Care of Mother, Child and Adolescent

ania is a 27 year old nullipara whose baby is in a breech position. After several hours of labor, the baby was delivered via a Caesarian section delivery with moderate meconium stain. What is the most likely cause of meconium stain in babies who are in breech presentations?

cervical pressure on the buttocks and rectum

After an hour of administering oxytocin intravenously, the nurse assesses a woman's contractions to be 80 seconds in length. The nurse's first action would be to:

discontinue the oxytocin infusion.

Another variant of gestational hypertensive process is the HELLP syndrome named for the common symptoms that occur with it? Which of the following symptoms is not a part of this syndrome

elevated lipid function

A married couple unable to conceive a child for almost 5 years now came to the fertility clinic for evaluation. As the nurse on duty, your most basic fertility assessment procedures should begin with....

health history taking and a physical examination

Bella is a primigravida who is in the active phase of labor with the frequency of the contractions to be not more than 2-3 contractions in a 10 minute period. Cervical dilation is at 2-3 cm. pain medications were given to her due to the pains labor brings. What type of uterine contractions does Bella manifests?

hypotonic contractions

A woman is admitted with a diagnosis of ectopic pregnancy. For which procedure should the nurse prepare?

immediate surgery

What would be the physiologic basis for a placenta previa?

low placental implantation

Abruptio placentae is a placental separation from the uterus before the fetus is born, it usually occurs late in pregnancy and cuts off blood supply to the fetus. It is manifested by the following signs and symptoms except

painless vaginal bleeding

Admitting Section has just called your Station to inform you to prepare for a patient diagnosed to have placenta previa. What is the classic symptom of this condition?

painless vaginal bleeding in the third trimester

When a woman in labor has reached 8 cm dilation, the nurse notices the fetal heat rate suddenly slows. On perineal inspection, the nurse observes the fetal cord has prolapsed. The nurse's first action would be to:

place her in a knee-chest position.

A woman in labor has sharp fundal pain accompanied by slight vaginal bleeding. What would be the most likely cause of these symptoms?

premature separation of the placenta

Due to prolonged labor, the OB on duty informed you that she will augment labor on Mrs. Cruz in Bed 3. While preparing for this procedure you should be certain the woman meets the criteria for labor augmentation. Which of the following is not a part of the criteria?

presence of CPD

A pregnant client has an Rh-negative blood type. Following the birth of the client's infant, the nurse administers her Rho(D) immune globulin. The purpose of this is to:

prevent maternal D antibody formation.

A woman in labor is at risk for abruptio placentae. Which assessment would most likely lead the nurse to suspect that this has happened?

sharp fundal pain and discomfort between contraction

After several work ups and diagnostic tests, Mr & Mrs Santos had been advised to try assisted reproductive techniques to aid them in achieving conception. An intrauterine insemination preparations were started 2 months ago and the couple had been complaining that it is taking a long time for the procedure to succeed. The best answer you can give them is to tell them that:

takes an average of 6 months to achieve

For couples having problems with subfertility, one recommendation is to undergo alternative insemination procedures such as intrauterine insemination (IUI). This procedure involves instillation of sperm from a masturbatory sample into the female reproductive tract by means of a cannula to aid conception at the time of ovulation. Which of the following is not true about IUI?

the sperm can either be instilled into the cervix or directly into the uterus anytime

The nurse is evaluating care provided to a patient in the third trimester of pregnancy who has been diagnosed with gestational hypertension. Which finding indicates that treatment has been successful for this patient?

urine protein 0

One of your patients who had a Cesarian birth several days ago was just diagnosed to have an infection of the lining of her uterus. She manifested the usual symptoms of infection most especially fever suggesting that much of the invasion occurred during labor or birth and is consistent with the time it takes for infectious organisms to grow. On what post-partal day does fever occurs?

3rd to 4th postpartal day

A woman at 32 weeks' gestation is admitted in preterm labor. On the nurse's admission assessment, which of following findings would cause the nurse to question the administration of a tocolytic agent?

Cervical dilation of 5 cm

A woman is admitted to the labor room with a diagnosis of multiple gestation. Knowing that multiple gestation can complicate delivery such as entangled cords or arrest of descent, many infants of multiple gestations are born via what type of delivery?

Cesarian Section

Clarisse, 27 years old, married has missed her period by 6 weeks. Upon waking up, she had severe lower abdominal pain. This prompted her to visit her OB-Gyne and was advised to have a transvaginal ultrasound. The result showed that she has an Ectopic pregnancy. Higher incidence of this condition usually occurs in what part of the woman's reproductive organs?

Fallopian tube

A friend of yours contacted you because her aunt is having a dark brown to bright red vaginal bleeding and she is on her second trimester of pregnancy. She also told you that a grapelike cysts are present in her perineal pads. These signs are specific for what type of complication of pregnancy?

Gestational Trophoblastic Disease

After delivery, a patient is diagnosed with placenta succenturiata. For what procedure should the nurse prepare this patient?

Manual removal of accessory lobes

During a home visit, a postpartum patient is complaining of a painful area on one breast. The nurse notes a local area on one breast to be red and warm to touch. For which health problem should the nurse plan care for this patient?

Mastitis

One factor that causes female subfertility is tubal transport problems. The diagnosis of this condition is done after sonographic examination of the fallopian tubes and uterus using an ultrasound contrast agent introduced in the uterus through a narrow catheter inserted in to the uterine cervix followed by intravaginal scanning. What type of examination does this procedure describes?

Sonohysterosalpingogram

A pregnant woman is admitted to the hospital with a diagnosis of placenta previa. Which action would be the priority for this woman on admission?

assessing fetal heart tones by use of an external monitor

A woman of 16 weeks' gestation telephones the nurse because she has passed some "berry-like" blood clots and now has continued dark brown vaginal bleeding. Which action would the nurse instruct the woman to do?

-Maintain bed rest, and count the number of perineal pads used.

A woman has been diagnosed as having gestational hypertension. Which symptom for this condition is the most typical?

-blood pressure elevation

A 37 year old married woman on her second trimester, manifesting light vaginal bleeding and mild abdominal cramps was admitted to your ward due to incompetent cervix. The most common treatment for this is a procedure called a cerclage to help your pregnancy last longer. When is this procedure best performed?

12 to 14 weeks of pregnancy

Spontaneous miscarriage is the loss of a pregnancy before viability of the fetus. At what age does a fetus considered to be viable?

16 to 24 weeks

Marissa, a multipara woman is one of the patients in the Labor Room where you are assigned. Upon assessment you have learned from her that she has a history of a precipitate labor. This is a condition where the birth of the baby is completed in less than how many hours?

3 hours

While assisting in the delivery room, on the second stage of labor when the cervix has fully dilated, you have noticed that the head of the fetus is in the same place in the birth canal. This signifies that the baby hasn't moved farther down the birth canal within the last hour. This condition is commonly caused by Cephalopelvic disproportion (CPD). What type of dysfunctional labor is present?

Arrest of Descent

A postpartal woman is developing a thrombophlebitis in her right leg. Which assessments would the nurse make to detect this?

Assess for pedal edema.

Infertility is the inability to conceive a child or sustain a pregnancy to birth. Because most couples have the potential to conceive but are just less able to conceive without additional help, the term subfertility is more often used today. This condition is said to exist in a couple when a pregnancy has not occurred after how many years of engaging in unprotected coitus?

At least 1 year

The nurse is reviewing the plan of care for a pregnant patient experiencing a threatened miscarriage. Which outcome would be appropriate for this patient?

Bleeding spontaneously stops within 24 to 48 hours.

It is a blood disorder that may occur with any trauma, so it can accompany such conditions as premature separation of the placenta and hypertension of pregnancy

Disseminated Intravascular Coagulation

The nurse is preparing an education session on the 2020 National Health Goals to prevent complications of pregnancy. What should the nurse include as the best preventive measure to eliminate complications of pregnancy?

Encourage all pregnant patients to have prenatal care.

The nurse assesses that a fetus is in a breech presentation. Where would you auscultate for fetal heart sounds?

High in the abdomen

The nurse is identifying nursing diagnoses for a patient with gestational hypertension. Which diagnosis would be the most appropriate for this patient?

Ineffective tissue perfusion related to vasoconstriction of blood vessels

This condition happens when an Rh- mother is sensitized and carries a fetus who is Rh+. Maternal antibodies form and destroy fetal red blood cells, leading to anemia, edema, and jaundice in the newborn

Isoimmunization

The nurse on duty at the Labor Room was checking the chart of one patient named Helen. Helen failed to meet the expected growth rate of her fetus so an ultrasound was requested revealing the pockets of the amniotic fluid to be less than average. Oligohydramnios was then diagnosed. This condition suggests that a disorder may exist in what organ of the fetus

Kidney

A woman is said to be in preterm labor when she has had uterine contractions every 10 minutes for 1 hour and cervical dilatation begins. What drug will her doctor prescribe to halt preterm labor?

Magnesium Sulfate

Susan a 41 years old primigravida is admitted to the labor because of strong regular contractions, back and belly pains, and bloody vaginal discharges. On her 2nd trimester of pregnancy she was diagnosed to have gestational hypertension. Which of the following is medication is most likely be part of the pharmacologic treatment

Magnesium Sulfate

A woman develops gestational diabetes. Which assessment should she make daily?

Measure serum for glucose level by a finger prick.

What is the medication of choice if ectopic pregnancy is discovered before the tube ruptures to cause the conceptus to be reabsorbed?

Methotrexate

Mariana, on her third trimester of pregnancy, manifests vaginal bleeding. She had a history of uterine surgery. A sonogram was requested revealing a serious pregnancy condition wherein the placenta grows too deeply into the uterine wall. .This condition is called ___________

Placenta Accreta

Wilma 29 y.o. Gravida 2 Para 1, is admitted with the following symptoms: difficulty breathing, premature contractions, an a uterus that is larger than expected for the fetus's age. A sonogram revealed that there is too much amniotic fluid that can lead to ruptured membranes and premature birth because of increased intrauterine pressure. What complication of pregnancy is being describe by this signs and symptoms?

Polyhydramnios

A woman on her 26th month of gestation came to the clinic for consultation. Upon assessment, you have noticed that she is having persistent uterine contractions that causes cervical effacement over 80% and an increased vaginal discharge with menstrual-like cramping. This is indicative that your patient might be having what type of labor?

Preterm Labor

It is tearing of the fetal membranes with loss of amniotic fluid before the pregnancy is at term.

Preterm rupture of the membranes

Which action would be most appropriate for the woman who experiences dysfunctional labor in the first stage of labor?

Provide ongoing communication about what is happening

Vaginal bleeding during pregnancy is always serious until ruled otherwise because it has the potential to diminish the blood supply to both the mother and fetus. As a rule, to improve placental circulation and prevent supine hypotension syndrome, in what position will you put women with bleeding during pregnancy?

Side lying

A multipara client in labor is having contractions that are 2 minutes apart but rarely over 50 mm Hg in strength; the resting uterine tone is high, 20 to 25 mm Hg. The client asks what she can do to make contractions more effective. The nurse's best response is which?

Rest between contractions

Rosanna Gravida has an Rh- blood type. Her record shows that she had a previous miscarriage at 16 weeks into her last pregnancy. To minimize isoimmunization, what medication should the nurse check that she received following the miscarriage?

RhIG (RhoGAM)

A patient who is 16 weeks pregnant is passing pieces of body tissue along with blood clots and dark red blood from the vagina. What should the nurse direct the patient to do at this time?

Seek immediate medical attention and bring the expressed vaginal material.

Fran is in her 21st week of gestation and in her routine prenatal care her health care provider noticed that her blood pressure increased above her pre-pregnancy level. Other symptoms were also noted suggesting a preeclampsia. Which of the following symptoms is not a classic symptom of Preeclampsia?

Seizure

A woman with thrombophlebitis should be continually assessed for a possible life-threatening complication such as pulmonary embolus or the obstruction of the pulmonary artery by a blood clot. Which of the following symptoms will likely be a manifestation of this condition?

Sudden, sharp chest pain

A pregnant patient with a history of premature cervical dilatation undergoes cervical cerclage. Which outcome indicates that this procedure has been successful?

The client delivers a full-term fetus at 39 weeks' gestation

The nurse is assessing a patient in labor. On which complication of labor as identified within the 2020 National Health Goals will the nurse focus?

Uterine rupture

Anna who had just delivered a healthy baby boy few hours ago was wheeled back to the DR because she was observed in the ward to be pale, and hypotensive. Upon vaginal inspection, a lot of blood is still oozing from her vagina soaking several pads already. What are the most frequent cause of postpartal hemorrhage?

Uterine atony or a retained placental fragment

Which of the following statement is true about thrombophlebitis?

women who have spent prolonged time in a birthing room with their legs positioned in stirrups