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HEART AND HANDS MIDWIFERY PREP PART 1 EXAM QUESTIONS AND ANSWERS
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HEART AND HANDS MIDWIFERY PREP PART 1 EXAM QUESTIONS AND ANSWERS
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HEART AND HANDS MIDWIFERY PREPPART 1 EXAM QUESTIONS AND
ANSWERS
What is the cornerstone of safe, sustainable midwifery practice? - Answers -careful
prenatal assesment
When is prenatal care crucial? - Answers -During the last six weeks of pregnancy
What are the components of prenatal care? - Answers -Nutrition\nExercise\nNon-
allopathic healing\n herbology\n homeopathy\nMind body integration\n yoga\n
meditation\nTests and screening\nRoutine Urinalysis\nVitals\nPalpation\n fetal heart
monitoring\n fundal height \n fetal growth
What information should be discussed during the initial phone call? - Answers -Why
home birth?\nWhat are you looking for in a midwife?\nRule out risk\nCurrent health,
partner, and pregnancy history\npersonal philosophy of care and back up plan
What is the most important task of the initial interview? - Answers -to determine
compatability
Social insincts - Answers -Lead us to make socially recognized choices
Biological instincts - Answers -survival and self realization: deeply rooted
When may HIPAA be broken? - Answers -1. If it is believed that the care provider's life
is in danger or someone else's life, safety or property are in danger\n2. Evidence or
suspicion of child, disabled or elderly person abuse or neglect\n \n3. court order
What are you required to disclose in the initial visit? - Answers -insurance and legal
status
What two serious complications should be discussed early in care? - Answers -PP
hemorrhage and possible need for resuscitation (procedure and indications)
What preexisting conditions are contraindicated for home birth? - Answers -Diabetes\
nHypertension\nHyperthyroid disorder\nChronic lung disease\nSevere asthma\nClotting
disorder\nEpilepsy\nCongenital heart disease\nKidney disease\nExtreme obesity
,What conditions that may arise during pregnancy are contraindicated for home birth? -
Answers -Rh-/ with antibodies\nSevere anemia\nCancer\nAcute viral infections:
Rubella, CMV, Toxoplasmosis, Chicken pox, Herpes\nor any of the preexisting
conditions listed
What lifestyle factors and conditions may be contraindicated for home birth? - Answers -
Unresolved STI\nChronic malnutrition\nDrug addiction\nModerate/Frequent alcohol use\
nSmoking
What abortion method is least traumatic to the uterine lining? - Answers -Suction
What two abortion-related factors may effect placental implantation? - Answers -D&C,
post abortion sepsis
What is the rate of uterine rupture for VBAC with low transverse scar and stimulant
induction? - Answers -<1%
What labor stimulant is associated with uterine rupture? - Answers -Misoprostol/Cytotec
(6% rate)
What are the risks of Cesarean section? - Answers -Sepsis\nperforation of organs\
nScarring of the uterine lining\n increased risk of future abnormal placental implantation\
nHemorrhage\nIncreased risk for adhesions\n3.6X greater chance of death
What factors decrease risk of rupture and increase chances for successful VBAC? -
Answers -Double layer suturing\nLow transverse incision (uterine layer)\nNo other
uterine surgeries\nAt least 18 months since cesarean\nUS of placenta is favorable \
nClient lives less than 20 min from hospital
What therapeutic options may be effective for healing emotional VBAC scars? -
Answers -Hypnotherapy\nEye movement desensitization and reprocessing (EMDR)\
nSupport groups and Organizations (ICAN)
List the main symptom of fibroids - Answers -Painless bleeding with intercourse
What are fibroids? How can they effect pregnancy? - Answers -Fibroids are benign
uterine masses. Fibroids experience considerable growth during pregnancy. If inside the
uterus, may cause IUGR by restricting space, or cause abnormal placental implanation
What is one treatment option for fibroids? - Answers -Green tea
How can cervical scarring be softened near term? - Answers -Evening primrose oil
massaged into the tissue
,List the gynecoligical surgeries that may effect pregnancy - Answers -Cervical cone
biopsy\nCervical cauterization or cryosurgery\nLEEP (correlation w/ incompetent cervix
and preterm labor)
Concerns to consider for client with a history of IUD use - Answers -Anemia\nScarring
(Predisposes for ectopic pregnancy or irregular implantation or the placenta, and
hemorrhage
PID and IUD use have two similar effects on pregnancy - Answers -Anemia\nUterine
scarring
History of hormonal contraception may cause deficiency of what nutrient? - Answers -
Folic acid
What is the window for rupture of ectopic pregnancy? - Answers -10-13 weeks
What are the main symptoms of ectopic pregnancy? - Answers -Bleeding, non-rhythmic
pain unaffected by position change
In the third trimester, bleeding and non-rhythmic pain amy indicate what serious
complication? - Answers -Placental abruption
What conditions should be ruled out if a client is experiencing chronic brown bleeding? -
Answers -Molar pregnancy, missed abortion/incomplete miscarriage
What is varicella? - Answers -Chicken pox
What may be indicated by repeated episodes of painless bleeding? - Answers -placenta
previa
Generalized edema may indicate ...? - Answers -Diet concerns\nPossible preeclampsia
(after 26 weeks)\nif before 24 weeks, refer for consultation
What should be done to treat generalized edema? - Answers -Eliminate processsed
foods\ninclude high quality protein\ninclude fresh veggies\nsalt food to taste
What are some preeclampsia warning signs? - Answers -headaches, visual
disturbances, epigastric pain
The normal fluctuations of what substances may cause headaches in pregnancy? -
Answers -Hormones
Why is a history of flu-like symptoms important? - Answers -May indicate a dangerous
viral infection
, By trimester, what is the fetal risk of being infected with toxoplasmosis? - Answers -1st:
15%\n2nd: 30%\n3rd: 60%
How can a pregnant woman avoid contracting toxoplasmosis? - Answers -Avoid
uncooked meat and fish\nAvoid changing the litter box\nWear gloves when gardening
and wash produce
Toxoplasmosis - Answers -"Toxoplasmosis is known to cause severe neurological
damage to the fetus, but only if contracted after 10 wks. Mothers can minimize their
chances of contracting toxoplasmosis by avoiding uncooked meat and any contact with
cat feces," (p. 16)
What is varicella? - Answers -Varicella is chicken pox and can be extremely dangerous
in pregnancy. p. 16
What is cytomegalovirus? - Answers -"Cytomegalovirus is a farily common infection--
60% of the general population has antibodies--and is most damaging in the 1st
trimester," p. 16
Define hyperemesis gravidarium. - Answers -Nausea and vomiting that is chronic and
self perpetuating. May be unable to retain food or liquid and may require IV therapy.
Theories of causes include emotional issues or elevated estrogen levels irritating the
liver.
Hyperemesis gravidarium: herbal remedy - Answers -Ginger Root. Three times daily.
Fresh grated in tea or ground in capsules.
Common complaints of early pregnancy: Fatigue. List 2 possible causes. - Answers -1.
elevated hormone levels\n2. anemia, esp. if combined with dizziness or nausea beyond
the 1st trimester. (p. 17)
Urinary Tract Problems\n(list symptoms) - Answers -Symptoms of UTI\n1. stinging\n2.
urgency\n3. pain after urination\nmay be nearly absent in pregnancy due to
progesterone's softening effect on the urethra (p. 17)
Pyelonephritis\nDefine and Describe Consequences on Pregnancy - Answers -
Pyelonephritis is a kidney infections. Kidney infections can lead to premature labor. (p.
17)
Teratogen. Define - Answers -"Any substance that can harm the fetus or cause fetal
anomalies is called a teratogen," (p. 17)
Describe Continuity of Care and it's importance to midwifery practice. - Answers
-"Midwives typically provide comprehensive, continuous prenatal care. By doing so, they
get to know clients well enough to have some sense of what to anticipate at the birth.
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