OB Test #1

Are the breasts primary or accessory organs?

accessory- they are specialized for milk secretion after pregnancy

What triggers ovulation?

LH

What is the function of the labia minora?

highly vascular, abundant in nerve endings, lubricates vulva, swells with simulation

How long is an egg good for?

24 hours

What two elements play the biggest role in becoming a mother after delivery of her newborn? Confidence and happiness with the pregnancy Love and attachment to the child and engagement with the child Planned and desired pregnancy and previous experience with infants Interactions with the child and support systems

Love and attachment to the child and engagement with the child Explanation: A mother begins the process of becoming a mother during the pregnancy and this continues for the rest of her life. The two critical elements of becoming a mother are developing love and attachment to the newborn and becoming engaged with the child by assuming caregiving for the child as he grows and changes.

What layer makes up the major portion of the uterus?

Myometrium

The nurse notes a newborn has a temperature of 97.4oF (36.3oC) on assessment. The nurse acts to prevent which complication first? Seizure Respiratory distress Cardiovascular distress Hypoglycemia

Respiratory distress Explanation: It takes oxygen to produce heat and an infant who has an episode of cold stress is at risk for respiratory distress. The infant needs to be warmed. The temperature should be in the range of 97.7°F to 98.6°F (36.5°C to 37°C). After respiratory distress sets in, it can be followed by seizures, cardiovascular distress, or hypoglycemia.

IS teh clitorus internal or external?

external

What happens when ovulation occurs?

temp spikes

What hormone is responsible for an increase in body temp?

progesterone

What is the purpose of the vulva?

protects urethra nad vagina openings

What ist he function of the prepuce?

hood like covering over clitosrus, site of female circumcision practice in some culture

When teaching a class of new parents about the needs of their newborn, the nurse explains that the newborn's voiding is a good indicator that he or she is getting enough fluids. The nurse determines that the teaching was successful when the parents state which number of voidings per day is a good indicator of adequate fluids? 6 to 8 4 to 6 8 to 10 2 to 4

6 to 8 Explanation: From birth to about 3 months of age, the newborn's kidneys are unable to concentrate urine and they will urinate frequently. Approximately 6 to 8 voidings per day is average and indicates adequate fluid intake.

What hormones does the anterior pituitary secrete?

FSH LH

In recording a postpartum mother's urinary output, the nurse notes that she is voiding between 100 to 200 ml with each hourly void. How would the nurse interpret this finding? The urinary output is inadequate and the mother needs to drinks more fluids. The urinary output is inadequate suggestive of urinary retention. The urinary output is normal. The urinary output is above expected levels.

The urinary output is normal. Explanation: Expected urinary output for a postpartum woman is at least 100 ml with each void on an hourly basis. Therefore 100 to 200 ml are a normal volume for each void.

While examining a newborn, a nurse observes salmon patches on the nape of the neck and on the eyelids. Which is the most likely cause of these skin abnormalities? bruising from the birth process an immature autoregulation of blood flow an allergic reaction to the soap used for the first bath concentration of immature blood vessels

concentration of immature blood vessels Explanation: A concentration of immature blood vessels causes salmon patches. Bruising does not look like salmon patches but would be more bluish-purple in appearance. Harlequin sign is a result of immature autoregulation of blood flow and is commonly seen in low birth weight newborns. An allergic reaction would be more generalized and would not be salmon colored.

To which layer of the uterine wall does the placenta attatch?

endometrium

What is the outmost layer of the uterine wall?

perimetrium, serosa

what is the vestibule?

oval area enclosed by labia minora laterally located inside labira minora and outside hymen

A nursing student learns that a certain condition occurring in up to 3 in every 1,000 births is a major cause of death. What is this condition? infection hemorrhage pulmonary embolism hypertension

pulmonary embolism Explanation: Pulmonary embolism occurs in up to 3 per 1000 births and is a major cause of maternal mortality.

A woman who delivered her newborn by cesarean birth is admitted to the postpartum unit. During the delivery, the mother received two doses of morphine sulfate. The nurse notes that the client's respiratory rate is 11 and her oxygen saturation is 93%. What should the nurse do first? Call the Medical Response Team to her room. Notify the health care provider of the findings. Have another nurse come listen to the client's respirations and count the rate. Ask the charge nurse to look in on the client before the end of the shift.

Notify the health care provider of the findings. Explanation: If the nurse notes abnormal findings on her exam—such as depressed respiratory status like this client is presenting—the nurse will immediately notify a health care provider. Having a peer come in to confirm your findings is always fine but this does not preclude notification of the physician. Asking the charge nurse to look in on the client later indicates there is no urgency to the situation, which there is.

What is the middle layer of the uterine wall?

myometruim- smooth muscular layer

A newborn's parents ask the nurse how to prevent the newborn from becoming ill. What is the best response by the nurse? "Be sure to keep the newborn's umbilical cord stump clean and dry." "Keep your newborn at home and do not allow visitors for the first month." "Be sure to keep all scheduled doctor appointments for vaccinations." "Always wash your hands before you pick up or provide care to your newborn."

"Always wash your hands before you pick up or provide care to your newborn." Explanation: Handwashing is the best way to prevent infections in newborn infants. Even the nursery personnel are required to perform a hand scrub before beginning their work in most nurseries. Vaccinations reduce the risk of infections but good handwashing is priority. Keeping the umbilical cord dry and clean helps prevent an infection at the site. It is not appropriate to restrict visitors who are healthy.

A nurse is working with the parents of a newborn girl. The parents have a 2-year-old boy at home. Which statement would the nurse include when teaching these parents? "Expect to see your 2-year-old become more independent when the baby gets home." "Talk to your 2-year-old about the baby when you're driving him to day care." "Ask your 2-year-old to pick out a special toy for his sister." "Have your 2-year-old stay at home while you're here in the hospital."

"Ask your 2-year-old to pick out a special toy for his sister." Explanation: The parents should encourage the sibling to participate in some of the decisions about the baby, such as names or toys. Typically siblings experience some regression with the birth of a new baby. The parents should talk to the sibling during relaxed family times. The parents should arrange for the sibling to come to the hospital to see the newborn.

When instructing a new mom on providing skin care to her newborn, which statement, made by the mother, indicates additional teaching is needed? "I can use talc powders to prevent diaper rash." " I will change my baby's diapers frequently." "I will give sponge baths until the umbilical cord falls off." "It is not necessary to give my baby a bath daily."

"I can use talc powders to prevent diaper rash." Explanation: Talc powders can be a respiratory hazard and should not be used with a newborn. All other statements are correct.

A neonate born by cesarean birth required oxygen after the birth. The mother expresses concern because this was not a factor with her previous vaginal birth. What response by the nurse is most appropriate? "This is likely just coincidence." "Neonates born by cesarean do not benefit from the squeezing of the contractions, which helps to clear the lungs." "Normally, neonates born by cesarean do better after delivery since it is a much gentler birth." "You are older now and that can impact how your neonate adapts to the birth process." "Neonates born by cesarean tend to need oxygen supplementation due to the rapid change in fetal circulation when the uterus was cut during the birth."

"Neonates born by cesarean do not benefit from the squeezing of the contractions, which helps to clear the lungs." Explanation: During labor and delivery, the contractions provide pressure on the fetus. These forces "squeeze" the fetus's thoracic cavity. This aids the fetus in forcing the amniotic fluid from the lungs. The neonate born by cesarean does not have this experience, which may result in some initial periods of tachypnea and a need for oxygen supplementation. Maternal age and the uterine incision do not impact this phenomenon.

The student nurse is attending her first cesarean delivery and is asked by the mentor what should be carefully assessed in this infant. After responding "Respiratory status" the student is asked "Why?" What would be the best response? "There is more fluid present in the lungs at birth after a cesarean delivery than after a vaginal delivery." "Surfactant may be missing from the lungs depending on the newborn's gestational age." "The respiratory centers in the brain have not been stimulated when a newborn is delivered by a cesarean delivery." "A newborn delivered by cesarean has less sensory stimulation to breathe."

"There is more fluid present in the lungs at birth after a cesarean delivery than after a vaginal delivery." Explanation: The process of labor stimulates surfactant production, and much of the fetal lung fluid is squeezed out as the fetus moves down the birth canal. This so-called vaginal squeeze is an important way nature helps to clear the airway in preparation for the first breath. The vaginal squeeze also plays a role in stimulating lung expansion. The pressure of the birth canal on the fetal chest releases immediately when the infant is born. The lowered pressure from chest expansion draws air into the lungs.

New parents are getting ready to go home and have received information to help them learn how best to care for the new infant. Which statement indicates that they need additional teaching about how to soothe their newborn if he becomes upset? "We'll turn the mobile on that's hanging above his head in his crib." "We'll lightly rub his back as we talk to him softly." "We'll swaddle him snuggly to make him feel secure." "We'll hold off on feeding him for a while because he might be too full."

"We'll hold off on feeding him for a while because he might be too full." Explanation: The parents need more teaching that feeding or burping can be helpful in relieving air or stomach gas. Turning on a mobile above the newborn's head is helpful in calming the newborn. The movement is distracting, and the music is comforting. The newborn's back should be rubbed lightly while the parents speak softly to him. Swaddling the newborn provides security and comfort.

A client has been discharged from the hospital after a cesarean birth. Which instruction should the nurse include in the discharge teaching? "Follow up with your healthcare provider within 3 weeks of being discharged." Notify the healthcare provider if your temperature is greater than 99° F (37.2° C)." "You should be seen by your healthcare provider if you have blurred vision." "Call your healthcare provider if you saturate a peri-pad in less than 4 hours."

"You should be seen by your healthcare provider if you have blurred vision." Explanation: The client needs to notify the healthcare provider for blurred vision as this can indicate preeclampsia in the postpartum period. The client should also notify the healthcare provider for a temperature great than 100.4° F (38° C) or if a peri-pad is saturated in less than 1 hour. The nurse should ensure that the follow-up appointment is fixed for within 2 weeks after hospital discharge.

The nurse is conducting a breast exam on a postpartum mother on the second day following delivery. What findings would the nurse determine to be normal? Select all that apply. Breasts feel slightly firm. Nipples have several cracks on both breasts. One reddened area on the left breast 3 cm in size. Flattened nipple on the right breast Breasts are non-painful

Breasts feel slightly firm. Flattened nipple on the right breast Breasts are non-painful Explanation: Normal findings for a breast exam in a Day 2 postpartum mother should include non-painful breasts, slight engorgement indicative of the milk coming in, and nipples that are either erect or can be drawn out. Reddened areas and cracked nipples are abnormal findings.

A nurse is making a home visit to a black woman who gave birth to a healthy newborn 4 days ago. When developing the plan of care for this woman, which considerations would the nurse need to integrate into the plan of care? Select all that apply. Extended family members may be involved with caring for the infant. Bathing the newborn may be postponed for the first week. The woman may avoid eye contact with the nurse who is making the visit. The woman may stay at home for the first 40 days. Oils may be used on the newborn's skin and hair.

Extended family members may be involved with caring for the infant. Bathing the newborn may be postponed for the first week. Oils may be used on the newborn's skin and hair. Explanation: In the black culture, the mother may share care of the infant with extended family members, avoid bathing the newborn for the first week, and apply oils to the newborn's skin and hair to prevent dryness and cradle cap. Avoiding eye contact with health care providers would be more commonly associated with the Filipino American culture. Staying home for the first 40 days after birth would be more commonly associated with Islamic culture.

The nurse is assessing a 3-day-old infant. The infant's sclerae have a yellow tinge as does the infant's forehead and nose. What would the nurse do next? Obtain a transcutaneous bilirubin level. Draw blood for a metabolic panel. Prepare the infant for an exchange transfusion. Initiate phototherapy.

Obtain a transcutaneous bilirubin level. Explanation: Following visual identification of jaundice, the blood level of circulating bilirubin needs to be measured either by a transcutaneous bilirubin meter or a blood draw for a bilirubin level. Until the level of bilirubin in the blood is known to be elevated, neither phototherapy nor an exchange transfusion would be implemented. A metabolic panel is not useful in determining the level of neonatal jaundice.

A postpartum woman with an episiotomy asks the nurse about perineal care. Which recommendation would the nurse give? Avoid using soap for any perineal care. Wash her perineum with her daily shower. Use an alcohol wipe to wash her episiotomy line. Refrain from washing lochia from the suture line.

Wash her perineum with her daily shower. Explanation: A suture line should be kept free of lochia to discourage infection. Washing with soap and water at the time of a shower will help to do this.

The nurse is preparing to assess the pulse on a newborn who has just arrived to the nursery after being cleaned in the labor and birth suite and swaddled in a blanket. Which action should the nurse prioritize? Perform a 3-minute surgical-type scrub. Wear clean gloves. Use infection transmission precautions. Clean hands with a betadine scrub.

Wear clean gloves. Explanation: Infection control is a priority nursing intervention. Gloves need to be worn when in contact with the infant who has not been bathed after birth. All options are valid options; however, a three-minute surgical scrub is generally only required at the beginning of a shift. The nurse should always wash the hands before putting on gloves to care for an infant and after taking gloves off. Standard precautions are used with every client.

The nurse is teaching a prenatal class and illustrating some of the basic events that will happen right after the birth. The nurse should point out which action will best help the infant maintain an adequate body temperature? Bathe the infant immediately after birth. Place the infant on the mother's abdomen after birth. Wrap the infant in a warm, dry blanket. Turn the temperature up in the birth room.

Wrap the infant in a warm, dry blanket. Explanation: Evaporation is one of the four ways a newborn can lose heat. As moisture evaporates from the body surface of the infant, the newborn loses heat. Wrapping the infant in a warm, dry blanket will allow the moisture to be absorbed, limiting heat loss from evaporation. Bathing the infant will only add to the evaporative heat loss. The newborn's skin is wet, so placing him on the mother' abdomen will not prevent evaporation and heat loss. Increasing the ambient temperature in the birth room does not address the evaporation problem.

During a routine assessment the nurse notes the postpartum client is tachycardic. What is a possible cause of tachycardia? delayed hemorrhage bladder distention extreme diaphoresis uterine atony

delayed hemorrhage Explanation: Tachycardia in the postpartum woman can suggest anxiety, excitement, fatigue, pain, excessive blood loss or delayed hemorrhage, infection, or underlying cardiac problems. Further investigation is always warranted to rule out complications. An inability to void would suggest bladder distention. Extreme diaphoresis would be expected as the body rids itself of excess fluid. Uterine atony would be associated with a boggy uterus and excess lochia flow.

A client who gave birth by cesarean birth 3 days ago is bottle-feeding her neonate. While collecting data the nurse notes that vital signs are stable, the fundus is four fingerbreadths below the umbilicus, lochia are small and red, and the client reports discomfort in her breasts, which are hard and warm to touch. The best nursing intervention based on this data would be: encouraging the client to wear a supportive bra. having the client stand facing in a warm shower. informing the primary care provider that the client is showing early signs of breast infection. using a breast pump to facilitate removal of stagnant breast milk.

encouraging the client to wear a supportive bra. Explanation: These assessment findings are normal for the third postpartum day. Hard, warm breasts indicate engorgement, which occurs approximately 3 days after birth. Vital signs are stable and do not indicate signs of infection. The client should be encouraged to wear a supportive bra, which will help minimize engorgement and decrease nipple stimulation. Ice packs can reduce vasocongestion and relieve discomfort. Warm water and a breast pump will stimulate milk production.

What is the innermost layer of the uterine wall?

endometrium

What hormones are secreted during female sexual stimulation?

estrogen and testerone

A nurse is conducting a class for a group of pregnant women who are near term. As part of the class, the nurse is describing the process of attachment and bonding with their soon to be newborn. The nurse determines that the teaching was successful when the group states that bonding typically develops during which time frame after birth? first 30 to 60 minutes first 3 to 5 days first month first 6 months

first 30 to 60 minutes Explanation: Bonding is the close emotional attraction to a newborn by the parents that develops during the first 30 to 60 minutes after birth. It is unidirectional, from parent to infant. It is thought that optimal bonding of the parents to a newborn requires a period of close contact within the first few minutes to a few hours after birth.

A nursing instructor explains to students that, regardless of their gestational age, all newborns experience the same pattern that includes which periods? Select all that apply. first period of reactivity period of increased responsiveness period of decreased responsiveness second period of reactivity third period of reactivity

first period of reactivity period of decreased responsiveness second period of reactivity Explanation: All newborns, regardless of gestational age, progress through a specific pattern of events. The first period of reactivity begins at birth and lasts for approximately 30 minutes. The newborn is alert and moving and may appear hungry. It is a time parents can interact with their newborn. Next comes the period of decreased responsiveness at 30 to 120 minutes of age, which is also called the transition stage. Activity is decreased, and the infant may sleep. Movements are less jerky; during this time, it is difficult to arouse the infant. The third stage is the second period of reactivity, which begins when the newborn awakens and shows an interest in environmental stimuli. This period lasts 2 to 8 hours in the normal newborn.

When examining a newborn's eyes, the nurse would expect which assessment? follows your finger a full 180 degrees has a white rather than a red reflex follows a light to the midline produces tears when he cries

follows a light to the midline Explanation: Newborns do not usually follow past the midline until 3 months of age. They do not tear.

The nurse is assessing a neonate as he transitions to extrauterine life. The nurse integrates understanding that which structure closes as a result of the neonate's first breath? umbilical artery ductus arteriosus ductus venosus foramen ovale

foramen ovale Explanation: Before birth, the foramen ovale allowed most of the oxygenated blood entering the right atrium from the inferior vena cava to pass into the left atrium of the heart. With the neonate's first breath, air pushes into the lungs, triggering an increase in pulmonary blood flow and pulmonary venous return to the left side of the heart. As a result, the pressure in the left atrium becomes higher than in the right atrium. The increased left atrial pressure causes the foramen ovale to close, thus allowing the output from the right ventricle to flow entirely to the lungs. The closure of the ductus arteriosus depends on the high oxygen concentration of the aortic blood that results from aeration of the lungs at birth. Closure of the ductus venosus occurs because shunting from the left umbilical vein to the inferior vena cava is no longer needed. The umbilical arteries and vein begin to constrict at birth because with placental expulsion blood flow ceases.

A nurse is caring for a client who has just received an episiotomy. The nurse observes that the laceration extends through the perineal area and continues through the anterior rectal wall. How does the nurse classify the laceration? first degree second degree third degree fourth degree

fourth degree Explanation: The nurse should classify the laceration as fourth degree because it continues through the anterior rectal wall. First-degree laceration involves only skin and superficial structures above muscle; second-degree laceration extends through perineal muscles; and third-degree laceration extends through the anal sphincter muscle but not through the anterior rectal wall.

What is the fourchette?

half moon area behind the opening

Screening for this most common birth defect is required by law in most states. Each nurse should know the law for his or her state and the requirements for screening. The nurse would expect a newborn to be screened for which defect as the most common? hearing vision genetic-linked skeletal malformations

hearing Explanation: Hearing loss is the most common birth defect in the United States: one in 1,000 newborns are profoundly deaf, and 3 in 1,000 have some degree of hearing impairment. Newborn hearing screening is required by law in most states. Vision, genetic-linked, and skeletal malformations are other forms of birth defects that can occur.

The Apgar score is based on which 5 parameters? heart rate, muscle tone, reflex irritability, respiratory effort, and color heart rate, breaths per minute, irritability, reflexes, and color heart rate, respiratory effort, temperature, tone, and color heart rate, breaths per minute, irritability, tone, and color

heart rate, muscle tone, reflex irritability, respiratory effort, and color Explanation: A newborn can receive an Apgar score ranging from 0 to 10. The score is based on 5 factors, each of which is assigned a 0, 1, or 2. Heart rate (should be above 100), muscle tone (should be able to maintain a flexion position), reflex irritability (newborn should cry or sneeze when stimulated), and respiratory effort are evaluated by the presence of a strong cry and by color. Color is evaluated by noting the color of the body and hands and feet.

A nursing student will pick which value as a correct laboratory value for a newborn? hemoglobin (Hbg) 17 g/dL (170 g/L) hematocrit (Hct) 40% (0.4) platelet count 75,000/µL (75 ×109/L) white blood cell (WBC) count 40,000/mm³ (40 ×109/L)

hemoglobin (Hbg) 17 g/dL (170 g/L) Explanation: The normal laboratory values for a newborn include Hgb 16 to 18 g/dL (160 to 180 g/L), Hct 46% to 68% (0.46 to 0.68), platelet count 4,500,000/µL to 7,000,000/µL, (4,500 to 7,000 ×109/L) and WBC count 10 to 30,000/mm³ (0,1 to 30 ×109/L). From the values noted, only Hbg of 17 g/dL (170 g/L) is within normal range.

A nurse is analyzing a journal article that explains the changes at birth from fetal to newborn circulation. The nurse can point out the closure of the ductus arteriosus is related to which event after completing the article? drop in pressure in the neonate's chest higher oxygen content of the circulating blood higher oxygen levels at the respiratory centers of the brain precipitous drop in blood pressure

higher oxygen content of the circulating blood Explanation: The first few breaths greatly increase the oxygen content of circulating blood. This chemical change (i.e., higher oxygen content of the blood) contributes to the closing of the ductus arteriosus, which eventually becomes a ligament. A drop in the pressure results in a reversal of pressures in the right and left atria, causing the foramen ovale to close, which redirects blood to the lungs. A drop in blood pressure and higher oxygen levels at the respiratory centers of the brain do not result in the closure of the foramen ovale.

A nursing instructor informs the student that which stimuli initiate respirations in the newborn? Select all that apply. hypercapnia alkalosis hypoxia acidosis decreased CO2

hypercapnia hypoxia acidosis Explanation: The first breath of life is a gasp that generates an increase in transpulmonary pressure and results in diaphragmatic descent. Hypercapnia, hypoxia, and acidosis resulting from normal labor become the stimuli for initiating respirations.

A nursing instructor informs students that recent research has shown that delayed cord clamping provides which advantages? Select all that apply. improving the newborn's cardiopulmonary adaptation preventing childhood anemia increasing blood pressure preventing childhood obesity improving oxygen transport increasing red blood cell flow

improving the newborn's cardiopulmonary adaptation preventing childhood anemia increasing blood pressure improving oxygen transport increasing red blood cell flow Explanation: Recent studies show the benefits of delayed cord clamping as improving the newborn's cardiopulmonary adaptation, preventing childhood anemia without increasing hypovolemia-related risks, increasing blood pressure, improving oxygen transport, and increasing red blood cell flow. It does not help in preventing childhood obesity.

What is the opening into the vagina called?

introitus

The nurse is explaining to new parents that a potential complication of a cesarean birth is transient tachypnea. The nurse explains that this is due to which occurrence? lack of thoracic compressions during birth loss of blood volume due to hemorrhage inadequate suctioning of the mouth and nose of the newborn prolonged unsuccessful vaginal birth

lack of thoracic compressions during birth Explanation: A baby born by cesarean birth does not have the same benefit of the birth canal squeeze as does the newborn born by vaginal birth. This may result in the fluid in the lungs being removed too slowly or incompletely. Research findings support the need for thoracic compression to assist with the removal of the fluid and facilitate adequate breathing in the newborn.

Which factors could increase the risk of overheating in a newborn? Select all that apply. limited ability of diaphoresis underdeveloped lungs isolette that is too warm limited sugar stores lack of brown fat

limited ability of diaphoresis isolette that is too warm Explanation: Limited sweating ability, a crib that is too warm or one that is placed too close to a sunny window, and limited insulation are factors that predispose a newborn to overheating. The immaturity of the newborn's central nervous system makes it difficult to create and maintain balance between heat production, heat gain, and heat loss. Underdeveloped lungs do not increase the risk of overheating. Lack of brown fat will make the infant feel cold because the infant will not have enough fat stores to burn in response to cold; it does not, however, increase the risk of overheating.

x A nurse is instructing a woman that it is important to lose pregnancy weight gain within 6 months of birth because studies show that keeping extra weight longer is a predictor of which condition? diabetes long-term obesity feelings of increased self-esteem increased sex drive

long-term obesity Explanation: Women who have not returned to their prepregnant weight by 6 months postpartum are likely to retain extra weight. This inability to lose is a predictor of long-term obesity. It will not necessarily lead to diabetes, but it may decrease a woman's self-esteem and sex drive if she feels less attractive with the extra weight.

A nurse is inspecting the perineal pad of a client who gave birth vaginally to a healthy newborn 6 hours ago. The nurse observes a 5-inch stain of lochia on the pad. The nurse would document this as: scant. light. moderate. heavy.

moderate. Explanation: Typically, the amount of lochia is described as follows: scant-a 1- to 2-inch lochia stain on the perineal pad or approximately a 10-mL loss; light or small- an approximately 4-inch stain or a 10- to 25-mL loss; moderate- a 4- to 6-inch stain with an estimated loss of 25 to 50 mL; and large or heavy-a pad is saturated within 1 hour after changing it.

The nurse has been asked to conduct a class to teach new mothers how to avoid developing stress incontinence. Which action would the nurse include in the discussion as possible strategies for the new mothers to do? Select all that apply. performing Kegel exercises avoiding smoking losing weight if obese increasing fluid intake starting jogging

performing Kegel exercises avoiding smoking losing weight if obese Explanation: Postpartum women should consider low-impact activities such as walking, biking, swimming, or low-impact aerobics as they resume physical activity. They should also consider a regular program of Kegel exercises; losing weight, if necessary; avoid smoking; limiting intake of alcohol and caffeinated beverages; and adjusting the fluid intake to produce a 24-hourly output of 1,000 mL to 2,000 mL.

x When an infant smiles at the mother and the mother in turn smiles and kisses her baby, this would be which phase of attachment? proximity reciprocity commitment all of the above

reciprocity Explanation: Proximity refers to the physical and psychological experience of the parents being close to their infant. Reciprocity is the process by which the infant's abilities and behaviors elicit parental responses (i.e., the smile by the infant gets a smile and kiss in return). Commitment refers to the enduring nature of the relationship.

A nurse is explaining to a new mother that her newborn is susceptible to both dehydration and overhydration. The nurse integrates knowledge of which aspect as the underlying mechanism for this risk? Select all that apply. reduced number of nephrons at birth reduced glomerular filtration rate limited concentration ability immature acid-base regulation decreased ability to produce urine

reduced glomerular filtration rate limited concentration ability Explanation: A full complement of one million nephrons is present by 34 weeks gestation. The glomeruli and nephrons are functionally immature at birth, resulting in a reduced glomerular filtration rate (GFR) and limited concentrating ability. A limited ability to concentrate urine and the reduced GFR make the newborn susceptible to both dehydration and fluid overload. Frequently the newborn's kidneys are described as immature, but they are able to carry out their usual responsibilities and can handle the challenge of excretion and maintaining acid-base balance. The majority of term newborns void immediately after birth, indicating adequate renal function. Although the newborn's kidneys can produce urine, they are limited in their ability to concentrate it until about 3 months of age, when the kidneys mature more.

A nurse is assessing a newborn with the parents. The nurse explains that which aspect of newborn behavior is an important indication of neurologic development and function? reflex crying response voluntary movements orientation to surroundings

reflex Explanation: The presence and strength of a reflex is an important indication of neurologic development and function. It is built into the nervous system and does not need the intervention of conscious thought to take effect. These reflexes end at different levels of the spine and brain stem, reflecting the function of the cranial nerves and motor system.

While assessing a postpartum client who gave birth about 12 hours ago, the nurse evaluates the client's bladder and voiding. The nurse determines that the client may be experiencing bladder distention based on which finding? Select all that apply. moderate lochia rubra rounded mass over symphysis pubis dullness on percussion over symphysis pubis fundus boggy to the right of the umbilicus elevated oral temperature

rounded mass over symphysis pubis dullness on percussion over symphysis pubis fundus boggy to the right of the umbilicus Explanation: If the bladder is distended, the nurse would most likely palpate a rounded mass at the area of the symphysis pubis and note dullness on percussion. In addition, a boggy uterus that is displaced from midline to the right suggests bladder distention. If the bladder is full, lochia drainage would be more than normal because the uterus cannot contract to suppress the bleeding. An elevated temperature during the first 24 hours may be normal, however, if the elevated temperature is greater than 100.4 degrees F (38 degrees C), infection is suggested.

What are the purpose of Bartholin's and skene's glands?

secrete mucus to keep the opening moist

what is the function of the clitoris?

small cyndrical mass of erectile tissue and nerves, function is sexual stimulation

What is the purpsoe of estrodiol?

stops FSH

What are the female reproductive organs collectively called?

the vulva

Review of a woman's labor and birth record reveals a laceration that extends through the anal sphincter muscle. The nurse identifies this laceration as which type? first-degree laceration second-degree laceration third-degree laceration fourth-degree laceration

third-degree laceration Explanation: A third-degree laceration extends through the anal sphincter muscle. A first-degree laceration involves only skin and superficial structures above the muscle. A second-degree laceration extends through the perineal muscles. A fourth-degree laceration continues through the anterior rectal wall.

The client, who has just been walking around her room, sits down and reports leg tightness and achiness. After resting, she states she is feeling much better. The nurse recognizes that this discomfort could be due to which cause? thromboembolic disorder of the lower extremities hormonal shifting of relaxin and estrogen infection normal response to the body converting back to prepregnancy state

thromboembolic disorder of the lower extremities Explanation: Thromboembolic disorders may present with subtle changes that must be evaluated with more than just physical examination. The woman may report lower extremity tightness or aching when ambulating that is relieved with rest and elevation. Edema in the affected leg, along with warmth and tenderness and a low grade fever, may also be noted. The woman's complaints do not reflect a normal hormonal response, infection, or the body converting back to the prepregnancy state.

When assessing the newborn's umbilical cord, what should the nurse expect to find? two smaller arteries and one larger vein two smaller veins and one larger artery one smaller vein and two larger arteries one smaller artery and two larger veins

two smaller arteries and one larger vein Explanation: When inspecting the vessels in the umbilical cord, the nurse should expect to encounter one larger vein and two smaller arteries. In 0.5% of births (3.5% of twin births), there is only one umbilical artery, which can be linked to cardiac or chromosomal abnormalities.

What are the female internal reproductive organs? (4)

vagina ueterus fallopean tubes ovaries

What are the physiologic changes associated with female sexual stimulation?

vasocongestion vaginal expansion/elongation secretion of mucus- vestibular glands

The student nurse is attending her first cesarean delivery and is asked by the mentor what should be carefully assessed in this infant. After responding "Respiratory status" the student is asked "Why?" What would be the best response? "There is more fluid present in the lungs at birth after a cesarean delivery than after a vaginal delivery." "Surfactant may be missing from the lungs depending on the newborn's gestational age." "The respiratory centers in the brain have not been stimulated when a newborn is delivered by a cesarean delivery." "A newborn delivered by cesarean has less sensory stimulation to breathe."

"There is more fluid present in the lungs at birth after a cesarean delivery than after a vaginal delivery." Explanation: The process of labor stimulates surfactant production, and much of the fetal lung fluid is squeezed out as the fetus moves down the birth canal. This so-called vaginal squeeze is an important way nature helps to clear the airway in preparation for the first breath. The vaginal squeeze also plays a role in stimulating lung expansion. The pressure of the birth canal on the fetal chest releases immediately when the infant is born. The lowered pressure from chest expansion draws air into the lungs. Reference:

The client is preparing to go home after a cesarean birth. The nurse giving discharge instructions stresses to the family that the client should be seen by her primary care provider within what time interval? 2 weeks 3 weeks 4 weeks 5 weeks

2 weeks Explanation: The general rule of thumb is for a woman who had a cesarean birth be seen within 2 weeks after hospital discharge, unless the primary care provider has indicated otherwise or if the client develops signs of infection or has other difficulties.

How long are sperm viable?

2-3 days

How long is the neonatal period for a newborn?

28 Explanation: The neonatal period is the first 28 days of life.

The nurse is conducting a newborn assessment and notes the head circumference is 35 cm. What is the largest measurement that the nurse will predict for the chest circumference in this infant?

32 Explanation: The chest circumference in a term newborn is usually 2 to 3 cm smaller than the head circumference. Thus 35 - 3 = 32 cm.

Which finding would the nurse describe as "light" or "small" lochia? 1- to 2-inch lochia stain on the perineal pad or a 10 ml loss 4-inch stain or a 10 to 25 ml loss 4- to 6-inch stain with an estimated loss of 25 to 50 ml pad is saturated within 1 hour after changing it

4-inch stain or a 10 to 25 ml loss Explanation: Typically the amount of lochia is described as follows: scant: a 1- to 2-inch lochia stain on the pad or a 10 ml loss; light or small: 4-inch stain or a 10 to 25 ml loss; moderate: 4- to 6-inch stain with an estimated loss of 25 to 50 ml; large or heavy: a pad is saturated within 1 hour after changing it.

On a routine home visit, the nurse is asking the new mother about her breastfeeding and personal eating habits. How many additional calories should the nurse encourage the new mother to eat daily? 500 additional calories per day 1,000 additional calories per day 250 additional calories per day 750 additional calories per day

500 additional calories per day Explanation: The breast-feeding mother's nutritional needs are higher than they were during pregnancy. The mother's diet and nutritional status influence the quantity and quality of breast milk. To meet the needs for milk production, the woman should eat an additional 500 calories per day, 20 grams of protein per day, 400 mg of calcium per day, and 2 to 3 quarts of fluid per day.

The new mother has decided to feed her infant formula. When teaching her about the different types of formula, the nurse should stress the infant should receive how many calories each day? 650 calories 500 calories 800 calories 950 calories

650 calories Explanation: Newborns need about 108 cal/kg or approximately 650 cal/day. Therefore, they will need 2 to 4 ounces at each feeding to feel satisfied. Until about 6 months, most bottle-fed infants need six feedings a day.

A nurse is providing care to a neonate and his mother. On reviewing the maternal history, the nurse notes that the mother's glucose level at birth was 102 mg/dL. The nurse would anticipate that the neonate's blood glucose level would be approximately: 71 to 82 mg/dL. 32 to 44 mg/dL. 96 to 108 mg/dL. 50 to 66 mg/dL.

71 to 82 mg/dL. Explanation: Usually, a term newborn's blood glucose level is 70% to 80% of the maternal blood glucose level at birth. Using the mother's level of 102 and calculating 70% and then 80% of 102, the neonate's blood glucose would range between 71 to 82 mg/dL.

Which findings by a nurse would be considered abnormal when examining the eyes of a newborn? Select all that apply. Absent red reflex Swollen eyelids Positive "doll's eye" reflex Blue-tinged sclera Sub-conjunctival hemorrhages

Absent red reflex Blue-tinged sclera Explanation: The normal response is a red reflection from the retina, and absence of a red reflex is associated with congenital cataracts. The sclera should be white, not blue. All other findings are normal variants for an eye exam.

The nurse walks into a client's room and notes a small fan blowing on the mother as she holds her infant. The nurse should explain this can result in the infant losing body heat based on which mechanism? Conduction Convection Radiation Evaporation

Convection Explanation: There are four main ways that a newborn loses heat; convection is one of the four and occurs when cold air blows over the body of the infant resulting in a cooling to the infant. Conductive heat loss occurs when the newborn's skin touches a cold surface, causing body heat to transfer to the colder object. Heat loss occurs by radiation to a cold object that is close to, but not touching, the newborn. Evaporative heat loss happens when the newborn's skin is wet. As the moisture evaporates from the body surface, the newborn loses body heat along with the moisture. The cold air blowing on the infant's skin will cause heat loss.

When assessing the episiotomy site of a postpartum client that delivered 3-hours ago, the nurse would document which findings as expected? Select all that apply. Edema Redness Slight bruising Discharge Bleeding

Edema Slight bruising Explanation: During the early postpartum period, the perineal tissue surrounding the episiotomy is typically edematous and slightly bruised. The normal episiotomy site should not have redness, bleeding or discharge.

The nurse is caring for a newborn who was delivered via a planned cesarean delivery. The nurse determines the infant requires closer monitoring than a vaginal delivery infant based on which factor? Oxygen was cut off when the umbilical cord was clamped, resulting in decreased oxygen and increased carbon dioxide. Excessive fluid in its lungs, making respiratory adaptation more challenging. Fetal lungs are uninflated and full of amniotic fluid that must be absorbed. Much of the fetal lung fluid is squeezed out in cesarean delivery.

Excessive fluid in its lungs, making respiratory adaptation more challenging. Explanation: During a vaginal birth the infant is squeezed by uterine contractions, which squeeze fluid out of the lungs and prepare them for breathing. The infant who is born via cesarean delivery without labor first does not have the mechanical removal of the fluid from the lungs. This places the infant at increased risk for respiratory compromise, so there is a need to more closely assess a newborn after birth. The lungs should inflate once the baby is delivered and not wait until the amniotic fluid is absorbed. The umbilical cord is not clamped until the infant is out of the womb and starts to take its first breaths.

A nurse does an initial assessment on a newborn and notes a pulsation over the anterior fontanel (fontanelle) that corresponds with the newborn's heart rate. How would the nurse interpret this finding? This is an abnormal finding and needs to be reported immediately. If the fontanel feels full, then this is normal. This finding is normal if the pulsation can also be palpated in the posterior fontanel. It is normal to feel pulsations that correlate with the newborn's heart rate over the anterior fontanel.

It is normal to feel pulsations that correlate with the newborn's heart rate over the anterior fontanel. Explanation: Feeling a pulsation over the fontanel (fontanelle) correlating to the newborn's heart rate is normal. The pulsation should not be felt in the posterior fontanel. The fontanel should not be bulging under any circumstance in a newborn.

The nurse is assessing a newborn, 4 hours old, weighing 9 lbs, 2 oz (4088 g). While doing the initial assessment the RN mentioned that the mother's history showed her to be morbidly obese. Which assessment findings should the nurse prioritize as the newborn is continued to be monitored? Low temperature and hypertonia Jitteriness and irritability Hypotonia and fever Frequent activity and jitteriness

Jitteriness and irritability Explanation: Infants born to women who are morbidly obese are at a greater risk for developing hypoglycemia. Early signs of hypoglycemia in the newborn include jitteriness, poor feeding, listlessness (not frequent activity), irritability, low temperature (not fever), weak or high-pitched cry, and hypotonia (not hypertonia).

A nurse is developing a plan of care for a woman who has had a spontaneous vaginal delivery of a healthy newborn. The nurse determines the need for close monitoring for postpartum hemorrhage based on which information? Select all that apply. Labor of 1 1/2 hours Labor induction with oxytocin Forceps birth Third stage of labor of 10 minutes Hemoglobin 8.0 g/dL (80.0 g/L)

Labor of 1 1/2 hours Labor induction with oxytocin Forceps birth Explanation: Factors that increase a postpartum woman's risk for postpartum hemorrhage include: precipitous labor of less than 3 hours, labor induction, use of operative procedures such as forceps, and prolonged third stage of labor (greater than 30 minutes). A hemoglobin level less than 10.5 g/dL (105.0 g/L) increases the woman's risk for postpartum infection.

Which assessment finding 1 hour after birth should be reported to the health care provider? Fundus of uterus is palpable at the level of the umbilicus. Fundus is displaced to the right, and bladder is hard. Large, bruised hemorrhoids are protruding from the anal opening. Lochia rubra is saturating a pad every 45 to 60 minutes.

Lochia rubra is saturating a pad every 45 to 60 minutes. Explanation: The nurse should ask the woman to turn over so her buttocks can be inspected in order to ensure that blood is not pooling beneath her. If the nurse observes a constant trickle of vaginal flow or the woman is soaking through a pad every 60 minutes, she is losing more than the average amount of blood. She needs to be examined by her health care provider to be certain there is no cervical or vaginal tear, or that poor uterine contraction is not causing excessive bleeding. Following perineal assessment, the nurse should assess the rectal area for the presence of hemorrhoids. If any are present, the nurse should document their number, appearance, and size in centimeters. Fundus of uterus palpable at the level of the umbilicus is a normal finding immediately after birth. When the fundus is displaced to right and bladder is hard to palpation, the bladder is full, and the nurse needs to assist the client in emptying the bladder. The health care provider should be notified if a catheter needs to be inserted and there are no standing prescriptions for an in-and-out cath following birth.

During the early postpartum period, a new mother is displaying dependent behaviors. What behaviors would the nurse recognize as normal for this period? Select all that apply. Needing assistance with changing her peripad Desiring to hold her infant Telling the nurse about her delivery experience. Asking the nurse to take the newborn away so she can rest. Changing her newborn's diaper with guidance from the nurse.

Needing assistance with changing her peripad Telling the nurse about her delivery experience. Asking the nurse to take the newborn away so she can rest. Explanation: In the early postpartum period, the new mother is focused upon herself and concerned about her needs. She is very dependent, having difficulty making decisions and requesting help with self-care. She relives the delivery experience and wants to share it with others. This period may last several hours or several days.

A woman gave birth vaginally approximately 12 hours ago, and her temperature is now 100.8° F (38.2° C). Which action would be mostappropriate for the nurse to take? Continue monitoring the woman's temperature every 4 hours; this finding is normal. Notify the health care provider about this elevation; this finding reflects possible infection. Obtain a urine culture; the woman most likely has a urinary tract infection. Inspect the perineum for hematoma formation.

Notify the health care provider about this elevation; this finding reflects possible infection. Explanation: A temperature above 100.4° F (38° C) at any time or an abnormal temperature after the first 24 hours may indicate infection and must be reported. Abnormal temperature readings warrant continued monitoring until an infection can be ruled out through cultures or blood studies. A hematoma would not necessarily be a cause for an elevated temperature. Cultures may be warranted after notifying the health care provider. A temperature of 100.4° F or less during the first 24 hours postpartum is normal and may be the result of dehydration due to fluid loss during labor.

The nurse in the newborn nursery is placing a 30-minute-old newborn on a radiant warmer for thermoregulation. Where should she apply the temperature probe to be most accurate? Over the upper chest Over the right upper quadrant on the abdomen On the upper thigh On the scalp

Over the right upper quadrant on the abdomen Explanation: Temperature probes are placed in the right upper quadrant on the abdomen. The probe is never placed on bony prominences or over areas of brown fat because those areas tend to be warmer than the rest of the body.

A nursing mother calls the nurse and is upset. She states that her newborn son just bit her when he was nursing. Upon examining the newborn's mouth, two precocious teeth are noted on the lower central portion of the gums. What would be the nurse's bestresponse? "This is most unusual! Let me get the lactation specialist to assist you in breastfeeding. It should not be a problem though." "Precocious teeth can occur at birth but we may need to remove them to prevent aspiration." "The teeth will fall out within the first month, so don't worry about them." "The teeth will fall out when the newborn's baby teeth come in so this is a blessing."

Precocious teeth can occur at birth but we may need to remove them to prevent aspiration." Explanation: Precocious or natal teeth occur infrequently but need to be addressed when they are present. They may cause the mother discomfort when nursing and pumping may be needed initially until the mother can condition the newborn not to bite. Precocious teeth are often loose and need to be removed to prevent aspiration. Even if they are not loose, they are often removed due to them causing ulcerations on the newborn's tongue from irritation. They will not just fall out and are not the newborn's actual baby teeth that are just coming in early.

The nurse is assessing a newborn by auscultating the heart and lungs. Which natural phenomenon will the nurse explain to the parents is happening in the cardiovascular system? Oxygen is exchanged in the lungs. Fluid is removed from the alveoli and replaced with air. Pressure changes occur and result in closure of the ductus arteriosus. The oxygen in the blood decreases.

Pressure changes occur and result in closure of the ductus arteriosus. Explanation: The ductus arteriosus is one of the openings through which there was fetal circulation. At birth, or within the first few days, this closes and the heart becomes the source of movement of blood to and from the lungs. The exchange of oxygen in the lungs and increasing oxygen content in the blood are respiratory functions. The removal of the fluid from the alveoli occurs mainly during the birthing process and is completed by the lungs after birth.

A client who has given birth is being discharged from the health care facility. She wants to know how safe it would be for her to have intercourse. Which instructions should the nurse provide to the client regarding intercourse after birth? Avoid use of water-based gel lubricants. Resume intercourse if bright red bleeding stops. Avoid performing pelvic floor exercises. Use oral contraceptives for contraception.

Resume intercourse if bright red bleeding stops. Explanation: The nurse should inform the client that intercourse can be resumed if bright red bleeding stops. Use of water-based gel lubricants can be helpful and should not be avoided. Pelvic floor exercises may enhance sensation and should not be avoided. Barrier methods such as a condom with spermicidal gel or foam should be used instead of oral contraceptives.

A mother who just given birth has difficulty sleeping despite her exhaustion from labor. What are the causes of this inability to rest? Select all that apply. crying baby inability to get adequate pain relief frequent trips to the bathroom due to diuresis bottle feeding excess fatigue and overstimulation by visitors

orrect response: crying baby inability to get adequate pain relief frequent trips to the bathroom due to diuresis excess fatigue and overstimulation by visitors

Which statement is false regarding bathing the newborn? To reduce the risk of heat loss, the bath should be performed by the nurse, not the parents, within 2 to 4 hours of birth. Bathing should not be done until the newborn is thermally stable. While bathing the newborn, the nurse should wear gloves. Mild soap should be used on the body and hair but not on the face.

To reduce the risk of heat loss, the bath should be performed by the nurse, not the parents, within 2 to 4 hours of birth. Explanation: Bathing the newborn is not necessary for thermal stability. It can be postponed until the parents are able to do it.

A first-time mother informs the nurse that she is unable to breastfeed her newborn through the day as she is usually away at work. She adds that she wants to express her breast milk and store it for her newborn to have later. What instruction would be correct to offer the mother to ensure the safety of the stored expressed breast milk? Use the sealed and chilled milk within 24 hours. Use any frozen milk within 6 months of obtaining it. Use microwave ovens to warm the chilled milk. Refreeze any unused milk for later use if it has not been out more that 2 hours.

Use the sealed and chilled milk within 24 hours. Explanation: The nurse should instruct the woman to use the sealed and chilled milk within 24 hours. The nurse should not instruct the woman to use frozen milk within 6 months of obtaining it, to use microwave ovens to warm chilled milk, or to refreeze the used milk and reuse it. Instead, the nurse should instruct the woman to use frozen milk within 3 months of obtaining it, to avoid using microwave ovens to warm chilled milk, and to discard any used milk and never refreeze it.

A new mother has been reluctant to hold her newborn. Which action by the nurse would help promote this mother's attachment to her newborn? talking about how the nurse held her own newborn while on the birthing table showing a video of parents feeding their babies allowing the mother to pick the best time to hold her newborn bringing the newborn into the room

bringing the newborn into the room Explanation: Proximity of the newborn and the mother can promote interest in the newborn and a desire to hold the infant. Exposure to other mothers and their behaviors can only serve to set up unrealistic and fearful situations for a reluctant mother.

What is the function of hte labia majora?

contains sweat and sebaceous glands, proects vagina opening

The nurse is providing teaching to a new mother who is breastfeeding. The mother demonstrates understanding of teaching when she identifies which characteristics as being true of the stool of breastfed newborns? Select all that apply. formed in consistency completely odorless firm in shape yellowish gold color stringy to pasty consistency

yellowish gold color stringy to pasty consistency Explanation: The stools of a breastfed newborn are yellowish gold in color. They are not firm in shape or solid. The smell is usually sour. A formula-fed infant's stools are formed in consistency, whereas a breastfed infant's stools are stringy to pasty in consistency.