1.

IV therapy within the scope of the direct-entry midwife includes the introduction of fluids
and electrolytes directly into a vein.
2. A) One benefit to IV therapy includes the need to correct any dehydration that may be
occurring due to hyperemesis during pregnancy, or less than adequate fluid intake
during labor.
B) IV fluids may also be used to replace blood volume in the birthing person
during a hemorrhage.
C) Another reason one may need IV therapy is to reverse/correct ketoacidosis in
the body, which results from exhaustion during labor.

3. A) A risk involved with IV therapy includes fluid overload.

B) Pulmonary edema may occur as well with IV therapy, which includes the collection of
fluids within the alveoli of the lungs.
C) Finally, an electrolyte imbalance may occur with improper IV therapy.
4. It is recommended that direct-entry midwives limit their use of IV therapy to emergency
situations, and only when within the skill level and knowledge of expertise.
5. The 3 factors that affect circulatory function include blood pressure, heart rate, and blood
volume.
6. During or after delivery, a birthing person may experience hypovolemia due to a significant
amount of blood loss, resulting in a drop in blood volume.
7. The body’s first response to hypovolemia is that the peripheral blood vessels constrict and
get smaller to shunt more blood to the major organs. In addition, the heart begins to beat more
rapidly.
8. After blood vessels constrict, and the heart starts beating faster, the body loses its ability to
compensate and keep up with the oxygen demands that are needed. While this occurs,
inadequate blood flow is returned to the heart and stretch receptors are not stimulated
adequately enough. Eventually, the heart stops beating.
9. IV therapy during hemorrhage works to replace the lost blood volume with fluids to prevent
the body from going into shock, and eventually cardiac arrest.
10. In the event of a massive hemorrhage, IV therapy alone is not sufficient as it may be
necessary for the client to receive a blood transfusion. The IV will only stabilize the client in
order to transfer to a higher level of care in order to replace and restore the red blood cells in
the body needed to carry oxygen to the tissues in order to sustain life.
11. Indications for an IV may include extreme dehydration that causes maternal exhaustion,
hypotensive blood pressure, shock like symptoms, or postpartum hemorrhage.
12. Signs and symptoms of shock include: