S2: Test 1

Moderate variability FHR

(normal) fluctuation range from 6 to 25 beats per minute

Early decelerations

*safe* Begin prior to peak of the contraction and end by the end of it. they are caused by head compression. no need for intervention if variability is within normal range (6-10) and the FHR is within normal range.

Which variables are scored on a biophysical profile? Select all that apply. One, some, or all responses may be correct. 1 Fetal tone 2 Fetal position 3 Fetal movement 4 Amniotic fluid index 5 Fetal breathing movements 6 Contraction stress test results

1 3 4 5

The electronic fetal monitor on a client receiving an infusion of oxytocin (Pitocin) displays contractions every 2 minutes and lasting 95 seconds. Which is the appropriate nursing action? 1 Stop the oxytocin (Pitocin) infusion. 2 Administer oxygen at 8 to 10 L/min. 3 Increase the main line fluid delivery rate to 150 mL/hr. 4 Prepare the client for insertion of an intrauterine pressure catheter.

1 The contraction pattern indicates hyperstimulation of the uterus. Stopping the oxytocin (Pitocin) infusion permits relaxation of the uterus and perfusion of the placenta. Oxygen cannot reach the placenta until the uterus is relaxed, so administering oxygen will not help. Increasing the rate of delivery of the main line fluid does not affect hyperstimulation of the uterus. Insertion of an intrauterine pressure catheter will only provide measurement of the internal uterine pressure and will not affect uterine contractions.

Fetal heart rate tracing abnormalities are observed on the fetal monitor when a client in active labor turns to the supine position. Which nursing action is most beneficial at this time? 1 Helping the client change her position 2 Informing the client of the problem with the fetus 3 Administering oxygen by mask to the client at 2 L/min 4 Readjusting placement of the fetal monitor on the client's abdomen

1 change position Changing the maternal position is the most beneficial action, especially with late- and variable-deceleration patterns, because this position change will increase placental perfusion. Although the client should be kept informed of the fetus's condition, this may be done during or immediately after the position change; the needs of the fetus are the priority. If oxygen is used, the concentration should be greater than 2 L/min. Readjusting placement of the fetal monitor may be done after the position change; the immediate needs of the fetus are the priority

Which action would the nurse take when a client's membranes rupture while her labor is being augmented with an oxytocin infusion and variable decelerations in the fetal heart rate occur? 1 Change the client's position. 2 Take the client's blood pressure. 3 Stop the client's oxytocin infusion. 4 Prepare the client for an immediate birth.

1 change position Variable decelerations are usually the result of cord compression; a change of position will relieve the pressure on the cord. Variable decelerations are not related to the mother's blood pressure or to the oxytocin. Preparing the client for an immediate birth is premature; other nursing measures should be tried first.

During a nonstress test, the baseline fetal heart rate of 130 to 140 beats per minute rises to 160 twice and 157 once during a 20-minute period. Each of these episodes lasts 20 seconds. Which action would the nurse take? 1 Discontinue the test because the pattern is within the normal range. 2 Encourage the client to drink more fluids to decrease fetal heart rate. 3 Notify the primary health care provider and prepare for an emergency birth. 4 Record this nonreassuring pattern and continue the test for further evaluation.

1 discontinue The baseline heart rate is within the expected range. The accelerations meet the criteria for an increase of 15 beats that lasts at least 15 seconds during a 20-minute period. This is a reassuring pattern that is indicative of fetal well-being. Drinking more fluids is unnecessary because the fetal heart rate is within the expected range. Preparing for an emergency birth is unnecessary because the test results indicate fetal well-being. The test results meet the standards for a reassuring pattern; further evaluation is unnecessary.

For which reason is an ultrasound done during the first trimester? 1 Estimate fetal age 2 Detect hydrocephalus 3 Rule out congenital defects 4 Approximate fetal linear growth

1 estimate age

During a nonstress test the nurse concludes that if accelerations of the fetal heart rate occur with fetal movement, this probably indicates which? 1 Fetal well-being 2 Fetal head compression 3 Uteroplacental insufficiency 4 Umbilical cord compression

1 fetal well being Accelerations of the fetal heart rate with fetal movement indicate fetal well-being. Early decelerations are associated with fetal head compression. Late decelerations are associated with uteroplacental insufficiency. Variable decelerations are associated with cord compression.

A nonstress test (NST) is scheduled for a client with mild preeclampsia. During an NST, the client asks what it means when the fetal heart rate goes up every time the fetus moves. Which is an appropriate response? 1 "These accelerations are a sign of fetal well-being." 2 "These accelerations indicate fetal head compression." 3 "Umbilical cord compression is causing these accelerations." 4 "Uteroplacental insufficiency is causing these accelerations."

1 fetal well being The NST is performed before labor begins. Accelerations with movementand a baseline variability of 5 to 15 beats/min indicate fetal well-being. This reactive NST is considered positive. Early decelerations are associated with fetal head compression during a contraction stress test (CST) or during labor. Variable decelerations are associated with cord compression during a CST or during labor. Late decelerations during a CST or during labor are associated with uteroplacental insufficiency.

Which common problem affects the client in labor when an external fetal monitor has been applied to her abdomen? 1 Intrusion on movement 2 Inability to take sedatives 3 Interference with breathing techniques 4 Increased frequency of vaginal examinations

1 intrusion on movement Because the client is attached to a machine and movement may alter the tracings, movement is discouraged. Placement of the external monitor leads does not interfere with the administration of sedatives. An external monitor does not interfere with breathing techniques. An external monitor does not necessitate more frequent vaginal examinations.

Which statement indicates a client understands the meaning of having a reactive nonstress test? 1 Normal because of increases in fetal heart rate (FHR) with fetal movement 2 Abnormal because of a decrease in FHR between contractions 3 Abnormal because of variability in FHR with each contraction 4 Normal because the FHR remained unchanged with maternal movement

1 normal A reactive nonstress test is an expected finding because there are 2 or more increases in FHR greater than 15 beats/min associated with fetal movement; it suggests fetal well-being. There are no uterine contractions during a nonstress test. Maternal movement has no bearing on nonstress test readings; fetal movements and FHR are monitored.

Between contractions that are 2 to 3 minutes apart and last about 45 seconds the internal fetal monitor shows a fetal heart rate (FHR) of 100 beats/min. Which is the priority nursing action? 1 Notify the health care provider. 2 Resume continuous fetal heart monitoring. 3 Continue to monitor the maternal vital signs. 4 Document the fetal heart rate as an expected response to contractions.

1 notify The expected FHR is 110 to 160 beats/min between contractions. An FHR of 100 beats/min is bradycardia (baseline FHR slower than 110 beats/min) and indicates that the fetus may be compromised, requiring notifying the health care provider and medical intervention. Resuming continuous fetal heart monitoring may be dangerous. The fetus may be compromised, and time should not be spent on monitoring. Continuing to monitor the maternal vital signs is not the priority at this time. Although a fetal heart rate slower than 110 beats/minute should be documented, it is not an expected response.

Late decelerations are present on the monitor strip of a client with an intravenous infusion who received epidural anesthesia 20 minutes ago. Which action would the nurse take immediately? 1 Reposition the client from supine to left lateral. 2 Increase the intravenous flow rate from 125 to 150 mL/hr. 3 Administer oxygen at a rate of 8 to 10 L/min by way of facemask. 4 Assess the maternal blood pressure for a systolic pressure below 100 mm Hg.

1 reposition Hypotension is a common side effect of epidural anesthesia that results in decreased placental perfusion and late decelerations on the fetal monitor. The priority intervention is repositioning the client to relieve compression of the vena cava and increase venous return, which in turn increases placental perfusion. Administering oxygen and increasing the flow rate are correct interventions, but neither is the priority because these interventions would not be effective until compression of the vena cava has been relieved and placental perfusion increased. Assessing the maternal blood pressure for a systolic pressure below 100 mm Hg only provides data and does not correct the late deceleration.

contraction cycle

1. Contraction Cycle Begins 2. Active-Site Exposure 3. Cross-Bridge Formation 4. Myosin Head Pivoting 5. Cross-Bridge Detachment 6. Myosin Reactivation

During a prenatal education class, the nurse discusses the importance of fetal movement awareness. Why is this an important concept to teach? 1 An increase in fetal movement indicates the onset of labor is near. 2 A decrease in fetal movement necessitates an evaluation of fetal well-being. 3 Fetal movement awareness increases the emotional bond of mother to fetus. 4 A perceived decrease in fetal movement is a symptom of preeclampsia.

2 A perceived decrease in fetal movement by the client requires evaluation of fetal well-being because it can be associated with increased risk of stillbirth, fetal growth restriction, or placental insufficiency. There are no consistent data about fetal movement changes before labor. Fetal movement awareness may help a client perceive her fetus as an individual and contribute to bonding with her fetus, but this is not the reason that fetal movement awareness is taught. A decrease in fetal movement is not a symptom of preeclampsia.

Which term would the nurse use to describe the first fetal movements that a pregnant client feels? 1 Lightening 2 Quickening 3 Engagement 4 Ballottement

2 Lightening is the descent of the fetus into the birth canal toward the end of pregnancy. Engagement occurs when the presenting part is at the level of the ischial spines. Ballottement refers to the technique that causes the fetus to rebound in the amniotic fluid after pressure has been exerted against the fetus.

The health care provider prescribes a contraction stress test (CST) for a client at 33 weeks' gestation whose nonstress test (NST) was nonreactive and whose biophysical profile (BPP) was inconclusive. Which maternal conditions would prompt the nurse to question the prescription? Select all that apply. One, some, or all responses may be correct. 1 Hypertension 2 Preterm labor 3 Placenta previa 4 Cervical insufficiency 5 Premature rupture of membranes

2 3 4 5 The CST may trigger a preterm birth in a client who is in preterm labor or has a history of preterm births. With a placenta previa, the contractions caused by the CST can stimulate bleeding. The CST is also contraindicated with cervical insufficiency, as these clients are already at a higher risk of preterm birth. The CST might also trigger a preterm birth in a woman whose membranes have ruptured prematurely. The CST is indicated to assess the influence of hypertension on the placental circulation and determine the response of the compromised fetus to labor.

A client is admitted in active labor. The nurse, performing Leopold maneuvers, determines that the fetus is in the left occiput anterior (LOA) position. Where would the nurse place the transducer of the electronic fetal monitor? 1 Right lower midline 2 Left lower quadrant 3 Left upper quadrant 4 Right upper quadrant

2 LL The LOA position indicates that the fetus is on the left side of the mother and in a head presentation with the occiput anterior; therefore fetal heart sounds are best found in the left lower quadrant of the woman's abdomen. If the fetal heartbeat is found toward the right lower midline of the mother's abdomen, the fetus is probably in a shoulder presentation, in the right scapular anterior position. If the fetal heartbeat is found in the left upper quadrant of the mother's abdomen, the fetus is in the breech presentation on the left side of the mother (left sacrum anterior). If the fetal heartbeat is found in the right upper quadrant of the mother's abdomen, the fetus is in the breech presentation on the right side of the mother (right sacrum anterior).

Which instruction would the nurse provide to the client in early pregnancy scheduled for her first obstetric ultrasound? 1 Postpone breakfast until after the test. 2 Drink water until bladder is full. 3 Empty the bladder immediately before the test. 4 Insert a suppository after arising on the day of the test

2 drink water until bladder is full A full bladder raises the uterus above the pelvis, providing better visualization of its contents. This preparation is helpful for the transabdominal portion of the ultrasound. The client may then be allowed to void before the transvaginal portion of the ultrasound. It is not necessary to arrive for the test with an empty stomach. The bladder should not be emptied until after the test. It is not necessary to evacuate the bowels before the test.

A nonstress test evaluates the condition of the fetus by comparing the fetal heart rate with which factor? 1 Fetal lie 2 Fetal movement 3 Maternal blood pressure 4 Maternal uterine contractions

2 fetal movement In a healthy, well-oxygenated fetus the heart rate increases with fetal movement; there should be an acceleration of 15 beats with fetal movement. Fetal lie and maternal blood pressure are not a part of the evaluation of the fetus in the nonstress test. Maternal uterine contractions are used in the contraction stress test.

The nurse who is admitting a newborn to the nursery observes a fetal scalp monitor site on the scalp. Which complication would the nurse monitor this newborn for? 1 Injury 2 Infection 3 Feeding problems 4 Respiratory distress

2 infection The monitor site represents a break in the integrity of the scalp, which allows access by microorganisms. There is no further risk for injury. A fetal scalp monitor site does not interfere with feeding. A fetal scalp monitor site does not affect respirations.

A client at 42 weeks' gestation is admitted for a nonstress test. The nurse concludes that this test is being done because of which possible complication related to a prolonged pregnancy? 1 Polyhydramnios 2 Placental insufficiency 3 Postpartum infection 4 Subclinical gestational diabetes

2 placental insufficiency Placental function peaks at 37 weeks and declines slowly thereafter; therefore, continuation of the pregnancy past term (42 weeks) places the fetus at risk because of placental insufficiency. Oligohydramnios (decreased amniotic fluid volume), not polyhydramnios (increased amniotic fluid volume), may occur in postterm gestations. A prolonged pregnancy does not present a risk for a postpartum infection. A prolonged pregnancy is unrelated to gestational diabetes.

Which condition is suspected when immediately after a client's membranes rupture, the fetal heart rate monitor shows variable decelerations of more than 90 seconds followed by bradycardia? 1 Fetal acidosis 2 Prolapsed cord 3 Head compression 4 Uteroplacental insufficiency

2 prolapsed cord

A 42-year-old client at 39 weeks' gestation has a reactive nonstress test (NST). Which interpretation pertains to this result? 1 Immediate birth is indicated. 2 This is the desired response at this stage of gestation. 3 Further testing is unnecessary with this desired outcome. 4 The result is inconclusive, indicating the need for further evaluation.

2 this is the desired response

Late fetal heart rate decelerations begin to appear when a client's cervix is dilated 6 cm, and her contractions are occurring every 4 minutes and lasting 45 seconds. Which is the likely cause of these late decelerations? 1 Imminent vaginal birth 2 Uteroplacental insufficiency 3 Pattern of nonprogressive labor 4 Normal pressure on the presenting part during contractions

2 uteroplacental insufficiency Late decelerations are indicative of uteroplacental insufficiency and, left uncorrected, lead to fetal hypoxia, fetal myocardial depression, or both. The imminence of birth cannot be determined from fetal heart rate decelerations, only from cervical dilation. Birth occurs after the cervix has dilated to 10 cm and the fetus has passed through the birth canal. Nonprogressive labor cannot be determined from fetal heart rate decelerations, only from cervical dilation. Late decelerations are not normal, are not reassuring, and must not be ignored.

When should the uterus no longer be palpable?

2 weeks

Which is the most appropriate response when a client asks if the nurse thinks the ordered nonstress test is necessary? 1 "It's a fast, harmless procedure." 2 "You seem to have doubts about this test." 3 "This test is routinely done at this time in a pregnancy." 4 "There may be problems, and we want to reduce the risks."

2 you seem to have doubts Observing that the client is having doubts encourages her to discuss her fears and anxieties. Telling the client that the test is fast, harmless, or routine cuts off communication and does not allow the client to express her fears and anxiety. The mention of risk may frighten the client and does not encourage the client to discuss the situation further.

A client in labor is receiving an oxytocin infusion. Which intervention is a priority for the nurse when repetitive late decelerations of the fetal heart rate are observed? 1 Administer oxygen. 2 Place the client on the left side. 3 Discontinue the oxytocin infusion. 4 Check the client's blood pressure

3 Treat the immediate potential cause of the decelerations by discontinuing the oxytocin infusion. The infusion should be stopped because it is the likely source of fetal compromise. Additional interventions including administering oxygen, placing client on the left side, and monitoring vital signs should be initiated to support both the mother and the unborn child. These interventions are supportive therapy—not treatment of the cause.

In which location would the Doppler ultrasound transducer be placed to best auscultate fetal heart tones when the fetus is in the right occiput posterior (ROP) position? 1 Above the umbilicus in the midline 2 Above the umbilicus on the left side 3 Below the umbilicus on the right side 4 Below the umbilicus near the left groin

3 below on R side Fetal heart tones are best auscultated through the fetal back. In this case the presenting part is in the ROP position; the back is below the umbilicus and on the right side. Above the umbilicus in the midline is the placement that should be used when the fetus is lying in the midline in a breech position. Placement above the umbilicus on the left side is appropriate when the fetus is in the left sacrum anterior position. Placement below the umbilicus near the left groin is appropriate when the fetus is in the left occiput anterior or left occiput posterior position.

Which action would the nurse take when a 15-beat-per-minute acceleration of the fetal heart rate above the baseline occurs during a contraction? 1 Call the practitioner to prepare for an imminent birth. 2 Turn the mother on her left side to increase venous return. 3 Record the fetal response to contractions and continue to monitor the heart rate. 4 Document the fetal heart rate abnormality and monitor the fetal heart rate continuously.

3 record the fetal response to contractions Periodic accelerations are the most reassuring of fetal heart rate indicators, regardless of the cause. The fetal response is recorded and monitoring continues unchanged. This increase in the fetal heart rate does not require intervention by the practitioner at this time. Turning the mother on her left side to increase venous return is done when a fetal heart rate deceleration occurs. This acceleration is not a fetal heart rate abnormality and does not require a specific frequency of monitoring.

A client in labor is having an indwelling urinary catheter inserted. Which action by the nurse would help prevent late decelerations of the fetal heart rate during this procedure? 1 Position both the client's legs in stirrups simultaneously. 2 Urge the client to take deep breaths frequently. 3 Place a rolled towel under the client's right hip. 4 Loosen the transducer belts around the client's abdomen.

3 rolled towel Elevating the right hip during catheter insertion displaces the uterus to the left. This action improves placental perfusion and prevents supine hypotension caused by pressure on the vena cava with its associated late fetal heart rate decelerations. Placing the feet in stirrups simultaneously helps prevent trauma to ligaments at the time of birth; it is not done when a urinary catheter is inserted. The client should be encouraged to breathe normally throughout the procedure. Taking frequent deep breaths would not directly prevent late decelerations of the fetal heart rate. Adjusting the belts around the client's abdomen does not affect the fetal heart rate.

Which result after 20 minutes of a nonstress test is suggestive of fetal reactivity? 1 Absence of long-term variability 2 Above-average fetal baseline heart rate of 160 beats/min 3 No late decelerations associated with contractions 4 Two accelerations of 15 beats/min lasting 15 seconds

4 2 accelerations of 15 bpm lasting 15 sec According to the American Congress of Obstetricians and Gynecologists, fetal reactivity is a fetal tracing 15 beats' acceleration above baseline lasting 15 seconds or more, normal baseline rate, and long-term variability amplitude of 10 or more beats/min. An absence of long-term variability is an ominous sign that must be addressed. An above-average baseline heart rate is acceptable up to 160 beats/min. An increasing baseline heart rate is a sign of maternal infection. Contractions are not expected with a nonstress test; early, late, or variable fetal heart rate decelerations are associated with uterine contractions.

As a client enters the second stage of labor, fetal monitoring shows early decelerations of the fetal heart rate with a return to the baseline at the end of each contraction. Which is the common cause of this fetal heart rate pattern? 1 Maternal diabetes 2 Fetal cord prolapse 3 Maternal hypotension 4 Fetal head compression

4 fetal head compression Early decelerations are expected occurrences as the fetal head passes through the birth canal; the fetal heart rate returns to baseline quickly, indicating fetal well-being. Early decelerations are not related to maternal diabetes. Variable decelerations occur with umbilical cord compression, not prolapse. Maternal hypotension will cause late decelerations because of fetal hypoxia.

A pregnant client's blood test reveals an increased alpha-fetoprotein (AFP) level. Which condition is indicated with this result? 1 Cystic fibrosis 2 Phenylketonuria 3 Down syndrome 4 Neural tube defect

4 neural tube defect Increased levels of alpha-fetoprotein in pregnant women have been found to reflect open neural tube defects such as spina bifida and anencephaly. Cystic fibrosis is a genetic defect that is not associated with the AFP level. A Guthrie test soon after ingestion of formula can determine whether an infant has phenylketonuria. Down syndrome is a chromosomal defect that is associated with a low AFP level.

When will uterus return to normal size

6 weeks

Doula

A caregiver who provides continuous physical, emotional, and educational support for the mother before, during, and after childbirth.

variability in fetal HR

Absent: non detected Minimal: no more than 5 beats/min Moderate: fluctuates 6-25 beats/min Marked: greater than 25 beats/min fluctuations in the baseline FHR that cause the printed line to have an irregular wavelike appearance rather than a smooth, flat one

Late decelerations

Bad (placental insufficiency) Impaired exchange of oxygen and waste products in the placenta (uteroplacental insufficiency) may result in a pattern of late (delayed) decelerations.

What are the possible negative impacts of COLD STRESS in the newborn?

Cold stress can severely impede plant growth by disrupting normal cell structure and function

Variable decelerations

HR up or down, cord compression = VERY BAD Prolapsed cord= push head up, change mom position

Describe how hyperthermia is similar and different in affecting the newborn to heat loss

Infants in a cold environment may lose heat by conduction, convection, evaporation or radiation.

EFM (electronic fetal monitoring)

Measures fetal heart rate and uterine contractions with: Fetal Doppler FHR and fetal movement can be recorded Tocodynamometer frequency and duration of contractions

Cholasma

Pigmented area of the face (mask of pregnancy)

What advantage do full term infants have over preterm infants for heat loss

Premature and low-birthweight babies usually have little body fat and may be too immature to regulate their own temperature, even in a warm environment.

diastasis recti

Separation of the longitudinal muscles of the abdomen (rectus abdominis) during pregnancy.

What circulatory changes are necessary for a successful transition from intrauterine to extrauterine life?

Umbilical cord clamping decreases oxygen concentration, increases carbon dioxide concentration, and decreases the blood pH.

Powers of labor

Uterine contractions and maternal pushing efforts

intermittent contractions

allowing relaxation of the uterine smooth muscle and resumption of blood flow to and from the placenta to permit gas, nutrient, and waste exchange for the fetus.

Surfactant

any substance that interferes with the hydrogen bonding between water molecules and thereby reduces surface tension

ambivalence

being uncertain about the pregnancy

Premonitory signs of labor

braxton hicks contractions, lightening, increase in clear and nonirritating vaginal secretions, "bloody show", energy spurt, small weight loss

How does a cesarean delivery versus a vaginal delivery impact respiration?

c section babies are more likely to develop asthma because the normal hormone changes of labor do not occur in the mom but the fluid in the lungs is still there and the baby has to work to reabsorb it after birth

imbalance of what electrolytes can be associated with leg cramps in pregnancy

calcium, magnesium, phosphorus

Pica

compulsive eating of nonnutritive substances such as clay, ice, dirt, cornstarch, coffee grounds

Introversion

concentration on oneself and ones body such as what foods to eat

false labor

contractions - inconsistant and activity does not alter them and may decrease them discomfort - felt in abdomen and groin, may be more annoying than painful cervix - no significant change

true labor

contractions - pattern, walking increases frequency and strength discomfot - felt in lower back and moves to the front, back pain may continue, early labor may feel like cramps cervix - effacement and dilation

Baroreceptors

detect changes in blood pressure stimulate the vagus nerve to slow FHR and decrease the blood pressure, thus lowering cardiac output. As fetal blood pressure decreases, the heart rate accelerates to maintain normal cardiac output.

what could cause a false negative on a pregnancy test

diuretics - makes urine too diluted

ptyalism

excessive salivation

what is a physiologic benefit of providing analgesics to a breastfeeding patient experiencing afterpains

facilitates the milk ejection reflex

Describe the phases of the transition period (first 6-8 hrs after birth) for the parents of a newborn. How do the phases affect a newborn's interest in feeding? What are sleep patterns like in this time period?

fetal lung fluid is reabsorbed, blood flow to lungs and tissues, changes in HR, RR, GI function, and temp. decreased resposiveness then exaggerated responsiveness

Nursing responsibilities related to intrapartum fetal surveillance by any mode include promoting

fetal oxygenation, identifying and reporting nonreassuring findings, supporting parents, communicating with the physician or nurse-midwife, and documenting all care.

The purpose of intrapartum fetal surveillance is to identify

fetal well-being and to identify the fetus who may be having hypoxic stress beyond the ability to compensate for it.

marked variability in FHR

greater than 25 bpm

Pretend you are teaching new parents about cold stress. What are the most important teaching points you will include?

hats should be warn, swaddle

The priority nursing care of the mother after birth is to assess for

hemorrhage, promote firm uterine contraction, and promote parent-infant attachment.

identify the physiologic changes needed for successful initiation and maintenance of respirations.

hypercarbia, acidosis, and hypoxia which stimulate the respiratory center in the brain to initiate breathing

Identify nursing interventions to prevent heat loss in the newborn.

infant should be dressed to prevent heat loss by radiation to cold windows or walls. Hot room. Many low birth weight infants can be kept warm in a bassinet, dry the infant, swaddling, head cap

Acceleration of FHR

is defined as a visually apparent, abrupt increase in FHR above baseline rate. 15 bpm greater than baseline that lasts at least 15 seconds occur with fetal movement

What teaching do parents need to care for their newborn under phototherapy?

it is safe, protect the babies eyes

LOA position

left occiput anterior

LOP position

left occiput posterior

nadir

lowest point of FHR

How does a preterm birth (before 37 weeks) impact respiration?

may not have made enough surfactant yet. When there is not enough surfactant, the tiny alveoli collapse with each breath. As the alveoli collapse, damaged cells collect in the airways. They further affect breathing.

Tachysystole

more than 5 contractions in 10 minutes

What infants are at greater risk for experiencing cold stress?

naked preterm

The priority nursing care of the newborn immediately after birth is to promote

normal respirations, maintain normal body temperature, and promote attachment.

involuntary contraction

not under conscious control as are skeletal muscles. The mother cannot cause labor to start or stop by conscious effort. Walking or other activity may stimulate existing labor contractions. Anxiety and excessive stress can diminish them.

what should be included in the initial prenatal assessment for a new patient who is approximately 8 weeks along

obstetric history psychosocial history contraceptive history EDD partners medical and surgical history

what immunizations would a nurse advise a pregnant woman to avoid

ones with live viruses varicella, smallpox, measles, mumps, rubella

Component of Birth Process— 4 P's

passage - maternal pelvis and soft tissues passenger - fetus, membrane, placenta powers - uterine contractions, maternal pushing efforts, psyche - how they are feeling

a maternal supine position can reduce

placental blood flow because the uterus compresses the aorta and inferior vena cava.

What role does brown fat serve to help newborns thermoregulate?

produces heat to help maintain your body temperature in cold conditions

Thirty minutes after initiation of epidural anesthesia the fetus is experiencing late decelerations. List the following nursing actions in order of priority. 1. Increase intravenous fluids. 2. Reassess the fetal heart rate (FHR) pattern. 3. Reposition the client on her side. 4. Document interventions and related maternal/fetal responses. 5. Notify the health care provider if late decelerations persist.

reposition her increase fluids reassess FHR pattern notify HCP if late decelerations persist document

When the fetal monitor is applied to a client's abdomen, it records late decelerations. Which action would the nurse take?

reposition on her L side

ROA position

right occiput anterior

ROP position

right occiput posterior

round ligament pain

sharp pain in side or inguinal area; usually right side interventions: good body mechanics; avoid strenuous exercise no sudden movements avoid stretching and twisting at the same time

4 stages of normal labor

stage 1, cervical dilation and effacement; stage 2, expulsion of the fetus; stage 3, expulsion of the placenta; and stage 4, maternal physiologic stabilization and parent-infant bonding

what should a patients cervix look like immediately after birth

the perineum might appear bruised

common maternal responses during the 1st trimester

uncertainty, ambivalence, self as primary focus

Explain phototherapy to the parents. What else can help their newborn get rid of excess bilirubin?

using light to eliminate bilirubin in the blood feeding your baby often

Which condition is most commonly associated with late decelerations of the fetal heart rate? 1 Head compression 2 Maternal hypothyroidism 3 Uteroplacental insufficiency 4 Umbilical cord compression

uteroplacental insufficiency

coordinated contraction

uterus can contract and relax in a coordinated way, as can other smooth muscles such as the heart. As the woman approaches full term, contractions become organized and gradually assume a regular pattern of increasing frequency, duration, and intensity during labor. Coordinated labor contractions begin in the uterine fundus and spread downward toward the cervix to propel the fetus through the pelvis