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H & H NARM STUDY FLASHCARDS QUESTIONS WITH COMPLETE SOLUTIONS
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H & H NARM STUDY FLASHCARDS QUESTIONS WITH COMPLETE SOLUTIONS
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H & H NARM STUDY FLASHCARDS QUESTIONSWITH COMPLETE SOLUTIONS
Adequate _____ is necessary to build new red blood cells and
______ must be available to maintain the integrity of the cell
membrane. ______ is crucial for iron absorption. Correct
Answers Adequate protein is necessary to build new red
blood cells and folic acid must be available to maintain the
integrity of the cell membrane. Vitamin C is crucial for iron
absorption.
After or during a postpartum hemorrhage what assessments
would you make which would help you decide whether or not to
transport? Correct Answers Assess the mother's blood loss and
vital signs.
If her blood pressure is low, she looks pale or feels cold and
clammy, or if her pulse is erratic, give oxygen and transport,
treating for shock.If she is stable, push fluids, keep her warm
and quiet and continue to assess vital signs.
Any baby who has had shoulder dystocia should be checked for
what? Correct Answers Bruising, injury to clavicles and Erb's
palsy due
to nerve damage. Erb's palsy can be detected with an
asymmetrical moro reflex.
At what point during pregnancy would placenta previa be
diagnosed? What maternal complication is associated with
placenta previa? Correct Answers Placenta previa cannot be
determined until the last trimester when the presenting part of
the baby distends to the lower uterine segment.
,Placenta previa is associated with increased risk of pp
hemorrhage due to poor contractibility of the lower uterine
segment
At what point in gestation might it be necessary to confirm GA
through bimanual exam? Correct Answers If she is less than
16 weeks you may confirm EDD with a bimanual exam to size
the uterus.At 10 weeks the uterus is the size of a large orange or
softball; at 12 weeks the size of a grapefruit; at 14 weeks the
size of a cantaloupe. At 16 weeks bimanual exam is no longer
necessary as the fundus can be palpated midway between the
pubic bone and umbilicus.
Define fourth stage hemorrhage Correct Answers Blood loss
in excess of two cups or 500cc after
the placenta had delivered but within 24 hours of the
birth.Roughly 80-90% are caused by uterine atony.
Define third stage hemorrhage Correct Answers An excess of
two cups or 500cc of blood loss after the birth of the baby but
before delivery of the placenta.
Define True Pelvis and False Pelvis Correct Answers True
Pelvis - All dimensions from the inlet downward
False Pelvis - Iliac crests or hipbones and above The false pelvis
or hip size is unreliable in predicting pelvic adequacy.
Describe Hematoma? What is the largest risk with hematoma?
Correct Answers An asymmetrical painful swelling in the
perineal area caused by soft tissue trauma. This can happen with
or without repair.If repair is needed and if hemostasis is not
,achieved, bacteria can grow in the pooled blood which can lead
to infection and repair breakdown. If the repair does break
down, reconstructive surgery may be necessary.
How does nonadrenaline help the baby during the birthing
process? Correct Answers Head compression intensifies the
release of
nonadrenaline, which helps protect the baby from asphyxia by
bringing more blood to it's heart, brain and adrenals as well as
the placenta.
How is EDD calculated? Correct Answers Using Naegele's
Rule.Count back three months and add one week to the first day
of last normal menstruation.
How is inlet disproportion diagnosed in labor? Correct Answers
Arrest at 6cm dilation; lack of descent past -3
or -2 station; deflexion or asynclitism and cervix not well
applied to head. Particularly ominous is the cervix hanging like
an empty sleeve.
How long is it safe to wait for delivery of the placenta? Correct
Answers As long as there is no bleeding, the uterus remains
firm,
and the fundal height is stable, you can wait several hours. Risks
include: infection and the cervix beginning to close. After 2-3
hours discuss going to the hospital, after another 20 minutes or
so, transport.
How long should your postpartum watch be? Correct Answers
At least two hours or until the mother's
, blood pressure, pulse, temp and lochia flow are within normal
range for at least an hour.
How many home visits are necessary when planning a home
birth? Correct Answers A minimum of two is essential: one
early in pregnancy to see the mother and her supporters in their
own element and another around 35 weeks to be sure that
supplies are ready and last minute concerns are addressed.
How much blood loss is the maximum which is safe to lose
during a miscarriage? Correct Answers Two cups. If the
mother wants to go through miscarriage at home make sure she
is not anemic and keep a close watch out for hemorrhage. If the
miscarriage extends beyond a day or two she is at increased risk
for infection and must take her temp every 4 hours.
How often should blood pressure be checked during labor?
Correct Answers Blood pressure should be checked hourly or
every twenty minutes if it was borderline high in pregnancy or is
elevated in labor.
How often should blood pressure be checked throughout labor?
Correct Answers Blood pressure can be checked every hour if
B/P
readings have been normal throughout pregnancy and the
beginning of labor. They have have been borderline high during
pregnancy/labor, check every 20 minutes.
How often should FHT be checked during labor? Correct
Answers FHT should be taken every half hour.
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