Midwifery and Gynecological Nursing-Sample Paper (Subscribe for Full Solution)

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Midwifery and Gynecological Nursing-Sample Paper (Short)

⏩ Q-1 🔸 a. List down the benefits of the Pelvis. 03

Benefits of the Pelvis:

The pelvis is a crucial anatomical structure in the human body, providing several key benefits:

1) Support and stability:

The pelvis forms the base of the spine and supports the weight of the upper body when standing and sitting. It also acts as a stable base for movement and locomotion.

2) Protection of Organs:

Pelvis works to enclose and protect vital reproductive organs (such as uterus, ovaries and testes), urinary bladder, and part of the gastrointestinal system.

3) Child birth:

During child birth, the pelvis plays a critical role by providing a passageway (birth canal) through which the child can be born. Ease or difficulty in delivery depends on the shape and size of the pelvis.

4) Attachment of muscles:

Numerous muscles are attached to the pelvis bone such as the muscles of the lower back, abdomen, buttocks (gluteal muscles) and pelvic floor muscles. These muscles provide a contribution to posture, movement and stability.

5) Weight distribution:

The pelvis helps distribute the weight of the upper body evenly over the lower limbs when standing and walking, reducing stress on the spine and lower back.

6) Support and protect reproductive organs:

The pelvic floor muscles also play an important role in providing proper support and protection to the reproductive organs.

7) Blood Vessels and Nerve Pathways:

The pelvis contains major blood vessels and nerve pathways that supply the lower limbs and pelvic organs and work to maintain proper circulation and nerve pathways.

Overall, the pelvis is important for maintaining posture, facilitating movement, protecting internal organs, and providing support for reproductive and urinary function.

Its structural integrity is vital to overall health and well-being.

Thus, the pelvis has many important advantages.

QUE🔸3) Describe injection oxytocin drug.

Injection oxytocin:

Oxytocin is an octopeptide. Oxytocin is naturally produced in the hypothalamus but is stored and released in the posterior pituitary. Oxytocin has a half life of 3-4 minutes and its duration of action is about 20 minutes.
It is rapidly metabolized and degraded by oxytocinase.

Mode of Action

Oxytocin helps the uterine muscles contract. Oxytocin’s main mode of action is contraction of the fundal part of the uterus and relaxation of the cervix.
Oxytocin also helps in the release of prostaglandins from the decidua and also helps in stimulating milk ejection from the breast.

•>Preparation used

1) Synthetic oxytocin
It has oxytocic effect apart from vasopressor action.
Syntocin is available in ampoules containing 5 IU/Ml.
Pitocin 5 IU/ml.

2) Syntometrine (Sandoz):
Combination of Syntocin 5 unit and Ergometrine 0.5 mg.

3) Desamino oxytocin:
Not inactivated by oxytocinase and is 50-100% more effective than oxytocin. It is available in buccal tablets.
Contains 50 IU.

4) Oxytocin Nasal Solution:
Contains 40 units/ml.

Indication:
Oxytocin is used as a therapeutic and diagnostic test during pregnancy, labor and the puerperium period.

1) Pregnancy:
Early pregnancy
Used to accelerate abortion and for induction of abortion with other abortifacient agents.
To stop bleeding after evacuation of uterus.

Late Pregnancy:

For induction of labour.
After expulsion of the placenta.
For cervical ripening.

2) Labor

Augmentation of Labour.
Uterine inertia.
During active management of the third stage of labor.
Used as an alternative to ergometrine after expulsion of the placenta.
To prevent and treat post partum haemorrhage.

3) Purperium or postpartum
To prevent and treat post partum haemorrhage.
To increase milk ejaculation.

Contraindications:

Pregnancy
Grand Multipara,
Contracted pelvis,
History of previous caesarean section,
hysterotomy,
Malpresentation.

During labor
All contraindications during pregnancy,
obstructed labour,
Incoordinate uterine contractions,
Fetal distress.

Its time
hypo volemic state,
Cardiac Diseases.

•> Dangers/ Complications of Oxytocin (Dangers/ Complications of Oxytocin):

Maternal
Uterine hyperstimulation
(over activity),
uterine rupture,
water intoxication,
hypotension,
antidiuresis,
Pituitary Soc.

fits
Fital Distress,
fetal hypoxia,
Increase incidence of neonatal jaundice.

Route and Dose of Oxytocin Administration

controlled intravenous infusion,
Bolus IV (intravenously),
IM (Intra Muscular),
Buccal tablets or nasal spray.

Induction or Augmentation of Labour:
IV (intravenously) Initial dose is started at a low rate (1-2 milliunits per minute) then the dose can be gradually increased to increase uterine contractions. A maximum of 20-40 munits/minute can be administered and is Every woman vice is different.

To increase uterine contractions and to prevent and treat post-partum haemorrhage:

IM (Intra Muscular)
If IM (intra muscular) administration is to be done, 10 IU is given immediately after delivery of the baby.
OR
If IV (intravenous) administration is to be done, 20 IU is administered in a pint of 500 ml of normal saline or Ringer’s lactate and then the infusion is provided.

•> Nursing Responsibilities (Nursing Responsibilities)

Administering injection oxytocin is a critical responsibility for the nurse Although oxytocin plays an important role in facilitating labor and managing labor progression, the nursing responsibilities for oxytocin administration are as follows.

1) Assessment and Preparation
assessment
Before administering injection oxytocin, the nurse should properly assess the pregnant woman’s labor progress, fetal heart rate, and uterine contractions and maternal vital signs. Due to which medication can be properly initiated and continued.

Preparation
Prepare oxytocin solution properly according to hospital protocols and as prescribed by health care personnel.

2) Monitoring
Uterine contractions
Continuously monitor uterine contractions by palpation method and assess whether urine contractions are regular and proper or not.

Fetal heart rate
Continuously monitor fetal heart rate and assess for signs and symptoms of fetal distress.

3) Administration

Initiation and Adjustment

Properly administering medication prescribed by a health care provider.
Keep the infusion rate low initially and then increase the infusion based on uterine contractions and labor progression.

4) Patient education
Explanation
Provide explanation to the mother and her support portion about the purpose of oxytocin infusion, its side effects, and continuous monitoring.
Expectations
Provide an explanation to the mother and her spotters about the expected increase in intensity and frequency of uterine contractions after administration of oxytocin.

5) Documentation
Charting
Documentation of oxytocin administration, including starting time, infusion rate, maternal vital signs, uterine contraction pattern, and continuous charting of fetal heart rate.

Response to treatment
Properly monitor uterine contractions and assess progress of labor to assess how effective oxytocin is after oxytocin infusion.
And any side of oxytocin
Assess whether there is an effect or not.

6) Communication
Communication with other healthcare personnel for oxytocin administration eg.
obstetrician,
Collaboration with midwife and other nurses.

Patient updates
Provide ongoing patient updates to the mother and her support person including information on labor progress, fetal well-being, and any changes after oxytocin administration.

7) Emergency Response
If any type of side effect is observed during the administration of oxytocin and other symptoms are observed such as uterine hyperstimulation, then oxytocin should be discontinued immediately and supportive care should be provided.

Thus there is a need to perform this type of nursing responsibility while providing injection oxytocin.

⏩ Q.5 Define following (Any Six) Give following definition (Any Six) 6×2=12

🔸1) Puerperal pyrexia-

Peripheral pyrexia:

Peripheral pyrexia A condition in which the body temperature increases to more than 100.4°F (38 °C) within 14 days after delivery is called “peripheral pyrexia”.

Or
When oral temperature at two different times in 10 days after first 24 hours of delivery
A temperature of 100.4°F (38°C) or higher is called “purereal pyrexia”.

🔸2) Prolong labour-

When the combined duration of the first and second stages of labor is more than 18 hours, it is called prolonged labor.

Cervical dilatation rate <1 cm/hr and descent of the presenting part <1 cm/hr in at least four hours of observation is called prolonged labour.

🔸3) Multiple Pregnancy

Multiple Pregnancy:

When more than one fetus develops in the uterus simultaneously and at the same time, it is called “multiple pregnancy”.

When two fetuses develop together in the uterus, they are called twins.
When three fetuses develop simultaneously in the uterus, they are called triplets.
When four fits develop simultaneously, they are called quadruplets.

Varieties and types of twin pregnancy

1) Dizygotic twins:
This commonest ie fertilization of two ova is the result of fertilization by two spermatozoa.
Two placentas are seen in this.
In this case, communication vessels are absent.
Thus, there may be two amnion and two chorion membranes.
Genetic features may be different in this.
They do not accept skin grafts.

2) Monozygotic twins
Monozygotic twins develop due to fertilization of this single ovum by a single sperm.
Communication vessels are present in this.
It contains two amnion membranes.
Monozygotic twins usually have the same sex.
Genetic features are also found to be the same.
Physical features like ice, hair color, ear sap, palmar crisis etc are seen in it.
He also accepts skin grafts.

4) Fibroids – Fibroids

Fribroid:

Fibroids are also known as “uterine fibroids” or “leiomyomas”. It is a non-cancerous (benign) growth that develops in the uterine tissues and muscles.

They differ in size, from small nodules to large masses that can distort the shape of the uterus. Fibroids can develop as single growths or multiple growths, and are fairly common, affecting 70-80% of women by age 50.

5) Inevitable Abortion-

Inevitable Abortion:

Inevitable abortion is a type of abortion in which the expulsion of the conceptus progresses with cervical dilatation. In this abortion, the pregnancy cannot be saved because most of the portion of the placenta is detached (from the uterine wall).

This is a clinical type of abortion in which the changes in the abortion have progressed to the point where continuation of the pregnancy becomes impossible. It is called “inevitable abortion”.

6) Mammogenesis –

Mammogenesis:

Maemogenesis is the first phase of the physiology of lactation. which prepares the breast for lactation. In this stage, the ductal and lobulo-alveolar system of the breast grows to prepare the breast for the secretion of milk.

⏩ (B) Fill in the blanks. 05

1) 15-20 lobes are present in placenta are called

Cotyledons,

2) Normal length of umbilical cord is———-cm. The normal length of the umbilical cord is cm.

50-60 cm

3) The fusion of ovum & sperm is called ——

Fertilization

4) Premature separation of placenta is called ——– Premature separation of placenta is called ————.

Abruption placenta

5) During pregnancy endometrium is known as —-

Decidua

⏩ (C) State whether the following statements are True or False. 05

1) Tab. Mesoprostol can be safely administered by midwife. Tablet mesoprostol can be safely given by a midwife.

True

2) Total weight gain during pregnancy is 17 kg Total weight gain during pregnancy is 17 kg.

False

(Reason := An average pregnant woman usually gains about 11 kg of weight during pregnancy which
During 1st trimester :=1 kg,
During 2nd trimester :=5kg,
During 3rd trimester :=5 kg, thus, a total weight gain of 11 kg. No weight gain of 17 kg).

3) Abdominal girth is more than normal in oligo-hydraminous. Abdominal girth is greater than normal in oligohydramnios

False

(Reason: Oligohydramnios is a condition in which the amount of amniotic fluid is reduced during pregnancy, due to which the abdominal girth of the pregnant woman is smaller than her gestational age, i.e. the abdominal girth does not enlarge.)

4) Breast feeding is contraindicated for mother who is suffering with Epilepsy. Best Freeding is contraindicated in mothers with epilepsy.

False

(Reason: If the mother uses antiepileptic medication, it will not affect the child, otherwise there is no problem)

5) Chadwick’s sign is bluish discoloration of vagina. Chadwick’s sign indicates bluish discoloration of vagina.

True

💪 💥☺ALL THE BEST ☺💥💪

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