Chapter 33 Review

A 26-year-old female who is 34 weeks pregnant is experiencing a seizure. Her husband tells you that her blood pressure has been high and that she had been complaining of a headache for the past few days. You should

Place her on her side, administer high-flow oxygen, and transport.

A history of pelvic inflammatory disease or tubal ligations increases a woman’s risk for:

An ectopic pregnancy

A mother who is pregnant with her first baby is typically in the first stage of labor for approximately:

16 hours

A nuchal cord is defined as an umbilical cord that:

Is wrapped around the baby’s neck

A pregnant trauma patient may lose a significant amount of blood before showing signs of shock because:

Pregnant patients have an overall increase in blood volume

By the 20th week of pregnancy, the uterus is typically at or above the level of the mother’s:

Belly button

Common interventions used to stimulate spontaneous respirations in the newborn include all of the following, EXCEPT:

Positive-pressure ventilations

During your visual inspection of a 25-year-old woman in labor, you see the baby’s head crowning at the vaginal opening. What should you do?

Apply gentle pressure to the baby’s head as it delivers

Following delivery of a full-term baby, you have properly cared for the baby and have clamped and cut the umbilical cord. During transport, you note that the mother is experiencing moderate vaginal bleeding. You should

Firmly massage the uterine fundus with a circular motion

From what internal female organ is the fetus expelled during delivery?

Uterus

The amniotic fluid serves to

Insulate and protect the fetus

If a baby is born at 7:52, the second Apgar score should be calculated at

7:57

The presence of meconium in the amniotic fluid indicates

That the baby’s airway may be obstructed

Three days after delivering her baby, a 30-year-old woman complains of a sudden onset of difficulty breathing. Her level of consciousness is decreased and she is tachycardic. The EMT should suspect

Pulmonary embolism

When determining the frequency of contractions, you should time the contractions from the

Start of one to the start of the next

When preparing a pregnant patient for delivery, you should position her

On a firm surface with her hips elevated 2 to 4 inches

Which of the following questions is of LEAST pertinence when determining whether a mother will deliver her baby within the next few minutes?

"have you had a sonogram?"

You and your partner are both male and are attending to a 28-year-old female patient complaining of diffuse abdominal pain. The patient is 34 weeks pregnant with her first child. The patient refuses to allow you to examine her, and her husband informs you that their culture does not allow males to examine or care for pregnant women. You should:

respect the patients wishes, ensure that the appropriate documentation is completed, and transport the patient

You are attending to a 23-year-old female patient who is 16 weeks pregnant with her second child. The patient has apparently fallen and sustained an injury to her upper right arm. When you ask about the incident history, the patient is reluctant to explain what happened and becomes very quiet. Based on this information, you should

Continue your care in a private area, document any details regarding the scene and the incident and reassure her as you provide

Your 22-year-old patient is in active labor. Upon visual inspection, you note that the infant’s leg is protruding from the vagina. Appropriate management of this situation includes

Placing the mother supine with her head down and pelvis elevated

A 33-year-old woman who is 36 weeks pregnant is experiencing vaginal bleeding. During transport, you note that she suddenly becomes diaphoretic, tachycardic, and hypotensive. You should

Place her in a left lateral recumbent position

A precipitous labor and delivery is MOST common in women who:

Have delivered a baby before

Abruptio placenta occurs when

The placenta prematurely separates from the uterine wall

After the fetus has descended into the pelvis at the end of the third trimester, many mothers experience:

Easier breathing

An infant is considered to be premature if it

weighs less than 5 lb or is born before 36 weeks’ gestation

Braxton-Hicks contractions are characterized by

Alleviation of pain with movement or changing positions

Fetal complications associated with drug- or alcohol-addicted mothers include all of the following, EXCEPT:

Profound tachycardia

Following delivery of a pulseless and apneic infant who has a foul odor, skin sloughing, and diffuse blistering, you should:

Provide emotional support to the mother

Following delivery of the placenta, the mother is experiencing vaginal bleeding. After massaging the uterine fundus and allowing the mother to breastfeed, the bleeding stops. This occurred because

These actions simulate the production of oxytocin and cause uterine contraction

If a newborn’s heart rate is less than 60 beats/min following delivery, you should

Provide ventilations for 30 seconds

In contrast to abruptio placenta, placenta previa:

may not present with hevay vaginal bleeding

Most medical models base a pregnant woman’s due date

on the first day of her last menstural cycle

Placenta previa is defined as

Development of the placenta over the cervical opening

Signs and symptoms of preeclampsia include:

Headache and edema

Spina bifida is a development defect in which

a portion of the spinal cord or meninges protudes outside of the vertebrae

Supine hypotensive syndrome occurs when

the pregnant uterus compresses the inferior vena cava

The ONLY indications for placing your gloved fingers in the vagina during delivery are

breech presentation and prolapsed umbilical cord

The onset of labor begins with

contractions of the uterus

The umbilical cord

carries oxygen to the baby via the umbilical vein

The vagina and the neck of the uterus comprise the

Birth canal

Upon delivery of an infant’s head, you note that the umbilical cord is wrapped around its neck. You should:

Attempt to slip the cord gently over the infants head

When the mother is experiencing a contraction, you should instruct her to

Take quick short breaths

Which of the following are normal physiologic changes that occur in the mother’s respiratory system during pregnancy?

Increased respiratory rate and decreased respiratory reserve

Which of the following is NOT a component of the Apgar score

Body size

Which of the following is NOT generally considered an obstetrical emergency

Return of contractions following delivery of the baby

Which of the following occurs during true labor?

Uterine contractions become more regular

Which of the following statements regarding gestational diabetes is correct?

In some cases women with gestational diabetes require insulin injections.

Which of the following statements regarding suctioning of a newborn’s mouth and oropharynx is correct

Suctioning is indicated prior to cutting the cord if respiratory distress is present

Which of the following statements regarding the placenta is correct?

The placenta allows oxygen, carbon dioxide, and other products to transfer between the mother and the fetus but does not allow blood to mix the mother and fetus

Which of the following statements regarding twins is correct?

Most twins are born within 45 minutes of each other

While examining a woman in labor, you see the umbilical cord protruding from the vagina. You should

push the infants head away from the cord

You have just delivered a baby boy. His body is pink, but his hands and feet are blue. His heart rate is approximately 110 beats/min and his respirations are rapid and irregular. He has a weak cry when stimulated and resists attempts to straighten his legs. His Apgar score is

8

You have just delivered a premature baby. Your assessment reveals that he is breathing adequately; however, his heart rate is 90 beats/min. You should:

Keep him warm and ventilate with a BVM