Midwifery Licensing flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Naegele's rule

Estimated date of delivery is calculated as the first day of the last menstrual period minus three months plus seven days; first-trimester ultrasound crown-rump length provides more accurate dating when available.

Physiologic anemia of pregnancy

Plasma volume increases roughly 40-50% while red cell mass rises only 20-30%, diluting hemoglobin; thresholds for anemia are below 11.0 g/dL in the first trimester and below 10.5 g/dL later.

Reactive nonstress test

A tracing showing at least two accelerations of 15 beats per minute lasting 15 seconds within a 20-minute window; before 32 weeks the threshold is 10 beats per minute for 10 seconds.

Anti-D immune globulin timing

Given at 28 weeks to unsensitized RhD-negative patients and within 72 hours after birth of an RhD-positive infant, plus after abortion, ectopic pregnancy, amniocentesis, or antepartum bleeding.

Preeclampsia definition

New hypertension after 20 weeks gestation accompanied by proteinuria or maternal organ dysfunction such as renal, hepatic, neurologic, or hematologic involvement, or uteroplacental dysfunction.

Fundal height rule

Between 20 and 36 weeks, fundal height in centimeters approximates gestational age in weeks within plus or minus 2 cm; a lag or excess prompts evaluation for growth restriction or polyhydramnios.

Active phase of labor

Begins at 5 cm dilation and progresses at least 1 cm per hour in most labors; slower progress defines active-phase arrest or protraction and warrants evaluation of powers, passenger, and pelvis.

Uterine tachysystole

More than five contractions in 10 minutes averaged over 30 minutes, with or without fetal heart rate changes; management includes repositioning, reducing or stopping oxytocin, and considering tocolysis.

Category III fetal tracing

A tracing with absent baseline variability plus recurrent late or variable decelerations, bradycardia, or a sinusoidal pattern; it predicts abnormal acid-base status and requires immediate resuscitation.

Intrauterine resuscitation measures

Stop oxytocin, reposition the patient laterally, give an intravenous fluid bolus, correct hypotension, administer oxygen for hypoxemia, and consider tocolysis when tachysystole is present.

Postpartum hemorrhage definition

Cumulative blood loss of at least 1000 mL or any loss accompanied by signs of hypovolemia within 24 hours of birth; uterine atony causes most cases.

Shoulder dystocia sequence

Call for help, place the patient in McRoberts position, apply suprapubic pressure, attempt internal rotation, then deliver the posterior arm; episiotomy alone does not release the impaction.

Apgar score components

Five elements scored 0-2 each at 1 and 5 minutes: appearance, pulse, grimace, activity, and respiration; the score describes newborn status but does not direct resuscitation.

Newborn weight loss limit

Physiologic loss up to about 7-10% of birth weight occurs in the first days; birth weight is typically regained by 10-14 days, and greater loss prompts feeding assessment.

Delayed cord clamping

Waiting at least 30-60 seconds before clamping in vigorous term infants improves iron stores; in preterm infants it reduces intraventricular hemorrhage and the need for transfusion.

Edinburgh Postnatal Depression Scale

A ten-item self-report screen for postpartum depression; a score of 10 or more triggers further assessment and 13 or more suggests likely depression requiring clinical evaluation.

Lochia progression

Lochia rubra occurs days 1-3, serosa days 4-10, and alba after about 10 days; foul odor or return to rubra suggests infection or retained placental tissue.

Cervical cancer screening intervals

Begin at 21 years with cytology every 3 years; ages 30-65 may use cytology every 3 years, co-testing every 5 years, or primary HPV testing every 5 years.

Emergency contraception options

Copper intrauterine device is most effective up to 5 days; ulipristal acetate works up to 120 hours; levonorgestrel works up to 72 hours with reduced efficacy at higher body weight.

Amsel criteria

Diagnosis of bacterial vaginosis requires three of four findings: homogeneous discharge, clue cells, vaginal pH above 4.5, and a positive whiff test with potassium hydroxide.

Osteoporosis T-score threshold

A dual-energy x-ray absorptiometry T-score of -2.5 or lower defines osteoporosis; screening begins at 65 years for all women and earlier with risk factors.

Menopause definition

Menopause is defined retrospectively after 12 consecutive months of amenorrhea without another cause; perimenopause averages about four years and vasomotor symptoms often persist for years.

Informed consent elements

Disclosure of diagnosis, proposed intervention, material risks and benefits, alternatives including no treatment, and the patient's voluntary agreement; consent is an ongoing process.

Mandatory reporting exception

Suspected child abuse or neglect, and often elder or dependent-adult abuse, must be reported to designated authorities; this statutory duty generally overrides confidentiality.

Scope of practice

Authority defined by state statute and board rules, covering supervision or collaboration requirements, prescriptive authority, and procedures; practicing outside it risks licensure discipline.

Documentation late entry

Corrections are made with a new dated and timed entry labeled as an addition; original records are never altered or erased, preserving the legal integrity of the chart.

Magnesium sulfate toxicity signs

Loss of deep tendon reflexes, respiratory depression, and oliguria signal magnesium toxicity; stop the infusion and give calcium gluconate while monitoring reflexes, respiration, and urine output.

Antihypertensives in pregnancy

Labetalol, nifedipine, and methyldopa are preferred agents for hypertension in pregnancy; angiotensin-converting enzyme inhibitors and angiotensin receptor blockers are contraindicated.

Antenatal corticosteroid regimen

Betamethasone 12 mg intramuscularly every 24 hours for two doses, or dexamethasone 6 mg every 12 hours for four doses, given between 24 and 34 weeks to reduce neonatal respiratory morbidity.

Number needed to treat

Calculated as 1 divided by the absolute risk reduction; it expresses how many patients must receive an intervention for one additional favorable outcome.

Sensitivity and specificity

Sensitivity is true positives divided by all people with disease; specificity is true negatives divided by all people without disease; predictive values additionally depend on disease prevalence.

Plan-do-study-act cycle

A quality improvement method cycling through planning a change, testing it on a small scale, studying measured results, and acting to adopt, adapt, or abandon before the next cycle.