Chapter 33 - Obstetrics and Neonatal Care

Question 1

The female reproductive system includes:

Answer 1

ovaries
fallopian tubes
uterus
cervix
vagina
breasts

Question 2

The ovaries are two ______, one on each side of the uterus, that are similar in function to the male testes.

Answer 2

glands

Question 3

If an egg is fertilized, the egg implants in the ____________ - the lining of the inside of the uterus.

Answer 3

endometrium

Question 4

The _______ is a muscular organ that encloses and protects the developing fetus for approximately 9 months (40 weeks).

Answer 4

uterus

Question 5

During pregnancy, the ________ contains a mucous plug that seals the uterine opening, preventing contamination.

Answer 5

cervix

Question 6

The _______ is a disk-shaped structure attached to the uterine wall that provides nourishment to the fetus.

Answer 6

placenta

Question 7

The placenta is connected to the fetus by the _________ ______.

Answer 7

umbilical cord

Question 8

The _______ ________ consists of two layers of cells, keeping the circulation of the woman and fetus separated but allowing substances to pass between them.

Answer 8

placental barrier

Question 9

The umbilical _______ carries oxygenated blood from the placenta to the heart of the fetus.

Answer 9

vein

Question 10

The umbilical _________ carry deoxygenated blood from the heart of the fetus to the placenta.

Answer 10

arteries

Question 11

The fetus develops inside a fluid-filled, baglike membrane called the ________ ___.

Answer 11

amniotic sac

Question 12

The amniotic sac contains about ______ to _______ mL of amniotic fluid, which helps insulate and protect the floating fetus.

Answer 12

500

1000

Question 13

During pregnancy, many normal changes occur in the body that are not all directly related to the reproductive system. the primary systems involved with these changes are:

Answer 13

respiratory
cardiovascular
musculoskeletal

Question 14

In the reproductive system, ________ levels increase to support fetal development and prepare the body for childbirth.

Answer 14

hormones

Question 15

Rapid uterine growth occurs during the ________ trimester of pregnancy.

Answer 15

second

Question 16

As the uterus grows, it pushes up on the ____________, displacing it from its normal position.

Answer 16

diaphragm

Question 17

With respiratory capacity changes, with increased respiratory rates and _______ minute volumes.

Answer 17

decreased

Question 18

Overall blood volume gradually increases throughout the pregnancy to:

Answer 18

allow for adequate perfusion of the uterus

prepare for the blood loss that will occur during childbirth

Question 19

Blood volume may eventually increase as much as _____% by the end of the pregnancy.

Answer 19

50

Question 20

By the end of pregnancy, the pregnant patient’s heart rate increases up to ______% to accommodate the increase in blood volume.

Answer 20

20

Question 21

In the reproductive system, hormone levels _______ to support fetal development and prepare the body for childbirth; puts pregnant woman at an increased risk for complications from trauma, bleeding, and some medical conditions.

Answer 21

increase

Question 22

Changes in the cardiovascular system and the increased demands of supporting the fetus significantly increase the workload of the ________.

Answer 22

heart

Question 23

Increased hormones affect the musculoskeletal system by making the joints “looser” or _______ stable.

Answer 23

less

Question 24

You may safely use ________ to treat any heart or lung disease in a pregnant patient without harm to the fetus.

Answer 24

oxygen

Question 25

Diabetes in a pregnant woman, called ____________ diabetes, resolves in most women after delivery.

Answer 25

gestational

Question 26

One complication that occasionally occurs, typically in patients who are pregnant for the first time, is ________, or pregnancy-induced hypertension.

Answer 26

preeclampsia

Question 27

Preeclampsia can develop after the _____th week of gestation.

Answer 27

20

Question 28

Signs and symptoms of preeclampsia include:

Answer 28

``` severe hypertension severe or persistent headache visual abnormalities such as seeing spots, blurred vision, or sensitivity to light swelling in the hands and feet (edema) anxiety ```

Question 29

__________, a related condition to preeclampsia, is characterized by seizures that occur as a result of hypertension.

Answer 29

Eclampsia

Question 30

To treat a patient having seizures caused by eclampsia, you should:

Answer 30

``` lay the patient on her left side maintain her airway administer supplemental oxygen if necessary if vomiting occurs, suction the airway provide rapid transport call for an ALS intercept, if available ```

Question 31

Transporting a pregnant patient on the left side can prevent _____ _______ ________ which is caused by compression of the descending aorta and the inferior vena cava by the pregnant uterus when the patient lies supine and may result in hypotension.

Answer 31

supine hypotensive syndrome

Question 32

Internal bleeding may be a sign of an _________ pregnancy, when an embryo develops outside the uterus, most often in a fallopian tube.

Answer 32

ectopic

Question 33

An ectopic pregnancy occurs once in every ______ pregnancies.

Answer 33

300

Question 34

The leading cause of maternal death in the _________trimester is internal hemorrhage into the abdomen following rupture of an ectopic pregnancy.

Answer 34

first

Question 35

Consider the possibility of an ______ pregnancy in a woman who has missed a menstrual cycle and complains of sudden, severe, usually unilateral pain in the lower abdomen.

Answer 35

ectopic

Question 36

____________ in early pregnancy may be a sign of a spontaneous abortion or miscarriage.

Answer 36

Hemorrhage

Question 37

Hemorrhage in the later stages of pregnancy may indicate a serious condition involving the ________.

Answer 37

placenta

Question 38

In _________ ________, the placenta separates prematurely from the wall of the uterus, most commonly caused by hypertension or trauma.

Answer 38

abruptio placenta

Question 39

In ________ ______, the placenta develops over and covers the cervix.

Answer 39

placenta previa

Question 40

Passage of the fetus and placenta before _______ weeks is called abortion.

Answer 40

20

Question 41

Abortions may be _________ (_________) or __________.

Answer 41

spontaneous (miscarriage) or induced

Question 42

The most serious complications of an abortion are _________ and ________.

Answer 42

bleeding | infection

Question 43

Bleeding from an abortion can result from portions of the fetus or placenta being left in the uterus (incomplete abortion) or from injury to the wall of the ________.

Answer 43

uterus

Question 44

Infections from an abortion can result from such _________ and from the use of ___________ __________.

Answer 44

perforation | nonsterile instruments

Question 45

Fetal alcohol syndrome describes the condition of infants born to women who have abused _________.

Answer 45

alcohol

Question 46

If a woman is in the last month or two of pregnancy, compressions may need to be applied a little ______ on the sternum than usual.

Answer 46

higher

Question 47

In trauma incidents, if possible, one provider should be assigned to manually displace the ______ toward the patient's left side to facilitate blood return to the right side of the heart.

Answer 47

uterus

Question 48

If spinal injury of a pregnant woman is suspects, tilt the backboard _____* to the left.

Answer 48

30

Question 49

The three stages of labor are:

Answer 49

dilation of the cervix delivery of the fetus delivery of the placenta

Question 50

The first stage of labor begins with the onset of ___________ and ends when the cervix is fully _________.

Answer 50

contractions | dilated

Question 51

The first stage of labor is usually the longest, lasting an average of ______ hours for a first delivery.

Answer 51

16

Question 52

Labor is generally longer in a __________(a woman experiencing her first pregnancy) than in a __________(a woman who has experienced previous pregnancies).

Answer 52

primigravida | multigravida

Question 53

Preterm or false labor is called ______-__________ contractions.

Answer 53

Braxton-Hicks

Question 54

Toward the third trimester, the head of the fetus normally descends into the woman's pelvis as the fetus position for delivers and is called ___________.

Answer 54

lightening

Question 55

The second stage of labor begins when the fetus begins to encounter the ______ ______ and ends with _________ of the newborn (spontaneous birth).

Answer 55

birth canal | delivery

Question 56

During the second stage of labor, under no circumstances should you let the woman sit on the ______.

Answer 56

toilet

Question 57

During the second stage of labor, the perineum will begin to bulge significantly, and the top of the fetus's head should begin to appear at the vaginal opening which is called _________.

Answer 57

crowning

Question 58

the third stage of labor begins with the ______ of the newborn and ends with the delivery of the ________.

Answer 58

birth | placenta

Question 59

During the third stage of labor, the placenta must completely separate from the ________ _______.

Answer 59

uterine wall

Question 60

The third stage of labor may take up to ______ minutes.

Answer 60

30

Question 61

During delivery, place the patient on a firm surface padded with blankets, folded sheets, or towels and elevate the hips about ____" to _____" with a pillow or blankets.

Answer 61

2 | 4

Question 62

If the woman's water was broken, ask whether the fluid was ________ (________) - fetal stool.

Answer 62

green (meconium)

Question 63

After delivery of the placenta, gently massage the woman's ______ with a firm, circular, "kneading" motion.

Answer 63

abdomen

Question 64

When massaging a woman's abdomen after delivery of the placenta, you should be able to feel a firm, grape-fruit sized mass in the lower abdomen called the ______.

Answer 64

fundus

Question 65

A newborn will usually beginning breathing spontaneously within ____ to ____ seconds after birth and the heart rate will be ______ beats/min or higher.

Answer 65

15 30 120

Question 66

If the newborn does not spontaneously begin breathing, gently tap or flick the soles of the ______ or rub the ______.

Answer 66

feet | back

Question 67

If necessary, suction the mouth and then the nose using a bulb syringe or suction device with an __ or __ French catheter.

Answer 67

8 | 10

Question 68

If chest compressions for a newborn are required, use the ______-______ technique for two-person resuscitation.

Answer 68

hand-encircling

Question 69

For chest compression in a newborn, perform BVM ventilation during a pause after every _____ compression, using a compression-to-ventilation ration of _:_.

Answer 69

third | 3:1

Question 70

Chest compressions on a newborn will yield a total of ____ "actions" per minute (__ compressions and __ ventilations).

Answer 70

120 90 30

Question 71

Any newborn who requires more than routine resuscitation requires transport to a hospital with a Level ___ neonatal intensive care unit.

Answer 71

3

Question 72

About ___% to ___% of delivers are complicated by the presence of meconium.

Answer 72

12-16

Question 73

The Apgar score is sued to access the status of a newborn and assigns a number value (0,1 or 2) to these five areas of activity.

Answer 73

``` appearance pulse grimace or irritability Activity or muscle tone respirations ```

Question 74

A perfect Apgar score is ____.

Answer 74

10

Question 75

The Apgar score should be calculated at __ minute and ___ minutes after birth.

Answer 75

1 | 5

Question 76

The newborn's pulse rate should be at least _____ beats/min and you should reassess respirations and heart rate at least every ____ seconds.

Answer 76

100 | 30

Question 77

Assess the newborn's oxygenation via ______ _______ and observe for central cyanosis.

Answer 77

pulse oximetry

Question 78

Most infants are born head first, called a _____ presentations.

Answer 78

vertex

Question 79

Occasionally, the buttocks are delivered first, called a ______ presentation.

Answer 79

breech

Question 80

The fetus is at great risk for _____ from delivery in a breech delivery and _________ cords are more common.

Answer 80

trauma | prolapsed

Question 81

On rare occasions, the presenting part of the fetus is neither the head nor the buttock, but a single arm, leg, foot. This is called _____ presentation.

Answer 81

limb

Question 82

_______ of the umbilical cord is where the umbilical cord comes out of the vagina before the fetus.

Answer 82

Prolapse

Question 83

If prolapse of the cord occurs, keep the fetus's head from compressing the cord by:

Answer 83

place woman in knee-chest position; kneeling and bent forward, facedown

Question 84

_______ ______ is a developmental defect in which a portion of the spinal cord or meninges may protrude outside of the vertebrae and possibly outside of the body.

Answer 84

Spina bifida

Question 85

If a newborn is barns with spina bifida,

Answer 85

cover the open area with a sterile, most dressing have someone hold the newborn against his or her body

Question 86

Twins occur about once in every __ births.

Answer 86

30

Question 87

If twins are present, the second one will usually be born within ___ minutes of the first.

Answer 87

45

Question 88

A normal, full term single newborn will weigh approximately __ lb. at birth.

Answer 88

7

Question 89

Any newborn who delivers before ___ months (__ weeks) or weighs less than __lbs. at birth is considered premature.

Answer 89

8 36 5

Question 90

The ______ _______ will be absent or minimal on the premature newborn.

Answer 90

vernix caseosa

Question 91

Premature newborns as small as ____ lb. have survived and developed normally.

Answer 91

1

Question 92

Postterm pregnancy refers to pregnancies lasting longer the ____ weeks.

Answer 92

42

Question 93

Postpartum patients are at an increased risk of an _______ - most commonly called a ________ ______.

Answer 93

embolism | pulmonary embolism