Midwifery 127 Exam Prep Questions With Verified Answers

What does midwife mean? - Answer With woman. What are social determinants of health and illness? - Answer The social gradient. Stress Early development Work Unemployment Social Support Social exclusion Addition Food Transport What is the Primary Health Care approach to maternity care? - Answer Childbearing is a normal physiological process Childbearing is influenced by culture, economics, family, psychosocial factors and more. Maternal health is a public health issue. Care is planned, managed and involves the community. It is cost-effective, affordable, woman-centered, culturally appropriate and sustainable. What strategies do midwives use to promote midwifery as a primary health care initiative? - Answer Education, Collaboration, Advocation, Kindness Why does midwifery require reflection? - Answer Source of midwifery knowledge. Self-development and awareness. Allows you to make sense of experiences. Facilitates ability to develop strategies for practice improvement. Allows you to identify what you do well. Develops critical thinking skills. Enhances decision making. Provides fresh insights. The ANMC expects all professional midwives practice reflectively and ethically. What types of methods are used to reflect? - Answer Writing Audio taping Creative Talking to a 'critical friend' Exercise Meditation Name types of Reflection. - Answer Technical Practical Emancipatory. Describe technical reflection. - Answer - useful for change in practice procedures and routines. - based on theories of scientific reasoning. Describe practical reflection. - Answer - Useful for examining the 'lived experience' - based on interpretative theory (narrative inquiry) Describe emancipatory reflection. - Answer - useful in situations where power struggles are present. - based on critical theory. Aims to empower people through creating ' transformative action' Name two models of reflection. - Answer Gibbs Schlater & Minocha describe the Gibbs cycle? - Answer Description - What happened? Feelings - What were you thinking and feeling? Evaluation - what was good and bad about the experience. Analysis - what sense can you make of the situation. Conclusion - what else could you have done. Action Plan - if it arose, what would you do? Describe Schlater and Minocha reflective cycle. - Answer Basic Reflection. Observe. Notice effects. Report self awareness. Identify own position. Improve. Deeper Reflection. Observe - contextualize . Notice effects - Identify causes. Report self awareness - relate to practice. Identify own position - connect to theory. Improve - Justify changes. Describe Ethical midwifery practice. - Answer Is safe and effective. Is respectful and kind to self and others. values each persons unique individuality, through cultural safety principles. Is accessible Upholds the right to a person's self-determination. Values informed decision making. Maintains confidentiality. Who governs Australian Midwives? - Answer - Health practitioner regulation national law (1st July 2010) - The Australian health practitioner regulation agency (AHPRA). - The nursing & midwifery board of Australia (NMBA) Name the professional standards documents. - Answer Code of professional conduct for midwives. Code of Ethics for Midwives. Midwifery competency standards. what are the 3 main principles of professional conduct? - Answer 1. Midwives practice competently in accordance with legislation, standards and professional practice. 2. Midwives practice with in a woman-centred framework. 3. Midwives practice midwifery reflectively and ethically. Define the scope of practice for midwives. - Answer - Midwives provide care to healthy 'low risk' women and babies throughout the continuum of childbirth. - midwives need to to be aware of when the care of a woman and family falls outside their 'scope of work'. - ACM guidelines for referral provide guidance on when it is appropriate to consult with or refer care to another health professional. - Midwives who work outside their scope of practice can be subject to a notification to AHPRA for investigation into their practice. Points of Midwives practice competently in accordance with legislation, standards and professional practice. - Answer 1. Midwives practise in a safe and competent manner (primary health care) 2. Midwives practise in accordance with the standrds of the profession and broader health system. 3. Midwives practise and conduct themselves in accordance with laws relevant to the profession and practice of midwifery. 4. Midwives respect the dignity, culture, values and beliefs of each woman and her infant(s) in their care and the woman's partner and family, and of colleagues (primary health care). 5. Midwives treat personal information obtained in a professional capacity as private and confidential. 6. Midwives provide impartial, honest and accurate information in relation to midwifery care and health care products. Points of Midwives practice with in a woman-centred framework. - Answer 7. midwives focus on a woman's health needs, her expectations and aspirations, supporting the informed decision making of each woman. (primary health care and women centred care) 8. Midwives promote and preserve the trust and privilege inherent in the relationship between midwives and each woman and her infant/s. (PHC & WCC) 9. Midwives maintain and build on the community's trust and confidence in the midwifery profession. (PHC) Point of Midwives practice midwifery reflectively and ethically. - Answer Midwives practice midwifery reflectively and ethically. When assessing a pregnant woman what do you need to remember? - Answer The position of the woman. Comfort of the woman. Needs of the mother and baby. Consent required. What are the aims of Abdominal palpation? - Answer ASSESS fetal growth, size and well being. IDENTIFY fetal position and presentation. REASSURE progress of pregnancy. DETECT deviations from the norm. What are indications of abdominal palpation? - Answer To assess fetal growth. To listen to fetal heart Prior to vaginal examination (VE) in labour. To assess progress in labour. What are contraindications of abdominal palpation? - Answer Placental abruptions Preterm labour Lack of consent. what are the roles and responsibilities of the midwife during assessments of a pregnant women? - Answer Perform a competent and holistic examination. Gather accurate and relative information. Document appropriate findings. Recognize deviations from normal and initiate alternative care/ referral. Education and Support - information for the woman. What environment and resources are required for abdominal palpation? - Answer Private, safe and comfortable area. Watch, tape measure, Pinard or Doppler. what preparation should be taken before initiating an abdominal palpation? - Answer - Discussion and consent of the assessment. - warm clean hands. - ensure woman's bladder is empty - assisting woman to lay on the bed. - get woman to lift clothing to expose abdomen and ensure she is comfortable. During abdominal palpation what woman-centered principles should be used? - Answer Non-verbal communication - eye contact. Verbal communication - explanation. Encouragement for woman to participate and share. Discomfort - encourage woman to speak up, stop, address any concerns. Stop palpating if..; woman says so. Woman's self knowledge. Be gentle. Family participation. what is Lie describing? - Answer The baby's spine in relation to the woman's spine. Name the Lie positions. - Answer Longitudinal - longways, up and down, vertical. Oblique - diagonal Transverse - sideways, horizontal. what is Presentation describing? - Answer the part of the baby that is present in the woman's pelvis. Name the types of presentation. - Answer Cephalic (vertex) - Head Vertex - Brow or Face Breech - Bottom Shoulder (dorsoanterior) what is attitude describing? - Answer Flexion of the head - relationship of baby's head to its body. Name the types of attitude. - Answer Fully flexed - chin tucked in, back curve out. Poorly flexed - brow presentation, chin out straight, back is straight. Extended - face presentation, chin extended above, back is curved in. what is descent describing? - Answer How far the baby's has gone into the pelvis. what measurement is used to represent descent? - Answer 5th's - in or out. What is denominator describing? - Answer Describes the lowest part of the fetus. the landmark of the presentation that allows the degree of the rotation of the baby to be described. Occipital - showing part is back of the head. Sacrum - showing part is the buttocks. Mentum or Chin - showing part is the face. what is Position describing? - Answer The relationship between baby's denominator and 8 points on the pelvic brim (the mother's pelvis). What are the abbreviations for position? - Answer LOA, LOT, LOP, ROA, ROT, ROP. what does the 1st letter in position abbreviations indicate? - Answer where the baby's spine is to the mothers left or right hand sides. what does the 2nd letter in position abbreviations indicate? - Answer indicates the denominator (showing part) of baby. Usually O (Cephalic = occiput) S (Breech = Sacrum) A (shoulder = acromion process) M (Face = Mentum (chin)) G (Brow = glabella (3rd eye)) what does the 3rd letter in position abbreviations indicate? - Answer the baby's spine in relation to the mother's pelvis. A = anterior (at the front) P = Posterior ( at the back, spines together) L = Lateral/ T = Traverse (at the sides) What is the first step in abdominal palpation? - Answer - Inspection - Looking at the belly to form a brief, initial impression of progress and position. - visible physiological signs. ie previous surgeries Name the abdominal palpation order. - Answer Fundal palpation. Lateral palpation Deep Pelvic Palpation - Pawlicks Manoeuvre Assessing descent what does the fundal height indicate? - Answer Weeks of gestation should be represented in same centimeter measurement (+/- 2cm) after 24 weeks. what are the aims of abdominal palpation? - Answer Observe signs of pregnancy. Assess fetal size and growth. Locate fetal position and presentation. Detect any deviations from normal. Auscultate the fetal heart when indicated. Identification of scars. What does Assessing descent describe? - Answer How far baby's head has moved below the pelvic brim. Engagement of head . 5/5 up= mobile head. 4-3/5 up = fixed head. 2-1/5 up = engaged head All in. When does the head usually engage? - Answer 36/40 in a primipara. 38/40 or in labour in a muiltpara What is Pawlicks Manoeuvre used for? - Answer To assess the mobility of the presenting part on the fetus. ie. Head is easily moved when not engaged. What is the final physical stage of abdominal palpation? How & why is this done? - Answer Auscultation of fetal heart rate. Done with Pindar or sonicade over fetal shoulder. To confirm baby's wellbieing. social and emotional value - no other clinical or predictive value. what factors can effect uterus size? - Answer Full bladder. Distended colon. Parity. Lie of fetus. Multiple fetuses. Excess amniotic fluid. What should be documented in an antenatal abdominal palpation? - Answer Woman's feelings and observations. Abdominal palpation Inspection Fundal height Lie, position, Presentation, engagement. Fetal movements. Fetal heart rate. additional info. what are the midwife's responsibilities when completing a blood pressure measurement? - Answer know the normal ranges. Know the woman's medical history. Use an organised systematic approach. Minimize environmental factors that can affect vital signs. Accurately record findings. Analyse findings. Verify and report significant changes. Maintain a woman-centered approach. What are normal BP values during pregnancy? what is classified as hypertensive and hypotensive? - Answer Normal 100/60 - 139/89 Average 120/80 Hypertensive - >140/>90 Hypotensive - <100/<60 what determines Systolic pressure? - Answer Stroke Volume. Force of ventricular contraction. Distension of the arterial wall. what determines Diastolic pressure? - Answer Degree of peripheral resistance. Systolic pressure. Cardiac output. What does pregnancy effect on BP? - Answer Heamodynamic changes counterbalanced by progesterone on vessel walls. Decreased peripheral resistance. BP decreases in the 1st trimester ( systolic 5-10 mmHg average, Diastolic 10 -15 mmHg). BP rises gradually from mid pregnancy, returns to pre-pregnancy levels by term.