Maternal/Infant Unit 2 Exam

What is an anthropoid pelvis?

"ape-like" The inlet is large and the bottom is narrow May not accommodate a fetal head

What is the normal ratio of this test?

2:1 Ration indicates fetal lung maturity.

How many glasses of fluid should a pregnant woman drink daily to maintain adequate hydration?

8-10

What would an increase in the HR on the fetal monitor be called?

Above 160: Tachycardia Below 110: Bradycardia

What are some contraindications for a client who has HIV and is labor?

Amniocentesis, episiotomy internal fetal monitors, forceps, vacuum extraction, NO injections until agterr the first bath, Get a C-Section if maternal vial load is over 1000

Why is the BP of a 16 week pregnant woman lower?

Blood volume level is increased

What color should normal amniotic fluid be?

Clear, or tinted yellow

What are some measures to help a client with Nausea?

Crackers, dry toast, ginger ale, sprite, sea bands

Which nsg intervention is most effective in applying the gate control theory for relief of labor pains.

Cutaneous stimulation massage

What does the Leopold maneuver determine?

Determines the positioning of the baby through external palpations of the maternal uterus through the abdominal wall

A nurse is caring for a client who is receiving nifedipine for prevention of preterm labor. The nurse should monitor the client for the following manifestations?

Dizziness

What is Pica? What causes it?

Eating of non-food items such as paint Low Iron can be a cause of Pica

How would you approach a client who is 12 weeks pregnant and still smoking?

Educate the client on the risks of smoking on the fetus.

What would be the most appropriate thing to do for a dad who has been at bedside for 12 hours?

Give him a break Offer support, reassurance Encourage nutrition/hydration

What would be a danger sign of labor for a woman in labor?

Gush of fluid would be a danger sign- if the fluid wasn't clear, green in color Meconium staining, a green color of the amniotic fluid. The fetus has had a loss of rectal sphincter control. May indicate fetal hhypoxia Bleeding

What is the tx for Hyperemesis gravidarum?

IV fluids (LR) Pyridoxine (B6) and other vitamins as tolerated. Antiemetics (ondansetron, metoclopramide) Corticosteroids to treat refractory HG.

Treatment for constipation

Increase Fiber intake Bulk laxatives

A nurse is caring for a client who is in preterm labor and is scheduled to undergo an amniocentesis. The nurse should evaluate which of the following tests to assess fetal lung maturity?

Lecithin/Sphingomyelin (L/S) Ratio

What is the name of the test used to measure fetal lung maturity?

Lecithin/Sphingomyelin (L/S) Ratio

A nurse is caring for a client in the third stage of labor. What are some indications of placental separation?

Lengthening of the umbilical cord Appearance of dark blood from the vagina Fundus firm upon palpation

What is a nonstress test?

NST-most widely used technique for antepartum evaluation of fetal well-being performed during the third trimester. Doppler transducer and a tocotransducer are attached externally to a client's abdomen to obtain tracing strips. The client pushes a button attached to the monitor whenever they feel a fetal movement. This allows to monitor the response of the fetal heart rate to fetal movement.

Should the pregnant client take ASA? Why or why not?

No Because taking aspirin increases the risk of bleeding. Aspirin prevents platelet aggregation

A patient who is 6 months pregnant complains of back pain, what would the nurse suggest for her?

Pelvic Rock Exercise ball

After the delivery of the placenta, the uterus is sluggish to contract. What should be given to the client to help the uterus contract.

Pitocin

A nurse is caring for a client who is using patterned breathing during labor. The client reports numbness and tingling of the fingers. Which action should the nurse take?

Place an oxygen mask over the client's nose and mouth.

What are some factors of preterm labor?

Pre-rupture membranes

What behavior from a spouse would exhibit acceptance of pregnancy?

Preparing clothing and sleeping arrangements for babu, coming to appointments

A nurse is caring for a client who is in the second stage of labor. The clients labor has been progressing, and a vaginal delivery is expected in 20 min. The provider is preparing to administer lidocaine for pain relief and perform an episiotomy. The nurse should know that which of the following types of regional anesthetic block is to be administered?

Pudendal

What are foods rich in iron?

Red meats Legumes Dried fruit Dark green leafy veggies

A client reports tingling of her fingers when she is doing patterned breathing. What should the nurse do?

Slow down breathing to prevent hyperventilation

How do you do the maneuver?

Start at the fundus and palpate for the spine and move down using palm.

What are some side effects of niphedipine?

Tachycardia Headache Nausea Dizziness/lightheadedness Flushing Heartburn Muscle cramps Constipation cough

What is an amniocentesis?

The aspiration of amniotic fluid for analysis by insertion of a needle transabdominally into a client's uterus and amniotic sac. AFP (alpha-fetoprotein can be measured to assess fe neural tube defects in the fetus or chromosomal disorders.

How would you explain to a pregnant client that her fetus won't drown in her uterus?

The baby is supplied oxygen through the umbilical cord The baby will not take its first breath until after delivery

What does crowning look like?

The had of the baby is at the opening of the vagina

What is the purpose of giving Betamethasone?

To increase fetal lung maturity

What would be the first action the nurse would do for a client in labor and has late d-cells on the monitor.

Turn patient on left side

What prenatal test will be performed on the client who is 16 weeks pregnant?

US, STI testing, blood glucose monitoring

Why is a non-stress test done?

Assessing for an intact fetal CNS during the third trimester. Ruling out the risk for fetal death in clients who have DM.

A nurse is caring for a client who is in labor and observes late decelerations on the electronic fetal monitor. What is the first action the nurse should take?

Assist the client into the left-lateral position.

A nurse is providing care for a client who is in ppreterm labor at 32 weeks of gestation. Which of the following medications should the nurse anticipate the provider will prescribe to hasten fetal lung maturity?

Betamethasone

What drug is given to a client who has placenta previa and is 30 weeks gestation?

Betamethasone A corticosteroid given 12-24 hours before birth

Why doesn't amniotic fluid grow stagnant?

Constantly being formed by the amnion and being absorbed by direct contact with the fetal surface of the placenta.

A nurse is caring for a client and partner during the second stage of labor. The clients partner asks the nurse to explain how to know when crowning occurs. How should the nurse respond?

"The vaginal area will bulge as the baby's head appears."

What causes frequent urination during early pregnancy?

As the baby grows it presses down on the bladder

How would you go about asking your client about her menstrual history?

Ask her when the first day of her last period was Ask when the first day of missed period was Used to determine due date.

What can amniocentesis measure regarding fetal lungs?

Amniotic fluid is tested to determine whether the fetal lungs are mature enough to adapt to extrauterine life, or if the fetus will have Resp. distress.

A nurse is caring for a client who is 32 weeks of gestation and has a placenta previa. The nurse notes that the client is actively bleeding. Which medication should the nurse expect the provider will prescribe.

Betamethasone

What would you do if your client had a sudden gush of fluid from her vagina?

Check Fetal heart tones Rupture of membranes-labor is starting, pt will need exam. Baby should be born within 24 hours of rupture to prevent infection. (preferable)

A nurse is caring for a client who is 40 weeks of gestation and reports having large gush of fluids from the vagina while walking from the bathroom. Which of the following actions should the nurse take first?

Check the FHR

What is Hyperemesis gravidarum?

Excessive nausea and vomiting that is prolonged past 16 weeks of gestation or that is excessive and causes weight loss, dehydration, nutritional deficiencies, electrolyte imbalances, and ketonuria. Risk to the fetus for intrauterine growth restriction, small for gestational age, or preterm birth if the condition persists.

Amniotic fluid is meconial stained- what would you do for the laboring client immediately.

FHR monitoring

What would cause an immediate need for an emergency c-section?

Fetal distress: FHR decline Prolapsed cord Placenta Abruption

What instructions would you give to a pregnant client to observe the movements of a fetus assessment?

Fetal kicks

What is the most effective way to assess food intake during pregnancy?

Food Journal

What is an acoustic vibration device and why is it used during the test?

For acoustic sound stimulation, a specially designed acoustic stimulator is applied to mother's abdomen to produce a sharp sound which will startle or wake the baby. This is done if after 5 min of being on NST without any accelerations.

The 2nd stage of labor would bring the client to be what?

Frightened Crying Screaming Anger

A nurse is completing an admission assessment for a client who is 39 weeks of gestation and reports fluid leaking from the vagina for 2 days. Which of the following conditions is the client at risk for developing?

Infection

What would a client be in danger of when she reports to you when she has been leaking fluid from her vagina for a few days.

Infection

A nurse is caring for a client who is pregnant and undergoing a nonstress test. The client asks why the nurse is using an acoustic vibration device. Which of the following responses should the nurse make?

It awakens the sleeping fetus

What would you have the client with premature rupture of membranes of 16 weeks gestation do?

Keep a record of fetal counts

What position should the mom be in when she is in labor and has an external monitor on?

Lateral-Side lying

Why is the preterm fetus more effected by medication than a full-term fetus?

Lungs, Kidneys, and Liver are not developed

What is a good source of B12?

Meats

What should you ask the client on her first prenatal visit?

Menstrual History Hygiene Drug Sexually Active

What is the first action you should take if your client had a sudden gush of fluid from the vagina?

Monitor FHR

What happens to the GI system during labor?

Motility slows down, Digestive

What position should the client be in when she is pushing between contractions?

Resting position

A nurse is caring for a client who is in active labor. The client reports lower-back pain. The nurse suspects that this pain is related to a persistent occiput posterior fetal position. Which of the following nonpharmacological nursing interventions should the nurse recommend to the client?

Sacral counterpressure.

What stage of labor does crowning occur?

Second Stage

A nurse is admitting a client who is in labor and had HIV. Which of the following interventions should the nurse identify as contraindicated for this client?

Vacuum extractor Forceps Internal fetal monitoring

What vitamin would the vegetarian woman need to supplement during pregnancy?

Vitamin B-12