Maternity/ OB HESI review

ovulation occurs

14 days before menstrual period

Nageles rule

1st day of last period + 7 days - 3 months

The nurse is monitoring a client in the immediate postpartum period for signs of hemorrhage. Which sign, if noted, would be an early sign of excessive blood loss?

An increase in the pulse rate from 88 to 102 bpm

Six hours after an oxytocin (Pitocin) induction was begun and 2 hours after spontaneous rupture of the membranes, the nurse notes several sudden decreases in the fetal heart rate with quick return to baseline, with and without contractions. Based on this fetal heart rate pattern, which intervention is best for the nurse to implement? A. Turn the client to her side. B. Begin oxygen by nasal cannula at 2 L/min. C. Place the client in a slight Trendelenburg position. D. Assess for cervical dilation.

Ans- C, place the client in a slight trendelenburg position Rationale: The goal is to relieve pressure on the umbilical cord, and placing the client in a slight Trendelenburg position is most likely to relieve that pressure. The FHR pattern is indicative of a variable fetal heart rate deceleration, which is typically caused by cord compression and can occur with or without contractions. Option A may be helpful but is not as likely to relieve the pressure as the Trendelenburg position. Option B is not helpful with cord compression. Option D is not the priority intervention at this time. After repositioning the client, a vaginal examination is indicated to rule out cord prolapse and assess for cervical change.

The nurse in the labor room is caring for a client in the active stage of the first phase of labor. The nurse is assessing the fetal patterns and notes a late deceleration on the monitor strip. What is the most appropriate nursing action? A. Administer oxygen via face mask. B. Place the mother in a supine position. C. Increase the rate of the oxytocin intravenous infusion. D. Document the findings and continue to monitor the fetal patterns.

Answer- A. Administer oxygen via face mask Rationale: Late decelerations are due to uteroplacental insufficiency and occur because of decreased blood flow and oxygen to the fetus during the uterine contractions. Hypoxemia results; oxygen at 8 to 10 L/minute via face mask is necessary. The supine position is avoided because it decreases uterine blood flow to the fetus. The client should be turned onto her side to displace pressure of the gravid uterus on the inferior vena cava. An intravenous oxytocin infusion is discontinued when a late deceleration is noted. The oxytocin would cause further hypoxemia because of increased uteroplacental insufficiency resulting from stimulation of contractions by this medication. Although the nurse would document the occurrence, option 4 would delay necessary treatment.

PROBABLE signs of pregnancy

Ballottement Chadwick's sign Uterine enlargement Braxton Hicks contractions Positive pregnancy test

mothers with HIV

CANNOT breastfeed

second stage of labor

Full dilation spontaneous urge to push from perineal pressure BIRTH!!

The client begins to complain of tingling fingers and dizziness.

Have the client breathe into her cupped hands

if woman is receiving rubella titer 1 day postpardum

Pregnancy needs to be avoided for 1 to 3 months. The vaccine is administered by the subcutaneous route. Exposure to immunosuppressed individuals needs to be avoided. A hypersensitivity reaction can occur if the client has an allergy to eggs.

A client in labor is transported to the delivery room and prepared for a cesarean delivery. After the client is transferred to the delivery room table, the nurse should place the client in which position?

Supine position with a wedge under the right hip

Terbutaline (Brethine)

Uses to relax uterine smooth muscle to inhibit uterine activity - to stop labor contractions (for preterm labor) -SIDE EFFECTS: tachycardia/ feeling of nervousness

The nurse is monitoring a client in labor. The nurse suspects umbilical cord compression if which is noted on the external monitor tracing during a contraction?

Variable decelerations

The nurse is performing an initial assessment on a newborn infant. When assessing the infant's head, the nurse notes that the ears are low-set. Which nursing action is most appropriate?

notify the health care provider

The nursing instructor asks the nursing student about the physiology related to the cessation of ovulation that occurs during pregnancy. Which response, if made by the student, indicates an understanding of this physiological process? Select all that apply.

- "Ovulation ceases during pregnancy because the circulating levels of estrogen and progesterone are high." - "The release of the follicle-stimulating hormone and luteinizing hormone is inhibited by adaptations related to pregnancy."

Characteristics of amniotic fluid

- Allows for fetal movement - Surrounds, cushions, and protects the fetus - Maintains the body temperature of the fetus - Can be used to measure fetal kidney function

A postpartum client is diagnosed with cystitis. The nurse should plan for which priority action in the care of the client?

- Encouraging fluid intake - infection of the bladder (UTI)

The nurse is preparing to teach a prenatal class about fetal circulation. Which statements should be included in the teaching plan? Select all that apply.

- The ductus arteriosus allows blood to bypass the fetal lungs." - One vein carries oxygenated blood from the placenta to the fetus." - "Two arteries carry deoxygenated blood and waste products away from the fetus to the placenta."

contraction stress test

- if positive, (BAD) - if negative, GOOD

placenta function

- it is the way the baby gets food and oxygen - it provides an exchange of nutrients and waste products between the mother and developing fetus

Preeclampsia

- proteinuria - hypertension

The nurse is preparing a list of self-care instructions for a postpartum client who was diagnosed with mastitis. Which instructions should be included on the list? Select all that apply.

- wear a supportive bra - rest during the acute phase - maintain a fluid intake of at least 3000mL/ day - continue to breast-feed if the breasts are not too sore

Early decelerations

-NORMAL - "The monitor indicates that the FHR decelerates at the onset of several contractions and returns to baseline before each contraction ends"

placenta previa

-risk for hemorrhage during postpartum period