Afghanistan Midwifery Exit Exam flashcards
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- Naegele's rule
- Estimated date of delivery is calculated from the first day of the last menstrual period minus 3 months plus 7 days plus 1 year.
- Gravida and para
- Gravida is the total number of pregnancies including the current one; para is the number of births at 20 weeks or more.
- Normal fetal heart rate
- The normal fetal heart rate ranges from 110 to 160 beats per minute and should be auscultated regularly during labor.
- Anti-D immunoglobulin timing
- Rhesus-negative unsensitized women receive anti-D at 28 weeks gestation and within 72 hours of birth of an Rh-positive infant.
- Active phase of first stage
- Cervical dilation from 5 to 10 cm with regular contractions; expected dilation is at least 1 cm per hour.
- Cardinal movements of labor
- Engagement, descent, flexion, internal rotation, extension, restitution, external rotation, and expulsion describe fetal passage through the pelvis.
- Active management of third stage
- Prophylactic uterotonic, controlled cord traction, and uterine massage reduce postpartum hemorrhage after vaginal birth.
- Delayed cord clamping
- Clamping the cord 1-3 minutes after birth improves neonatal iron stores and hemoglobin without increasing maternal hemorrhage risk.
- Definition of postpartum hemorrhage
- Blood loss greater than 500 mL after vaginal birth or greater than 1000 mL after cesarean birth, or any loss causing hemodynamic instability.
- Lochia progression
- Lochia rubra occurs days 1-3, serosa days 4-10, and alba after day 10, lasting up to 6 weeks postpartum.
- Apgar score components
- Heart rate, respiratory effort, muscle tone, reflex irritability, and color are scored at 1 and 5 minutes after birth.
- Vitamin K for newborns
- A single 1 mg intramuscular dose of vitamin K is given to all newborns to prevent hemorrhagic disease of the newborn.
- Magnesium sulfate eclampsia regimen
- Loading dose 4-6 g intravenously over 20 minutes, then 1-2 g per hour; monitor reflexes, respiration, and urine output.
- Calcium gluconate antidote
- Calcium gluconate 1 g intravenously is the antidote for magnesium sulfate toxicity, given when reflexes are lost or respiration depressed.
- Shoulder dystocia maneuvers
- McRoberts position, suprapubic pressure, internal rotation, and delivery of the posterior arm relieve shoulder impaction.
- Prolapsed cord management
- Elevate the presenting part, position knee-chest or Trendelenburg, call for help, and prepare for immediate delivery to relieve cord compression.
- Placenta previa presentation
- Painless bright red vaginal bleeding in late pregnancy; avoid digital vaginal examination until placental location is confirmed.
- Newborn resuscitation golden minute
- Within the first minute after birth, warm, dry, stimulate, position the airway, and assess breathing and heart rate.
- Positive pressure ventilation indication
- Ventilation is indicated for apnea, gasping, or a heart rate below 100 beats per minute after initial resuscitation steps.
- Compression to ventilation ratio
- Neonatal chest compressions are delivered at a ratio of 3 compressions to 1 breath when heart rate is below 60 beats per minute.
- Neonatal epinephrine dose
- 0.01-0.03 mg/kg intravenously or 0.05-0.1 mg/kg endotracheally when heart rate remains below 60 beats per minute.
- Emergency contraception options
- Levonorgestrel 1.5 mg within 72 hours, ulipristal 30 mg within 120 hours, or copper intrauterine device within 5 days.
- Depot medroxyprogesterone interval
- Depot medroxyprogesterone acetate 150 mg intramuscularly every 3 months; fertility return may be delayed up to 6-12 months.
- Medical abortion regimen
- Mifepristone 200 mg followed 24-48 hours later by misoprostol 800 micrograms is effective up to 10 weeks gestation.
- Lactational amenorrhea method criteria
- Effective only when exclusively breastfeeding, amenorrheic, and within 6 months postpartum.
- WHO five moments hand hygiene
- Before patient contact, before aseptic procedure, after body fluid exposure, after patient contact, and after contact with surroundings.
- Oxytocin storage
- Oxytocin is stored at 2-8 degrees Celsius, protected from light, and used for labor induction and postpartum hemorrhage prevention.
- Cefazolin cesarean prophylaxis
- A single 2 g intravenous dose of cefazolin is given within 60 minutes before cesarean incision to prevent surgical site infection.
- Informed consent elements
- Informed consent requires disclosure of risks and benefits, comprehension, voluntariness, and decision-making capacity.
- Four ethical principles
- Autonomy, beneficence, nonmaleficence, and justice are the core principles guiding midwifery ethical decisions.
- Scope of practice referral
- Midwives must refer or consult when care needs exceed their competence or facility resources to protect maternal and newborn safety.
- Respectful maternity care
- Care free from abuse, discrimination, and neglect that supports informed choice, privacy, and dignity during childbirth.