Exam 2: Obstetrics

Which of the following techniques is an appropriate method of estimating the gestational age?

A 29-year-old woman is 28 weeks pregnant. She complains of nausea, abdominal pain, and right shoulder pain. She states she vomited once, which caused temporary relief; however, the pain returned shortly afterward. She has no pertinent medical history or allergies, has stable vital signs, and states that she ate a cheeseburger about 20 minutes prior to the start of her pain. The most likely cause of this patient's presentation is:

A pregnant woman is complaining of a severe headache and "feeling ill." Her vital signs are: heart rate 92, blood pressure 120/82 mmHg, and respiratory rate of 16. Which of the following questions would be most helpful in identifying a possible pregnancy-related emergency?

You have just delivered a healthy newborn to a 35-year-old woman. There is a steady flow of blood from the vagina and her uterus feels soft upon palpation. Her vital signs are: heart rate 122, respirations 20, blood pressure 90/60 mmHg. Appropriate management of this patient includes:

A 42-year-old woman is 38 weeks pregnant and in active labor. While assessing for crowning, you notice that although the top of the baby's head is visible, a loop of the umbilical cord is protruding from the vagina. You should:

The blood-rich structure that serves as a lifeline for the developing fetus is called the:

You are caring for a woman who is 32 weeks pregnant. While assessing her breathing, you notice that her rib cage expands visibly with each breath and that her tidal volume appears to be deep. You recognize:

A 32-year-old woman was the restrained passenger of a vehicle that hit a tree at a high rate of speed. She is 34 weeks pregnant and complains of excruciating abdominal pain. She is cool and diaphoretic and has a faint and rapid radial pulse. You suspect:

When is the ideal time to assess a neonate for the APGAR score?

You have just delivered an infant at 33 weeks gestation. The infant is blue and limp and has a brachial pulse of 70 beats per minute. What is the appropriate sequence of care for this infant?

You are caring for a patient who is 36 weeks pregnant. She states that she has been experiencing vaginal bleeding after intercourse, and denies any associated pain. Vital signs are: heart rate 84, respirations 18, blood pressure 102/72 mmHg, and warm, dry skin. The most likely cause of this patient's vaginal bleeding is:

A 25-year-old woman presents complaining of heavy vaginal bleeding accompanied by cramping abdominal pain and backache. She can't stop crying and reports that she is 11 weeks pregnant with her first child. Your physical exam reveals what appears to be the fetus and umbilical cord passing through the vaginal opening; however, the placenta has not been passed. Appropriate care for this patient includes:

You are caring for a 42-year-old woman who is 32 weeks pregnant with twins. She is complaining of a severe headache and blurred vision, and lives in a rural area approximately 30 miles from the nearest ED. Your physical exam reveals significant peripheral edema and the following vital signs: heart rate 98, blood pressure 156/98 mmHg, respirations 18. The patient states she has a history of hypertension, but has not taken her prescribed medications because "they aren't safe for the babies." Appropriate treatment for this patient includes:

What is the appropriate sequence of care for a newborn following a normal delivery?