Obstetric & Maternity Nursing Flashcards

Which sign indicates the placenta is separating and ready for delivery?

Answer: Lengthening of the umbilical cord and a gush of blood

Signs of placental separation include: lengthening of the umbilical cord, a sudden gush of blood, the uterus becoming globular and firmer, and the fundus rising in the abdomen. These occur 5–15 minutes after delivery of the baby.

A primiparous woman is breastfeeding and reports sore, cracked nipples. What is the most appropriate advice?

Answer: Ensure correct latch-on technique: baby's mouth covers the areola, not just the nipple

Sore cracked nipples are almost always caused by incorrect latch-on where the infant sucks only the nipple tip. Correcting latch-on so the infant takes the full areola into the mouth eliminates nipple trauma. Expressed breast milk on the nipple aids healing.

What is the recommended frequency of fetal movement counting (kick counts) in the third trimester?

Answer: Count until 10 movements felt; report if <10 movements in 2 hours

The '10-in-2' method: count fetal movements until 10 are felt. If fewer than 10 movements are felt in 2 hours, contact the healthcare provider. Daily kick counts in the third trimester help detect decreased fetal movement, which may indicate placental insufficiency.

A postpartum patient develops a fever of 38.5°C on day 3. Uterine tenderness is present on palpation. What is the likely diagnosis?

Answer: Endometritis (uterine infection)

Puerperal fever (>38°C after 24 hours postpartum and within 10 days) with uterine tenderness suggests endometritis — infection of the uterine lining. Risk factors include prolonged labor, PROM, multiple vaginal examinations, and cesarean delivery. Broad-spectrum antibiotics are required.

Which assessment finding in a breastfeeding newborn on day 3 of life indicates adequate milk intake?

Answer: 6–8 wet diapers and 3–4 stools per day, steady weight, alert baby

Adequate intake signs: 6+ wet diapers by day 4–5, 3+ stools per day initially (may change after week 1), weight loss <7–10% of birth weight in first week, and the baby appearing satisfied after feeds. Fewer wet diapers and excessive weight loss indicate inadequate intake.

What is the purpose of administering vitamin K to a newborn immediately after birth?

Answer: Prevent hemorrhagic disease of the newborn (vitamin K deficiency bleeding)

Newborns have very low vitamin K levels and immature gut flora that cannot yet synthesize it. Vitamin K is essential for synthesis of clotting factors II, VII, IX, and X. Without it, the neonate is at risk for intracranial hemorrhage and other bleeding (VKDB). IM vitamin K at birth prevents this.