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A client in labor is administered with an anesthetic through the spinal subarachnoid space. Which of the following actions by the nurse is the least appropriate when managing the client?
The midwife maintains the client flat on bed for 8 to 12 hours.
Inform the client that headaches may occur.
Monitor the client for hypertension.
Administer IV fluids.
The midwife should monitor the client for hypotension, not hypertension Subarachnoid or spinal block relieves uterine and perineal pain and numbs the lower extremities, vagina and perineum. The anesthetic may cause headaches. The client should be flat on the bed for 8 to 12 hours. Administration of IV fluids is also appropriate.
A midwife is teaching a 14-year-old girl about contraceptives. The client gave
birth to a healthy baby girl three days ago. The midwife is correct when she says that the most effective way to protect against conception is through:
Natural family planning.
Abstinence is the most effective way to protect against conception. Natural family planning has a failure rate of about 20%. Oral contraception has a failure rate of about 3%. If used correctly, oral contraceptives are 99.5% effective. Surgical methods have a failure rate between 0.1 and 0.4%.
A midwife is assessing four female clients with signs and symptoms involving the
reproductive system. All clients are engaging in heterosexual sexual relationships. The midwife requires identification and treatment of sexual partners of all of the following clients except:
A client diagnosed with genital herpes.
A client diagnosed with chlamydia.
A client diagnosed with bacterial vaginosis.
A client with hepatitis B.
A client diagnosed with bacterial vaginosis is not required to identify her sexual partners for treatment. Engaging in unprotected sex increases the risk for bacterial vaginosis for women only, and it is believed that bacterial vaginosis can be transmitted between women. Therefore, only women who engage in sexual relationships with other women need to identify their sexual partners for treatment of bacterial vaginosis.
A midwife is assessing the fertility of couples who have been trying to conceive
for a period of time without success. Which of the following couples has primary infertility?
A couple engaging in unprotected sex for half a year. No previous conceptions are reported.
A couple engaging in unprotected sex for one year. A previous conception is reported.
A couple engaging in unprotected sex for one year. No previous conceptions are reported.
A couple engaging in unprotected sex for half a year. A previous conception is reported.
Infertility is engaging in unprotected sex for one year without an occurring pregnancy. If the couple has no previous conceptions, it is called primary infertility. If the couple reported a previous conception, it is called secondary infertility.
A couple is considering artificial insemination after the man fails to respond to
medications that intend to increase his sperm count. Which of the following statements about artificial insemination is false?
A donorâ€™s sperm can be used.
The sperm is instilled into the female reproductive tract one day after ovulation.
It involves selective termination of gestational sacs.
The sperm is instilled into the cervix or uterus.
Artificial insemination does not involve selective termination of gestational sacs. Selective termination is performed in in vitro fertilization. Artificial insemination may be considered if the man has inadequate sperm count or if the woman has a condition that interferes with sperm motility.
Medical CPM Exam (Certified Professional Midwife) Detailed Information
CPM Certified Professional Midwife
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Test Code : CPM
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Certified Professional Midwife exam
licensed nurse midwives create the correct birth for each woman | CPM Real Questions and VCE Practice Test
When three midwives gather for a lunchtime wreck at St. Mary's OB-GYN and Midwifery hospital, the banter naturally turns to children — greater mainly, to how newborns enter this world.
The midwives share reports about the joys of fresh births. They compare notes on the array of aids they present mothers to make the deliveries as comfy as feasible — Jacuzzi tubs, activity balls, aromatherapy, massage, music, nitrous oxide. The relaxed dialog underscores the midwife philosophy that childbirth is a herbal procedure, not a pathological condition.
Normalization of the delivery manner is a tenet of the care midwives give to ladies before, all through and after childbirth. licensed Nurse Midwives, like these on staff at St. Mary's, also are informed to deliver primary and well-woman look after girls all the way through their lives.
St. Mary's clinical center has recognized the value of midwife care by way of including these three midwives to its body of workers within the ultimate year. yet another will be part of the practice in August. The midwives work independently however additionally collaboratively with OB-GYN's within the maternity ward, with excessive-risk Maternal Fetal drugs physicians, and with consultants in St. Mary's Neonatal Intensive Care Unit.
"St. Mary's is now a one-cease shop for every thing regarding childbirth. every little thing is effortlessly seamless. When girls walk via our doors, they have the midwife care, the abilities of OB-GYNs if crucial, and the high-risk specialists all within the equal building. That is not discovered anywhere else within the Grand Valley or on the Western Slope," said CNM Holly carpenter.
chippie and her fellow midwives Anita Sheetz, Katherine O'Reilly, and soon, Leslie Gibson, have childbirth journey that adds as much as greater than three decades and to greater than three,000 babies. They also have greater than 25 years of education between them. every has a string of professional initials following her name.
They offer the epitome of up to date medical institution-linked delivery care. They additionally signify an ancient career.
The term midwife came about within the center a long time in England. In historic English 'mid' potential 'with.' 'Wif' means 'girl.' but the practice of experienced ladies attending childbirths changed into first documented in historical Egypt.
Perceptions of midwifery have changed via heritage. from time to time, midwives had been maligned and misunderstood. Some had been considered witches in the early days of this country because they used herbal remedies. Midwives were marginalized in different eras as caregivers for less than the bad or for the "hippie" subculture.
presently, the pendulum has swung to licensed midwives being identified as pregnancy and beginning consultants. more than 12,000 licensed Nurse Midwives (CNMs) presently apply in the u.s.. They attend 12 percent of all non-Caesarean births. more than 95 percent of the births they attend are in hospitals in preference to homes.
Sheetz, who has been a midwife for 21 years, said she thinks more ladies within the U.S. are turning to certified midwives as a result of midwives' patient-driven perspective toward childbirth.
"we endorse ladies being empowered to have the delivery it is correct for them. We are attempting to assist them in making whatever decisions they make. we are right here to aid help them in their choices," Sheetz pointed out.
Jeff Emerson, St. Mary's follow administrator, spoke of the demand for midwife care is why the sanatorium decided so as to add nurse midwives to the group of workers.
"For us, we noticed a necessity within the community that changed into no longer being met. We noticed constructing a strong midwife follow as a true improvement to the group," he pointed out.
Having midwives on workforce at a health facility is yet another step in normalizing a profession that historically dealt with practically all births within the united states. It wasn't until the remaining half of the 18th century, when the apply of medication became professionalized and medical interventions grew to become the norm in childbirth, that physicians edged out midwives. via the starting of the 20th century, less than half of all U.S. births had been attended by using midwives.
Midwifery started a gradual comeback in hospitals in the 1950s when working towards become professionalized and when some health facility directors developed in-health facility midwifery features to support take care of the submit-conflict baby boom.
Use of midwives nevertheless has lots of catching up to do within the u.s.. in many countries, midwives bring the majority of babies. Midwives bring greater than seventy five p.c of children in extraordinary Britain, France, Germany and Scandinavia.
Midwives can take credit score for triggering changes in attitudes concerning childbirth within the remaining half century. They helped to gain acceptance for the once radical concept that fathers may still be allowed within the beginning room. Midwives pushed for little ones to be left in mothers' rooms instead of being positioned in nurseries. and they have been instrumental in promotion the return to breast-feeding.
today, the American faculty of Nurse Midwives oversees certification and carrying on with education for midwives. probably the most particularly expert degree of midwife is licensed Nurse Midwife. These midwives were expert as nurses and earned grasp's levels in certified midwifery courses. they have got passed countrywide certification tests.
St. Mary's midwives are all during this class of CNMs. on account of their level of coaching, they are allowed to supply typical women's health care together with delivery services. they could additionally prescribe medicines.
licensed midwives (CM) — have bachelor's degrees in fields aside from nursing and additionally a master's in midwifery. they have got the same midwifery schooling and flow the equal countrywide exam as CNMs.
licensed expert Midwives (CPMs) — have apprenticeship practicing, or are graduates of a formal midwifery education software. CPMs have to move a countrywide certification examination, which is distinct from the check for CNMs and CNs. CPMs don't work in a health center atmosphere.
Midwives are trained and have the experience to appreciate when something is not right all through a pregnancy or beginning. If there are complications, the St. Mary's midwives say they can talk to, collaborate or refer sufferers to a better stage of care, usually an OB-GYN. If a woman is diabetic, needs a C-area or has different circumstances requiring health care professional care, the midwives direct those people to a physician and continue supporting their patients by way of working collaboratively with the doctors.
Midwives aid natural childbirth. but if moms prefer to have pain medicinal drugs or epidurals, midwives support these choices at the identical time they promote attempting comfort measures like whirlpool baths and therapeutic massage. They also have a brand new alternative for ladies — nitrous oxide, in any other case accepted in dentist workplaces as "laughing gas." girls in labor can administer it to themselves by keeping a mask to their faces all through contractions. The nitrous oxide passes via their gadget in seconds and is safe for the child.
"one of our most critical jobs," O'Reilly pointed out, "is to supply women the entire alternatives and support them make educated choices about what they want."
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