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EMR - First on Scene - 9th Edition La Baudour - Bergeron > Care During Pregnancy and Childbirth Chapter 22 > Flashcards

Care During Pregnancy and Childbirth Chapter 22 Flashcards

0
Q

The rupturing of membranes is an important milestone in the birthing process. It is the:
A. First contraction of which the mother is aware.
B. Widening of the cervical opening.
C. Rupturing of the amniotic sac.
D. Detachment of the placenta.

A

C. Rupturing of the amniotic sac.

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1
Q

The structure that is only present during the development of a fetus is the:

A. Placenta
B. Uterus
C. Vagina
D. Cervix

A

A. Placenta

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2
Q 
The organ that delivers oxygenated blood and nourishment to the fetus and removes fetal waste is the:
A. Pubis
B. Placenta
C. Vagina
D. Cervix
A

B. Placenta

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3
Q

A vaginal discharge occurs:

A. Only during the first stage of childbirth.
B. During the first and second stages of childbirth.
C. Throughout the different stages of childbirth.
D. Only during abnormal childbirth.

A

C. Throughout the different stages of childbirth.

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4
Q

Which of the following statements about labor pains is most accurate?
A. They come at the same time intervals during all stages of labor.
B. They come at longer time intervals as the birth of the child nears.
C. They come at shorter time intervals as the birth of the child nears.
D. They come at regular time intervals during all stages of labor.

A

C. They come at shorter time intervals as the birth of the child nears.

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5
Q

For your personal safety during a field birth, it is best to have gloves and:
A. Face mask, eye shield, and gown.
B. Face mask, gown, and red biohazard bags.
C. Gown, red biohazard bags, and basin.
D. Face mask, red biohazard bags, and basin.

A

A. Face mask, eye shield, and gown.

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6
Q

When evaluating the mother before delivery, all the following information is important to have, EXCEPT:

A. Her name, age, and expected due date.
B. If she has been under a physician’s care during pregnancy.
C. If her water has broken and, if so, when and what color.
D. When she expected to begin labor contractions.

A

D. When she expected to begin labor contractions.

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7
Q

All of the following are signs that the birth of the baby is imminent EXCEPT when the mother:

A. Has the feeling that the baby is trying to be born.
B. Is experiencing labor contractions that are two minutes apart.
C. Is experiencing labor contractions at 10-minute intervals.
D. Is straining, crying out, and complaining of the urge to go to the bathroom.

A

C. Is experiencing labor contractions at 10-minute intervals.

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8
Q

It is essential that you take BSI precautions for your safety as well as the mother’s:

A. During both assessment and delivery.
B. While you are assessing the patient.
C. Only if you determine as necessary.
D. As the baby delivers only.

A

A. During both assessment and delivery.

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9
Q

You should consider the delivery normal if the:

A. Baby’s feet appear first.
B. Baby’s head appears first.
C. Mother is experiencing irregular contractions.
D. Mother tells you the baby is about to be born.

A

B. baby’s head appears first.

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10
Q

During a normal delivery you should do all do the following, EXCEPT:

A. Support the head, trunk, and legs.
B. Suction the baby’s mouth, nose, and the cord.
C. Support the head and assist in the birth of the shoulders.
D. Keep the baby level with the vagina until the cord stops pulsating.

A

B. Suction the baby’s mouth, nose, and the cord.

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11
Q

When preparing to cut the umbilical cord, place the first clamp:

A. 6 inches from the baby’s belly.
B. 4 inches from the baby’s belly.
C. Only if your jurisdiction allows you to do so.
D. 10 inches from the belly.

A

A. 6 inches from the baby’s belly.

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12
Q

The placenta, or afterbirth:

A. Does not concern you because it will deliver at the hospital.
B. Needs to be delivered by you and saved for further examination at the hospital.
C. Needs to be delivered by you and discarded into a red biohazard bag.
D. Needs to be delivered and examined by you before being discarded.

A

B. Needs to be delivered by you and saved for further examination at the hospital.

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13
Q

When caring for the baby, you must do all of the following immediately after birth, EXCEPT:

A. Clear the baby’s airway.
B. Make sure the baby is breathing.
C. Perform a quick assessment of the baby.
D. Clamp off the cord and cut it.

A

D. Clamp off the cord and cut it.

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14
Q

During the assessment of the infant, remember that the heart rate is:

A. Slower than that of a child or adult.
B. The same as that of a child or an adult.
C. Faster than that of a child or an adult.
D. Dependent on the weight of the newborn.

A

C. Faster than that of a child or an adult.

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15
Q

You are caring for a pregnant woman who is 24 weeks along and is complaining of a headache and nausea. Her pulse is 140 strong and regular, and her blood pressure is 174/96. Her condition is most likely caused by:

A. Supine hypotensive syndrome.
B. Ectopic pregnancy.
C. Preeclampsia
D. Placenta previa.

A

C. Preeclampsia

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16
Q

You are caring for an 18 year old female with a complaint od severe abdominal pain and vaginal bleeding. You should:

A. Apply low-flow oxygen.
B. Inspect the vagina.
C. Ask her when her last menstrual cycle was.
D. Find out what she had to eat.

A

C. Ask her when her last menstrual cycle was.

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17
Q

The first hour of life after birth can be a difficult time for some babies and mothers. True or false?

A

True

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18
Q

An unborn baby is called a:

A

Fetus

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19
Q

Define ovum.

A

An unfertilized egg produced by the mother.

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20
Q

Define uterus.

A

The muscular structure that holds the baby during pregnancy.

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21
Q

What is a full term pregnancy?

A

A pregnancy that has achieved a complete gestation of between 38 and 40 weeks.

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22
Q

Define trimester.

A

3 months of pregnancy usually broken into:
1st trimester: months 1-3
2nd trimester: months 4-6
3rd trimester: months 7-9

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23
Q

Define labor.

A

The process the body goes through to deliver a baby.

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24
Q

What is the cervix?

A

The opening of the uterus.

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25
Q

What is a bloody show?

A

The normal discharge of blood prior to delivery of the baby.

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26
Q

Define vagina.

A

The birth canal.

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27
Q

What is crowning?

A

The bulging out of the vagina caused by the baby’s head during delivery.

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28
Q

What does imminent delivery mean?

A

That the baby will likely deliver in the next few minutes.

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29
Q

Define amniotic fluid.

A

The fluid surrounding the baby contained within the amniotic sac.

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30
Q

Define amniotic sac.

A

The fluid filled sac that surrounds the developing fetus.

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31
Q

Define the birth canal.

A

The interior aspect of the vagina.

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32
Q

What is the placenta?

A

The organ of pregnancy that serves as the filter between the mother and developing fetus.

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33
Q

What is the umbilical cord?

A

The structure that connects the baby to the placenta.

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34
Q

What is the rupture of membranes?

A

The release of amniotic fluid prior to delivery caused by a rupture of the amniotic sac. When assessing the mother, the question, “has your water broken?” is commonly asked.

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35
Q

Amniotic fluid acts as a lubricant for the birth canal. True or false?

A

True

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36
Q

What is prenatal care?

A

The routine medical care provided to a mother during her pregnancy.

37
Q

What is a fontanel?

A

An area on the infant’s skull where the bones have not yet fused together, leaving a soft spot.

38
Q

Define newborn.

A

A baby that is less than 28 days old (also called neonate).

39
Q

Define unchallenged cord.

A

A condition where the umbilical cord is around the baby’s neck during delivery.

40
Q

What is a miscarriage?

A

The spontaneous natural loss of the embryo or fetus before the 28th week of pregnancy.

41
Q

What is spotting?

A

The normal discharge of blood during pregnancy.

42
Q

What is an ectopic pregnancy?

A

A condition that occurs when the fertilized egg implants somewhere other than the uterus.

43
Q

Define Fallopian tube.

A

The tube-like structure that connects the ovary to the uterus.

44
Q

Define ovary.

A

The structure that produces the ovum.

45
Q

What is meconium?

A

The product of the baby’s first bowel movement.

46
Q

A breech birth is:

A

A birth where the buttocks or feet deliver first.

47
Q

A prolapsed cord is:

A

A condition resulting in the delivery of the umbilical cord prior to the delivery of the baby.

48
Q

A stillborn is:

A

A fetus that is delivered dead.

49
Q

What is supine hypotensive syndrome?

A

An abnormally blood pressure that results when the mother is supine and the fetus puts pressure on the vena cava.

50
Q

What is preeclampsia?

A

A potentially life-threatening condition that affects the mother during the 3rd trimester and is characterized by high blood pressure and fluid retention.

51
Q

What is eclampsia?

A

A life-threatening condition characterized by seizures, coma, and eventually death of both the mother and baby.

52
Q

What is placenta previa?

A

A condition that results when the placenta grows and develops over the cervix.

53
Q

What is placenta abruptio?

A

A situation, often in trauma, where the force of the trauma abruptly tears the placenta partially or completely away from the wall of the uterus.

54
Q

What is the normal gestation period fo a human fetus?

A

40 weeks or approximately 9 months.

55
Q

How long is the average labor for first time mother?

A

16 hours, but can be shorter or longer.

56
Q

What are the 3 stages of labor?

A
  1. Onset of labor (regular contractions) to full dilation of the cervix (approx 10 centimeters).
  2. Baby’s entry into birth canal through birth (delivery of baby).
  3. Delivery of baby through delivery of placenta.
57
Q

What are the signs of imminent delivery?

A
  1. Contractions that are less than 3 minutes apart.
  2. The mother’s feeling of needing to bear down.
  3. The crowning at the vaginal opening.
58
Q

Upon delivery of the head, what should you do?

A
  1. Check for the presence of the umbilical cord around the neck.
  2. If present, gently slip it over the baby’s head.
  3. Suction the nose and mouth prior to the full delivery of the baby.
59
Q

Once the baby is delivered, how do you provide care?

A
  1. Stimulate the baby by drying him with a clean dry cloth. The baby should begin to breath on his own.
  2. If breathing is inadequate, provide appropriate care immediately.
  3. Wrap baby in a clean dry blanket/towel to retain body head.
  4. Cover head, but not face.
60
Q

What is the purpose of the placenta?

A

To provide oxygen and nourishment from the mother to the baby.

61
Q

Does the labor process shorten or lengthen with each successive birth?

A

Usually shorten.

62
Q

Another name for the placenta after the birth of the baby is:

A

Afterbirth

63
Q

What is contraction time?

A

The span of time from the beginning of a contraction until it relaxes.

64
Q

What is interval time?

A

The span of time from the start of 1 contraction to the beginning of the next contraction.

65
Q

What are the characteristics of labor pains?

A

Onset of contractions start about 30 minutes apart and become closer and closer until they are 2-3 minutes or less apart. The labor pains normally come at regular intervals and last for about 30 seconds to one minute. They may start, stop for a period of time, then start again.

66
Q

Light, painless, irregular contractions, which may increase gradually in intensity and frequency in the 3rd trimester are known as:

A

False labor or Braxton Hicks contractions. They are not as regular or rhythmic as true labor contractions.

67
Q

The skin between the vaginal and rectal openings is called:

A

The perineum. This skin may tear during the delivery of the baby head. This is normal and will be treated at the hospital.

68
Q

Most babies are born face down. True or false?

A

True

69
Q

Wait at least 3 minutes following delivery to clamp or tie th umbilical cord. True or false?

A

False. Wait at least 1 minute.

70
Q

When clamping the umbilical cord, the 1st clamp should be at least 6 inches from the baby belly and the 2nd clamp 2-3 inches further away from the 1st clamp and further away from the baby belly. True or false?

A

True

71
Q

You can cut the cord between the clamps with any sharp knife or scissors. True or false?

A

False. If you do not have sterile equipment Do NOT cut the cord.

72
Q

What are the steps for caring for a newborn?

A
  1. Clear the airway. Position baby on side with head slightly lower than body for drainage. Keep body at vagina level until cord is clamped. Clean mucous and blood from around mouth and nose with clean gauze or cloth. Use bulb syringe if needed.
  2. Make certain baby is breathing. Vigorously but gently rub back. Drying and cleaning with towel good for this. Also can snap fingers on bottom of feet.
  3. Assess: skin(blue, normal, pale); deformities; strength of cry(strong, weak); moves on own or lies still. Reassess for changes in few minutes. Inform transport personnel for Dr.
  4. Clamp or tie off cord if protocol allows.
  5. Keep baby warm in clean dry towel or blanket. Keep head covered, but not face. Encourage mom to nurse if she wants to.
  6. Tag baby with mom’s last name & delivery time. Don’t let adhesive touch baby skin; keep loose around baby wrist.
73
Q

How do you care for nonbreathing newborn?

A

Provide rescue breaths. Start with 2 gentle but adequate breaths using mouth to barrier or bag mask.

  1. If have pulse but breathing inadequate: Assess breathing & heartbeat (with stethoscope or grasp base of cord). Only use mask for infants. 40-60 breaths per minute. Reassess every 30 seconds.
  2. Heart rate is at least 100 bpm & spontaneous breathing present: stop ventilations but continue stimulation by rubbing skin.
  3. Heart rate less than 60 bpm: continue ventilation & start chest compressions.
74
Q

What is the compression/ventilation ratio for newborns?

A

3 to 1

75
Q

If allowed to administer oxygen to a newborn what method is used?

A

Blow by method

76
Q

Withholding oxygen to a newborn may cause more damage than delivering too much. True or false?

A

True

77
Q

Cutting the umbilical cord is a high priority. True or false?

A

False-it is low.

78
Q

Never untie or unclamp the cord once it has been cut. True or false?

A

True

79
Q

The risk of complications before, during, & after delivery increases if the mother has 1 or more certain factors. What are they?

A 
Younger than 18; older than 35.
1st pregnancy or more than 5 pregnancies.
Swollen feet, face, or abdomen from water retention.
High or low blood pressure.
Diabetes.
Illicit drug use during pregnancy.
Infections.
Alcohol dependency.
Injuries from trauma.
Premature rupture of membranes more than a couple hours before delivery.
History of seizures.
Pre-delivery bleeding.
80
Q

What are the signs & symptoms of an ectopic pregnancy?

A

Abdominal pain
Absence of normal menstrual cycle
Vaginal bleeding

81
Q

Always save pads & dressings, blood or liquid soaked materials from the mother and/or infant to transport to the hospital. Place them in biohazard bags or the correct container for transport and examination by the medical personnel. True or false?

A

True

82
Q

What is meconium staining?

A

When the baby’s first bowel movement mixes with amniotic fluid.

83
Q

What is aspiration pneumonia?

A

A lung infection resulting from the baby breathing in meconium staining for his first breath.

84
Q

What is limb presentation?

A

When a single arm or leg presents first at a birth.

Put the mom in a knee chest position to reduce pressure on the fetus & the umbilical cord.

85
Q

When is it necessary to place fingers into the vagina in a V to help provide oxygen to the baby?

A
  1. Breech birth

2. Prolapsed cord

86
Q

What determines a premature birth?

A
  1. A baby weighing less than 5.5 lbs.

2. Any baby born before the 37th week (prior to 9 months) of pregnancy.

87
Q

A pregnant woman’s blood volume increases about 45% as a natural protection and preparation for the mother who will lose blood during delivery. True or false?

A

True

88
Q

How much blood does a pregnant woman lose before she exhibits signs of shock?

A

40%

89
Q

How do vital signs change 4 pregnant women?

A
  1. Blood volume increases about 45%.
  2. Heart rate increases about 15 bpm.
  3. BP falls 10-15 mmHg.
    Don’t mistake the high pulse & low BP for shock symptoms.
90
Q

What is a nuchal cord?

A

A condition where the umbilical cord is around the baby’s neck during delivery.

EMR - First on Scene - 9th Edition La Baudour - Bergeron (26 decks)

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