. A soft, boggy fundus that is associated with visible blood loss
d. To assist the uterus to correctly expel the placenta in the shortest timeframe possible post birth
Fundal massage should be applied to:
c. A soft, boggy fundus that is associated with visible blood loss
The most effective pharmacological agent available to paramedics to assist in the control of PPH is:
Select one:
a. Oral misoprostol
b. IM oxytocin
c. Oral oxytocin
d. IV misoprostol
The most effective pharmacological agent available to paramedics to assist in the control of PPH is:
b. IM oxytocin
An APGAR assessment should be performed by the treating paramedic at:
Select one:
a. 3 and 7 minutes post birth
b. 2 and 6 minutes post birth
c. At least once in the first 10 minutes post birth
d. 1 and 5 minutes post birth
An APGAR assessment should be performed by the treating paramedic at:
d. 1 and 5 minutes post birth
Appropriate positioning of the pregnant women can be of assistance with her underlying perfusion during transport. The recommended position and gestational age where this becomes relevant are:
Select one:
a. Semi-recumbent with legs elevated 15 degress when gestational age >25 weeks
b. Left lateral tilt of 20 degrees when gestational age >16 weeks
c. Left lateral tilt of 15- 30 degrees when gestational age >20 weeks
d. Semi-recumbent with legs elevated 15 degress when gestational age >20 weeks
Appropriate positioning of the pregnant women can be of assistance with her underlying perfusion during transport. The recommended position and gestational age where this becomes relevant are:
c. Left lateral tilt of 15- 30 degrees when gestational age >20 weeks
Care of the vigorous newborn includes:
Select one:
a. Place newborn on a flat surface and commence CPR/ventilation
b. Dry newborn, immediately cut the umbilical cord, wrap newborn in a towel and allow father to have a cuddle
c. Suction newborn’s mouth and nose, administer high flow oxygen and dry head
d. Dry newborn thoroughly, place newborn naked on mother’s chest with skin-to-skin contact, dry newborn’s head, cover newborn and mother with warm blankets/towels
Care of the vigorous newborn includes:
d. Dry newborn thoroughly, place newborn naked on mother’s chest with skin-to-skin contact, dry newborn’s head, cover newborn and mother with warm blankets/towels
The most common type of breech presentation is:
Select one:
a. Complete breech
b. Breech with flexed legs
c. Frank breech
d. Footling breech
The most common type of breech presentation is:
c. Frank breech
Paramedics are attending a female patient who is 30 weeks gestation with her second child. She has had a mechanical fall from standing height and landed on her stomach. There was no head strike or loss of consciousness. She is now complaining of severe abdominal pain. What is the correct management of this patient?
Select one:
a. Transport to the maternity unit where patient is booked in
b. Advise patient to follow up with GP
c. Give patient two paracetamol tablets and leave them at home
d. Administer effective analgesia and transport to highest level trauma centre (preferably with an attached obstetrics facility) within state specific time frame
Paramedics are attending a female patient who is 30 weeks gestation with her second child. She has had a mechanical fall from standing height and landed on her stomach. There was no head strike or loss of consciousness. She is now complaining of severe abdominal pain. What is the correct management of this patient?
d. Administer effective analgesia and transport to highest level trauma centre (preferably with an attached obstetrics facility) within state specific time frame
Signs of placental separation in third stage labour do not include:
Select one:
a. Uterus becoming rounder, firmer, smaller
b. Lengthening of cord
c. Spontaneous rupture of membranes
d. Cramping/contractions return
Signs of placental separation in third stage labour do not include:
c. Spontaneous rupture of membranes
An assessment finding that indicates that an imminent birth may be about to occur include:
Select one:
a. Sharp generalised abdominal pain
b. Passing of mucosal plug
c. Crowning of fetal head
d. Intermittent contractions that are brief in nature
An assessment finding that indicates that an imminent birth may be about to occur include:
c. Crowning of fetal head
