exam questions with answer ,class notes
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PHYSIOLOGYAND CAREDURINGTHETHIRD STAGE OF LABOUR
PHYSIOLOGICAL PROCESSES 
 The third stage can be defined as the period from the birth of the 
baby to complete expulsion of the placenta and membranes. 
 It involves the development of the 
relationship between mother, 
baby and father, the separation, descent and expulsion of 
the placenta and membranes, the control of haemorrhage 
from the placenta site, and sometimes, the initiation of 
breast-feeding. 
 Although traditionally labour is divided into three distinct 
componen...
- Class notes
- • 42 pages •
PHYSIOLOGICAL PROCESSES 
 The third stage can be defined as the period from the birth of the 
baby to complete expulsion of the placenta and membranes. 
 It involves the development of the 
relationship between mother, 
baby and father, the separation, descent and expulsion of 
the placenta and membranes, the control of haemorrhage 
from the placenta site, and sometimes, the initiation of 
breast-feeding. 
 Although traditionally labour is divided into three distinct 
componen...
PHYSIOLOGYAND CAREDURINGTHETRANSITION AND SECONDSTAGEPHASESOF LABOR
The physiological changes are a continuation of the 
 same forces that occurred in the earlier hours of labour, 
 but activity is accelerated, but does not occur abruptly. 
Some women may experience an urge to push before the cervical 
os is fully dilated, and other may experience a lull before the 
onset of strong expulsive second stage contractions. 
 This latter phenomenon has been termed the resting phase of the 
second stage of labour. 
T
- Class notes
- • 22 pages •
The physiological changes are a continuation of the 
 same forces that occurred in the earlier hours of labour, 
 but activity is accelerated, but does not occur abruptly. 
Some women may experience an urge to push before the cervical 
os is fully dilated, and other may experience a lull before the 
onset of strong expulsive second stage contractions. 
 This latter phenomenon has been termed the resting phase of the 
second stage of labour. 
T
FIRST STAGE OF LABOUR:
FIRST STAGE OF LABOUR: 
PHYSIOLOGY AND CARE. 
 SESSION 1 
 R. NDERITU 
 A human pregnancy -last approximately 40 weeks 
 labour usually occurring between 37 and 42 weeks’ gestation (National 
Institute for Health and Clinical Excellence [NICE] 2007) 
 Complex physiologicaland psychological changes occur during the 
last few weeks of pregnancy, and also during the onset of labour, that 
prepare the woman for the process of labour and birth. 
 Labour: process by which 
expelle...
- Class notes
- • 229 pages •
FIRST STAGE OF LABOUR: 
PHYSIOLOGY AND CARE. 
 SESSION 1 
 R. NDERITU 
 A human pregnancy -last approximately 40 weeks 
 labour usually occurring between 37 and 42 weeks’ gestation (National 
Institute for Health and Clinical Excellence [NICE] 2007) 
 Complex physiologicaland psychological changes occur during the 
last few weeks of pregnancy, and also during the onset of labour, that 
prepare the woman for the process of labour and birth. 
 Labour: process by which 
expelle...
ANAEMIA PREVENTION AND CONTROL IN PREGNANCY
ANAEMIA PREVENTION AND CONTROL IN 
PREGNANCY 
ANAEMIA PREVENTION AND CONTROL IN PREGNANCY 
 AIM 
 • To inform participants about the problem 
of anaemia in pregnancy, its common causes, 
and prevention and control strategies and to 
review skills for case management. 
 OBJECTIVES: 
 At the end of the session, participants will be 
able to: 
 • Describe the problem of anaemia in 
pregnancy and list its effects on the 
OBJECTIVES: 
• Describe strategies for preventing anaemia in pre...
- Class notes
- • 16 pages •
ANAEMIA PREVENTION AND CONTROL IN 
PREGNANCY 
ANAEMIA PREVENTION AND CONTROL IN PREGNANCY 
 AIM 
 • To inform participants about the problem 
of anaemia in pregnancy, its common causes, 
and prevention and control strategies and to 
review skills for case management. 
 OBJECTIVES: 
 At the end of the session, participants will be 
able to: 
 • Describe the problem of anaemia in 
pregnancy and list its effects on the 
OBJECTIVES: 
• Describe strategies for preventing anaemia in pre...
antepartum hemorrhage
antepartum hemorrhage 
Bleeding from genital tract after 24weeks 
gestation but before onset of labor 
TYPES OF APH 
 Placenta praevia 
 Placenta abruption 
ASSESSMENT OF PHYSICAL CONDITION; 
 Maternal cx. 
 Assess emotional status 
 Pallor, breathlessness(indicate shock) 
 Observe pulse rate respiratory, blood pressure and temperatures 
 Assess amount of blood loss=ensure adequate fluid replacement 
 A gentle abdominal exam is done-observe signs of labour(N/B:-N...
- Class notes
- • 38 pages •
antepartum hemorrhage 
Bleeding from genital tract after 24weeks 
gestation but before onset of labor 
TYPES OF APH 
 Placenta praevia 
 Placenta abruption 
ASSESSMENT OF PHYSICAL CONDITION; 
 Maternal cx. 
 Assess emotional status 
 Pallor, breathlessness(indicate shock) 
 Observe pulse rate respiratory, blood pressure and temperatures 
 Assess amount of blood loss=ensure adequate fluid replacement 
 A gentle abdominal exam is done-observe signs of labour(N/B:-N...
PRETERM PRELABOUR RUPTURE OF MEMBRANES (PPROM)
PRETERM PRELABOUR RUPTURE OF 
MEMBRANES (PPROM) 
 R. NDERITU 
• occurs before 37 completed (preterm) weeks’ gestation, 
 where the fetal membranes rupture without the 
 onset of spontaneous uterine (PRELABOUR/PROM) 
 activity and the consequential cervical dilatation. 
• affects 2% of pregnancies and placental abruption is 
 evident in 4–7% of women who present with PPROM. 
 • The condition has a 17–32% recurrence rate in 
 subsequent pregnancies of affected women (Svigos et al 
 2...
- Case
- • 15 pages •
PRETERM PRELABOUR RUPTURE OF 
MEMBRANES (PPROM) 
 R. NDERITU 
• occurs before 37 completed (preterm) weeks’ gestation, 
 where the fetal membranes rupture without the 
 onset of spontaneous uterine (PRELABOUR/PROM) 
 activity and the consequential cervical dilatation. 
• affects 2% of pregnancies and placental abruption is 
 evident in 4–7% of women who present with PPROM. 
 • The condition has a 17–32% recurrence rate in 
 subsequent pregnancies of affected women (Svigos et al 
 2...
Hypertensive disorders
Hypertensive disorders 
DEFINE PRE-ECLAMPSIA 
 A type of hypertensive disorder that occurs during pregnancy esp. 
after 20 weeks gestation(new onset of hypertension) 
 When severe it can escalate to become ECLAMPSIA- convulsive 
state 
•It is marked by high blood pressure in women who have 
previously not experienced high blood pressure before. 
 •High level of protein in urine 
 •Edema of feet, legs and hands, face 
 •Organ injury 
 •It appears late in pregnancy after 20 ...
- Class notes
- • 42 pages •
Hypertensive disorders 
DEFINE PRE-ECLAMPSIA 
 A type of hypertensive disorder that occurs during pregnancy esp. 
after 20 weeks gestation(new onset of hypertension) 
 When severe it can escalate to become ECLAMPSIA- convulsive 
state 
•It is marked by high blood pressure in women who have 
previously not experienced high blood pressure before. 
 •High level of protein in urine 
 •Edema of feet, legs and hands, face 
 •Organ injury 
 •It appears late in pregnancy after 20 ...
MINOR DISCOMFORTS IN PREGNANCY
MINOR DISCOMFORTS IN 
PREGNANCY 
 R. NDERITU 
 Common complains of a pregnant woman that occurs due to 
physiologic alteration of pregnancy but don’t necessarily signify 
pathology. 
 • They are mainly caused by hormonal, accommodation, 
metabolic and/or postural changes. 
• They subside after delivery and the end of peuperium. 
• These remain minor as long as they do not pose much risk to the 
life of the mother and the baby. 
 • Remember: 
 • Minor disorders may escalate a...
- Class notes
- • 54 pages •
MINOR DISCOMFORTS IN 
PREGNANCY 
 R. NDERITU 
 Common complains of a pregnant woman that occurs due to 
physiologic alteration of pregnancy but don’t necessarily signify 
pathology. 
 • They are mainly caused by hormonal, accommodation, 
metabolic and/or postural changes. 
• They subside after delivery and the end of peuperium. 
• These remain minor as long as they do not pose much risk to the 
life of the mother and the baby. 
 • Remember: 
 • Minor disorders may escalate a...
PSYCHOTROPIC DRUGS
PSYCHOTROPIC DRUGS 
Structural Classification of the 
Nervous System 
 Central Nervous System: consist of brain 
 and spinal cord, which act as integrating and 
 command centers of the nervous system. 
 Peripheral Nervous System: it is the part of 
 nervous system outside the CNS. They link all 
 parts of the body by carrying impulses from 
 sensory receptors to CNS and from the CNS 
 to appropriate glands or muscles. 
Synaptic Transmission 
 Excitatory postsynaptic potentials (EPSP) ...
- Class notes
- • 78 pages •
PSYCHOTROPIC DRUGS 
Structural Classification of the 
Nervous System 
 Central Nervous System: consist of brain 
 and spinal cord, which act as integrating and 
 command centers of the nervous system. 
 Peripheral Nervous System: it is the part of 
 nervous system outside the CNS. They link all 
 parts of the body by carrying impulses from 
 sensory receptors to CNS and from the CNS 
 to appropriate glands or muscles. 
Synaptic Transmission 
 Excitatory postsynaptic potentials (EPSP) ...
PREGNANCY DIAGNOSING PREGNANCY.
PREGNANCY 
DIAGNOSING PREGNANCY. 
 DEFINITION OF TERMS 
 Trimester refers to a three month calendar period. 
 • Gravidity is the number of times a woman has 
been pregnant regardless of the outcome of the 
pregnancies. 
 • Parity refers to the delivery of a child that grew 
beyond 28 weeks (the age of viability) irrespective 
of whether the baby was born alive or dead. 
• A Primigravida is a woman who is pregnant for 
the first time. 
 • A Primipara is a woman who has had only one ...
- Class notes
- • 92 pages •
PREGNANCY 
DIAGNOSING PREGNANCY. 
 DEFINITION OF TERMS 
 Trimester refers to a three month calendar period. 
 • Gravidity is the number of times a woman has 
been pregnant regardless of the outcome of the 
pregnancies. 
 • Parity refers to the delivery of a child that grew 
beyond 28 weeks (the age of viability) irrespective 
of whether the baby was born alive or dead. 
• A Primigravida is a woman who is pregnant for 
the first time. 
 • A Primipara is a woman who has had only one ...