OB Exam 1 Review Questions with Correct Answers 100% Verified Types of Midwives - Correct Answer - Traditional Midwife
- Licensed Midwife
- Certified Nurse-Midwives
- infection (puperial or postpartum)
- hypertensice disease
- embolism
- LBW (preterm/small for gestational age) complications (17%)
- Sudden Infant Death Syndrome (SIDS) (8%)
- Maternal complications of pregnancy (6%)
- Unintentional
Doula - Correct Answer A woman who helps with the birth process, including massage during birth and help with breast-feeding. (labor support) High risk of maternal morbidity & mortality - Correct Answer - hemmorrhage
High risk of infant morbidity & mortality - Correct Answer - congenital malformations (20%)
Settings for childbirth - Correct Answer Modern hosptial settings Birth centers Home births Cost of L&D - Correct Answer Average vaginal delivery = 3-10 thousand dollars Average C-Section = 10-40 thousand dollars DRG - Correct Answer If the the cost exceeds the amount for the DRG, the facility has to pay the difference If the amount is less, the facility gets to keep the difference 1 / 4
Health care facilities stand to benefit from shorter hospital stays Postpartum period - Correct Answer Lasts from delivery of the placenta to approximately 6 weeks after delivery Also called the puperium or 4th trimester
Postpartum care - Correct Answer Mother-baby nursing:
- couplet care/rooming in
- care of moether & baby in same room to promote bonding
Infant security:
- prevent infant abduction
- use ID bands & security bands (Hugs)
Hospital length of stay:
- vaginal delivery = 24-48 hours
- C-Section delivery = 2-4 days
Uterine involution - Correct Answer the return of the uterus to its normal size and former condition after delivery usually takes 10-14 days
uterine descent - Correct Answer Immediately after delivery:
-Quite low (near pubic bone) then within 6-12 hours, springs up to level of umbilicus or U+1 Every postpartum day after delivery the uterus descends 1cm (1 fingerbreadth) below the umbilicus Documented U - 1, U - 2 etc....Uterus higher than expected, or deviated to right indicates a full bladder 2 / 4
After pains - Correct Answer Mild contraction pain that happens as a result of oxytocin release after birth to contract the uterus down to it's pre-pregnant state The more children a woman has, often the more severe the after pains
Drug of choice: aspirin
What can make after pains worse? - Correct Answer Breastfeeding
Uterine assessment - Correct Answer Palpate to check tone:
-Firm or boggy?A contracted uterus should feel "firm", like a grapefruit or softball If it isn't contracting efficiently, the uterus feels squishy, or "boggy" A boggy uterus is dangerous & leads to PPH Postpartum Hemmorrhage - Correct Answer a cumulative blood loss greater than or equal to 1000 mL or blood loss accompanied by signs or symptoms of hypovolemia within 24 hours after the birth process (includes intrapartum blood loss) regardless of rout of delivery Common cause of hypovolemic shock - Correct Answer usally due to blood loss during & after birth Signs of hypovolemic shock - Correct Answer - tachycardia
- pale skin
- cool clammy skin
- initial raise in BP then fall
- increased RR
- LOC changes
- urine output <5 ml/hr (with > 40% blood loss) 3 / 4
Where does bleeding most often occur? - Correct Answer at the placental insertion site lochia - Correct Answer postpartum vaginal discharge contains the sloughing of blood, mucus, and tissue assess amount, color, and changes should have no foul odor (sign of infection)
Lochia amount description - Correct Answer Scant: < 1 in
Small/light: 1-4 in stain
Moderate: 4-6 in stain
Heavy: one pad saturated in 1 hour, one pad saturated in 15 minutes
Colors of lochia - Correct Answer lochia rubra: days 1-3
- small clots, fleshy, earthy odor, red/brown
lochia serosa: days 4-10
- decreased amoun, pink/brown
lochia alba: days 11-21
- further decreased amoutns, white/cream/light yellow
- / 4
Postpartum bleeding - Correct Answer More bleeding with veginal delivery