PrepU - OB exam 2

stage 4 of labor

1-4 hours after labor for psychological changes

A client has just given birth to a healthy baby boy, but the placenta has not yet delivered. What stage of labor does this scenario represent? 1.First 2.Second 3. Third 4.Fourth

3. Third

A postpartal woman is developing a thrombophlebitis in her right leg. Which assessments would the nurse make to detect this? 1. Bend her knee, and palpate her calf for pain. 2. Ask her to raise her foot and draw a circle 3. Blanch a toe, and count the seconds it takes to color again 4. Assess for pedal edema.

4. Assess for pedal edema.

A nurse is reviewing a postpartum woman's history and labor and birth record. The nurse determines the need to closely monitor this client for infection based on which factor? 1. labor less than 3 hours 2.hemoglobin of 11.5 mg/dL 3. placenta removed via manual extraction 4. multiparity

3. placenta removed via manual extraction

fetal hr

110-160 hr in relationship to contraction

frequency

beginning of one contraction to beginning of next contraction MINUTES**

early hypovolemia causes hemorrhage

increase pulse increase BP

regional anesthesia is an ______block

pudendal block

The nurse is caring for a postpartum woman who is diagnosed with endometritis. Which position should the nurse encourage the client to maintain? 1. Flat in bed 2. On her left side 3. Trendelenburg 4. Semi-Fowler

4. Semi-Fowler

The nurse is monitoring a client who just received IV sedation. Which instruction should the nurse prioritize with the client and her partner? Ambulate only with assistance from the nurse or caregiver. Ambulate within 15 minutes to prevent spinal headache. Sit on the edge of the bed with her feet dangling before ambulating. Remain in bed for at least 30 minutes.

Ambulate only with assistance from the nurse or caregiver.

Which cardinal movement of delivery is the nurse correct to document by station? Descent Flexion Extension Internal rotation

Descent

The nurse is assessing a postpartum client at a 6-week well-care check and notes questionable behavior on assessment. Which behaviors should the nurse prioritize and report to the RN or health care provider? Tearful during appointment Talkative and asking questions Restless and agitated, concerned with self and not the infant States being tired and happy at same time

Restless and agitated, concerned with self and not the infant

At what time is the laboring client encouraged to push? When she feels the urge to push When the health care provider has arrived When the cervix is fully dilated When the fetal head can be seen

When the cervix is fully dilated

fetal monitor best heard

curved part closed to anterior uterine wall

A new mother talking to a friend states, "I wish my baby was more like yours. You are so lucky. My baby has not slept straight through the night even once. It seems like all she wants to do is breastfeed. I am so tired of her." This is an example of which behavior? positive bonding negative bonding positive attachment negative attachment

negative attachment

Lochia Alba

day 10-14 until 3-4 weeks postpartum

The student nurse is learning about normal labor. The teacher reviews the cardinal movements of labor and determines the instruction has been effective when the student correctly states the order of the cardinal movements as follows: internal rotation, flexion, descent, extension, external rotation, expulsion. descent, flexion, external rotation, extension, internal rotation, expulsion. descent, flexion, internal rotation, extension, external rotation, expulsion. internal rotation, flexion, descent, extension, external rotation, expulsion.

descent, flexion, internal rotation, extension, external rotation, expulsion.

latent phase (stage 1)

dilation : 0-3 cm frequency: 5-10 minutes duration: 30-45 seconds

stage 2 of labor

dilation of 10cm to child BIRTH frequency: 2-3 minutes duration: 60-90 seconds

active phase (stage 1)

dilation: 4-7 cm frequency: 2-5 minutes duration: 45-60 seconds **PAINFUL PHASE**

transition phase (stage 1)

dilation: 7-10 cm frequency: 1-2 minutes duration: 60-90 seconds **FINAL PUSH**

intervention for patient experiencing tingling in fingers

face mask of O2

A nurse is reviewing the FHR and notes it to be in the range of 100 to 106 bpm over the past 10 minutes. Which conditions might the nurse suspect as the cause? Select all that apply. fetal hypoxia effect of maternal analgesia prolonged umbilical cord compression maternal fever prematurity

fetal hypoxia effect of maternal analgesia prolonged umbilical cord compression

Lightening

fetus drops into pelvis

fetal cardinal movements

flex, rotate, extend

regular contractions (duration & frequency)

happen ever 2-3 minutes last 60-90 seconds

intensity

how hard the push is HARD muscle = GOOD contraction IUPC - inserted in vagina for numeric measurement

epidural needs an IV to prevent

hyPOtension

client with LATE deceleration should be placed

in left lateral postion

disseminated intravascular coagulation at risk of developing

preeclampsia

Primary & Secondary force

primary - uterine contractions secondary - maternal pushing effort

leopoid maneuvers

putting hands on abdomen to determine fetal position

fetus increase in o2 when.....

relaxation of uterine contractions

stage 3 of labor

separation and delivery of the placenta

duration

start of one contraction to finish of SAME contraction SECONDS**

effacement

thinning and shortening (0-100%) 0 - thick 100- thin

The nurse has been asked to present information to a group of civic leaders concerning women's health issues. In preparing the information, the nurse includes what goal from Healthy People 2020 related to women in labor? 1.Reduce the rate of cesarean births among low-risk births 2.Encourage women with previous cesareans to always have a cesarean 3.Ensure care during labor includes immunizations. 4. Ensure all couples receive preconceptional genetic counseling.

1.Reduce the rate of cesarean births among low-risk births

What two elements play the biggest role in becoming a mother after delivery of her newborn? 1. Confidence and happiness with the pregnancy 2. Love and attachment to the child and engagement with the child 3. Planned and desired pregnancy and previous experience with infants 4. Interactions with the child and support systems

2. Love and attachment to the child and engagement with the child

Lochia Rubra

3 -4 days postpartum

Lochia Serosa

3-10 days postpartum

A gravida 1 client is admitted in the active phase of stage 1 labor with the fetus in the LOA position. The nurse anticipates noting which finding when the membranes rupture? Bloody fluid Clear to straw-colored fluid Greenish fluid Cloudy white fluid

Clear to straw-colored fluid

A client in labor has administered an epidural anesthesia. Which assessment findings should the nurse prioritize? maternal hypotension and fetal tachycardia maternal hypertension and fetal bradycardia maternal hypotension and fetal bradycardia maternal hypertension and fetal tachycardia

maternal hypotension and fetal bradycardia

hypertension drugs CANNOT GIVE

methylergonovine maleate

dilation

opening and enlargement (0-10 cm) 0- closed 10 - fully opened, ready for birth

A primary care provider prescribes intravenous tocolytic therapy for a woman in preterm labor. Which agent would the nurse expect to administer? 1. magnesium sulfate 2. nifedipine 3. indomethacin 4. betamethasone

1. magnesium sulfate

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? 1. thromboembolic disorder of the lower extremities 2. hormonal shifting of relaxin and estrogen 3. infection 4. normal response to the body converting back to prepregnancy state

1. thromboembolic disorder of the lower extremities

A new mother asks the nurse what she is allowed to do when she goes home from the hospital. Which statement by the nurse would be correct? 1. You should be able to resume normal activities after 2 weeks. 2. You should not lift anything heavier than your infant in its carrier. 3. Only clean half of the house per day to allow yourself more rest 4. You need to hire a maid for the first month after delivery to help out around the house.

2. You should not lift anything heavier than your infant in its carrier.

During the assessment of a woman in labor, the nurse explains that certain landmarks are used to determine the progress of the birth. The nurse identifies which area as one of these landmarks? 1. ischial spine 2. ischial tuberosity 3. pubic symphysis 4. cervical os

1. ischial spine

A client who recently gave birth to her third child expresses a desire to have her older two children come to the hospital for a visit. What should the nurse say in response to this request? 1. "As long as they are well, absolutely. Why don't we give you a dose of pain medication beforehand so that you will enjoy the visit?" 2. "I recommend that you introduce the new baby to her siblings once you are back at home. Right now you need to rest and recover." 3. "Your baby is so vulnerable to infections right now that it would be better to wait until you are at home to introduce her to her siblings." 4. "That's a great idea! They can also take the baby out into the hall and walk with it for a while to give you a break."

1. "As long as they are well, absolutely. Why don't we give you a dose of pain medication beforehand so that you will enjoy the visit?"

The nurse is providing care to a client in labor. On examination, the nurse determines the fetus is at -1 station. The nurse interprets this as indicating that the fetus is: 1. 1 cm above the ischial spines. 2. 1 cm below the ischial spines. 3. 1 cm below the pubic bone. 4. 1 cm above the pubic bone.

1. 1 cm above the ischial spines.

A client presents to the birthing center in labor. The client's membranes have just ruptured. Which assessment is the nurse's priority? 1. FHR 2. signs of infection 3. fetal position 4. maternal comfort level

1. FHR

The nurse is analyzing the readout on the EFM and determines the FHR pattern is reassuring based on which recording? Acceleration of at least 15 bpm for 15 seconds Increase in variability by 27 bpm Deceleration followed by acceleration of 15 bpm Decrease in variability for 15 seconds

Acceleration of at least 15 bpm for 15 seconds

The nurse is assessing a client in labor for pain and notes she is currently not doing well handling the increased pain. Which opioid can the nurse offer to the client to assist with pain control? meperidine thiopental hydroxyzine hydrochloride secobarbital

meperidine

asthma drugs CANNOT GIVE

misoprostol prostaglandin carboprast

Nesting

increase energy from increase hormone level

ensure which of the following before performing an amniotomy? 1. fetal engagement 2. fetal lie 3. fetal attitude 4. fetal position

1. fetal engagement

While making a follow-up home visit to a client in her first week postpartum, the nurse notes that she has lost 5 pounds. Which reason for this loss would be the most likely? 1. diuresis 2. lactation 3. blood loss 4. nausea

1. diuresis

The nurse is caring for a client who is considered low-risk and in active labor. During the second stage, the nurse would evaluate the client's FHR at which frequency? 1. every 15 minutes 2. every 10 minutes 3. every 5 minutes 4. every 20 minutes

1. every 15 minutes

A nurse is caring for a pregnant client who is in labor. Which maternal physiologic responses should the nurse monitor for in the client as the client progresses through birth? Select all that apply. 1. increase in heart rate 2. increase in blood pressure 3. increase in respiratory rate 4. slight decrease in body temperature 5. increase in gastric emptying and pH

1. increase in heart rate 2. increase in blood pressure 3. increase in respiratory rate

The nurse suspects that a mother who delivered her infant 2 weeks ago is experiencing postpartum depression. What is the first line of treatment for this client? 1. scheduling electroconvulsive therapy 2. administrating a selective serotonin reuptake inhibitor 3. talking to the client and reassuring her that she will feel better soon 4. telling the client that she has no need to be depressed

2. administrating a selective serotonin reuptake inhibitor

Which assessment on the third postpartal day would make the nurse evaluate a woman as having uterine subinvolution? 1. Her uterus is 2 cm above the symphysis pubis 2. Her uterus is three finger widths under the umbilicus 3. Her uterus is at the level of the umbilicus 4. She experiences "pulling" pain while breastfeeding.

3. Her uterus is at the level of the umbilicus

In recording a postpartum mother's urinary output, the nurse notes that she is voiding between 100 to 200 mL with each void. How would the nurse interpret this finding? 1. The urinary output is inadequate and the mother needs to drinks more fluids 2. The urinary output is inadequate suggestive of urinary retention 3. The urinary output is normal 4. The urinary output is above expected levels.

3. The urinary output is normal

The nurse is caring for a client within the first four hours after her cesarean birth. Which nursing intervention would be most appropriate to prevent thrombophlebitis? 1. Roll a bath blanket or towel and place it firmly behind the knees 2. Limit oral intake of fluids for the first 24 hours to prevent nausea 3. Assist client in performing leg exercises every two hours 4. Ambulate the client as soon as her vital signs are stable.

4. Ambulate the client as soon as her vital signs are stable

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? 1. talking about how the nurse held her own newborn while on the birthing table 2. showing a video of parents feeding their babies 3. allowing the mother to pick the best time to hold her newborn 4. bringing the newborn into the room.

4. bringing the newborn into the room

A postpartal woman is developing thrombophlebitis in her right leg. Which assessment should the nurse no longer use to assess for thrombophlebitis? 1. Assess for reddness and warmth. 2. Ask about increased pain with weight bearing. 3. Ask if she has pain or tenderness in the lower extremities. 4.Dorsiflex her right foot and ask if she has pain in her calf.

4.Dorsiflex her right foot and ask if she has pain in her calf.

A woman is to undergo labor induction. The nurse determines that the woman requires cervical ripening if her Bishop score is: 5. 6. 7. 9.

5