Quiz 12: The Puerperium Flashcards
The puerperium starts:
When the infant is delivered
When the placenta is delivered
One hour after delivery of the infant
24 hours after delivery of the placenta
When the placenta is delivered
Soon after a normal delivery a healthy patient’s pulse rate should be:
Below 80 beats per minute
Below 100 beats per minute
Below 120 beats per minute
Above 100 beats per minute
Below 100 beats per minute
In the puerperium stress incontinence:
Is common
Is uncommon
Requires referral to the doctor
Is a sign of a urinary tract infection
Is common
In the puerperium the haemoglobin concentration becomes stable by:
6 weeks
Day 7
Day 4
Day 1
Day 4
In a normal puerperium the cervical os should be closed by:
Day 3
Day 7
Day 14
6 weeks
Day 7
Normal lochia:
Is colourless
Has no smell
Has an offensive smell
Has a non-offensive smell
Has a non-offensive smell
On day seven postpartum the size of a normally involuting uterus should correspond to a gestational age of approximately:
8 weeks
12 weeks
16 weeks
20 weeks
12 weeks
A normally involuting uterus will be:
Soft and tender
Soft and not tender
Firm and tender
Firm and not tender
Firm and not tender
Which of the following statements is the most important one when considering the first hour following delivery of the placenta?
The blood pressure and pulse rate must be determined every 15 minutes.
The haemoglobin concentration must be estimated.
The patient must pass urine during this period.
Ensure continuously that the uterus is well contracted.
Ensure continuously that the uterus is well contracted.
To prevent a postpartum haemorrhage after delivery of the placenta:
The patient must be shown how to rub up the uterus.
An intravenous infusion should be started before every delivery.
An intravenous infusion with 20 units of oxytocin should be put up after delivery of the placenta.
The haemoglobin concentration must be estimated every 2 hours for the first 12 hours after delivery.
The patient must be shown how to rub up the uterus.
How frequently should a primipara visit the clinic for postpartum care in the puerperium?
At least daily for seven days
At least daily for 5 days and again on day seven
At least once between days 3 and 6
The patient must be kept in hospital for at least 5 days
At least once between days 3 and 6
A patient has puerperal pyrexia if her temperature:
Rises to 37.3 °C and is maintained for 24 hours during the first 10 days postpartum
Rises to 38 °C or higher and is maintained for 24 hours during the first 10 days postpartum
Rises to 37.5 °C on two occasions during the first 10 days postpartum
Rises to 38 °C or higher during the puerperium
Rises to 38 °C or higher during the puerperium
Which of the following indicate that puerperal pyrexia is caused by a genital tract infection?
General malaise
Rigors
Offensive lochia
A marked tachycardia
Offensive lochia
How must a patient with a urinary tract infection causing puerperal pyrexia be treated?
Admission to hospital for intravenous broad-spectrum antibiotics
Admission to hospital, tepid sponging and paracetamol to bring down the temperature
Oral broad-spectrum antibiotics given to the patient at home
Oral broad-spectrum antibiotics and paracetamol given to the patient at home
Admission to hospital for intravenous broad-spectrum antibiotics
If a patient presents with puerperal pyrexia, it would be most important to:
Hospitalise the patient and start her on ampicillin and metronidazole (Flagyl).
Treat the patient with ampicillin and metronidazole (Flagyl) at home.
Hospitalise the patient and immediately start with tepid sponging and paracetamol to bring down the temperature.
Find the cause of the pyrexia and start the appropriate treatment.
Find the cause of the pyrexia and start the appropriate treatment.
A patient who develops the ‘puerperal blues’ needs to be:
Referred to a psychiatrist
Isolated together with her infant
Comforted and given an explanation of her feelings
Treated with a benzodiazepine (e.g. Ativan)
Comforted and given an explanation of her feelings
What is a secondary postpartum haemorrhage?
Any vaginal bleeding that appears excessive, after the first hour following delivery of the placenta
Any vaginal bleeding that appears excessive, after the first 24 hours following delivery of the placenta
Any vaginal bleeding that appears excessive, between the fifth and 15th day of the puerperium
Any vaginal bleeding in the puerperium which is severe enough to cause the patient to become shocked
Any vaginal bleeding that appears excessive, after the first 24 hours following delivery of the placenta
What is the most common cause of a secondary postpartum haemorrhage?
Intra-uterine infection with or without a retained piece of placenta
An infected slough of the cervix or vagina
Breakdown of a Caesarean section scar
Gestational trophoblastic disease
Intra-uterine infection with or without a retained piece of placenta
The treatment of a patient with a secondary postpartum haemorrhage will include:
Ampicillin and metronidazole (Flagyl)
Syntometrine and/or oxytocin
Removal of retained products of conception under spinal or general anaesthesia
All of the above
All of the above
Observations of the presence or absence of offensive lochia in the patient or jaundice in her infant in the puerperium:
Can be made by the patient as well as the midwife
Should not be expected from patients as they are too unreliable
Should only be made by a midwife or doctor
Should only be made by a doctor
Can be made by the patient as well as the midwife
