Chapter 16: Section 6

Which of the following statements regarding a breech birth is false? A. You should arrange for immediate transport to an appropriate medical facility. B. A breech birth slows the labor. C. There will be crowning of the infant's head. D. A breech birth can result in injury to the newborn and the mother.

C. There will be crowning of the infant's head.

If an infant does not begin breathing independently after delivery, the EMR may: A. suction the nose only. B. tilt the infant's head up in a hyperextended position. C. gently stimulate the soles of the feet and/or back. D. wait 5 minutes, then reassess.

C. gently stimulate the soles of the feet and/or back.

Vaginal bleeding in a pregnant woman is often the first sign of: A. labor. B. stillborn delivery. C. miscarriage. D. ectopic pregnancy.

C. miscarriage.

A mother tells you that she was pregnant for only 7 months with the infant you have just helped deliver. You should recognize that the infant will likely: A. require CPR. B. have bluish skin. C. need to be kept especially warm. D. have a larger head than a full-term infant.

C. need to be kept especially warm.

When you assess for crowning, you notice the umbilical cord protruding through the vagina. Your care should include all of the following EXCEPT: A. arranging for immediate transport. B. laying the mother on her right side. C. raising the mother's hips. D. administering oxygen to the mother.

C. raising the mother's hips.

For the EMR, assisting with delivery involves: A. determining exactly when the woman will deliver. B. transporting the pregnant woman only. C. supporting the newborn's head as it emerges and telling the woman to stop pushing. D. pulling on the newborn to expedite the birth.

C. supporting the newborn's head as it emerges and telling the woman to stop pushing.

The muscular organ that holds and nourishes a developing fetus is called the: A. placenta. B. vagina. C. uterus. D. fallopian tube.

C. uterus.

You arrive on the scene and find a 32-year-old woman who tells you she is 8 1/2 months pregnant. This is her fifth pregnancy, and she's afraid she won't be able to make it to the hospital in time. She tells you her last labor lasted less then 2 hours. She is having frequent contractions. What should you do?

Calm yourself and the woman, check for crowning during a contraction, wash your hands, and put on sterile gloves. Put her on a padded and firm surface with blankets, folded sheets, or towels. Elevate her hips at 2 inches to 4 inches and allow her to move into a comfortable position. Place her on her back with her knees bent. Have many clean towels available. Cover the newborn with the towels and clean the mother and the area around her after the delivery.

You should begin chest compressions on a newborn if the pulse rate is less than: A. 100 beats per minute. B. 80 beats per minute. C. 70 beats per minute. D. 60 beats per minute.

D. 60 beats per minute.

The infant's head is beginning to emerge. Which of the following should occur? A. The woman should stop pushing. B. The woman should push harder. C. The woman should breathe rapidly. D. Both A and C.

D. Both A and C.

After an infant has been delivered, you should immediately: A. try to get the infant to cry. B. invert the infant. C. begin mouth-to-mouth resuscitation. D. clear the infant's nose and mouth.

D. clear the infant's nose and mouth.

Complications of pregnancy include all of the following EXCEPT: A. premature birth. B. prolapsed cord. C.breech birth. D. multiple births.

D. multiple births.

If a newborn shows no signs of life and has an unpleasant odor, you should first: A. begin resuscitation efforts. B. try to keep the newborn warm. C. tell the mother she has had a miscarriage. D. provide physical care and psychological support for the mother.

D. provide physical care and psychological support for the mother.

A mother in the second stage of labor says she has to move her bowels. You should: A. help her to the bathroom. B. find a container she can use as a bedpan. C. ask her if she is sure it is not just the pressure of the infant that she is feeling. D. tell her she is only feeling the pressure of the infant and should not try to relieve the feeling now.

D. tell her she is only feeling the pressure of the infant and should not try to relieve the feeling now.

A young mother in labor tells you that this is her first pregnancy, that she has been having contractions for the past 8 hours, and that her water broke some time ago. You should prepare to: A. deliver the infant because birth is imminent after 8 hours of labor. B. ask about discharge of bloody mucus because delivery will be a long time off unless this has also occurred. C. transport her immediately to the nearest hospital because the length of her labor indicates a serious problem with the pregnancy. D. time the contractions and check to see if the head is crowning before transporting her to a hospital.

D. time the contractions and check to see if the head is crowning before transporting her to a hospital.

Define: Breech Presentation

Delivery in which the infant's buttocks appear first rather than the head

Define: Miscarriage

Delivery of the fetus before it is mature enough to survive outside the womb

Define: Fetus

Developing infant in the uterus

List the seven questions you should ask yourself when deciding if there is enough time to reach the hospital before delivery.

Find out if the ambulance is responding and how far it is to the hospital. Also consider the weather, natural disasters, and the traffic. See how these events may prevent a prompt arrival of transportation.

Define: Placenta

Life-support system of the fetus (commonly called the afterbirth)

Fill in the blank: Your primary purpose is to _______ in the delivery of the infant.

assist

Fill in the blank: Contractions should be timed from the _______ of one contraction to the beginning of the next contraction.

beginning

Fill in the blank: In a(n) _______ birth, the infant's buttocks come down the birth canal first, rather than the head.

breech

Fill in the blank: To determine when the infant's head is _______ , you must observe the vaginal opening during a contraction.

crowning

Fill in the blank: A(n) _______ , also called a spontaneous abortion, is the delivery of an incomplete or underdeveloped fetus.

miscarriage

Fill in the blank: In the event of _______ births, another set of labor contractions will begin shortly after the delivery of the first infant.

multiple

Fill in the blank. Stage _______ of labor is when the mother's body prepares for birth.

one

Fill in the blank: The _______ , or afterbirth, draws nutrients from the wall of the mother's uterus.

placenta

Fill in the blank: Any newborn weighing less than 5 pounds or delivered before 36 weeks of pregnancy is considered ______.

premature

Fill in the blank: In a normal delivery, there is no need to cut the _______ cord.

umbilical

Define: Crowning

Appearance of the infant's head through the birth canal

You usually have time to transport a woman in labor when the contractions are more than how many minutes apart? A. 4 minutes B. 5 minutes C. 6 minutes D. 7 minutes

B. 5 minutes

Which of the following is false when preparing for a delivery? A. You should elevate the mother's hip 2" to 4" with pillows and blankets. B. You must maintain a sterile environment when preparing for delivery. C. You should have plenty of clean towels ready to cover the infant. D. If you do not have a sterile delivery kit, use the gloves from your EMR life support kit.

B. You must maintain a sterile environment when preparing for delivery.

As soon as a baby is born, it is important to: A. cool the baby to stimulate breathing. B. ensure that the baby is dried and warmed. C. keep the newborn's head higher than its body. D. immediately cut the umbilical cord.

B. ensure that the baby is dried and warmed.

If the infant's head is crowning, that means the infant will be born: A. breech. B. in a matter of minutes. C. with breathing difficulties. D. with a prolapsed cord.

B. in a matter of minutes.

You should handle the umbilical cord when: A. it is caught in the vagina. B. it is wrapped around the infant's neck. C. delivery of the placenta is delayed. D. you pull on it to deliver the placenta.

B. it is wrapped around the infant's neck.

The process of delivering an infant is called: A. crowning. B. labor. C. contractions. D. fetus.

B. labor.

After the placenta is delivered: A. place it in a bag and discard it with the medical waste. B. place it in a plastic bag and transport it to the hospital for examination. C. place it in a bag of sterile water. D. keep it at a lower level than the infant.

B. place it in a plastic bag and transport it to the hospital for examination.

When timing contractions, you should: A. time the interval between contractions. B. time the contraction cycles from the beginning of one contraction to the beginning of the next. C. time the contraction cycles from the end of one contraction to the end of the next. D. time the contraction cycles from the beginning of one contraction to the end of the next.

B. time the contraction cycles from the beginning of one contraction to the beginning of the next.

Define: Bloody show

Bloody mucus plug that is discharged from the vagina when labor begins

Describe the second stage of delivery.

The crowning of the newborn and the delivery of the baby.

Describe the third stage of delivery.

The delivery of the placenta. Stabilization of the mother, newborn and the delivery of the placenta.

Define: Bag of waters

Amniotic fluid-filled sac

A woman in labor is 30 minutes from the nearest hospital, and an ambulance has not yet been called when you arrive on the scene. This is her first pregnancy. Her bag of waters has not broken and her contractions are 8 minutes apart. You should: A. transport the mother immediately in your own vehicle. B. prepare for the delivery, given the mother's condition. C. call an ambulance but prepare for the delivery. D. call an ambulance but transport the mother in your own vehicle if contractions start occurring closer together.

A. transport the mother immediately in your own vehicle.

The mother's contractions are 4 minutes apart, and the infant's head is not crowning yet. In what stage of labor is the mother? A. First B. Second C. Third D. Between the second and the third

A. First

The first thing you must decide during a childbirth situation is whether you: A. are calm enough to handle the situation. B. have the proper equipment to deal with the situation. C. have time to transport the mother to the hospital before delivery. D. can rely on the mother to know enough about childbirth to help you with the delivery.

A. are calm enough to handle the situation.

If the newborn is surrounded by the bag of waters: A. carefully break the bag and push it away from the nose and mouth of the newborn. B. leave the bag in place and wait for ALS assistance. C. leave the bag in place and transport immediately to an appropriate medical facility. D. carefully puncture the bag to remove the fluid, but leave the bag in place.

A. carefully break the bag and push it away from the nose and mouth of the newborn.

The best way to detect crowning is to: A. observe the vaginal opening during a contraction. B. ask the mother if she feels the infant's head at her vaginal opening. C. wait until a contraction has ended and then observe the vaginal opening. D. use your gloved fingertips to feel gently for the infant's head at the vaginal opening.

A. observe the vaginal opening during a contraction.

To prevent the infant's head from emerging too rapidly, you should tell the mother to: A. stop pushing. B. hold her breath. C. push more slowly. D. relax her abdominal muscles.

A. stop pushing.

During the first stage of labor: A. the bloody show occurs. B. the crowning of the infant's head occurs. C. the pregnant woman should not be transported. D. the placenta is delivered.

A. the bloody show occurs.

Describe the first stage of delivery.

Initial contractions, the bag of water breaks, and the bloody show happens.

Define: Contractions

Muscular movements of the uterus

Define: Uterus

Muscular organ that holds and nourishes the developing fetus

What is the appropriate procedure for putting on sterile gloves?

Open the packaging of the gloves. Then begin putting on the first glove. Grasp the second glove by the inside using your gloved hand. Then put the second glove on.

Define: Bulb syringe

Rubber or plastic device used for gentle suction with newborns and infants

Name three important steps of care after a miscarriage.

Save the fetus and the tissues passing through the vagina. Control the woman's bleeding with a sanitary pad or large dressing. Treat her for shock and transport her to the hospital.

You arrive at the scene of a 27-year-old woman complaining of severe abdominal pain. The patient denies being pregnant, although she reports that she missed her last menstrual period. The patient is pale with a rapid pulse and decreased blood pressure. What is most likely wrong with this patient, and what is the proper treatment?

She is experiencing an ectopic pregnancy. Do a complete patient assessment and measure the patient's vital signs. Treat her for shock and provide a prompt transport to an appropriate medical facility.