EMT: Chapter 33 [obstetrics & neonatal care]
the Apgar score should be calculated at _________________ minutes after birth.
1 and 5
after delivery, if the infant does not begin breathing after __________ seconds, you should begin resuscitation efforts.
10-15 seconds
once the infant is delivered, feel for a brachial pulse or the pulsations in the umbilical cord. if the pulse rate is below _________ beats/min, begin assisted ventilations.
100
approximately ___________ of deliveries are complicated by the presence of meconium in the amniotic fluid.
12-16%
when performing CPR on a newborn, a compression to ventilation ratio of 3:1 should be used; this will yield a total of ______________ "actions" per minute.
120
A mother who is pregnant with her first baby is typically in the first stage of labor for approximately
16 hours
Preeclampsia MOST commonly occurs after the ___ week of gestation.
30th
in situations where assisted ventilation is required, you should use a newborn BVM and ventilate with high-flow O2 at a rate of ______________ breaths/min/
40-60
bleeding that exceeds approximately _______ mL is considered excessive.
500
What would the Apgar score be for a newborn whose body is pink but whose hands and feet are cyanotic, has a pulse rate of 98 bpm, cries but does not recoil from stimulus, resists attempts to straighten hips and knees, and has slow respirations?
6
If a baby is born at 7:52 p.m., the second APGAR score should be calculated at
7:57 PM
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
When the cervix begins to dilate
a mucus plug is expelled from the vagina
You are assessing a 30-year-old woman who is 35 weeks' pregnant. She tells you that her amniotic sac has not ruptured, but she is experiencing irregular contractions that "come and go." Upon visual inspection, you note a small amount of brown mucus draining from her vagina. You should
administer O2 and transport
A 26-year-old woman complains of a stabbing pain in the right lower quadrant of her abdomen. She states that her last menstrual period was 7 weeks ago and that she had pelvic inflammatory disease approximately 3 months ago. You should be MOST suspicious that this patient is experiencing
an ectopic pregnancy
A history of pelvic inflammatory disease or tubal ligations increases a woman's risk for
an ectopic pregnancy
During your visual inspection of a 19-year-old patient 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
You are assessing a 25-year-old woman who is 39 weeks' pregnant. She is experiencing regular contractions that are approximately 3 minutes apart and states that her amniotic sac broke 2 hours ago. After taking the appropriate BSI precautions, you should
assess her for crowning
You have just delivered a full-term infant. His respirations are rapid and irregular and he has a strong cry. What should you do next?
assess the brachial or umbilical pulse
If a newborn's heart rate is 75 bpm, what should you do?
begin assisted ventilation with a BVM and room air
By the 20th week of pregnancy, the uterus is typically at or above the level of the mother's
belly button
Signs and symptoms of pregnancy-induced hypertension (preeclampsia) include all of the following, EXCEPT
blood in the urine
Which of the following is NOT a component of the APGAR score?
body size
The ONLY indications for placing your gloved fingers in the vagina during delivery are
breech presentation and prolapsed umbilical cord
The umbilical cord
carries O2 to the baby via the umbilical vein
which of the following is NOT true regarding delivery with a nuchal cord?
clamp the cord, then suction the airway before cutting the cord
A placenta previa is MOST accurately defined as
development of the placenta over the cervical opening
After a baby is born, it is important
ensure it is thoroughly dried and warm
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
If a newborn has gasping respirations after being dried and suctioned
further stimulation is not likely to improve ventilation
A 30-year-old pregnant female is gravida-3 and para-2. This means that she has
given birth to 2 live babies
Signs and symptoms of preeclampsia include
headache and edema
Which of the following statements regarding gestational diabetes is correct
in some cases, women with gestational diabetes require insulin injections
Which of the following is a normal change in pregnancy?
increased respiratory rates and decreased minute volumes
Compared to full-term infants, premature infants are at a higher risk for
infection
The amniotic fluid serves to
insulate and protect the fetus
The answer to which of the following questions will help you determine whether delivery for this patient is imminent?
is this your first pregnancy?
A nuchal cord is defined as an umbilical cord that
is wrapped around the baby's neck
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 provide ventilatory assistance
Which of the following statements regarding twins is MOST correct?
most twins are born within 45 minutes of each other
When preparing a pregnant patient for delivery, you should position her
on a firm surface with her hips elevated 2"-4"
When transporting a pregnant patient in her third trimester, how should you position her?
on her left side
Most medical models base a pregnant woman's due date
on the first day of her last menstrual cycle
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
Common interventions used to stimulate spontaneous respirations in the newborn include all of the following, EXCEPT
positive-pressure ventilations
A pregnant trauma patient may lose a significant amount of blood before showing signs of shock because
pregnant pts have an overall increase in blood volume
Fetal complications associated with drug- or alcohol-addicted mothers include all of the following, EXCEPT
profound tachycardia
____________________ is a situation in which the umbilical cord comes out of the vagina before the infant.
prolapsed cord
Following delivery of a pulseless and apneic infant that has a foul odor, skin sloughing, and diffuse blistering, you should
provide emotional support to the mother
If a newborn's heart rate is less than 60 beats/mins following delivery, you should
provide ventilations for 30 seconds
the "P" in Apgar stands for:
pulse
While examining a woman in labor, you see the umbilical cord protruding from the vagina. You should
push the infant's head away from the cord
What is a primary characteristic of eclampsia?
seizures
During delivery of the baby's head, you should suction the mouth before the nose because
suctioning the nose first may cause the baby to gasp and aspirate fluid
When the mother is experiencing a contraction, you should instruct her to
take quick short breaths
The presence of thick meconium in the amniotic fluid indicates
that the baby's airway may be obstructed
the first sign of labor begins with the onset of contractions and ends when:
the cervix is fully dilated
which of the following statements if FALSE?
the leading cause of abruptio placenta is an ectopic pregnancy
Which of the following statements regarding the placenta is MOST correct?
the placenta allows O2, CO2, and other products to transfer btw mother and fetus but doesn't allow blood to mix
In contrast to a placenta previa, a placenta abruptio occurs when
the placenta prematurely separates from the uterine wall
A 35-year-old woman who is 30 weeks' pregnant presents with a severe headache and swelling in her hands and feet. She is conscious and alert with a blood pressure of 148/94 mm Hg, a pulse of 100 beats/min, and respirations of 24 breaths/min. During transport, you should be MOST concerned with
the possibility that she may experience a seizure
Supine hypotensive syndrome occurs when
the pregnant uterus compresses the inferior vena cavas
If amniotic fluid is green, what does this signify?
the presence of meconium
Vigorous suctioning of a newborn's airway is indicated if
there is meconium in the amniotic fluid
When determining the frequency of contractions, you should
time the contractions from the start of one to the start of the next
General treatment guidelines when caring for a woman with traumatic vaginal bleeding includes
transporting to an appropriate facility
As you are delivering the head during birth, you observe the umbilical cord is wrapped once around the neck. What should you do?
try to slip the cord gently over the head
all of the following are correct regarding postterm pregnancy EXCEPT:
ultrasounds are not accurate at determine due dates
Which of the following occurs during true labor?
uterine contractions become more regular
An infant is considered to be premature if it
weighs less than 5 pounds or was born before 36 weeks gestation
When does the onset of labor begin?
when uterine contractions begin
