Exam 1: terms and questions

1. A labor nurse keeps this vasopressor in the room during the client's induction of an epidural in order to promptly treat severe maternal hypotension. a. betamethasone b. hemabate c. prostaglandin E2 d. ephedrine

D. ephedrine

Methylergonovine/methergine

causes uterine, smooth muscles and vascular contraction and arterial vasoconstriction; used in the treatment of postpartum hemorrhage; do not administer if patient is hypertensive

normal temperature of a newborn

97.7-100 degrees

1. Vitamin K is prescribed for a neonate. The student nurse prepares to administer the medication in which muscle site? a. Vastus lateralis b. Abdomen c. Deltoid d. Triceps

A. Vastus Lateralis

A primigravida is receiving magnesium sulfate for the treatment of pregnancy induced hypertension (PIH). The nurse who is caring for the client is preforming assessments every 30 minutes. Which assessment finding would be of most concern to the nurse? a. urinary output of 10 ml since the previous assessment b. deep tendon reflexes of 2+ c. fetal heart rate of 120 BPM d. respiratory rate of 14 BPM

A. urinary output of 10 ml

1. Which of the following doses of Rh immune globulin RhoGAM is appropriate for an unsensitized pregnant client at 28 weeks gestation? a. 300mcg b. 10mcg c. 500mcg d. 50mcg

A: 300 mcg

What does APGAR stand for

A: appearance (color) P: pulse G: Grimace (reflex irritability) A: Activity (muscle tone) R: Respirations

Vitamin K/ Phytonadione/ Aqua-Mephyton

Administered to preven hemorrhagic disease of the newborn

Ilotycin/Erythromycin opthalmic ointment

An antimicrobial instilled into the neonatal conjunctival sac to prevent neonatal ophthalmia caused by gonorrhea and chlamydia

1. In the 12th week of gestation, a client completely expels the products of conception. Because the client is Rh negative, the nurse must: a. Do not have to give RhoGAM, since this is not a birth or stillborn b. Make certain she receives RhoGAM within 2 hours c. Make certain the client does not receive RhoGAM, since the gestation only lasted 12 weeks. d. Administer RhoGAM within 72 hours

D: administer RhoGAM within 72 hours

1. Which of the following hormones would be administered for the stimulation of uterine contractions? a. Estrogen b. Progesterone c. Fetal cortisol d. Oxytocin

D: oxytocin

Breast engorgement and mastitis are words that refer to the same breast condition in the postpartum period. a. True b. False

False

operative vaginal delivery

Medically assisted childbirth in which the woman delivers without the assistance of forceps or vacuum cup on the fetal head

NIPS

Neonatal infant pain score

Kangaroo Care

Placing the neonate skin-to-skin with the parent for temperature stabilization and to enhance bonding

Carboprost/ Hemabate

Prostaglandin that stimulates uterine contractions; is used to treat postpartum hemorrhage due to uterine atony uncontrolled by other methods

Postpartum/puerperal

The 6-week period of time following childbirth

Swaddling

Snuggly wrapping the neonate in a blanket to promote comfort and thermoregulation

Ballard or Dubowitz

Standardized tests to calculate the gestational age of the neonate

SIDS

Sudden infant death syndrome

Hemolytic disease of the newborn

The potential for hemolysis of Rh-positive newborn RBC's due to the presence of Rh- negative maternal antibodies

tuck pads

Topical pads with active ingredient of witch hazel used to relieve perineal discomfort due to trauma or hemorrhoids

sitz bath

a bath in which the hips and buttocks are immersed in warm water for the therapeutic effect of moist heat in the perineal and anal regions

Direct Coombs

a blood test that checks for the presence of maternal antibodies in neonatal blood.

Uterine atony

a decreased tone of the uterus muscle; the primary cause of postpartum hemorrhage in the immediate postpartum period

5 minute score

how well the infant is transitioning to extrauterine life

1 minute score

how well the infant tolerated labor and delivery

Afterpains

moderate to severe cramp-like pains caused by uterine contractions during the first few postpartum days

NTE

neutral thermal environment; refers to an environment that maintains body temperature with minimal metabolic changes and/or oxygen consumption

PAHT

pediatric abusive head trauma; also known as shaken baby syndrome

Duscosate sodium/ colace

stool softener routinely administered to all post partum patients

oxytocin

the hormone responsible for uterine contractions and the let-down reflex (milk ejection) in breastfeeding

Hemorrhagic disease of the newborn

the potential for hemorrhage in the newborn due to vitamin K deficiency

Neonate

Referring to a newborn from birth through 28 days of life

metabolic screen

A blood test that checks for inborn errors of metabolism

1. A nursing instructor asks a nursing student to describe the procedure for administering erythromycin ointment into the eyes of the neonate. The instructor determines that the student needs to research this procedure further if the student states: a. "I will flush the eyes after instilling the ointment" b. "Administration of the eye ointment may be delayed until an hour or so after birth so that parent/infant attachment and bonding can occur" c. "Do not touch tip of applicator to eye : after 1 minute excess ointment can be wiped off" d. "I will instill the eye ointment into each of the neonate's conjunctival sacs within one hour after birth"

A: I will flush the eyes after instilling ointment

Bonding

An emotional feeling between parent and newborn that begins during pregnancy or shortly after birth; it is unidirectional- rom parent to child

Narcan/ Naloxone hydrochloride

An opioid antagonist administered to the newborn to reverse respiratory depression if born after maternal pain medications were administered

1. Which of the following complications can be potentially life threatening and can occur in a client receiving the tocolytic agent Terbutaline (Brethine)? a. hyperemesis gravidarum b. pulmonary edema c. sickle cell anemia d. diabetic ketoacidosis

B: pulmonary edema

1. RHo (D) immune globulin (RhoGAM) is prescribed for a woman following delivery of a newborn infant and the nurse provides information to the woman about the purpose of the medication. The nurse determines that the woman understands the purpose of the medication if the woman states that RhoGAM will protect her next baby from which of the following? a. having Rh + blood b. sensitization - which is the formation of anti-D antibodies from Mom that crosses the placenta and attacks fetal blood cells causing hemolysis c. developing a rubella infection d. developing physiological jaundice

B: sensitization

Acrocyanosis

Cyanosis or bluish tint of the hands and feet of the newborn; caused by sluggish perfusion or hypothermia

1. A pregnant client is receiving magnesium sulfate for the management of preeclampsia. A nurse determines the client is experiencing toxicity from the medication if which of the following is noted on assessment? a. presence of deep tendon reflexes b. proteinuria of +3 c. serum magnesium level of 6 mEq/L d. respirations of 10 per minute

D. Respirations of 10 per minute

1. After reviewing the client's maternal history of magnesium sulfate during labor, which condition would the nursery nurse anticipate as a potential problem in the neonate? a. Hypoglycemia b. Jitteriness c. Tachycardia d. Hypotonia/respiratory depression

D: hypotonia and respiratory depression

hBIG

Hepatitis B immunoglobin administered to the neonate born to a mother who is hepatitis B positive, or if mother's hepatitis B status is unknown

Hyperbilirubinemia

High levels of unconjugated bilirubin in the neonate's blood due to physiologic or pathologic causes; exhibited by jaundice

Preeclampsia

Hypertension accompanied by underlying systematic pathology that can have severe maternal and fetal impact; a systemic disease with hypertension accompanied by proteinuria after 20th week of gestation

Bulb syringe

a device used to suction secretions from the newborn's mouth and nose

Tocolytic

a hormone or medication that inhibits muscular tone (contractions)

Uterotonic

a hormone or medication that stimulates muscular tone (contractions) in the uterus

Congenital heart screen

a non-invasive procedure that compares pre-ductal and post-ductal oxygen saturations to screen for congenital heart defects in the neonate

Cesarean birth

also referred to as a cesarean section or a c-section; an operative procedure in which the fetus is delivered through an incision in the abdominal wall and uterus

Circumcision

an elective procedure to remove the forskin of the penis

episiotomy

an incision in the perineum to provide more space for the fetal presenting part at delivery

Indirect Coomb's Test

antibody screen preformed on rh-negative woman to determine if Rh isoimmunization has occurred from exposure to Rh-positive fetal blood

Intrapartum

begins with the onset of regular uterine contractions and lasts until the expulsion of the placenta

Lochia rubra

bloody baginal discharge with small clots that is present for 1-3 days after delivery

lochia serosa

pink or brownish vaginal discharge that occurs at about 10 days and up to 3 weeks postpartum

RhoGAM; Rho(D) immunoglobin

prevention of isoimmunization in rh-negative women exposed to rh-positive blood

TDAP vaccine/ adacel

prevents whooping cough in neonates and infants by providing to mother and decreasing likelihood of infection

prolactin

the primary hormone responsible for lactation

involution

the process by which the uterus returns to a pre- pregnant size, shape, and location; and placental site heals

lactation

the production of breastmilk

1. A client's labor does not progress. After ruling out CPD (cephalopelvic disproportion) the doctor orders IV administration of 1000 ml normal saline (NS) with Pitocin 10 units to run at 2 mu/min. 2 mu/min is equivalent to how many ml/units? a. 0.02 b. 2.0 c. 0.002 d. 0.2

D: 0.2

What is an Apgar score

A rapid assessment of five physiological signs that indicate the physiological status of the newborn at birth

multigravida; multipara

A woman who has been pregnant multiple times; a woman who has given birth after 20 weeks multiple times

Para

A woman who has given birth after 20 weeks gustation; also the number of births that occurred after 20 weeks gestation

Primigravida; primipara

A woman who is pregnant for the first time; a woman who has given birth after 20 weeks gestation one time

1. The antagonist (Antidote) for Magnesium sulfate should be readily available to any client receiving IV magnesium. Which of the following drugs is the antidote for magnesium toxicity? a. Narcan b. RhoGAM c. Calcium Gluconate d. Hydralazine (Apresoline)

C: Calcium gluconate

1. A nurse is caring for a pregnant client with severe preeclampsia who is receiving IV magnesium sulfate. Select all nursing interventions that apply in the care for the client. a. Monitor maternal vital signs every 4 hours b. Notify the physician if respirations are less than 12 per minute c. Monitor renal function and cardiac function closely d. Keep ephedrine on hand e. Monitor deep tendon reflexes hourly f. Notify physician if urinary output is less than 25 ml/hour g. Turn down the lights and keep the woman in a side lying position

B,C,E,F,G

1. A nurse is caring for a 30 week gestation client in preterm labor, and the physician orders betamethasone (Celestone) IM. The client asks the nurse why she is receiving corticosteroids. The nurse tells the client that the betamethasone will: a. help stop the labor contractions b. help the baby's lungs mature faster c. decrease the incidence of fetal infection d. prevent the membranes from rupturing

B: help the baby's lung mature faster

1. Methergine is prescribed for a client with postpartum hemorrhage. Before administering the medication, a nurse contacts the health care provider who prescribed the medication if which condition is documented in the client's medical history? a. hypotension b. hypertension or preeclampsia c. hypothyroidism or graves disease diabetes mellitus or history of DKA

B: hypertension or preeclampsia

1. Which medication below is used for pre-induction cervical ripening or to induce an abortion? a. Ephedrine b. Pitocin c. Cervidil d. Narcan

C. Cervidil

1. A nurse prepares to administer a vitamin K injection to a newborn infant. The mother asks the nurse why her newborn infant needs the injection. The best response by the nurse would be: a. "Newborn infants have sterile bowels, and vitamin K promotes the growth of bacteria in the bowel." b. "The vitamin K will protect your infant from becoming jaundiced" c. "Newborn infants are deficient in vitamin K, and this injection prevents your infant from abnormal bleeding" d. "Your infant needs vitamin K to develop immunity"

C: Newborn infants are deficient in vitamin K, and this injection prevents your infant from abnormal bleeding

1. Which drug would the nurse choose to utilize as an antagonist for opioids? a. Calcium Gluconate b. Oxytocin c. Narcan d. Terbutaline

C: narcan

1. A client at 33 week gestation and leaking amniotic fluid is placed on an EFM. The electronic fetal monitor indicates uterine irritability and contractions occurring every 4-6 min. The doctor orders terbutaline. Which of the following teaching statements is appropriate to educate this client? a. You'll need to replace potassium lost by this drug. b. This medicine will make you breathe better c. This will dry your mouth and make you thirsty d. You may feel fluttering or tight sensations in your chest

D: you may feel fluttering or tight sensations in your chest

Gravida

a pregnant woman; also, the number of times the woman has been pregnant

Hearing Screen

a procedure to identify neonates at risk for hearing loss

Diastasis recti

a separation of the two rectus abdomens muscle bands at the midline

orthostatic hypotension

a sudden drop in the blood pressure when the woman stands up from a sitting lying position

Cold stress

a term used when there is excessive heat loss that leads to hypothermia and results in the utilization of compensatory mechanisms to maintain the neonate's body temperature

nulligravida, nullipara

a woman who has never been pregnant; a woman who has never given birth after 20 weeks

Live attenuated rubella virus vaccine/meruvax II

provides immunity to rubella by antibody protection; administered to non-immune women on the postpartum unit

Antepartum/antenatal

the time period beginning with the conception and ending with the onset of labor

Uterine fundus

the upper portion of the uterus

dibucaine/ nupercainal ointment

topical anesthetic ointment used to relieve perineal discomfort from episiotomy or lacerations after childbirth

benzocaine/dermoplast spray

topical anesthetic spray used to relieve perineal discomfort from episiotomy or lacerations after childbirth

Spontaneous vaginal delivery

unassisted or "natural" childbirth in which the woman delivers without the assistance of forceps or vacuum cup

Oxytocin/pitocin

uterotonic medication that causes uterine contractions; used to induce or augment labor or to prevent postpartum hemorrhage

lochia alba

yellow-to-white vaginal discharge that occurs at about 10 days and up to 3 weeks postpartum