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77 Cards in this Set

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Which of the following is NOT required for a diagnosis of true labor?
blood show

(true labor - rhythmic contractions, cervical dilatation, cervical effacement)
At term, bloody show is associated with
extrusion of endocervical gland mucus
Low back pain is commonly associated with
both active and false labor
Uterine contractions of increasing intensity are commonly associated with
active labor
Spontaneous onset of uterine activity is commonly associated with
both active and false labor
Progressive cervical dilation is commonly associated with
active labor
Lower abdomen and groin pain are commonly associated with
false labor
Waxing and waning intensity of uterine contractions is commonly associated with
false labor
Progressive cervical effacement is commonly associated with
active labor
Which of the following is characteristic of "Braxton Hicks" contractions?
all of the above (rhythmic contractions, no cervical change on serial examinations, lower abdominal discomfort)
The descent of the fetal head into the pelvis and the changing contour of the abdomen late in pregnancy is termed
lightening
Frequent urination found in late pregnency is the result of
pressure on the bladder from the enlarging gravid uterus
With lightening, a patient may notice
all of the above (increased urinary frequency, increased ease of respiratory effort, a flatter upper abdomen)
Which of the following is NOT an indication that a patient in late pregnancy should come to the hospital for evaluation?
Regular contractions 15 to 20 min apart is not an indication to come to the hospital
(go to hospital if: sudden gush of fluid, continuing gradual leakage of fluid, vaginal bleeding, decreased fetal movement)
The term "fetal lie" is defined as the
relationship of the long axis of the fetus with the maternal long axis
Presentation is determined by the
portion of the fetus lowest in the birth canal
Position is defined as
relationship of the fetal presenting part to the right and left side of the maternal pelvis
Leopold maneuvers are used to establish all of the following EXCEPT
fetal gender
(Leopold maneuvers used to establish fetal lie, fetal presentation, and fetal position)
The descent of the presenting part is identified by with Leopold maneuver?
Third maneuver
The location of small parts is determined by which Leopold maneuver?
Second maneuver
Determining what occupies the fundus is accomplished by what Leopold maneuver?
First maneuver
Identifying the cephalic prominence is accomplished by what Leopold maneuver?
Fourth maneuver
The most common fetal lie found during early labor is
longitudinal
The most common fetal presentation found in early labor is
vertex
The effacement of a patient in early labor with the cervix approximately 1 cm in length and 1 cm dilated is
50% effacement
The turning of the fetal head toward the sacrum is termed
anterior asynclitism
The station of a patient in labor with the presenting part (vertex) at the level of the ischial spines is
0
At 0 station, where is the biparietal diameter of the fetal head in relation to the pelvic inlet?
It has passed below the pelvic inlet
The clinical significance of the fetal head presenting at 0 station is that the biparietal diameter of the fetal head has negotiated the
pelvic inlet
Cervical effacement related to
the degree of cervical thinning
The first stage of labor is best described as the
onset of labor to full cervical dilation
The second stage of labor is best described as the
complete dilation of the cervix to delivery of the infant
The third stage of labor is best described as the
delivery of the infant to the delivery of the placenta
The fourth stage of labor is best described as the
period extending up to 2 hours after delivery of the placenta
The active phase of the first stage of labor is generally defined to begin when the cervix is how dilated?
4 cm dilated - active stage of labor begins
The vertex presentation occurs in approximately what percent of term?
95%
Which of the following terms describes the cardinal movement of labor that allows the smaller diameter of the fetal head to present to the maternal pelvis?
Flexion
Which of the following terms describes the movement of the fetal head as it reaches the introitus?
Extension of the fetal head
Which of the following describes the movement of the fetal head to "face forward" relative to the shoulders?
External rotation
Descent is fetal movement in labor defined as
movement of the presenting part through the birth canal
The latent phase of stage one labor in nulliparas has a mean duration of
6.5 hours
The active phase of stage one labor in nulliparas has a mean duration of
4.5 hours
The latent phase of stage one labor in multiparas has a mean duration of
5.0 hours
The active phase of stage one in multiparas has a mean duration of
2.5 hours
The second stage of labor in multiparas has a mean duration of
0.5 hours
All of the following are part of the examination after spontaneous rupture of the membranes EXCEPT
Measurement of the pH of the fluid
(Exam after SPOM - exam of fluid for blood, exam of fluid for meconium, auscultation or measurement of the fetal heart rate)
During the active phase of labor, if electronic fetal monitoring is not used, the fetal heart rate should be auscultated every
15 minutes
During the second stage of labor in the absence of electronic fetal monitoring, fetal heart rate auscultation should be performed after
each uterine contraction
An external tocodynamometer provides information about
contraction frequency
The sensory nerves from the lower birth canal and perineum enter the spinal cord at
S2 through S4
Epidural anesthesia is best used to provide
anesthesia for the active phase of labor and delivery
Spinal anesthesia is best used to provide
short-term anesthesia for vaginal or abdominal delivery
Pudendal anesthesia or block is best used to provide
perineal anethesia for vaginal delivery
Which of the following anesthetic techniques is associated with maternal aspiration?
General anesthesia
Which of the following is an associated maternal risk when spinal anesthesia is used?
all of the above (hypotension, loss of desire to push, headache)
Maternal aspiration syndrome is a particularly significant risk of general anesthesia in obstetric cases because
of decreased gastrointestinal function during labor
The major cause of maternal mortality from obstetrical anesthesia is
aspiration of vomitus
The most common result of compression of the fetal head during labor is
molding
Outlet forceps during delivery should best be used when
the fetal skull at perineal floor, scalp visible, anteroposterior, righ occiput anterior to left occiput anterior (45 degrees)
A low forceps delivery should best be used when
the leading edge of the skull is beyond +2 station
The second stage of labor in nulliparas has a mean duration of
1.0 hours
A midforceps delivery should best be used when
the fetal head is engaged and the leading edge of the skull is above +2 station
Forceps may be used to
all of the above (rotate the fetal head, augment maternal voluntary pushing efforts, and control delivery of fetal head)
The usual postpartum blood loss in a vaginal delivery is
500 mL
What percent of patients will undergo spontaneous labor and delivery between 37 and 42 weeks?
85%
First-degree vaginal laceration at birth
involves the vaginal mucosa and perineal skin
Second-degree vaginal laceration at birth
involves underlying fascia or muscle but not rectal sphincter or rectal mucosa
Third-degree vaginal laceration at birth
extends through the rectal sphincter but not into the rectum
Fourth-degree vaginal laceration at birth
extends into the rectal mucosa
Compared with extension of a mediolateral episiotomy, what is the risk of extension of a midline episiotomy?
midline episiotomy GREATER RISK extension
During delivery of the fetal head, the likelihood of laceration or extension of episiotomy is decreased by performance of
Ritgen maneuver
Which of the following is NOT a sign of placental separation?
There is decreased sensation of pressure is NOT a sign
(signs of placental separation - the uterus rises in abdomen to become globular in shape, there is a gush of blood, there is an apparent "lengthening" of the umbilical cord
It is customary to wait approximately how many minutes for spontaneous extrusion of the placenta?
30 minutes
Obstetric cervical lacerations are most commonly discovered at what "o-clock" during potpartum cervical inspection?
3 and 9 o-clock
The maternal mortality rate associated with cesarean delivery is how many times that of a vaginal birth?
Two to four
Postpartum uterine hemorrhage occurs in approximately what percent of patients?
1%
Vaginal examination of a patient in early labor finds the presenting part (vertex) to be at the level of the ischial spines. The station is reported as
0