Exam 3
Glucose Challenge Test (GCT)
-50g carb load at 24-28 weeks -Blood needs drawn 1 hour after ingestion -second antibody screen as well -Abnormal result (135)-> 3 hour glucose tolerance test -no fasting
Benefits of mushrooms
-Anti-angiogenesis -Anti-aromatase -improves immune function -mushroom lectin to pebbly cancer cells informing natural killer T cells so it's eliminated
Benefits of seeds and nuts
-Omega 3 fatty acids, especially flax, chia, hempseeds, walnuts -Lignin in seeds such as flax, chia, hemp prevent breast and other cancers -Prevent neurodegeneration and diseases while improving neurogenesis
Methergine (Methylergonovine)
Med for postpartum hemorrhage should not be given in pt with HTN
Kick Counts
10 times in 2 hours -have something to eat or drink to increase perfusion to placenta
Appropriate percentage of oxygenation initially at newborn resuscitation
21% to prevent blindness
Hemabate (Carboprost)
med for postpartum hemorrhage should not be given to patients with asthma
Biophysical Profile (BPP)
6 or below indicates poor intrauterine environment-> deliver
A client, 38 weeks' gestation, is being induced with IV oxytocin (Pitocin) for hypertension and oligohydramnios. She is contracting q 3 min x 60 to 90 seconds. She suddenly complains of abdominal pain accompanied by significant fetal heart bradycardia. Which of the following interventions should the nurse perform first? A Turn off the oxytocin infusion. B Administer oxygen via face mask. C Increase the client's LR drip. D Call the obstetrician.
A
Occiput presentation
Fetal head is flexed
Reason why cervical ripening agents are contraindicated in patients with a previous C-section
Risk of uterine rupture
What is OA?
The nurse palpates the fetal posterior fontanel and knows that baby is in this position
Food Addiction
Cravings caused by certain foods triggering the reward centers of the brain-> usually mistaken for low blood sugar due to inflammation -Educate on GBOMBS and the benefits
A client is scheduled for an external version. The nurse would expect to prepare which of the following medications to be administered prior to the procedure? A Oxytocin (Pitocin). B Ergonovine (Methergine). C Betamethasone (Celestone). D Terbutaline (Brethine).
D
A client, G3P2002, is immediately postexternal version. The nurse monitors this client carefully for which of the following? A Decreased urinary output. B Elevated blood pressure. C Severe occipital headache. D Variable fetal heart decelerations.
D
A nurse determines that a client is carrying a fetus in the vertical lie. The nurse's judgment should be questioned if the fetal presenting part is which of the following? A Sacrum B Occiput C Mentum D Scapula
D
Name the 5 P's and how they impact the process of L&D
-Passenger: Part of fetus that first enters the pelvis -Passageway: birth canal that's composed of mother's rigid, bony pelvis and soft tissues -Powers: involuntary contractions of uterus and voluntary aid in expulsion of fetus -Position: physical placement of the mother during the laboring process -Psyche: emotions can cause either relaxation or muscle tension during birth
Management of Shoulder Dystocia
-Turtle Sign: bobbing in and out - GET HELP -McRobert's Maneuver: flex legs way back and coach to push when requested by provider for more room -Suprapubic pressure: solid pressure just above the pubic bone, following along the back side of baby's head
Benefits of onions and garlic
-antibacterial -antiviral -antifungal -antiparasitic while preserving microbiome -phytonutrients such as quercetin which may decrease inflammation of osteoarthritis
Benefits of beans/legumes
-resistant starch and fiber -slow glucose and calorie absorption, decreasing insulin resistance -increase healthy microbiome -bacteria feed on RS produce fatty acids which prevents colon cancer
The physician has ordered oxytocin (Pitocin) for induction for 4 gravidas. In which of the following situations should the nurse refuse to comply with the order? A Primigravida with a transverse lie. B Multigravida with cerebral palsy. C Primigravida who is 14 years old. D Multigravida who has type 1 diabetes.
A
Dilatation
Cervical opening
Effacement
Cervical thinning
Benefits of greens
repair and protect cellular DNA, anti-oxidant activity and anti-inflammatory, removing free radicals and AGES
Examples of seeds and nuts
sesame seeds: vitamin E flax seed: prevent breast cancer chia seeds
Flax seeds
source of foidal estrogen and protein
Examples of greens
spinach, beet tops, parsley, rhubarb -cruciferous: cabbage, horseradish, radish, broccoli
Initial steps in the birth of every newborn
warm, dry, stimulate
Identify the use of terbutaline (including dose & route) as it is related to this image.
Terbutaline 0.25mg, subq for tachysystole. This med relaxes smooth muscle, which decreases contractility. Also increases placental perfusion.
2 Reasons for decreased variability
fetal sleep cycle, medication (narcotic/anesthetic), maternal hypoglycemia, stressed infant
Safe titration of Pit in labor induction
initiate at 1-2mu; increase by 1-2mu q30min with max of 20mu (unless ordered by provider)
NST
monitor 20 minutes, 2-3 accelerations= reactive
External Version contraindicated in these 2 scenarios
oligohydramnios and ROM
What is the cause of this deceleration? A Cord compression B Maternal infection C Fetal head compression D Placental insufficiency
C
Secondary Powers
Aids in expulsion of fetus; Voluntary
A woman had a baby by normal spontaneous delivery 5 minutes ago. The nurse notices a gush of blood expelled from the vagina and the umbilical cord lengthened. What should the nurse conclude? A- The mother has an atonic uterus B- The placenta is about to be delivered C- Assess for internal lacerations and vaginal hematoma D- This is simply expulsion of old blood
B- Placenta is about to be delivered - a gush of blood and lengthening of cord are key signs that the placenta is separating and about to deliver
The major risk associated with meconium stained fluid is best described by which of the following statements? A- Prolonged Fetal Hypoxia B- Development of chorioamnionitis C- Fetal umbilical cord compression D- Meconium aspiration
D- meconium aspiration
RN should do this if a fetus is presenting in a shifted, or asynclitic position
Empty the bladder
A patient receiving Pitocin can receive O2 via nasal canula. A True B False
False
The nurse can place the intra-uterine pressure catheter. A True B False
False
The nurse is questioning whether the maternal or fetal heart rate is being graphed. State how to determine whose heart rate is on the monitor.
If mom moves or adjustment is made to the FHM, could be picking up maternal HR. Assess maternal HR and compare to what the monitor says.
The RN calculates that MVU are 210. What action should the RN take on the Pit drip?
Increase drip rate
Why A1C is not an accurate lab result after 1st trimester
Increased maternal blood circulation
Contraindication for delivery of a fetus in transverse lie
Induction (Pit)
Primary Powers
Involuntary contractions of the uterus
3 Independent Nursing Interventions to Assess Adequacy of Contractions During Labor
Palpation of contractions, observe mother's reaction, observe monitor for duration & frequency of contractions & potential IUPC
Transverse lie
The fetus is horizontal to mother's spine
Vertical lie
The fetus is lying parallel to the mother
Passenger Presentation
The part of fetus that enters the pelvis
Discuss newborn thermoregulation
When cold: tachypnea to respiratory distress, hypoglycemia, continued decrease in temperature, and acidosis -Normal blood sugar: 40 or above - Low temp=sepsis; poor feeding is symptom, admission to NICU, IV, antibiotics after culture of blood or spinal fluid completed
Passageway
composed of the mother's rigid bony pelvis and the soft tissues of the cervix, the pelvic floor, the vagina, and the introitus
Benefits of Berries
darker colored such as berries, cherries, and pomegranates greatest nutrient density -increases endothelial nitrous oxide creating elastic vessels -Improves immune function and decrease cancer risk
During a vaginal examination the nurse palpates the fetal buttocks that are facing the left posterior and are 1 cm above the ischial spines. Which of the following is consistent with this assessment? A- LOA, -1 station B- LSP, -1 station C- LSA, +1 station D- LOP, +1 station
B- LSP; -1 station
Which of the following situations would contraindicate the use of cytotec for cervical ripening? A- Previous cesarean section B- A multigestational pregnancy C- A cervix 50% effaced D- Gestational diabetes
A- previous C-section
The labor and delivery nurse performs Leopold's maneuvers. A soft round mass is felt in the fundal region. A flat object is noted on the left and small objects are noted on the right of the uterus. A hard round mass is noted above the symphysis. Which of the following positions is consistent with these findings? A Left occipital anterior (LOA) B Left sacral posterior (LSP) C Right mentum anterior (RMA) D Right occipital posterior (ROP)
A
Which of the following nonpharmacological interventions recommended by nurse midwives may help a client at full term to go into labor? (Select all that apply.) A Engage in sexual intercourse. B Perform yoga exercises. C Eat raw spinach. D Massage the breast and nipples.
A,D
The nurse is caring for a client recovering from cesarean delivery of macrosomic infant. Current assessment is heavy rubra flow, uterus palpates high in abdomen and lobular. Fundal massage expresses bright red bleeding and clots. The nurses best response to this scenario is best expressed by which of the following statements? A- Call resident of provider for bimanual exam and expression of clots B- Have another bag of IV pitocin available C- Expect immediate insertion of Bakri balloon D- Prepare client for dilatation and curettage and possible hysterectomy
A- Call resident of provider for bimanual exam and expression of clots -this is lower level and may resolve problem -expect order related to oxytocic agent
The nurse is performing a vaginal examination on a client in labor. The client is found to be 5 cm dilated, 90% effaced, and station -2. Which of the following has the nurse palpated? A-Thin cervix B-Bulging membranes C-Head at the pelvic outlet D-Closed cervix
A- thin cervix
Fetal heart rate has minimal variability and late decelerations in above described clinical situation. Which of the following statements identifies physiologic rationale for fetal distress? A-Ruptured membranes has occurred B-Maternal hyperglycemia and acidemia reduce blood flow to uterine placental unit C- Fetal sleep associated with inability of mother to eat or drink normally D- Elevated blood pressure and vasospasm is limiting placental blood flow
B- maternal hyperglycemia and acidemia reduce blood flow to uterine placental unit
A client just spontaneously ruptured membranes. Which of the following factors makes her especially at high risk for having a prolapsed cord? A Station +3 B Station -3 C Oligohydramnios D Dilation 2 cm
B
A client, G4P1021, has been admitted to the labor and delivery suite for induction of labor. The following assessments have been made: Bishop score of 3, fetal heart rate of 156 with good variability and no decelerations, TPR 98.6ºF, P 88, R 20, BP 120/80, negative obstetric history. Cervidil (dinoprostone) has been inserted. Which of the following findings would warrant the removal of the prostaglandin suppository? A Bishop score of 10. B Fetal heart of 152. C Respiratory rate of 24. D Contraction frequency of 1 minute
D
A fetus is in the LOA position in utero. Which of the following findings would the nurse observe when doing Leopold's maneuvers? A Hard round object in the fundal region B Flat object above the symphysis pubis C Soft round object on the left side of the uterus D Small objects on the right side of the uterus
D
A primigravid client received Prepidil (dinoprostone) for induction 8 hours ago. The Bishop score is now 10. Which of the following actions by the nurse is appropriate? A Perform nitrazine analysis of amniotic fluid. B Report abnormal findings to the obstetrician. C Place woman on her side. D Monitor for onset of labor
D
A woman, who is in active labor, is told by her obstetrician, "Your baby is in the flexed attitude." When she asks the nurse what that means, what should the nurse say? A The baby is in the breech position. B The baby is in the horizontal lie. C The baby's presenting part is engaged. D The baby's chin is resting on its chest
D
Which of the folllowing fetal heart rate patterns would the nurse perceive as normal? A- Baseline 140, moderate variability, decelerations into a V-shape to 110 B- Baseline 130, minimal variability, no obvious decelerations or accelerations C- Baseline 140 with minimal to absent variability with decelerations to 120 returning to baseline 20 seconds after the contraction was completed D- Baseline 140, moderate variability, with decelerations that mirror the contraction to a nadir of 100
D
The nurse notices the fetal head suddenly retracting back into the birth canal from a crowning position. This would alert the nurse to be prepared for which of the following situations? A- Continue to coach through second stage labor this is normal B- Straight catheterization to alter descent of fetal head C- Request forceps of vacuum extractor for assisted delivery D- McRobert's procedure and possible application of suprapubic pressure
D- McRobert's procedure and possible application of suprapubic pressure
Which of the following would prevent complications of immobility after cesarean delivery? A- Post-op antibiotics B- Assessment of ability to tolerate sips of water C- Removal of foley catheter D- Turn, cough, and deep breathe
D- turn, cough, and deep breathe
TOLAC and VBAC
Trial of Vaginal Birth After C-Section & Vaginal Birth After C-Section
The nurse can place a fetal scalp electrode. A True B False
True
RN observes green amniotic fluid during delivery and the baby is born non-vigorous and apneic. What steps should be taken next?
Warm, dry, stimulate; oxygenate with positive pressure ventilation (PPV) using ambu bag, neopuff, or neo-T
While performing Leopold's maneuvers on a woman in labor, the nurse palpates a hard round mass in the fundal area, a flat surface on the left side, small objects on the right side, and a soft round mass just above the symphysis. Which of the following is a reasonable conclusion by the nurse? A The fetal position is transverse. B The fetal presentation is vertex. C The fetal lie is vertical. D The fetal attitude is flexed
C
Station
How far down the fetal head is in the birth canal
RN palpates the anterior fontanel during a cervical assessment. This is the next best action.
Reposition mom
Examples of onions and garlics
chives, leek, garlic, onion, scallions
Maternal blood sugar is over 400 mg/dl. Based on nursing judgment interpreting both maternal and fetal assessment which IV solution would the nurse expect to be ordered by the provider? A- 0.9% normal saline B-5% dextrose and water C- 0.45% normal saline D- Lactated Ringers
A- Normal Saline
A nurse is coaching a woman through second stage labor. Which of the following should the nurse encourage the woman to do? A- Take one or two deep cleansing breaths before bearing down B- Push between contractions till fetal head crowns C- Blow our forcibly between contractions D- Hold breath as long as possible
A- Take one or two deep cleansing breaths before bearing down -helps client focus, may increase oxygenation, delay pushing efforts until she's close to peak of contractions
Which of the following statements describes evidenced-based practice that provides prophylactic protection against incisional infection? A- Antibiotics within one-half hour of incision B- Chlorhexidine scrub C- Incisional irrigation during surgery D- Sterile technique with every dressing change
A- antibiotics within one-half hour of incision
You are the nurse caring for a client in active labor and noticed a small amount of bloody show. Your cervical exam was 6 cm. 80%, -1 station, able to palpate the anterior fontanel. Based on this assessment priority nursing action is best described by which of the following statements? A-Reposition to far side or use the peanut ball B-Ultrasound for placental placement C-Perform a straight catheterization D- Decrease pitocin drip because patient is in active labor
A- reposition to far side or use peanut ball
A client, 6 cm and 80% effaced, has just received Demerol (meperidine) 50 mg IV for pain. Which of the following fetal heart changes would the nurse expect to observe on the internal fetal monitor tracing? A Drop in baseline heart rate. B Increase in number of variable decelerations. C Decrease in variability. D Rise in number of early decelerations.
C
One minute post delivery the nurse makes the following infant assessments to include: on-going positive pressure ventilation related to grunting respiration at delivery with adequate chest excursion, apical heart rate is 110, no grimacing or crying related to stimulation, partially flexed extremities and systemic pallor a. Which of the following is the correct Apgar score for this infant? (Hint: effective PPV is = 1 point) A- 3 B- 4 C- 5 D- 6
B-4 -PPV is 1, heart rate above 100 is 2 points, no reflex response is 0, partial flexion is 1, pallor is 0, total=4
Describe nursing actions before, during, and after AROM
Before: IV access, place absorbent pads under client During: provide assistance to HCP and reassure client After: assess FHT & for cord prolapse; assess color & consistency of fluid; limit cervical assessments; keep area under pt clean & dry
A client is complaining of severe back labor. Which of the following nursing interventions would be most effective? A Assist mother with childbirth breathing. B Encourage mother to have an epidural. C Provide direct sacral pressure. D Use a hydrotherapy tub.
C
An induction of a 42-week gravida with IV oxytocin (Pitocin) is begun at 0900 at a rate of 0.5 milliunits per minute. The woman's primary physician orders: Increase the oxytocin drip by 0.5 milliunits per minute every 10 minutes until contractions are every 3 minutes 60 seconds. The nurse refuses to comply with the order. Which of the following is the rationale for the nurse's action? A Fetal distress has been noted in labors when oxytocin dosages greater than 2 milliunits per minute are administered. B The practitioner should increase the dosage of oxytocin at a minimum time interval of every 30 minutes. C It is unsafe practice to administer oxytocin intravenously to a woman who is carrying a postdates fetus. D A contraction duration of 60 seconds can lead to fetal compromise in a baby that is postmature
B
An ultrasound report states, "The fetal head has entered the pelvic inlet." What does the nurse interpret this statement to mean? A The fetus has become engaged. B The fetal head has entered the true pelvis. C The fetal lie is horizontal. D The fetus is in an extended attitude
B
During a vaginal delivery, the obstetrician declares that a shoulder dystocia has occurred. Which of the following actions by the nurse is appropriate at this time? A Administer oxytocin intravenously per doctor's orders. B Flex the woman's thighs sharply toward her hips. C Apply oxygen using a tight-fitting face mask. D Apply downward pressure on the woman's fundus.
B
During evaluation of an actively laboring multiparous patient the nurse assesses persistent fetal heart rate decelerations mirroring uterine contraction. Which of the following choices is the appropriate nursing intervention for this situation? A- Discontinue the oxytocin infusion B- Vaginal exam to ascertain cervical progress C- Change the woman's position D- Insert an internal monitor
B
The nurse is assessing an internal fetal heart monitor tracing of an unmedicated, full-term gravida who is in transition. Which of the following heart rate patterns would the nurse interpret as normal? A Variable baseline of 140 with V-shaped decelerations to 120 unrelated to contractions. B Variable baseline of 140 with decelerations to 100 that mirror each of the contractions. C Flat baseline of 140 with decelerations to 120 that return to baseline after the end of the contractions. D Flat baseline of 140 with no obvious decelerations or accelerations
B
The physician has ordered Prepidil (dinoprostone) for 4 gravidas at term. The nurse should question the order for which of the women A Primigravida with Bishop score of 4. B Multigravida with late decelerations. C G1P0000 contracting every 20 minutes x 30 seconds. D G6P3202 with blood pressure 140/90 and pulse 92.
B
The practitioner is performing a fetal scalp stimulation test. Which of the following fetal responses would the nurse expect to see? A Spontaneous fetal movement. B Fetal heart acceleration. C Increase in fetal heart variability. D Resolution of late decelerations
B
Current research related to the treatment of GBS recommends that a patient who is allergic to penicillin without evidence of anaphylaxis should receive which of the following antibiotics in labor based on susceptibility of streptococci to its effects? A- Cleocin B- Ancef C- Vancomycin D- Ampicillen
B- Ancef
The client has an epidural for pain control. The client is aware of increasing sensations with contractions. Cervical assessment is 7 cm, 90%, -1 station. The fetal head which had been applied to cervix is now palpated askew from cervix. The fetal head is in LOA position. What is the nurse's best response to this situation? A-Change position side to side every half hour B-Assess and empty bladder with straight catheterization C-Increase pitocin drip D-Call provider for delivery
B- Assess and empty bladder with straight catheterization
Which type of fetal injury should the nurse assess in the newborn after delivery subsequent to moderate shoulder dystocia? A- Congenital hip dysplasia B- Brachial plexus injury C- Fractured scapula D- Facial drooping
B- Brachial plexus injury
A nurse increases the dose of Pitocin per orders. Documentation associated with Pitocin titration should include which of the following statements? A-Fetal heart rate is reassuring B-Contractions are inadequate C-The client has a pain level of less than 4 out of 10, during contractions D-The cervix has not significantly changed
B- Contractions are inadequate
You are initiating a pitocin drip. The administration of pitocin should follow which of the following guidelines? A- The pitocin IV should be utilized as a secondary piggyback, exchanged for IV antibiotics if necessary B- The pitocin IV should be plugged into the most proximal port toward the insertion site of the primary IV C- The pitocin IV should be plugged into the port proximal to the medication pump D- The pitocin IV should be plugged into the primary IV tubing distal to the site of insertion
B- most proximal port toward the insertion site of primary IV
The nurse is examining the CBC results for a preeclamptic patient who is in active labor and requesting an epidural. The results are WBC 18,000, HGB 10.9, platelet count 68,000. Interpretation of these results indicates which of the following nursing actions? A-Request order for iron supplement B-Notify anesthesia of thrombocytopenia C- Assess for signs of infection to include temperature D- Initiate IV bolus for safe epidural placement
B- notify anesthesia of thrombocytopenia -elevation of WBC is normal -Hgb reflects hemodilution -Thrombocytopenia places pt at risk for hematoma development and should be reported
A multiparous client in active labor is having difficulty relaxing through contractions due to acute back pain. The nurse can best support the patient in this situation by which of the following actions? A- Reposition frequently to increase perfusion B- Provide counterpressure to lower back C- Empty the client's bladder allow descent of fetal head D- Request and IV with glucose to improve energy and endurance
B- provide counterpressure to lower back - helps decrease sensation of pain; emptying the bladder isn't helpful unless fetal head is displaced off cervix
There are four clients in active labor in the labor suite. Which of the women should the nurse monitor carefully for the potential of uterine rupture? A Age 15, G3P0020, in active labor. B Age 22, G1P0000, eclampsia. C Age 25, G4P3003, last delivery by cesarean section. D Age 32, G2P0100, first baby died during labor.
C
The nurse is assessing the vital signs of a client in labor at the peak of a contraction. Which of the following findings would the nurse expect to see? A- Decreased respiratory rate B- Hyperthermia C- Hypertension D- Decreased pulse rate
C- HTN
A gestational diabetic, insulin controlled, antepartum client, 29 weeks gestation is admitted with nausea, abdominal pain, thirst, confusion, blurred vision, fruity breath, and fatigue. Fetal heart rate has minimal variability and late decelerations with occasional mild contractions. Which of the following is expected maternal assessment? A-Maternal vital signs every 15 minutes B- Urine protein creatinine ratio C- Maternal blood sugar D- GBS culture
C- Maternal blood sugar
A client is being induced with pitocin, current dose is 8 mu, augmented with AROM, currently has an epidural and internal monitors. The MVU's are 195. The cervix is 5 cm and unchanged from last assessment, the fetus is LOA position and well applied to cervix. Which of the following nursing interventions is appropriate based on this assessment? A-Empty the bladder B-Reposition side to side C-Increase pitocin per protocol D-Request a glucose IV
C- increase Pit per protocol
A multiparous woman is admitted to labor and delivery for an ordered pitocin induction. Cervical assessment reveals of Bishop score of 9. Which action should the prudent nurse take at this time? A-Request the resident to assess the cervix and call physician to confirm orders B-Bolus the patient with an isotonic solution of Lactated Ringers C- Initiate pitocin per ordered protocol D- Call the physician and request an order for a cervical ripening agent.
C- initiate Pit per ordered protocol -Bishop score of 9 indicates a ripe cervix -Score less than 4 would suggest need for cervical ripening agent; Pit is appropriate
Which of the following situations would contraindicate an induction with pitocin? A- Multigravida with cerebral palsy B- Primigravida who is 14 years old C- Primigravida with a transverse lie. D- Multigravida who has type 1 diabetes
C- primigravida with a transverse lie - a baby in transverse lie is in a scapular presentation. The baby is incapable of vaginal delivery, so induction is contraindicated
A patient who had a prolonged pitocin induction is delivered and continuing to receive magnesium sulfate at 2 grams and hour. Nursing assessment is boggy uterus and heavy rubra flow. If medical intervention is deemed necessary the nurse would be prepared to administer which of the following medications? A-Labetalol B-Calcium gluconate C-Pitocin D-Misoprostol
D- Misoprostol -Labetalol is an antihypertensive, since this client is delivered on Mag Sulfate you do know she is preeclamptic and probably HTN. -Misoprostol is given rectally and effective in encouraging the uterus to clamp down on itself relieving uterine atony
The nurse has increased the pitocin titration to maximum dose of 20 milliunits. The client received an epidural and AROM with clear fluid 5 hours ago. The uterine contraction pattern demonstrates coupling. Fetal heart analysis is reassuring with intermittent variable decelerations. The only cervical change was from 3 to 4 cm. several hours ago. The nurse might recommend which of the following strategies? A- Reposition the client in order to labor down B- An amnioinfusion to decrease variable decelerations. C- Antibiotics due to prolonged rupture of membranes D- Turn off pitocin for 30 minutes to an hour in order to de-saturate uterine receptor sites
D- Turn off Pit for 30 min to an hour in order to de-saturate uterine receptor sites -problem isn't fetal heart rate but dysfunctional labor
A nurse is caring for four clients on the labor and delivery unit. Which of the following actions should the nurse take first? A-Check the blood sugar of a gestational diabetic B-Assess the vaginal blood loss of a client who is post-spontaneous abortion C-Assess the patellar reflexes of a client with mild preeclampsia D-Check the fetal heart rate of a client who just ruptured membranes
D- check fetal heart rate of a client who just ruptured membranes
An epidural is administered to a patient who is now experiencing nausea and dizziness with a blood pressure reading of 90/50. Fetal heart variability is minimal with late decelerations. The client has received 3 liters of IV fluid. Which of the following interventions is the nurse's best priority response to this situation assuming routine epidural orders are in place? A- Initiate intrauterine resuscitation B- Place in semi-fowler's position C- Continue IV fluids at maximum rate D- Give ephedrine 5 mg per anesthesia's orders and observe maternal heart rate
D- ephedrine
The delivered client has a heavy rubra flow, mild tachycardia, normal blood pressure, fundal assessment is firm and even at the umbilicus. Which of the following statements best describes nursing action related to this situation? A- Continue to massage the uterus until the flow decreases B-Suggest the client breast feed her baby C-Encourage the client to empty her bladder D-Inform provider of probable lower uterine segmental bleed or cervical laceration
D- inform provider of probable lower uterine segmental bleed or cervical laceration
You are caring for a client with severe preeclampsia immediate post-op cesarean. Which of the following assessments should be immediately communicated to the physician? A- Fundus firm with moderate flow B- Respiratory rate of 12 per minute C- Magnesium level of 6 D- Output of 40 ml for the last two hours
D- output of 40 mL for the last 2 hours -should be 30mL/hr
Examples of beans
LEGUMES!!!!! -chickpeas, peanuts, black beans, lima beans, peas, lentils
Best type of IV solution for fluid bolus with epidurals
LR
Fetal is presenting this part if the baby is breech
Sacrum