Answer to Question 1
D
Feedback:
The laxness of body cartilage may cause separation of the symphysis pubis if a pregnant patient falls with the legs outspread. A suture separation this way is very painful, especially on walking or turning. If separation of the symphysis pubis is still present at the time of birth, this can make labor very painful, especially during the pelvic division of labor as the fetus is pushed through the pelvic ring. The patient may need additional analgesia at this time. Elevating the legs, positioning on the side, or applying heat to the region will not help with the pain from the injury.
Answer to Question 2
B
Feedback:
Pregnancy counseling should include education about ways to avoid unintentional injuries such as using automobile seat belts. Puncture wounds need to be evaluated for depth. The patient might need a tetanus injection after this type of injury. If someone punches or kicks the pregnant patient's abdomen, the patient needs to be evaluated for damage to the uterus, bladder, or placenta. If the pregnant patient receives an animal bite, it needs to be evaluated and determined if the animal was rabid. If so, the patient needs rabies inoculations, which are safe to administer during pregnancy.
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