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Abnormalities of Puerperium: Comprehensive Questions and Answers for Medical Students, Exams of Nursing

William Jessup UniversityNursing

A comprehensive overview of abnormalities of the puerperium, covering key concepts, clinical scenarios, and potential complications. It includes detailed explanations of cardinal movements of labor, analgesics and anesthetics used during childbirth, management of delivery, postpartum complications, and puerperal complications. Particularly useful for medical students studying obstetrics and gynecology, as it presents a series of questions and answers that test understanding of the subject matter.

Typology: Exams

2024/2025

Available from 10/30/2024

lucinda-bernadette
lucinda-bernadette 🇺🇸

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AHN 548 Abnormalities of Puerperium Exam 5 | Comprehensive Questions and Answers
Latest Updated 2024/2025 With 100% Verified Solutions
*#Cardinal Movements of Labor* - How a fetus in a vertex presentation passes through birth canal
a) Engagement
b) Flexion
c) Descent and Internal Rotation
d) Extension of Fetal Head
e) External Rotation
f) Expulsion
b) Flexion - Allows smaller diameters of fetal head to present as fetus moves through birth canal
c) Descent and Internal Rotation - Usually from an occiput transverse position to an occiput anterior or
occiput posterior position
d) Extension of Fetal Head - Occurs as it reaches the introitus and exits the birth canal
e) External Rotation - After delivery of the head the fetus rotates face forward relative to shoulders
f) Expulsion - ...
*ANALGESICS + ANESTHETICS* - *IV Narcotics: avoid near delivery bc of possible neonatal depression*
-May need to reverse effects with narcan/naloxone if neonatal depression at time of delivery
*Epidural*: good pain relief for L&D, less spinal HA
*Spinal*: fast, short acting, frequent spinal HA
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AHN 548 Abnormalities of Puerperium Exam 5 | Comprehensive Questions and Answers

Latest Updated 2024/2025 With 100% Verified Solutions

#Cardinal Movements of Labor - How a fetus in a vertex presentation passes through birth canal a) Engagement b) Flexion c) Descent and Internal Rotation d) Extension of Fetal Head e) External Rotation f) Expulsion b) Flexion - Allows smaller diameters of fetal head to present as fetus moves through birth canal c) Descent and Internal Rotation - Usually from an occiput transverse position to an occiput anterior or occiput posterior position d) Extension of Fetal Head - Occurs as it reaches the introitus and exits the birth canal e) External Rotation - After delivery of the head the fetus rotates face forward relative to shoulders f) Expulsion - ... ANALGESICS + ANESTHETICS - IV Narcotics: avoid near delivery bc of possible neonatal depression

  • May need to reverse effects with narcan/naloxone if neonatal depression at time of delivery Epidural: good pain relief for L&D, less spinal HA Spinal: fast, short acting, frequent spinal HA

General: Emergent c-sections Pudendal block: for pain relief at delivery Local block: for repair of episiotomy or tear Which type of anesthetic puts someone at risk for aspiration? - GENERAL T/F: If pt is in active phase of arrest, and does not dilate in 2-4 hours, she needs to have a C-section. - TRUE T/F: Molding of the fetal head and caput succedaneum are normal. - TRUE The upper limit is ___ hours in nulliparas and ___ hour in multiparas. - 3 hours in nulliparas 1 hour in multiparas Abnormalities in second stage (failure to descend) may be treated with ____ if there is no CPD and contractions are inadequate and fetus status is reassuring. - PITOCIN T/F: Operative vaginal delivery (vacuum or forceps) is usually only attempted if head is LOW in pelvis (below +3 AND cervix is completely dilated) - TRUE T/F: If the head does not descend with adequate contractions and operative vaginal delivery is not possible, deliver by cesarean - TRUE MANAGEMENT OF DELIVERY - - Control delivery of head + prevent maternal lacerations

  • Avoid routine episiotomy: risk to anal sphincter Crowning - The largest diameter of fetal head is encircled by vulvar ring
  • Failure to separate spontaneously could be sign of placenta accreta/increta/percreta #Pt with previous c-section --> scarred uterus --> at highest risk for placenta _____ - ACCRETA After delivery of placenta uterine atony may develop with hemorrhage! Avoid this with _____ and _____ ____ - Pitocin Uterine massage Abnormal Placentation - Top: fetal surface of placenta—note defect in central portion Bottom: : central area of placenta has a defect that should not be present. Fourth Stage of Labor - After delivery of placenta--methodically inspect:
  • Cervix
  • Vagina
  • Urethra
  • Vulva
  • Perineum
  • Placenta
  • Uterus
  • Lacerations must be sutured
  • No standard—usually first 2-6 hours post delivery
  • Frequently assess vital signs + bleeding Placenta - Retained placental tissue / accreta? Uterus - Uterine rupture? Uterine inversion?

The ___ stage of labor has high risk for hemorrhage - FOURTH How to Classify OB lacerations? - First degree: vaginal mucosa or perineal skin Second degree: involves subcutaneous tissue Third degree: involves rectal sphincter Fourth degree: involves rectal mucosa POST PARTUM COMPLICATIONS - a) Post- Partum Hemorrhage b) Coagulopathy c) Amniotic Fluid Embolus a) Post-Partum Hemorrhage: causes - - Uterine atony,

  • Vaginal or cervical lacerations,
  • Retained placenta, possibly due to: accreta/increta/percreta
  • Uterine inversion,
  • Uterine rupture,
  • Coagulopathy/DIC, possibly due to:
  • Amniotic fluid embolus or preeclampsia b) Coagulopathy: causes - - Obstetrical causes of DIC (abruption, preeclampsia, amniotic fluid embolus, sepsis, retained dead fetus)
  • Dilutional secondary to excessive IV fluids
  • Primary blood disorder (von Willebrand's disease or ITP) c) Amniotic Fluid Embolus - - Classically occurs immediately after delivery or with rapid labor
  • Assoc with acute onset of resp and CV collapse with DIC

T/F: Endometritis postpartum is polymicrobial. - TRUE

  • Anaerobes: peptococci, peptostreptococci & Bacteroides fragilis
  • Aerobes: E. coli and enterococci, rarely clostridia) Puerperal complications: SEPTIC PELVIC VEIN THROMBOPHLEBITIS - Similar presentation as endometritis but patient has spiking fevers even after 1 week of antibiotics ADD heparin (RT side affected more often than left)
  • Increased risk with cesarian section Puerperal complications: VENOUS THROMBOEMBOLIC DISEASE - At increased risk for first 6 weeks
  • Increased risk with cesarian section