Obstetric & Maternity Nursing Flashcards

A pregnant patient at 10 weeks has hyperemesis gravidarum. Which finding indicates the need for hospitalization?

Answer: Ketonuria, 5% weight loss from pre-pregnancy weight, inability to tolerate any oral fluids

Hyperemesis gravidarum requiring hospitalization is defined by persistent vomiting, dehydration (ketonuria), significant weight loss (>5% pre-pregnancy weight), and inability to tolerate any oral intake. IV fluid and antiemetic therapy are needed to prevent Wernicke's encephalopathy from thiamine deficiency.

Which maternal blood type combinations require administration of Rh immune globulin (RhoGAM)?

Answer: Rh-negative mother with Rh-positive baby or unknown paternity

RhoGAM prevents Rh sensitization in Rh-negative women exposed to Rh-positive fetal blood. It is given at 28 weeks and within 72 hours of delivery if the baby is Rh-positive (or type is unknown). Also given after any pregnancy loss, amniocentesis, or abdominal trauma in Rh-negative women.

A postpartum patient has severe perineal pain, swelling, and a tense bluish mass near the episiotomy site. What has occurred?

Answer: Hematoma formation

A postpartum vulvar or perineal hematoma presents as a painful, tense, blue-purple mass resulting from vessel injury during delivery. Blood accumulates in the subcutaneous tissue. Small hematomas may be managed conservatively; large or expanding ones require surgical drainage.

Which position is recommended for a patient in labor with a prolapsed umbilical cord while awaiting emergency delivery?

Answer: Knee-chest position or Trendelenburg with manual elevation of presenting part

Knee-chest or steep Trendelenburg position, combined with manual elevation of the fetal presenting part off the cord, relieves compression of the umbilical cord and preserves oxygenated blood flow to the fetus until emergency cesarean can be performed.

What does a fetal biophysical profile (BPP) score of 6/10 indicate?

Answer: Equivocal result — possible fetal compromise requiring further evaluation or delivery

BPP scores: 8–10/10 = normal (reassuring), 6/10 = equivocal (may repeat in 24 hours or consider delivery depending on gestation), 4 or below = abnormal (delivery is usually indicated). A score of 6 warrants close evaluation and clinical judgment.

A neonate develops jaundice at 18 hours of life. How does this differ from physiological jaundice?

Answer: Pathological; jaundice in the first 24 hours suggests hemolytic disease requiring investigation

Physiological jaundice appears after 24 hours of life (day 2–3 in term infants) and peaks by day 3–5. Jaundice appearing within the first 24 hours is always pathological and suggests hemolytic disease (Rh/ABO incompatibility, G6PD deficiency) or infection. Immediate investigation is required.