Quiz 6: Monitoring the condition of the mother during the first stage of labour

Question 1

What is a partogram?

A chart for recording cervical dilatation only

An observation chart to record the clinical findings during the antenatal period

A machine to record the fetal heart rate

A chart to record the progress of labour together with the maternal and fetal condition

Answer 1

A chart to record the progress of labour together with the maternal and fetal condition

Question 2

During the first stage of labour a partogram must be used:

On all patients

Only on high-risk patients

Only in level 1 clinics

Only in level 2 and 3 hospitals

Answer 2

On all patients

Question 3

Which of the following indicates that the general condition of a patient in the first stage of labour is normal?

The patient’s temperature, pulse rate, and blood pressure are normal

The patient is at ease and relaxed between contractions and does not appear pale

The urine output is normal and ketonuria is not present

The patient’s blood pressure is normal and proteinuria is not present

Answer 3

The patient is at ease and relaxed between contractions and does not appear pale

Question 4

The correct management of a 17-year-old primigravida patient who appears very anxious and complains of painful contractions in early labour is:

The patient must immediately receive analgesics.

A Caesarean section must be done.

The patient must be comforted and reassured and receive appropriate analgesia. If possible, someone she knows should stay with her.

The membranes must be ruptured to ensure a rapid progress of labour.

Answer 4

The patient must be comforted and reassured and receive appropriate analgesia. If possible, someone she knows should stay with her.

Question 5

What is the normal maternal temperature during labour?

35. 5–36.0 °C
36. 0–37.0 °C
37. 5–37.5 °C
38. 0–38.0 °C

Answer 5

36.0–37.0 °C

Question 6

Why is maternal pyrexia an important complication during the first stage of labour?

Maternal pyrexia may cause maternal exhaustion and oliguria.

Maternal pyrexia may cause convulsions.

Maternal pyrexia may cause hypertension during labour.

Maternal pyrexia may be caused by an infection which could be dangerous to the patient.

Answer 6

Maternal pyrexia may be caused by an infection which could be dangerous to the patient.

Question 7

What is the normal maternal pulse rate during labour?

60–80
80–100
100–120
120–140

Answer 7

80–100

Question 8

What causes a rapid maternal pulse during labour?

Fetal distress
Hypertension
Pyrexia
Ketonuria

Answer 8

Pyrexia

Question 9

How often should the blood pressure be monitored in a low-risk patient during the latent phase of labour?

Every 15 minutes
Every 30 minutes
Hourly
2-hourly

Answer 9

2-hourly

Question 10

Which of the following may cause hypertension during labour?

Anxiety
Fetal distress
Chorioamnionitis
Anaemia

Answer 10

Anxiety

Question 11

Which of the following would be the best management if a patient’s blood pressure was 90/50 mm Hg while she was lying on her back?

The patient must change into the lateral position and the blood pressure measurement should be repeated after a further 1 to 2 minutes.

As maternal hypotension may cause fetal distress, the fetal heart rate must be checked immediately.

The patient should be reassured that some patients normally have a low blood pressure and, therefore, there is no need for concern.

As blood loss is the most likely cause for hypotension, active resuscitation must be started immediately.

Answer 11

The patient must change into the lateral position and the blood pressure measurement should be repeated after a further 1 to 2 minutes.

Question 12

A common clinical sign of shock is:

Pyrexia
Bradycardia
Hypertension
A cold and sweaty skin

Answer 12

A cold and sweaty skin

Question 13

The definition of oliguria is a urine output of less than:

10 ml per hour
20 ml per hour
50 ml per hour
100 ml per hour

Answer 13

20 ml per hour

Question 14

Oliguria is an important sign of:

Dehydration
Pyelonephritis
Anxiety
Heart failure

Answer 14

Dehydration

Question 15

Which of the following statements is correct?

All patients should receive an intravenous infusion from the time of admission to the labour ward.

Oral fluids must be given to all patients until full cervical dilatation is reached.

All patients to be delivered vaginally must be encouraged to take oral fluids while in the active phase of labour.

A 50 ml ampoule of 50% dextrose should be given intravenously as soon as ketonuria develops during labour.

Answer 15

All patients to be delivered vaginally must be encouraged to take oral fluids while in the active phase of labour.

Question 16

Infection of the urinary tract may cause:

1+ proteinuria
2+ proteinuria
3+ proteinuria
4+ proteinuria

Answer 16

1+ proteinuria

Question 17

Ketonuria during labour:

Is always abnormal and must be treated

Is an important sign of fetal distress

May be seen in normal patients

Is a sign of renal disease

Answer 17

May be seen in normal patients

Question 18

Which of the following is a sign of maternal exhaustion during labour?

Bradycardia
Proteinuria
A dry mouth and oliguria
Pallor and hypotension

Answer 18

A dry mouth and oliguria

Question 19

What may cause maternal exhaustion during labour?

Chorioamnionitis
Preterm labour
Placenta praevia
Prolonged labour

Answer 19

Prolonged labour

Question 20

How should you treat a patient with maternal exhaustion?

Stop the contractions with nifedipine (Adalat).

Give oxygen by face mask.

Give 2 litres of Ringer’s lactate with 5% dextrose by intravenous infusion.

Deliver the infant by Caesarean section.

Answer 20

Give 2 litres of Ringer’s lactate with 5% dextrose by intravenous infusion.