Narm: Varney's Midwifery

Front 1

If the ovum is fertilized, the corpus luteum is maintained by the production of ___ by the syncytiotrophoblast.

Back 1

chorionic gonadotropin 544

Front 2

What causes the mother's basal body temperature to continue at its elevated level following ovulation?

Back 2

progesterone from the corpus luteum 544

Front 3

Which hormones does the placenta produce?

Back 3

estrogens, progesterone, chorionic gonadotropin, chorionic somatomammotropin (aka human placental lactogen) 544

Front 4

What is pseudocyesis?

Back 4

imaginary pregnancy 544

Front 5

Which two hormones are responsible for the presumptive signs of breast enlargement?

Back 5

estrogen and chorionic somatomammotropin (HPL) 544

Front 6

Which two hormones are thought to cause pigment changes in the skin during pregnancy?

Back 6

estrogen and progesterone 544

Front 7

When do skin pigmentation changes such as chloasma, linea nigra, stretch marks and secondary areolae usually occur?

Back 7

around the 5th or 6th lunar month of pregnancy 544

Front 8

Most of the pigmentation changes of pregnancy (including chloasma) _____ and ___ after pregnancy has ended, with the exception of striae.

Back 8

regress and disappear 545

Front 9

Fine silvery white striae are ___.

Back 9

old 545

Front 10

New striae are which color?

Back 10

reddish brown 545

Front 11

What are vascular spiders?

Back 11

minute reddened elevations of the skin, each with a central body from which radicles branch out 545

Front 12

Where do vascular spiders generally occur?

Back 12

on the face, neck, upper chest and arms 545

Front 13

To what are vascular spider and palmar erythema during pregnancy generally attributed?

Back 13

a hyperestrogenemic state 545

Front 14

When do vascular spider and palmar erythema generally occur?

Back 14

around the 5th to 6th lunar month of pregnancy 545

Front 15

Palmar erythema in the first trimester indicates the possibility of ...

Back 15

hepatitis 545

Front 16

Nausea is considered a ___ sign of pregnancy.

Back 16

presumptive 545

Front 17

____ signs of pregnancy are maternal physiological changes that the woman experiences and that in most cases indicate to her that she is pregnant.

Back 17

Presumptive 544

Front 18

____ signs of pregnancy are maternal physiological and anatomical changes that are detected upon examination and documented by the examiner.

Back 18

Probable 544

Front 19

____ signs of pregnancy are those directly attributable to the fetus, as detected and documented by the examiner.

Back 19

Positive 544

Front 20

The ___ undergoes a number of changes to become the corpus luteum of menstruation.

Back 20

ruptured graafian follicle 544

Front 21

What becomes the corpus luteum of pregnancy?

Back 21

the syncytiotrophoblast surrounding the blastocyst 544

Front 22

What produces the progesterone needed to maintain the uterine lining for implantation and the earliest stages of pregnancy?

Back 22

the corpus luteum 544

Front 23

Which hormone produced by the corpus luteum maintains the uterine lining for implantation and the earliest stages of pregnancy?

Back 23

progesterone 544

Front 24

Shortly after implantation, the placenta begins producing enough ____ to maintain the uterine lining for pregnancy.

Back 24

progesterone 544

Front 25

Which hormone is the basis for immunologic pregnancy test?

Back 25

chorionic gonadotropin 544

Front 26

What is another name for human placental lactogen?

Back 26

chorionic somatomammotropin 544

Front 27

What is another name for chorionic somatomammotropin?

Back 27

human placental lactogen 544

Front 28

"Normal" nausea and vomiting in pregnancy rarely extend past the ____

Back 28

first trimester 545

Front 29

_____ (the basis for the take-home pregnancy test), is produced by the syncytiotrophoblast.

Back 29

Human chorionic gonadotropin 545

Front 30

Human chorionic gonadotropin is produced by ...

Back 30

the syncytiotrophoblast 545

Front 31

Implantation time varies from __ to __ days after ovulation.

Back 31

6 to 12 days 545

Front 32

Is it possible to detect hCG in maternal plasma or urine before implantation takes place?

Back 32

no 545

Front 33

Is it always possible to detect hCG and therefore pregnancy when a woman misses the first days of her menstrual period?

Back 33

No, if implantation has not yet occurred, hCG cannot be detected 545

Front 34

Once implantation occurs, hCG levels ___ every 2 days.

Back 34

double 545

Front 35

When do hCG levels peak?

Back 35

at about 8.5 to 10 weeks gestation 545

Front 36

A positive pregnancy test is considered a ___ sign of pregnancy.

Back 36

probable 546

Front 37

How is uterine growth during the early months of pregnancy accomplished?

Back 37

hyperplasia (an increased number of cells) 547

Front 38

Which two hormones are responsible for uterine enlargement?

Back 38

estrogen and progesterone 547

Front 39

What is hypertrophy?

Back 39

an increase in the size of the cells 547

Front 40

What is hyperplasia?

Back 40

an increase in number of cells 547

Front 41

What is Chadwick's sign?

Back 41

the bluish or purplish discoloration of the vulva and vaginal mucosa and vaginal portion of cervix 547

Front 42

What is Goodell's sign?

Back 42

softening of the cervix 547

Front 43

What is Hegar's sign?

Back 43

softening and compressibility of the uterine isthmus 547

Front 44

When are Chadwick's, Goodell's and Hegar's signs evident?

Back 44

by about 6 weeks gestation 547

Front 45

Which way does the uterus dextrorotate as it rises up to become an abdominal organ?

Back 45

to the right 547

Front 46

Whan does Piscacek's sign become evident?

Back 46

around the 8th to 10th week of pregnancy 547

Front 47

What is Piscacek's sign?

Back 47

a rough irregular contour in one of the cornual areas of the uterus 547

Front 48

___ are nonrhythmic, sporadic, painless uterine contractions that start about the 6th week of pregnancy.

Back 48

Braxton Hicks contractions 547

Front 49

____ contractions increase in frequency, duration and intensity as well as attain some degree of rhythm and regularity close to term, at which time they are frequently misinterpreted as labor contractions.

Back 49

Braxton Hicks contractions 547

Front 50

The ____ uterus has one horn with its associated fallopian tube and uterus and one cervix. The opposite side of the uterus may be absent or underdevelped

Back 50

unicornuate 407

Front 51

The ___ uterus has two separate cavities, each with its own cervix. The uterus itself may have a v-shape.

Back 51

didelphys 407

Front 52

In a didelphys uterus, pregnancy may occur in ____ cavities.

Back 52

either or both 408

Front 53

The ___ uterus has a heart-shape, owing to two separate uterine cavities separated by myometrial tissue and one cervix

Back 53

bicornuate 408

Front 54

The ___ uterus is essentially a normal uterus with a septum running down its midline.

Back 54

septate 408

Front 55

In a septate uterus, the septum may be complete, or ____

Back 55

partial 408

Front 56

How many cervixes does the septate uterus have?

Back 56

one 408

Front 57

With which two pelves is deep transverse arrest associated?

Back 57

platypelloid and android 873

Front 58

What are signs of deep transverse arrest?

Back 58

1) prolonged 2nd stage
2) sagittal suture in the transverse diameter of mother's pelvis
3) development of 2nd stage hypotonic uterine dysfunction 4) extensive molding of head
5) considerable caput formation
6) lack of descent of fetal head 873

Front 59

What is the primary management plan for deep transverse arrest?

Back 59

prevention - when you suspect from your original evaluation of the mother's pelvis that this may be a possibility 874

Front 60

Which 3 maternal signs may indicate the possibility of CPD?

Back 60

1) shoulders wider than hips, regardless of height
2) short, square stature
3) short, broad hands and feet 872

Front 61

It is quite unusual to find a pelvis so ____ that labor is absolutely contraindicated.

Back 61

so severely contracted 872

Front 62

What is the only true test for CPD?

Back 62

a trial of labor 873

Front 63

A cesarean section is called for when there is a combination of failure to progress, arrested labor, and hypotonic uterine dysfunction along with suspected CPD before ____ occurs.

Back 63

deep transverse arrest 873

Front 64

What do slowly rising or leveling hCG levels indicate?

Back 64

ectopic pregnancy 624

Front 65

What do dropping hCG levels indicate?

Back 65

early pregnancy loss or viable pregnancy that is actually more than 12 weeks gestation 624

Front 66

What do very rapidly increasing hCG levels indicate?

Back 66

hydatidiform mole or multiple gestation 624

Front 67

hCG levels should double every two days until ____ weeks gestation.

Back 67

10 weeks 624

Front 68

Signs of lightening occurs approximately ____ before labor.

Back 68

2 weeks 737

Front 69

What are 5 signs of lightening?

Back 69

1) decrease in shortness of breath
2) increased frequency of urination
3) increased pelvic pressure (feels like she has to poop)
4) leg cramps
5) edema in lower extremities
737

Front 70

When pregnancy is carefully dated and menstrual and ultrasound assessments are consistent, the incidence of postdates pregnancy falls to ___%

Back 70

1-3% 721

Front 71

The standard definition of a postdates pregnancy is ___ days beyond LMP.

Back 71

294 page 721

Front 72

The standard definition of a postdates pregnancy is ___ days beyond ovulation/fertilization.

Back 72

280 page 721

Front 73

The first trimester (12 weeks) covers the entire ___ period and the first two weeks of the ___ period.

Back 73

embryonic and fetal 556

Front 74

At the moment of fertilization, the male and female ___ from the ovum and sperm fuse.

Back 74

pronuclei 556

Front 75

The pronucleus of each gamete contains ____ chromosomes.

Back 75

23 page 556

Front 76

What is the name of the process by which mature ova and sperm are developed?

Back 76

gametogenesis 556

Front 77

Every cell in an individual's body undergoes this type of cellular division, except gametes.

Back 77

mitotic 556

Front 78

Immediately following fertilization, the resulting zygote begins to undergo mitotic cellular division, called ____.

Back 78

cleavage 560

Front 79

The zygote undergoes cleavage and becomes a ...

Back 79

morula 560

Front 80

The morula reorganizes cells and becomes a ....

Back 80

blastocyst 560

Front 81

What is the name of the cellular mass that implants in the uterine lining?

Back 81

blastocyst 560

Front 82

When is the process of implantation in the uterine lining completed?

Back 82

on the tenth or eleventh day postfertilization 560

Front 83

What event marks the beginning of the embryonic period?

Back 83

the implantation of the blastocyst in the uterine lining 560

Front 84

At the time of implantation, the embryo is known as a _____ embryo.

Back 84

bilaminar 50

Front 85

What are the names of the two layers of cells that arise from the inner cell mass of the bilaminar embryo?

Back 85

epiblast and hypoblast 560

Front 86

What does the embryonic epiblast become?

Back 86

the embryonic ectoderm, mesoderm and endoderm 560

Front 87

What does the embryonic hypoblast become?

Back 87

the yolk sac 560

Front 88

Morphogenesis is the development of ...

Back 88

body form 560

Front 89

_____ is a process by which the bilaminar embryonic disc is converted into a trilaminar embryonic disc.

Back 89

Gastrulation 560

Front 90

The bilaminar embryonic disc becomes a .... embryonic disc.

Back 90

trilaminar 560

Front 91

The primitive streak forms on the surface of the _____

Back 91

epiblast 560

Front 92

The trilaminar embryonic disc gives rise to the three germ layers:

Back 92

1) endoderm, 2) ectoderm, 3) mesoderm 560

Front 93

The mesoderm gives rise to ____ and ___

Back 93

connective tissues and muscles 561

Front 94

The endoderm forms the _____ of the gastrointestinal tract.

Back 94

epithelial lining 561

Front 95

The ectoderm divides into the ___ ectoderm and the ___ ectoderm.

Back 95

the surface ectoderm and the neuroectoderm 561

Front 96

Which forms the skull and skeleton: the endoderm, mesoderm or ectoderm?

Back 96

mesoderm 561

Front 97

The endoderm primarily forms the ____ or many organs.

Back 97

epithelial lining 561

Front 98

Which forms hair, nails and skin: endoderm, mesoderm or ectoderm?

Back 98

ectoderm 561

Front 99

Which forms the retina: endoderm, mesoderm or ectoderm?

Back 99

ectoderm 561

Front 100

Which forms the blood cells: endoderm, mesoderm or ectoderm?

Back 100

mesoderm 561

Front 101

How many pairs of somites are there in the embryo?

Back 101

43-44 page 560

Front 102

The first trimester includes weeks __ through __

Back 102

1 through 12 563

Front 103

The second trimester includes weeks __ through __

Back 103

13 through 27 563

Front 104

The first trimester is ___ weeks long

Back 104

12 page 563

Front 105

The second trimester is __ weeks long

Back 105

15 page 563

Front 106

The third trimester is __ weeks long

Back 106

13 page 563

Front 107

The third trimester includes weeks __ through __

Back 107

28 through 40 page 563

Front 108

What happens on day 1 of embryonic development?

Back 108

fertilization, zygote forms

Front 109

What happens on day 3 of embryonic development?

Back 109

zygote becomes a morula of 12 cells

Front 110

What happens on day 4 of embryonic development?

Back 110

morula becomes a blastocyst

Front 111

What happens on day 6 of embryonic development?

Back 111

blastocyst begins implantation in uterine lining

Front 112

What happens on day 10 of embryonic development?

Back 112

blastocyst is firmly embedded in the uterine lining and is now a bilaminar embryo

Front 113

What happens on day 15 of embryonic development?

Back 113

morphogenesis begins

Front 114

What happens in week 2 of embryonic development?

Back 114

implantation

Front 115

What happens in week 3 of embryonic development?

Back 115

development of trilaminar disc and ectoderm, endoderm and mesoderm

Front 116

What happens on day 20 of embryonic development?

Back 116

formation of neural tube, blood cells and primordial cardiovascular system

Front 117

What happens on day 22 of embryonic development?

Back 117

heart begins to beat

Front 118

What happens on day 21 of embryonic development?

Back 118

somites begin to develop

Front 119

What happens in week 4 of embryonic development?

Back 119

trilaminar folding begins and baby looks like c-shaped salamander

Front 120

What happens in week 5 of embryonic development?

Back 120

rapid development of brain and eyes begin to develop and head is very large compared to the rest of the body

Front 121

What happens in week 6 of embryonic development?

Back 121

mouth, nose, palate and finger buds begin to form, legs and arm development

Front 122

What happens in week 7 of embryonic development?

Back 122

intestines are outside the body, ears begin to form, eyelids form, and toe buds form

Front 123

What happens in week 8 of embryonic development?

Back 123

ossification of bones, head is half the size of the body

Front 124

What happens in week 9 of embryonic development?

Back 124

fetal period begins

Front 125

What happens in week 10 of embryonic development?

Back 125

external genitalia clearly visible, fetus makes breathing motions, intestines inside the abdomen, urination, fetus can swallow

Front 126

What happens in month 4 of embryonic development?

Back 126

fingernails develop, bone development continues, toenails are not developed yet, reflex response begins, eyelids are fused

Front 127

What happens in month 5 of embryonic development?

Back 127

baby covered in vernix, mother can feel baby's movements, legs become long, toenails form

Front 128

What happens in month 6 of fetal development?

Back 128

hair growth (eyebrows, eyelashes, lanugo, head hair), crying and sucking begin, baby begins to dream

Front 129

What happens in month 7 of fetal development?

Back 129

baby appears old and wrinkly, eyes open and close, fat development begins

Front 130

What happens in month 8 of fetal development?

Back 130

fingernails become long, lanugo disappears from face, fat continues to develop, vernix still present

Front 131

What happens in month 9 of fetal development?

Back 131

toenails are long, fat continues to develop, baby is chubby

Front 132

What happens in month 10 of fetal development?

Back 132

lanugo disappears, baby is chubby

Front 133

The period of postpartum recovery lasts approximately ___ weeks.

Back 133

6 1041

Front 134

The speed of involution of the uterus in the postpartal period is not affected by the administration of...

Back 134

medications 1041

Front 135

___ will speed the process of uterine involution postpartum.

Back 135

Breastfeeding 1041

Front 136

Complete regeneration of the endometrium at the placental site postpartum takes approximately ___

Back 136

6 weeks 1042

Front 137

The uterus loses ____ of its weight in the first week postpartum.

Back 137

half 1042

Front 138

The uterus is nonpalpable by the ___ day postpartum.

Back 138

10th day 1042

Front 139

Lochia rubra lasts for the first 2-3 days postpartum and contains primarily ___ and ___

Back 139

blood and decidual 1043

Front 140

Lochia alba begins on the ___ day postpartum (the same day that the uterus cannot be palpated any longer)

Back 140

the 10th day 1042

Front 141

Lochia alba contains primarily __ and ___

Back 141

leukocytes and decidual cells 1043

Front 142

Approximately 40% of postpartal women have nonpathological ___ from immediately postdelivery up to the 2nd day postpartum.

Back 142

proteinuria 1044

Front 143

What explains the profuse perspiration that can occur in the early postpartum days?

Back 143

diuresis, the body discarding excess interstitial fluid and excess blood volume 1044

Front 144

How long does it take for stretch marks to change from brown to silvery white?

Back 144

several months 1044

Front 145

The white blood cell count may be ____ during labor, due to leukocytosis.

Back 145

elevated 1045

Front 146

There is usually a reduction of approximately ____ in total blood volume during delivery and the puerperium. Not all of this is blood loss. Some is excreted through diuresis.

Back 146

1.5 Liters 1045

Front 147

Why does the mother often speak to the baby in a high pitched voice?

Back 147

the baby can hear especially well in the high-frequency range 1047

Front 148

In breastfeeding women, the suckling of the baby stimulates the production of oxytocin by the ___

Back 148

posterior pituitary 1059

Front 149

Afterbirth pains can be relieved by...

Back 149

frequent urination (a full bladder keeps the uterus from contracting fully and the periods of relaxing and contraction cause the most pain, rather than just a uterus that remains well contracted) 1059

Front 150

Which type of medication is not recommended for breastfeeding mothers who want relief from afterpains?

Back 150

aspirin because it may decrease platelet counts 1059

Front 151

Which two medications can a breastfeeding mother take for afterpains?

Back 151

tylenol (acetominophen) and ibuprofen, but ibuprofen is best because of its anti-inflammatory properties 1059

Front 152

Although engorgement is not an inflammatory process, the increased metabolism associated with milk production may cause a mildly elevated ____

Back 152

temperature 1059

Front 153

What do Montgomery's tubercles do?

Back 153

they secrete a substance that is both lubricating and antimicrobial, protecting the nipples and areolae during pregnancy and lactation 1071

Front 154

Prolactin is secreted by the ____

Back 154

pituitary 1071

Front 155

Which 3 hormones are most responsible for the continued and accelerated growth of the breasts during pregnancy?

Back 155

human placental lactogen, prolactin and chorionic gonadotropin 1071

Front 156

Although prolactin levels increase as much as 10 to 20 fold during pregnancy, milk is not produced because of the elevated levels of ....

Back 156

progesterone 1071

Front 157

Without nipple stimulation, prolacting levels drop to those of nonpregnant, nonlactating women within ____ weeks.

Back 157

2 page 1071

Front 158

Nipple stimulation via suckling provides the stimulation for the release of this hormone.

Back 158

prolactin 1071

Front 159

Colic is characterized as crying and screaming that continues for ___ to ___ hours at a time.

Back 159

3-4 hours 1080

Front 160

Research indicates that more than 1/3 of colicky infants improved after their mothers removed this food from their diet for more than a week.

Back 160

cow's milk and its byproducts 1081

Front 161

Can the food the mother ate cause gas in the baby?

Back 161

No 1080

Front 162

Why does a baby get gassy?

Back 162

gas is formed as a byproduct of the digestion of insoluble fiber in the intestinal tract, not because the mother ate gassy foods 1080

Front 163

Can colic be caused by eating broccoli, chocolate, onions or any other foods?

Back 163

it is unlikely 1080

Front 164

Milk production over the first four months postpartum is generally this amount per day...

Back 164

.75 liters 1081

Front 165

Does a mothers fluid intake affect her milk volume?

Back 165

NO, she cannot increase or decrease her milk supply (or change its consistency) by drinking more or less 1081

Front 166

Can women who "diet" in the postpartum period negatively affect their baby's growth?

Back 166

No 1081

Front 167

Will working hard (physical labor) cause less milk production?

Back 167

No 1081

Front 168

Will eating better make better milk?

Back 168

No, diet has almost no effect on the volume or composition of milk unless the mother is grossly undernourished, as in a prolonged famine 1081

Front 169

Will eating poorly cause milk to be inferior?

Back 169

No, diet has almost no effect on the volume or composition of milk unless the mother is grossly undernourished, as in a prolonged famine 1081

Front 170

According to Varney's, are there any herbs that can help a mother produce more milk?

Back 170

no, there is no evidence that eating or drinking specific herbs or foods will increase the milk supply 1081

Front 171

Occasional-use and casual use pumps are used by a mother when she is away from a nursing infant, at work or school for example. These pumps are capable of removing substantial quantities of milk but not of _____.

Back 171

building the milk supply 1084

Front 172

What is the 4-3-3 rule for storing breastmilk?

Back 172

Milk can be stored at room temperature for 4 hours, in the refrigerator for 3 days or in the freezer for 3 to 6 months 1084

Front 173

If the midwife suspects an HSV infection on the breast, should the baby breastfeed?

Back 173

Not until it is completely healed and the infant should be fed formula or banked milk during this period 1086

Front 174

Temperature elevation caused by dehydration usually occurs in the first ____ hours postpartum.

Back 174

24 hours 1093

Front 175

Pyelonephritis is characterized by a low-grade fever with ..

Back 175

spikes 1094

Front 176

Other than severe engorgement, precursory signs and symptoms of mastitis usually are not evident before the end of the ____

Back 176

first postpartal week 1096

Front 177

Does the pulse rate increase with mastitis?

Back 177

yes, often 1096

Front 178

The acute onset of sharp, stabbing pain at the nipple when the infant nurses should lead the midwife to consider that the mother has...

Back 178

thrush 1097

Front 179

What is the main sign of thrush on the breast?

Back 179

acute sharp stabbing pain at the nipple when the infant nurses 1097

Front 180

If the mother has thrush on the breast, should the infant be treated?

Back 180

yes, even if the infant shows no symptoms 1097

Front 181

What are the signs of superficial thrombophletis?

Back 181

leg pain, inflammation at the site, localized heat and tenderness, palpation of a knot or cord 1097

Front 182

What is Homan's sign used to diagnose?

Back 182

deep thrombophlebitis 1097

Front 183

How do you elicit Homan's sign?

Back 183

place one hand on the mother's knee and apply gentle pressure to keep leg straight. dorsiflex the foot. if there is calf pain, the sign is positive and the diagnosis is deep thrombophlebitis 1097

Front 184

What are the symptoms of deep thrombophlebitis?

Back 184

positive Homan's sign, mild fevere, mild tachycardia, abrupt onset with severe leg pain worsening with motion or when standing, edema of the ankle, leg and thigh, pain with calf pressure, tenderness along entire course of the involved vessel(s) 1097

Front 185

What is the treatment for thrombophlebitis?

Back 185

bed rest, elevation of leg, hot packs, elastic stockings and analgesia if needed. under no circumstances should the leg be massaged 1097

Front 186

What is thrombophlebitis?

Back 186

pain and swelling caused by a vein blocked by a blood clot 1097

Front 187

Is the risk for pulmonary embolism less/equal/or more for deep vein thrombosis than for superficial vein thrombosis?

Back 187

more risk 1097

Front 188

Pulmonary embolism is ____ with superficial thrombophlebitis.

Back 188

unlikely 1097

Front 189

What are the most common three symptoms of pulmonary embolism?

Back 189

tachypnea, dyspnea and sharp chest pain of sudden onset 1097

Front 190

What is a hematoma?

Back 190

a tissue swelling that contains blood 1097

Front 191

What are the dangers of hematoma?

Back 191

blood loss amounting to hemorrhage, anemia and infection 1097

Front 192

Hematomas arise from spontaneous or traumatic rupture of ____

Back 192

a blood vessel 1097

Front 193

What is the most common sign of hematoma?

Back 193

extreme pain out of proportion to the expected amount of discomfort and pain 1097

Front 194

What might perineal, vaginal, urethral, bladder or rectal pressure and severe pain following birth indicate?

Back 194

hematoma 1097

Front 195

Which type of maternal hematoma might necessitate consulting a physician for care?

Back 195

one that continues to enlarge rather than stabilizing 1098

Front 196

If a broad ligament hematoma is suspected, what should the midwife do?

Back 196

consult with a physician 1098

Front 197

What is the definition of late postpartum hemorrhage?

Back 197

hemorrhage that occurs after the first 24 hours postpartum 1098

Front 198

_____ occurs when the process of uterine contraction does not take place as it should and is either prolonged or stops.

Back 198

Subinvolution 1098

Front 199

True postpartum depression can develop at any point in the first ___ months.

Back 199

3 months 1099

Front 200

If a mother is suspected of having postpartum depression, what should the midwife screen for?

Back 200

hypothyroidism 1099

Front 201

How long does it take for the newborn to make its complete transition to extrauterine life?

Back 201

one month 961

Front 202

Can prolonged rupture of membranes cause fetal dehydration?

Back 202

yes, 961

Front 203

In which four areas are the most quick and dramatic transitions to extrauterine life seen?

Back 203

respiratory system, circulatory system, ability to thermoregulate and the ability to procure a source of glucose 961

Front 204

What is the organ responsible for fetal oxygenation prior to birth?

Back 204

the placenta 962

Front 205

What is the name of the phospholipid that reduces surface tension at the alveolar-air interface?

Back 205

surfactant 962

Front 206

Surfactant is a ...

Back 206

phospholipid 962

Front 207

What causes TTN (transient tachypnea of the newborn)?

Back 207

wet lungs 962

Front 208

Fetal circulation bypasses the lungs and instead flows through the opening between the right and left atria, called the ____

Back 208

foramen ovale 963

Front 209

Why does fetal blood bypass the lungs?

Back 209

because they are a closed, fluid-filled organ and need minimal blood flow 963

Front 210

In fetal circulation, oxygenated blood flows through the ___ to the brain.

Back 210

ductus arteriosus 963

Front 211

The pressure from increased blood flow in the left side of the neonatal heart causes the ___ to shut.

Back 211

foramen ovale 963

Front 212

How long does it take the ductus arteriosus in the newborn to shut?

Back 212

about 48 hours 963

Front 213

In fetal circulation, blood is shunted from ___ to ___ across the foramen ovale of the heart.

Back 213

right to left 964

Front 214

After birth, blood flow direction changes from ____ to ___ to ___ to ____.

Back 214

from right to left to left to right 964

Front 215

Closure of the foramen ovale is caused by increased pressure in the ....

Back 215

left atrium 964

Front 216

The fetal circulation system is a ___ system, while the neonatal circulation is a ___ system.

Back 216

low-pressure system becomes a high-pressure system 964

Front 217

The fetal temperature is typically ___ degrees higher the mother's.

Back 217

1.08 degrees 964

Front 218

How long does it take a term newborn to stabilize is ability to control its temperature adequately?

Back 218

2 days of life 964

Front 219

What are the clinical symptoms of hypothermia?

Back 219

tachypnea and increased heart rate (newborn speeds up metabolism which requires higher oxygen levels to keep warm) 965

Front 220

Any baby who has been stressed by hypothermia should be assessed for ____ and ____.

Back 220

hypoglycemia and hypoxia 965

Front 221

Which type of thermometer is probably the least reliable for newborns?

Back 221

tympanic thermometer (ear) 965

Front 222

Rectal temperature of a newborn is usually about ____ degrees above axillary temperature.

Back 222

.72 degrees but can be up to 3.6 degrees higher 965

Front 223

What is the preferred rectal and axillary temperature range for a newborn?

Back 223

97.7 to 99.5 degrees 965

Front 224

Which type of temperature may be falsely elevated in a cold-stressed infant secondary to metabolism of brown fat?

Back 224

axillary 966

Front 225

Before birth, the fetus is exposed to almost constant glucose levels that are at ___ to ___% of the mother's levels.

Back 225

60-70% of the mother's 965

Front 226

In preparation for extrauterine life, the healthy fetus stores glucose as ____, in the liver.

Back 226

glycogen 966

Front 227

Newborns who have low stores of glycogen, such as IUGR infants, postterm infants, preterm infants and infants experiencing fetal distress, are at risk for ...

Back 227

hypoglycemia 966

Front 228

What are some symptoms of hypoglycemia?

Back 228

jitteriness, cyanosis, apnea, weak cry, lethargy, limpness and refusal to feed 966

Front 229

Why must the midwife make every effort to minimize extremes of position of the infant in relation to the vaginal introitus (and thus the placenta) at birth?

Back 229

If the baby is too low, a blood bolus could cause respiratory distress, polycythemia, hyperviscosity or hyperbilirubinemia. If the baby is too high, reverse blood flow from the fetus to the placenta could cause severe hypovolemia 968

Front 230

Why doesn't blood normally reverse from the fetus back to the placenta after birth?

Back 230

the umbilical arteries (which carry blood from the fetus to the placenta) spasm quickly in the ambient temperature of the birth room and block blood flow (usually) 968

Front 231

Why should the midwife warm the heel before attempted to check glucose levels in the newborn?

Back 231

venous stasis (particularly in the cold newborn) can give incorrect results 968

Front 232

What is the capacity of the term newborn's stomach?

Back 232

less than 30cc 969

Front 233

Why do newborn's frequently regurgitate the contents of their stomachs?

Back 233

the cardiac sphincter - the juncture of the lower esophagus and the stomach - is incomplete 968

Front 234

Which type of immunoglobulin can cross the placenta and provides immunity to the fetus before it is born?

Back 234

IgG.
IgM and IgA cannot cross the placenta 971

Front 235

Why do small children get sick so often?

Back 235

their immune system is not fully developed until well into childhood 971

Front 236

What is one of the primary biological tasks during infancy and early childhood?

Back 236

building of immunity 971

Front 237

Abdominal masses found on physical newborn exam frequently are..

Back 237

renal 971

Front 238

When should bowel sounds be present in the newborn?

Back 238

by 30 minutes after birth 976

Front 239

How many hours after birth does physiological hypoglycemia occur and by when does it usually resolve?

Back 239

hypoglycemia occurs around 1.5 hours after birth and resolves by 3-4 hours after birth 966

Front 240

What can a murmur heard a few hours after birth in the neonate be?

Back 240

an indication that the ductus arteriosus has not fully closed 976

Front 241

Early feeding of the neonate provides the bacterial colonization of the intestines that leads to the development of ____

Back 241

vitamin K 977

Front 242

Where is vitamin K in the newborn created?

Back 242

in the intestinal tract 977

Front 243

What color is bile?

Back 243

dark green to yellow-brown

Front 244

What type of neonate mucus necessitates physician collaboration?

Back 244

bile-stained mucus 977

Front 245

The presence of large amounts of mucus in the newborn may indicate a problem such as...

Back 245

esophageal atresia 977

Front 246

Bile-stained mucus in the newborn is always a sign of ...

Back 246

illness, and feeding should be delayed until the cause has been determined 977

Front 247

Mucus in the newborn should be what color? (otherwise it's an indication of illness)

Back 247

clear 977

Front 248

Recovery from secondary apnea is prolonged and is directly related to..

Back 248

the length of the asphyxia 985

Front 249

The newborn in a state of asphyxia retains many of the features of the ___

Back 249

fetal circulation (lungs become resistant to expansion due to constriction of blood vessels and the formane ovale and ductus arteriosus continue to shunt blood around the lungs, bypassing them 986

Front 250

What is hypercarbia?

Back 250

build up of carbon dioxide 986

Front 251

Within a short period of time, a lack of oxygen causes a newborn to switch to an ____ pathway for metabolism, leading to metabolic acidosis.

Back 251

anaerobic 986

Front 252

What might the midwife suspect if a newborn is born with an initially vigorous respiratory effort with then quickly decompensates?

Back 252

a diaphragmatic hernia 996

Front 253

What would you suspect of the baby born with an abdominal contour that is unusually flat or concave?

Back 253

diaphragmatic hernia 996

Front 254

What is a diaphragmatic hernia?

Back 254

when part of the abdominal contents is above the diaphragm and in the chest cavity 996

Front 255

What is the most serious issue with diaphragmatic hernia in the newborn?

Back 255

the question of whether any lung development took place during the fetal period. if the herniation occurred early and is extensive, there will be little lung development and even with aggressive resuscitation and surgery, most of these infants die 996

Front 256

Normally, in a newborn, the ___ circumference is larger than the __ circumference.

Back 256

head is larger than chest 1005

Front 257

Why should a midwife who has any doubts about ambiguous genitalia in a newborn immediately contact a physician?

Back 257

because in some instances the finding of ambiguous genitalia has been linked with congenital adrenal hyperplasia, a condition that will cause life-threatening dehydration shortly after birth 1006

Front 258

Can newborns see in color right after they are born?

Back 258

Not really 1015

Front 259

Which pattern are newborns particularly attracted to?

Back 259

stripes! 1015

Front 260

What is a good rule of thumb in regards to newborn behavioral patterns in the first month?

Back 260

there is no pattern! 1014

Front 261

Healthy newborns spend up to __% of their time sleeping.

Back 261

60% 1014

Front 262

Complete absence of any of the newborn reflexes is a cause for...

Back 262

alarm 1014

Front 263

The loss of a previously strong reflex in the first month of life is a cause for ...

Back 263

alarm 1014

Front 264

Is the elicitation of an incomplete or depressed reflex necessarily a cause for alarm?

Back 264

not necessarily; this is fairly frequent and can be caused by neurological depression secondary to medication 1014

Front 265

Use of a barrier cream containing ___ can sometimes stop diaper rash at the earliest stages.

Back 265

zinc oxide 1018

Front 266

Because infants cannot ____ effectively, symptoms of overheating are mainly a red skin color, irritability and body warmth.

Back 266

sweat 1018

Front 267

The space between crib bars should be less than ___ inches

Back 267

2-3/8 inches page 1018

Front 268

When should the developmental milestone of rolling over generally be reached and what can delay this?

Back 268

by 4 months, but consistent placing of baby in the supine position for sleep may delay this 1018

Front 269

Why should a prolonged bottle feed never be used to calm an infant?

Back 269

residual sugars can cause dental caries and the accumulation of milk in the back of the oropharynx may also lead to ear infection 1020

Front 270

What is periodic breathing of the newborn?

Back 270

pauses in respiratory movement that last for up to 20 seconds alternating with breathing 1024

Front 271

Is cradle cap a concern?

Back 271

Only a cosmetic one 1024

Front 272

Breastmilk has very low concentrations of these three minerals, however all of these elements are extremely bioavailable and, therefore, efficiently absorbed.

Back 272

iron, zinc and calcium 1022

Front 273

By what age might a breastfed baby need an iron supplement?

Back 273

4-6 months of age, when the prenatal stores are used up because of rapid growth 1022

Front 274

What causes hiccups?

Back 274

spasmodic contractions of the diaphragm caused by irritation from regurgitation of gastric contents 1023

Front 275

Why do babies get hiccups so often?

Back 275

because the irritation from regurgitation (cardiac sphincter) of gastric contents causes the diaphragm to contract spasmodically 1023

Front 276

For how long should the infant be woken every 4 hours to eat?

Back 276

for the first 2 weeks 1023

Front 277

What is the possible diagnosis for a baby who starts to breastfeed and then pulls away from the breast while crying?

Back 277

infant thrush 1024

Front 278

Why do infants sometimes breathe noisily?

Back 278

the upper airways of infants are narrow and any slight nasal swelling can produce some noise; suctioning makes this worse 1024

Front 279

What are the most common abnormal finding in newborns?

Back 279

respiratory symptoms 1030

Front 280

Tachycardia in the newborn is a symptom of which five possible etiologies?

Back 280

overheating, infection, anemia, shock, cardiac defect 1030

Front 281

What are two symptoms of anemia in the newborn?

Back 281

tachycardia and pallor 1030

Front 282

Cold stress can cause the baby to breathe...

Back 282

fast 1030

Front 283

What are two symptoms of cold stress?

Back 283

pallor and tachypnea 1030

Front 284

With a larger pneumothorax, what symptoms might the midwife note?

Back 284

diminished breath sounds on one side, cyanosis, and perhaps overdistention of the chest on the affected side 1031

Front 285

What are signs of meconium aspiration syndrome?

Back 285

uneven breath sounds, a barrel-chested appearance, rales and rhonchi and cyanosis 1031

Front 286

Neonatal pneumonia may be acquired in the ____ period or during the passage through the birth canal.

Back 286

intrauterine period 1031

Front 287

What are the signs of neonatal pneumonia?

Back 287

respiratory distress plus hypothermia, color changes, and apnea 1031

Front 288

Neonatal pneumonia infection can be caused by ___, ____ or other organisms.

Back 288

bacteria, viruses 1031

Front 289

How long does transient tachypnea last?

Back 289

up to 48-72 hours 1032

Front 290

How long does it take for paralysis from brachial plexus injury to disappear?

Back 290

3-6 months with initial improvement evident within a few weeks 1035

Front 291

Should a baby with brachial plexus injury be seen by a doctor?

Back 291

yes, to get the arm splinted 1035

Front 292

If the midwife suspects a skull fracture (a depressed area of fetal skull, particularly over the parietal bones), what should she do?

Back 292

position the newborn on the side opposite the affected area and consult with a doctor 1035

Front 293

What are signs of bone fracture in the newborn?

Back 293

swelling, skin discoloration, lack of movement, crepitus (sometimes), asymmetric Moro reflex 1035

Front 294

What are subtle signs of newborn seizures?

Back 294

chewing, sucking motions, bicycling of limbs, drooling, apnea, deviation of the eyes and eyelid fluttering. they are evidenced as short, repetitive bursts of activity 1035

Front 295

What does seizure activity in the newborn indicate?

Back 295

neurological compromise; hypoxic-ischemic encephalopathy (HIE), hypoglycemia, hypocalcemia and infection 1035

Front 296

What is hypoxemia?

Back 296

decreased oxygen content in blood 795

Front 297

What is hypoxia?

Back 297

decreased level of oxygen in tissue 795

Front 298

What is acidemia?

Back 298

increased concentration of hydrogen ions in the blood 795

Front 299

What is acidosis?

Back 299

increased concentration of hydrogen ions in tissue 795

Front 300

What is asphyxia?

Back 300

hypoxia with metabolic acidosis 795

Front 301

What is the decidua basalis?

Back 301

it lies beneath the site of implantation of the embryo; becomes maternal contribution to placenta

Front 302

Possible causes of size smaller than dates in the third trimester.

Back 302

IUGR, SGA (genetically small infant, normally grown), placental pathology, fetal death, oligo (covert ruptured membranes or maternal dehydration), transverse or oblique lie, poor maternal weight gain 720

Front 303

Possible causes of size larger than dates in the first trimester.

Back 303

inaccurate dates, inaccurate measurement, full bladder or bowel, multiple pregnancy, uterine fibroids, ovarian cysts, maternal build 720

Front 304

Possible causes of size smaller than dates in the first trimester.

Back 304

inaccurate dates, missed abortion, ectopic pregnancy, maternal build 720

Front 305

Possible causes of size smaller than dates in the second trimester.

Back 305

inaccurate dates, inaccurate measurement, fetal anomaly, chromosomal abnormality, placental pathology, oligo, fetal death, severe early onset IUGR, fetal infection, elevated MSAFP/hCG 720

Front 306

Possible causes of size larger than dates in the second trimester.

Back 306

inaccurate dates or measurement, multiple pregnancy, fetal anomaly, chromosomal abnormality, polyhydramnios, early macrosomia 720

Front 307

Possible causes of size larger than dates in the third trimester.

Back 307

macrosomia, LGA (normally grown), gestatioal diabetes, breech presentation, placenta previa, polyhydramnios, excessive maternal weight gain 720

Front 308

IUD and PID can both cause anemia due to....

Back 308

excess menstruation HH16

Front 309

What are 7 nonhormonal methods for induction of labor?

Back 309

1) stripping membranes
2) AROM
3) nipple stim
4) castor oil
5) foley bulb or balloon catheter
6) sex
7) herbs 728

Front 310

What percentage of women begin labor with PROM?

Back 310

12% page 738

Front 311

What % of women with PROM begin labor spontaneously within 24 hours?

Back 311

80% page 738

Front 312

A cephalic presentation can have which four attitudes?

Back 312

vertex, sincipital (military), brow, face 747

Front 313

The anterior fontanel is also known as the...

Back 313

bregma 750

Front 314

The coronal suture lies between which two bones?

Back 314

the parietal bone and the frontal bone 750

Front 315

The lambdoidal suture lies between which two bones?

Back 315

the parietal bone and the occipital bone 750

Front 316

Does maternal age correlate with her baby's birth weight?

Back 316

no 599

Front 317

Which maternal factors influence her baby's birth weight?

Back 317

prepregnancy weight, weight gain during pregnancy, maternal disease, smoking, nutrition during pregnancy, gestation 599

Front 318

Which 4 maternal factors do not influence the baby's weight?

Back 318

maternal age, height, marital status and income 599

Front 319

Which type of juice is a good source of iron?

Back 319

prune juice

Front 320

Is whole wheat bread a good source of iron?

Back 320

yes

Front 321

Name 7 vegetarian sources of (incomplete) protein.

Back 321

tofu, green peas, peanut butter, egg noodles, brown rice, white rice, whole wheat bread

Front 322

Is white rice a good source of (incomplete) protein?

Back 322

yes

Front 323

Are green peas a good source of (incomplete) protein?

Back 323

yes

Front 324

Are egg noodles a good source of (incomplete) protein?

Back 324

yes

Front 325

The potential for infection of the fetus with toxoplasmosis is 5% if contracted prior to 8 weeks but increases to __ % as gestation continues.

Back 325

80% 677

Front 326

What are the common malformations associated with congenital rubella syndrome?

Back 326

cataracts, cardiac defects, deafness, glaucoma, microcephaly and other defects involving eyes, ears, heart, brain and CNS (first 3 are most common) 674

Front 327

What is Chadwick's sign?

Back 327

bluish or purple discoloration of the vulva and vaginal mucosa 547

Front 328

What is Goodell's sign?

Back 328

softening of cervix from nonpregnant state (tip of nose) to pregnant state (lips) 547

Front 329

What is Hegar's sign?

Back 329

softening and compressibility of uterine isthmus 547

Front 330

When do Chadwick's, Goodell's and Hegar's signs become evident?

Back 330

about 6 weeks gestation 547

Front 331

If rubella infection occurs during the first trimester, what are the possible effects?

Back 331

miscarriage, stillbirth, fetal anomalies, 52% chance of baby having congenital rubella syndrome (CRS) (85% if contracted in first 8 weeks) 674

Front 332

Is white rice a good source of (incomplete) protein?

Back 332

yes

Front 333

Are green peas a good source of (incomplete) protein?

Back 333

yes

Front 334

Are egg noodles a good source of (incomplete) protein?

Back 334

yes

Front 335

The potential for infection of the fetus with toxoplasmosis is 5% if contracted prior to 8 weeks but increases to __ % as gestation continues.

Back 335

80% 677

Front 336

What are the common malformations associated with congenital rubella syndrome?

Back 336

cataracts, cardiac defects, deafness, glaucoma, microcephaly and other defects involving eyes, ears, heart, brain and CNS (first 3 are most common) 674

Front 337

What is Chadwick's sign?

Back 337

bluish or purple discoloration of the vulva and vaginal mucosa 547

Front 338

What is Goodell's sign?

Back 338

softening of cervix from nonpregnant state (tip of nose) to pregnant state (lips) 547

Front 339

Is white rice a good source of (incomplete) protein?

Back 339

yes

Front 340

What is Hegar's sign?

Back 340

softening and compressibility of uterine isthmus 547

Front 341

Are green peas a good source of (incomplete) protein?

Back 341

yes

Front 342

When do Chadwick's, Goodell's and Hegar's signs become evident?

Back 342

about 6 weeks gestation 547

Front 343

Are egg noodles a good source of (incomplete) protein?

Back 343

yes

Front 344

If rubella infection occurs during the first trimester, what are the possible effects?

Back 344

miscarriage, stillbirth, fetal anomalies, 52% chance of baby having congenital rubella syndrome (CRS) (85% if contracted in first 8 weeks) 674

Front 345

The potential for infection of the fetus with toxoplasmosis is 5% if contracted prior to 8 weeks but increases to __ % as gestation continues.

Back 345

80% 677

Front 346

Is white rice a good source of (incomplete) protein?

Back 346

yes

Front 347

Are green peas a good source of (incomplete) protein?

Back 347

yes

Front 348

What are the common malformations associated with congenital rubella syndrome?

Back 348

cataracts, cardiac defects, deafness, glaucoma, microcephaly and other defects involving eyes, ears, heart, brain and CNS (first 3 are most common) 674

Front 349

Are egg noodles a good source of (incomplete) protein?

Back 349

yes

Front 350

What is Chadwick's sign?

Back 350

bluish or purple discoloration of the vulva and vaginal mucosa 547

Front 351

The potential for infection of the fetus with toxoplasmosis is 5% if contracted prior to 8 weeks but increases to __ % as gestation continues.

Back 351

80% 677

Front 352

What is Goodell's sign?

Back 352

softening of cervix from nonpregnant state (tip of nose) to pregnant state (lips) 547

Front 353

What is Hegar's sign?

Back 353

softening and compressibility of uterine isthmus 547

Front 354

What are the common malformations associated with congenital rubella syndrome?

Back 354

cataracts, cardiac defects, deafness, glaucoma, microcephaly and other defects involving eyes, ears, heart, brain and CNS (first 3 are most common) 674

Front 355

When do Chadwick's, Goodell's and Hegar's signs become evident?

Back 355

about 6 weeks gestation 547

Front 356

What is Chadwick's sign?

Back 356

bluish or purple discoloration of the vulva and vaginal mucosa 547

Front 357

If rubella infection occurs during the first trimester, what are the possible effects?

Back 357

miscarriage, stillbirth, fetal anomalies, 52% chance of baby having congenital rubella syndrome (CRS) (85% if contracted in first 8 weeks) 674

Front 358

What is Goodell's sign?

Back 358

softening of cervix from nonpregnant state (tip of nose) to pregnant state (lips) 547

Front 359

What is Hegar's sign?

Back 359

softening and compressibility of uterine isthmus 547

Front 360

When do Chadwick's, Goodell's and Hegar's signs become evident?

Back 360

about 6 weeks gestation 547

Front 361

If rubella infection occurs during the first trimester, what are the possible effects?

Back 361

miscarriage, stillbirth, fetal anomalies, 52% chance of baby having congenital rubella syndrome (CRS) (85% if contracted in first 8 weeks) 674

Front 362

Why don't you want to take your iron pill with your prenatal vitamin?

Back 362

calcium in the prenatal vitamin will decrease iron absorption 685

Front 363

TRUE or FALSE: Herpes zoster (shingles) is rare and has no known effect on mother or fetus.

Back 363

TRUE 678

Front 364

50% of human exposure to toxoplasmosis is through ...

Back 364

infected meat, especially pork 677

Front 365

Oocytes causing toxoplasmosis from cat feces in the soil can remain infectious for up to ...

Back 365

one year 677

Front 366

What are the effects of fetal toxoplasmosis infection?

Back 366

seizures, motor and cognitive defects, mental retardation, anencephaly, hydrocephalus, microcephaly, intracranial calcifications 677

Front 367

Which 2 clinical situations should lead to suspicion of cytomegalovirus (CMV) infection?

Back 367

1) symptoms of infectious mononucleosis with negative test results for mononucleosis and Epstein-Barr virus
2) signs of hepatitis with negative test results for Hep A, B and C
677

Front 368

How many pregnant women are infected by toxoplasmosis each year?

Back 368

1 in 1000 page 677

Front 369

Infection with rubella after the __ week of gestation rarely causes birth defects.

Back 369

20th 674

Front 370

Has evidence of teratogenicity of the rubella vaccine been demonstrated?

Back 370

no, a woman who didn't know she was pregnant when she was receiving the vaccine can be reassured 675

Front 371

Toxoplasmosis is a ___ infection.

Back 371

protozoal
677-8

Front 372

Toxoplasmosis is caused by a ...

Back 372

parasite
677-8

Front 373

When are the most severe cases of toxoplasmosis seen?

Back 373

when the mother contracts the parasite late in the first trimester
677-8

Front 374

Do many infants with toxoplasmosis infection demonstrate symptoms at the time of birth?

Back 374

no, they develop them throughout childhood
677-8

Front 375

What are the effects of toxoplasmosis?

Back 375

seizures, motor and cognitive deficits and mental retardation
the most severely affected with have neurologic anomalies such as anencephaly, hydrocephalus, microcephaly and intracranial calcifications
677-8

Front 376

When do toxoplasmosis oocytes in infected cat feces become infectious?

Back 376

three days after excretion
677-8

Front 377

Most persons infected with toxoplasmosis are ___

Back 377

asymptomatic
677-8

Front 378

For pregnant women exposed to toxoplasmosis, treatment can reduce....

Back 378

potential harmful effects to the fetus
677-8

Front 379

The earlier in pregnancy the mother contracts varicella, the ____ the risk of congenital varicella syndrome.

Back 379

greater
678-80

Front 380

The greatest risk of congenital varicella syndrome occurs in the first ______ of pregnancy.

Back 380

20 weeks
678-80

Front 381

What anomalies are associated with congenital varicella syndrome?

Back 381

cataracts, chorioretinitis, limb hypoplasia, hydronephosis, microcephaly, mental retardation, dermatome lesions and cutaneous scars
678-80

Front 382

If a mother contracts varicella from 6 days before birth to 2 days postpartum, what is the risk to the baby?

Back 382

mother has not yet had time to pass immunity on to the baby, 5% of infected babies die
678-80

Front 383

What is the most common presentation of parvovirus B19?

Back 383

a flushed red face with a characteristic "slapped cheek" pattern
680-1

Front 384

Congenital anomalies are not associated with this virus, which can cause fetal hydrops, aplastic anemia and fetal death.

Back 384

parvovirus
680-1

Front 385

What are the effects of parvovirus on the fetus?

Back 385

aplastic anemia, fetal hydrops and death
680-1

Front 386

When is maternal contraction of parvovirus most dangerous for the baby?

Back 386

in the first half of pregnancy
680-1

Front 387

What is another name for rubella?

Back 387

German measles
674-6

Front 388

What are the most important consequences of rubella contraction during pregnancy?

Back 388

miscarriage, stillbirth, fetal anomalies and therapeutic abortions
674-6

Front 389

If a woman contracts rubella during the first trimester, there is approximately a __% chance that her baby will be born with congenital rubella syndrome.

Back 389

52% chance
674-6

Front 390

What anomalies are associated with congenital varicella syndrome?

Back 390

cataracts, chorioretinitis, limb hypoplasia, hydronephosis, microcephaly, mental retardation, dermatome lesions and cutaneous scars
678-80

Front 391

If a woman contracts rubella during the first 8 weeks of pregnancy, what are her baby's chances of being born with congenital rubella syndrome?

Back 391

85%
674-6

Front 392

If a mother contracts varicella from 6 days before birth to 2 days postpartum, what is the risk to the baby?

Back 392

mother has not yet had time to pass immunity on to the baby, 5% of infected babies die
678-80

Front 393

What is the most common presentation of parvovirus B19?

Back 393

a flushed red face with a characteristic "slapped cheek" pattern
680-1

Front 394

Congenital anomalies are not associated with this virus, which can cause fetal hydrops, aplastic anemia and fetal death.

Back 394

parvovirus
680-1

Front 395

What are the effects of parvovirus on the fetus?

Back 395

aplastic anemia, fetal hydrops and death
680-1

Front 396

When is maternal contraction of parvovirus most dangerous for the baby?

Back 396

in the first half of pregnancy
680-1

Front 397

What is another name for rubella?

Back 397

German measles
674-6

Front 398

What are the most important consequences of rubella contraction during pregnancy?

Back 398

miscarriage, stillbirth, fetal anomalies and therapeutic abortions
674-6

Front 399

If a woman contracts rubella during the first trimester, there is approximately a __% chance that her baby will be born with congenital rubella syndrome.

Back 399

52% chance
674-6

Front 400

If a woman contracts rubella during the first 8 weeks of pregnancy, what are her baby's chances of being born with congenital rubella syndrome?

Back 400

85%
674-6

Front 401

Does infection after 20 weeks of rubella cause problems?

Back 401

no
674-6

Front 402

What are the most common manifestations of congenital rubella syndrome?

Back 402

cataracts, cardiac defects and deafness
674-6

Front 403

Does infection after 20 weeks of rubella cause problems?

Back 403

no
674-6

Front 404

What areas of the body does congenital rubella syndrome affect?

Back 404

eyes, ears, heart, brain and CNS
674-6

Front 405

What are the most common manifestations of congenital rubella syndrome?

Back 405

cataracts, cardiac defects and deafness
674-6

Front 406

Infants with congenital rubella syndrome commonly exhibit growth retardation both ___ and ___.

Back 406

in utero and postnatally
674-6

Front 407

What areas of the body does congenital rubella syndrome affect?

Back 407

eyes, ears, heart, brain and CNS
674-6

Front 408

A rubella antibody titer of 1:10 or above is indicative of ____
One of below 1:10 is indicative of ____

Back 408

1:10 or above is immunity
below 1:10 is lack of immunity
674-6

Front 409

Infants with congenital rubella syndrome commonly exhibit growth retardation both ___ and ___.

Back 409

in utero and postnatally
674-6

Front 410

A rubella antibody titer of 1:64 or above may indicate...

Back 410

present disease
674-6

Front 411

A rubella antibody titer of 1:10 or above is indicative of ____
One of below 1:10 is indicative of ____

Back 411

1:10 or above is immunity
below 1:10 is lack of immunity
674-6

Front 412

Is breastfeeding a contraindication to the rubella vaccine?

Back 412

no
674-6

Front 413

A rubella antibody titer of 1:64 or above may indicate...

Back 413

present disease
674-6

Front 414

What is a classic sign of rubella infection in the mother other than flu-like symptoms?

Back 414

a pale or bright red rash that spreads rapidly from the face over the entire body and fades rapidly
674-6

Front 415

Does infection after 20 weeks of rubella cause problems?

Back 415

no
674-6

Front 416

Is breastfeeding a contraindication to the rubella vaccine?

Back 416

no
674-6

Front 417

Does infection after 20 weeks of rubella cause problems?

Back 417

no
674-6

Front 418

Cytomegalovirus is a member of the ___ group.

Back 418

herpes-virus group
676-7

Front 419

What is a classic sign of rubella infection in the mother other than flu-like symptoms?

Back 419

a pale or bright red rash that spreads rapidly from the face over the entire body and fades rapidly
674-6

Front 420

What are the most common manifestations of congenital rubella syndrome?

Back 420

cataracts, cardiac defects and deafness
674-6

Front 421

What are the most common manifestations of congenital rubella syndrome?

Back 421

cataracts, cardiac defects and deafness
674-6

Front 422

What areas of the body does congenital rubella syndrome affect?

Back 422

eyes, ears, heart, brain and CNS
674-6

Front 423

Does infection after 20 weeks of rubella cause problems?

Back 423

no
674-6

Front 424

Which is the virus most frequently transmitted to a developing child before birth?

Back 424

cytomegalovirus
676-7

Front 425

What areas of the body does congenital rubella syndrome affect?

Back 425

eyes, ears, heart, brain and CNS
674-6

Front 426

Cytomegalovirus is a member of the ___ group.

Back 426

herpes-virus group
676-7

Front 427

Infants with congenital rubella syndrome commonly exhibit growth retardation both ___ and ___.

Back 427

in utero and postnatally
674-6

Front 428

What are the most common manifestations of congenital rubella syndrome?

Back 428

cataracts, cardiac defects and deafness
674-6

Front 429

Which is the virus most frequently transmitted to a developing child before birth?

Back 429

cytomegalovirus
676-7

Front 430

Infants with congenital rubella syndrome commonly exhibit growth retardation both ___ and ___.

Back 430

in utero and postnatally
674-6

Front 431

A rubella antibody titer of 1:10 or above is indicative of ____
One of below 1:10 is indicative of ____

Back 431

1:10 or above is immunity
below 1:10 is lack of immunity
674-6

Front 432

What areas of the body does congenital rubella syndrome affect?

Back 432

eyes, ears, heart, brain and CNS
674-6

Front 433

A rubella antibody titer of 1:10 or above is indicative of ____
One of below 1:10 is indicative of ____

Back 433

1:10 or above is immunity
below 1:10 is lack of immunity
674-6

Front 434

Infants with congenital rubella syndrome commonly exhibit growth retardation both ___ and ___.

Back 434

in utero and postnatally
674-6

Front 435

A rubella antibody titer of 1:64 or above may indicate...

Back 435

present disease
674-6

Front 436

A rubella antibody titer of 1:64 or above may indicate...

Back 436

present disease
674-6

Front 437

Is breastfeeding a contraindication to the rubella vaccine?

Back 437

no
674-6

Front 438

Is breastfeeding a contraindication to the rubella vaccine?

Back 438

no
674-6

Front 439

A rubella antibody titer of 1:10 or above is indicative of ____
One of below 1:10 is indicative of ____

Back 439

1:10 or above is immunity
below 1:10 is lack of immunity
674-6

Front 440

What is a classic sign of rubella infection in the mother other than flu-like symptoms?

Back 440

a pale or bright red rash that spreads rapidly from the face over the entire body and fades rapidly
674-6

Front 441

A rubella antibody titer of 1:64 or above may indicate...

Back 441

present disease
674-6

Front 442

What is a classic sign of rubella infection in the mother other than flu-like symptoms?

Back 442

a pale or bright red rash that spreads rapidly from the face over the entire body and fades rapidly
674-6

Front 443

Is breastfeeding a contraindication to the rubella vaccine?

Back 443

no
674-6

Front 444

Cytomegalovirus is a member of the ___ group.

Back 444

herpes-virus group
676-7

Front 445

Cytomegalovirus is a member of the ___ group.

Back 445

herpes-virus group
676-7

Front 446

What is a classic sign of rubella infection in the mother other than flu-like symptoms?

Back 446

a pale or bright red rash that spreads rapidly from the face over the entire body and fades rapidly
674-6

Front 447

Which is the virus most frequently transmitted to a developing child before birth?

Back 447

cytomegalovirus
676-7

Front 448

Which is the virus most frequently transmitted to a developing child before birth?

Back 448

cytomegalovirus
676-7

Front 449

Cytomegalovirus is a member of the ___ group.

Back 449

herpes-virus group
676-7

Front 450

Which is the virus most frequently transmitted to a developing child before birth?

Back 450

cytomegalovirus
676-7

Front 451

Generally, ____ is not a highly contagious virus.

Back 451

cytomegalovirus
676-7

Front 452

Infection with ____ requires close, intimate contact with a person excreting the virus in their urine, saliva, blood, tears, semen and breast milk.

Back 452

cytomegalovirus
676-7

Front 453

When a woman is pregnant, she should be encouraged to maintain excellent hand washing technique so as not to contract ______, especially if she works often with children.

Back 453

cytomegalovirus
676-7

Front 454

Cytomegalovirus is most often spread within households and in ______ and ____

Back 454

day care centers and in classrooms
676-7

Front 455

Cytomegalovirus can be spread through contact with which bodily fluids?

Back 455

urine, saliva, blood, semen, breastmilk, tears
676-7

Front 456

Although this virus is a common infection, it is not frequently diagnosed because of the minimal presence of symptoms. Therefore, it is the infection most frequently passed on to unborn children.

Back 456

cytomegalovirus
676-7

Front 457

______ infection is not usually recognized until after birth.

Back 457

cytomegalovirus
676-7

Front 458

Cytomegalovirus infection is not usually recognized until...

Back 458

after birth
676-7

Front 459

Most infants with cytomegalovirus disease survive, but 80-90% will have complications that can include...

Back 459

hearing loss, vision impairment and varying degrees of mental retardation
676-7

Front 460

Only 15% of infants with cytomegalovirus show signs ____

Back 460

at birth
676-7

Front 461

The Epstein-Barr virus causes...

Back 461

mononucleosis

Front 462

The Epstein-Barr virus is a member of the ____ group.

Back 462

herpes virus
676-7

Front 463

What are the signs of mononucleosis?

Back 463

malaise, fever of 102-104 degrees, loss of appetite, chills, severe sore throat, reddened with a whitish coating on the tonsils in at least one-third of the cases

Front 464

Vitamin C may be prophylactic for ...

Back 464

postpartum hemorrhage 602

Front 465

What are the three parts of the innominate bones of the pelvis?

Back 465

the pubis, the ischium and the ilium
1215

Front 466

The two ____ form the false pelvis.

Back 466

ilia
1215

Front 467

The pelvis is divided by the ___ into the false pelvis above this demarcation and the true pelvis below it.

Back 467

linea terminalis
1215

Front 468

The ____ diameter is the smallest diameter of the pelvis to which the fetus has to accommodate itself.

Back 468

interspinous diameter
1215

Front 469

What is leukorrhea?

Back 469

a profuse, thin or thick vaginal secretion that begins in the first trimester. The secretion is acidic 592-4

Front 470

Is cessation of menstruation a presumptive, probable or positive sign of pregnancy?

Back 470

presumptive 573

Front 471

Is nausea and vomiting a presumptive, probable or positive sign of pregnancy?

Back 471

presumptive 573

Front 472

Is tingling, tenseness, nodularity and enlargement of the breast and nipples a presumptive, probable or positive sign of pregnancy?

Back 472

presumptive 573

Front 473

Are primary and secondary areolar changes of the breast a presumptive, probable or positive sign of pregnancy?

Back 473

presumptive 573

Front 474

Is increased frequency of urination a presumptive, probable or positive sign of pregnancy?

Back 474

presumptive 573

Front 475

Is fatigue a presumptive, probable or positive sign of pregnancy?

Back 475

presumptive 573

Front 476

Are color changes to the breasts a presumptive, probable or positive sign of pregnancy?

Back 476

presumptive 573

Front 477

Is the appearance of Montgomery's tubercles or follicles a presumptive, probable or positive sign of pregnancy?

Back 477

presumptive 573

Front 478

Is continued elevation of basal body temperature in the absence of an infection a presumptive, probable or positive sign of pregnancy?

Back 478

presumptive 573

Front 479

Is expression of colostrum from the nipples a presumptive, probable or positive sign of pregnancy?

Back 479

presumptive 573

Front 480

Is excessive salivation a presumptive, probable or positive sign of pregnancy?

Back 480

presumptive 573

Front 481

Is Chadwick's sign a presumptive, probable or positive sign of pregnancy?

Back 481

presumptive 573

Front 482

Is quickening a presumptive, probable or positive sign of pregnancy?

Back 482

presumptive 573

Front 483

Is skin pigmentation (chloasma, breast and abdominal striae, linea nigra, vascular spiders, palmar erythema) a presumptive, probable or positive sign of pregnancy?

Back 483

presumptive 573

Front 484

Is enlargement of the abdomen a presumptive, probable or positive sign of pregnancy?

Back 484

probable 573

Front 485

Is palpation of the fetal outline a presumptive, probable or positive sign of pregnancy?

Back 485

probable 573

Front 486

Is ballottement a presumptive, probable or positive sign of pregnancy?

Back 486

probable 573

Front 487

Is fetal movement a presumptive, probable or positive sign of pregnancy?

Back 487

probable, although authorities vary, it could be positive 573

Front 488

Is change in the shape of the uterus a presumptive, probable or positive sign of pregnancy?

Back 488

probable 573

Front 489

Are Piscacek's, Hegar's and Goodell's sign a presumptive, probable or positive sign of pregnancy?

Back 489

probable 573

Front 490

Is palpation of Braxton Hicks contractions a presumptive, probable or positive sign of pregnancy?

Back 490

probable 573

Front 491

Is a positive pregnancy test a presumptive, probable or positive sign of pregnancy?

Back 491

probable 573

Front 492

Is sonographic evidence of pregnancy a presumptive, probable or positive sign of pregnancy?

Back 492

positive 573

Front 493

Are fetal heart tones a presumptive, probable or positive sign of pregnancy?

Back 493

positive 573

Front 494

Is visualization of the fetal skeleton by x-ray a presumptive, probable or positive sign of pregnancy?

Back 494

positive 573

Front 495

A woman often mistakes ____ for a period because it can often occur at the time the period is supposed to begin.

Back 495

implantation bleeding 579

Front 496

Progressive uterine growth is considered indirect evidence of...

Back 496

fetal growth 718

Front 497

When does nausea and vomiting begin to occur in pregnancy?

Back 497

around 5 to 6 weeks gestation 591-2

Front 498

Acupressure wristbands can be used to relieve ....

Back 498

nausea 591-2

Front 499

About half of women are over nausea and vomiting by week ___ of gestation, and 90% by week __.

Back 499

half by week 14 and 90% by week 22
591-2

Front 500

When is the peak prevalence of nausea and vomiting in pregnancy?

Back 500

at 11 weeks gestation
591-2

Front 501

Antihistamines are generally considered ___ during pregnancy.

Back 501

safe
591-2

Front 502

Which vitamin can be prescribed to relieve nausea and vomiting?

Back 502

B6
591-2

Front 503

Fatigue in pregnancy usually disappears by the ....

Back 503

end of the first trimester 592

Front 504

Fatigue occurs during the first trimester for no known reason. One idea is that it results from the initial fall in the the ....

Back 504

basic metabolic rate early in the pregnancy
592

Front 505

What are the two types of less common anemias?

Back 505

B12 and folic acid anemia 684

Front 506

Mean corpuscular volume indicates...

Back 506

the average size of blood cells 684

Front 507

Mean corpuscular hemoglobin indicates...

Back 507

average amount of hemoglobin per cell 684

Front 508

Is iron deficiency anemia microcytic or macrocytic?

Back 508

microcytic 684

Front 509

Iron deficiency anemia is microcytic, meaning...

Back 509

size of the red cell is decreased 684

Front 510

Vitamin B12 and folic acid deficiency are macrocytic, meaning...

Back 510

the red cell size is increased 684

Front 511

Which two vitamins aid the absorption of nonheme iron?

Back 511

Vitamin A and C 684-5

Front 512

High iron foods?

Back 512

leafy vegetables (the greener the better), collard greens, red meat, egg yolks, raisins, prunes, liver, oysters and some fortified cereals 684-5

Front 513

Phytic acid aids/inhibits iron absorption.

Back 513

inhibits 684-5

Front 514

Which foods contain phytic acid?

Back 514

grains and soy proteins, coffee 684-5

Front 515

Which food products inhibit nonheme iron absorption?

Back 515

dairy products 684-5

Front 516

Which sphincter is involved in regurgitation of stomach contents?

Back 516

cardiac sphincter 593

Front 517

Women with heartburn should avoid ____ and ____ with meals.

Back 517

beverages and very cold foods with meals
593

Front 518

What 11 recommendations would you give to a woman with heartburn?

Back 518

1) eat small, frequent meals
2) maintain good posture
3) stretch your arms high over your head to give room for the stomach to function
4) avoid fats with meals
5) avoid beverages with meals
6) avoid cold foods with meals
7) avoid spicy foods
8) drink cultured milk rather than sweet milk
9) drink skim milk
10) avoid heavy foods before bed
11) use antacid preparations with aluminum hydroxide, magnesium hydroxide or magnesium trisilicate 593

Front 519

This over the counter medication should be avoided during pregnancy because it contains sodium bicarbonate, which can increase edema.

Back 519

Alka-Seltzer 593

Front 520

Pain and numbness from carpal tunnel syndrome often worsen...

Back 520

at night 156

Front 521

What is the first treatment for carpal tunnel syndrome during pregnancy?

Back 521

splinting at night to place the wrist in a neutral position 156

Front 522

____ has been shown to reduce symptoms of carpal tunnel syndrome during pregnancy.

Back 522

aerobic exercise 156

Front 523

These two minerals can help relieve leg cramps.

Back 523

calcium and phosphorus 594

Front 524

___ or ___ on the back can help relieve back pain.

Back 524

Cold or heat 596-7

Front 525

Only 1/3 of women who experience painless _____ in the first trimester are having symptoms of impending abortion.

Back 525

vaginal bleeding 662

Front 526

____ has been shown to have no effect on the outcome of a pregnancy when first trimester bleeding is apparent.

Back 526

Bed rest 662

Front 527

What are the possible causes of first trimester bleeding?

Back 527

threatened abortion, ectopic pregnancy, severe cervicities, cervical lesions, cervical polyp, postcoital bleeding, spotting during implantation, bleeding from subchorionic bleed, demise of a twin, hydatidiform mole 662

Front 528

A woman experience first trimester bleeding should be advised to...

Back 528

avoid intercourse, avoid orgasm, do not change activity level (bed rest has no effect on outcome), notify midwife immediately if bleeding increases, if she gets lower abdominal cramps or back pain, pelvic pain other than cramping, gush of fluid from vagina, fever of more than 100.4 662

Front 529

When does a miscarriage become a fetal demise?

Back 529

at 20 weeks gestation 665

Front 530

Prognosis for continuation of a pregnancy is poor when a woman experiences both bleeding and ..

Back 530

pain 665

Front 531

Inevitable abortion is when there is vaginal bleeding and lower abdominal or back pain in addition to...

Back 531

cervical change or rupture of membranes 665

Front 532

What are the criteria for a woman to be able to miscarry safely at home?

Back 532

no excessive bleeding or pain, normal vital signs, not severely emotionally distressed, has previous hematocrit of 30% or more 664-5

Front 533

When is OB referral necessary during a miscarriage?

Back 533

if woman reports sharp pain on either side, experiences heavy bleeding last >1.5 hours or soaks >1 sanitary pad in 1 hour, has severe cramping lasting >1.5 hours, reports lightheadedness, rapid pulse, foul discharge, has a temp of 100.4 or higher, no products of conception are passed, bleeding continue >5 days

Front 534

What is a sign of an incomplete abortion?

Back 534

profuse or prolonged bleeding, infection 665

Front 535

S/S of uterine rupture can either be ___ or ___.

Back 535

dramatic or quiet 876-7

Front 536

A change in the fetal heart rate pattern, especially recurrent late decels, may be an early sign of impending....

Back 536

uterine rupture
876-7

Front 537

The late FHR decels caused by ____ are not relieved by repositioning, stopping administration of any oxytoxic and administration of oxygen.

Back 537

uterine rupture
876-7

Front 538

What is the most ominous pattern of FHR suggesting uterine rupture? (3 things)

Back 538

recurrent late decels, followed by prolonged decels and terminal bradycardia
876-7

Front 539

Do uterine contractions stop when there is uterine rupture?

Back 539

not usually 876-7

Front 540

In a uterine rupture, bleeding may be ___ or ____.

Back 540

slight or torrential
876-7

Front 541

What are abdominal palpation findings if a uterine rupture has occurred?

Back 541

1) presenting part is now moveable
2) loss of station and dramatic repositioning of fetus
3) fetal movements may become violent and then stop
4) fetal parts are more easily palpated
5) a round, firm contracted uterus may be felt beside the fetus (fetus is outside the uterus)
876-7

Front 542

In a silent uterine rupture, the woman may ____

Back 542

vomit
876-7

Front 543

In a uterine rupture, why might the woman have chest pain?

Back 543

bleeding into the peritoneum may irritate the diaphragm and caused referred pain to the chest
876-7

Front 544

What are three confounding possible diagnoses for uterine rupture?

Back 544

pulmonary embolism, amniotic fluid embolism (because of chest pain), abruptio placentae 876-7

Front 545

When does tubal pregnancy rupture usually occur?

Back 545

between 8-10 weeks 664

Front 546

What possibility should be considered in the differential diagnosis of all early pregnancy vaginal bleeding and pelvic pain?

Back 546

ectopic pregnancy
664

Front 547

Is previous ectopic pregnancy a predisposing factor to ectopic pregnancy?

Back 547

yes 666

Front 548

Progesterone is produced by the ____ in the first trimester of pregnancy.

Back 548

corpus luteum 666

Front 549

Increased metabolic activity is reflected by an increased in which three vital signs?

Back 549

temperature, pulse and respirations 752

Front 550

Why does the mother's temperature rise during labor?

Back 550

increased metabolic activity 752

Front 551

Hyperventilation is evidenced by what 2 feelings?

Back 551

dizziness and tingling in the extremities 752

Front 552

Are liquids affected by the reduced gastric motility during labor?

Back 552

no 753

Front 553

Why are oral medications ineffective during labor?

Back 553

gastric motility is at a virtual standstill 753

Front 554

What is the pH of amniotic fluid?

Back 554

7.0 to 7.5, alkaline 743-4

Front 555

What are the organisms most frequently associated with chorioamnionitis and amnionitis?

Back 555

GBS, E. coli, ureaplasma urealyticum, fusobacterium species and mycoplasma hominis 867-7

Front 556

What are the effects of chorioamnionitis on the mother?

Back 556

dysfunctional contractions, labor dystocia and abnormal cervical dilation; potential for being very sick both intrapartally and postpartally 867-7

Front 557

What are the effects of chorioamnionitis on the baby?

Back 557

life-threatening intrauterine pneumonia and acidosis, cerebral palsy 867-7

Front 558

What are signs and symptoms of chorioamnionitis?

Back 558

maternal fever, maternal tachycardia, fetal tachycardia, tender uterus, vaginal walls unusually warm (hot) to touch, foul-smelling purulent amniotic fluid, elevated white blood cell count 867-7

Front 559

Vaginal walls hot to the touch: what is this a sign of?

Back 559

possible amnio/chorioamnionitis 867-7

Front 560

What does steamy translucence of the umbilical cord and fetal membranes after birth indicate?

Back 560

chorioamnionitis 867-7

Front 561

A baby born with chorioamnionitis may have an Apgar score below 7 or may have high scores and then...

Back 561

crash 10-25 minutes after birth 867-7

Front 562

What would foul-smelling amniotic fluid indicate?

Back 562

chorioamnionitis 867-7

Front 563

What is a possible cause of a baby born with intrauterine pneumonia?

Back 563

chorioamnionitis 867-7

Front 564

What is the length of the biparietal diameter?

Back 564

9.5cm 823

Front 565

What is the largest transverse diameter of the fetal head?

Back 565

biparietal diameter 823

Front 566

The suboccipitofrontal diameter extends from the...

Back 566

base of the occiput to the forehead

Front 567

What is the distance of the suboccipitobregmatic diameter?

Back 567

9.5 cm 823

Front 568

How long is the occipitofrontal diameter?

Back 568

11.5 cm 823

Front 569

The occipitofrontal diameter extends from the....

Back 569

occiput to the bridge of the nose 823

Front 570

Which fetal head diameter presents in the well-flexed aftercoming head in a breech baby as he starts to emerge?

Back 570

the suboccipitomental

Front 571

Which is the largest diameter of the fetal head?

Back 571

the occipitomental 823

Front 572

How long is the occipitomental diameter?

Back 572

12.5 to 13.5 cm 823

Front 573

The occipitomental diameter extends from the...

Back 573

posterior fontanel to the chin 823

Front 574

The submentobregmatic diameter of the fetal skull is presenting with which presentation.

Back 574

face 823

Front 575

The submentobregmatic diameter is also called the ...

Back 575

trachelo 823

Front 576

How long is the trachelo, or submentobregmatic diameter?

Back 576

9.5 cm 823

Front 577

What are the 10 cardinal movements of the RSA breech?

Back 577

1) descent throughout
2) engagement of the hips in RSA
3) internal rotation of the buttocks 45 degrees to RST
4) birth of the buttocks by lateral flexion
5) external rotation of the buttocks 45 degrees from RST to RSA and engagement of the shoulders
6) internal rotation of the shoulder 45 degrees back to RST
7) birth of the shoulders by lateral flexion
8) engagement of the head with sagittal suture in transverse or left oblique diameter and occiput in right side of pelvis
9) internal rotation of the head 45 or 90 degrees bringing sagittal suture into the anteroposterior diameter
10) birth of the head by flexion
893-7

Front 578

In a breech presentation, both the buttocks and the shoulders engage in the ____ diameter and then rotate to the ___ diameter to be born.

Back 578

enter in oblique diameter and then rotate to anteroposterior diameter 893-7

Front 579

In the breech, which hip and shoulder is birthed first, posterior or anterior?

Back 579

posterior 893-7

Front 580

In the breech, the head enters the pelvis in one of two diameters. What are they, in reference to the sagittal suture and the diameters of the pelvis?

Back 580

the head enters the pelvis with the sagittal suture in the transverse diameter of the mother's pelvis or in the oblique diameters, with the baby's occiput anterior 893-7

Front 581

What is the Pinard maneuver?

Back 581

if the legs and feet are not born spontaneously in the frank breech, the pinard maneuver will cause delivery of the legs and feet by extracting them 894

Front 582

With delivery of the breech, it is important to keep the head flexed by using the mariceau-smellie-veit maneuver and by having someone apply...

Back 582

suprapubic pressure 898-9

Front 583

What is the Mariceau-Smellie-Veit maneuver?

Back 583

this maneuver maintains the breech head in flexion by placing the index finger in the baby's mouth 898-9

Front 584

What is the difference between a nuchal arm and an extended arm in the breech?

Back 584

extended arms go straight up, nuchal arms flex at the elbo so the arm is wedged behind the head and they can not be delivered like you would an extended arm 896-7

Front 585

How do you deliver a nuchal arm in a breech?

Back 585

turn the hips in the direction that the hand is facing 90-180 degrees so that the friction of the arm against the vaginal walls forces it to be dislodged from behind the head and then you can deliver the hand by splinting the forearm and bringing it down 896-7

Front 586

What is an incomplete uterine inversion?

Back 586

inside of fundus protrudes through the cervical os 915

Front 587

What is a complete uterine inversion?

Back 587

inside of fundus descends to immediately within the vaginal introitus 915

Front 588

What is a uterine prolapse?

Back 588

the uterine fundus extrudes beyond the vulva 914

Front 589

What is the difference between a uterine prolapse and a uterine inversion?

Back 589

in a prolapse, the inside of the fundus protrudes beyond the vulva. in an inversion is protrudes through the cervix or into the vaginal introitus but not outside
915

Front 590

What is the major result of uterine inversion?

Back 590

shock 915

Front 591

Having the mother attempt to push out a placenta without a contraction can cause...

Back 591

uterine inversion 915

Front 592

If a woman goes into shock after giving birth without obvious reason, what should be checked?

Back 592

a vaginal examination should be performed to check for uterine inversion 915

Front 593

What five things are graded in the Apgar score?

Back 593

heart rate, color, respiratory effort, muscle tone, reflex irritability

Front 594

What indicates circumoral cyanosis?

Back 594

a blue ring around the mouth

Front 595

Jaundice visible after a week to ten days is...

Back 595

pathological 1026-7

Front 596

The newborn who has acquired an intrauterine viral infection will present with signs that may include...

Back 596

early jaundice, hepatosplenomegaly, petechiae, palpable lymph nodes and be small for dates 1033

Front 597

Bacterial infections in the newborn are commonly caused by which two bacteria?

Back 597

GBS or E. coli 1033

Front 598

What is the difference between a uterine prolapse and a uterine inversion?

Back 598

in a prolapse, the inside of the fundus protrudes beyond the vulva. in an inversion is protrudes through the cervix or into the vaginal introitus but not outside
915

Front 599

What is the major result of uterine inversion?

Back 599

shock 915

Front 600

Having the mother attempt to push out a placenta without a contraction can cause...

Back 600

uterine inversion 915

Front 601

If a woman goes into shock after giving birth without obvious reason, what should be checked?

Back 601

a vaginal examination should be performed to check for uterine inversion 915

Front 602

What five things are graded in the Apgar score?

Back 602

heart rate, color, respiratory effort, muscle tone, reflex irritability

Front 603

What indicates circumoral cyanosis?

Back 603

a blue ring around the mouth

Front 604

Jaundice visible after a week to ten days is...

Back 604

pathological 1026-7

Front 605

The newborn who has acquired an intrauterine viral infection will present with signs that may include...

Back 605

early jaundice, hepatosplenomegaly, petechiae, palpable lymph nodes and be small for dates 1033

Front 606

Bacterial infections in the newborn are commonly caused by which two bacteria?

Back 606

GBS or E. coli 1033

Front 607

When does late onset bacterial infection in the newborn present?

Back 607

7 days to three months 1033

Front 608

What are the signs of late onset bacterial infection in the newborn?

Back 608

disinterested suck, lethargy, color changes, occasional apnea, temperature lability 1033

Front 609

What is the most important action the midwife can take with late onset newborn bacterial infection?

Back 609

acknowledge that there is a problem 1033

Front 610

Newborns with late onset newborn bacterial infection need to be...

Back 610

treated in the hospital 1033

Front 611

What are signs of early onset newborn bacterial infection?

Back 611

apnea, tachypnea, labored breathing, respiratory distress, poor color, temperature instability, hypotension 1033

Front 612

When does early onset bacterial infection in the newborn present?

Back 612

0-6 days 1033

Front 613

What are the primary signs of heart disease in the newborn?

Back 613

cyanosis and/or tachypnea and/or pallor 1034

Front 614

What is gastroschisis?

Back 614

the abdominal organs are outside the abdomen and are NOT covered by a sac 1036

Front 615

What is oomphalocele?

Back 615

the abdominal organs are outside the abdomen and are covered by a sac 1036

Front 616

What are the two common neural tube defects?

Back 616

meningocele and meningomyelocele 1036

Front 617

Which newborn test screens for hypothyroidism?

Back 617

the PKU test 979

Front 618

What is meningocele?

Back 618

a bony defect of the spinal cord 1036

Front 619

What is meningomyelocele?

Back 619

the vertebra is defective and the spinal cord and spinal roots are externally located in a sac 1036

Front 620

Signs of excessive salivation, respiratory distress, swallowing problems and abdominal distention are present in the newborn with...

Back 620

tracheo-esophageal fistula or esophageal atresia 1036