Exam 2 Maternity

The nurse is providing anticipatory guidance to a woman in her second trimester regarding signs/symptoms that she might experience in the coming weeks. Which of the following comments by the client indicates that further teaching is needed? "During the third trimester I may experience frequent urination." "During the third trimester I may experience heartburn." "During the third trimester I may experience back pain." "During the third trimester I may experience persistent headache."

"During the third trimester I may experience persistent headache."

What are the five P's during a vaginal birth?

1) passenger 2) passageway 3) powers 4) position 5) psychological

How many vessels are on the placenta?

2 arteries and 1 vein

Amount of blood loss normal for a vaginal birth?

500mL

The LATCH score gives us an indication of how well the baby is breastfeeding at any given time. True False

false

When providing care for the laboring woman the nurse should understand that accelerations with fetal movement: Warrant close observation Are a positive sign of oxygenation Are caused by umbilical cord compression Are caused by placental-utero insufficiency

Are a positive sign of oxygenation

Which of the following is the highest priority of the nurse who is caring for the laboring patient? Involvement of the patient's partner with the labor and delivery. Pain relief measures that are offered are acceptable to the patient. Assessment of fetal response to the labor. Monitoring appropriate fluid intake.

Assessment of fetal response to the labor.

Because nausea and vomiting are such common complaints of pregnant women, the nurse provides anticipatory guidance to a 6-week gestation client by telling her to do which of the following? Avoid eating greasy foods. Drink orange juice before rising. Drink 2 glasses of water with each meal. Eat 3 large meals plus a bedtime snack.

Avoid eating greasy foods

The new mother notes that her baby has a "bulge" on the back of one side of the head. She calls the nurse into the room to ask what the bulge is. The nurse notes that the bulge covers the right parietal bone and does not cross the suture lines. The nurse explains to the mother that the bulge results from which of the following? The position that the baby took in her pelvis during the last trimester of her pregnancy Molding of the baby's skull so that the baby could fit through her pelvis. Swelling of the tissues of the baby's head from the pressure of her pushing. Bleeding from small blood vessels under the baby's scalp but above the skull bone.

Bleeding from small blood vessels under the baby's scalp but above the skull bone.

The maternity nurse understands that as the uterus contracts during labor, maternal-fetal exchange of oxygen and waste products: Continues except when placental functions are reduced. Diminishes as the spiral arteries are compressed. Is not significantly affected. Increases as blood pressure decreases.

Diminishes as the spiral arteries are compressed.

A primigravida at 39 weeks of gestation is observed for 2 hours in the intrapartum unit. The fetal heart rate has been normal. Contractions are 10 to 15 minutes apart, 20 to 30 seconds in duration, and of mild intensity. Cervical dilation is 1 to 2 cm and uneffaced (unchanged from admission). Membranes are intact. The nurse should expect the woman to be: Admitted for extended observation. Admitted and prepared for a cesarean birth. Discharged home to await the onset of true labor. Discharged home with a sedative.

Discharged home to await the onset of true labor.

The nurse is caring for a laboring woman, G3 P2002, who was examined 15 minutes ago. Her cervix was 8 cm dilated and 90% effaced. She now states she is feeling strong pressure in her rectum and wants to move her bowels. Which of the following action should the nurse perform first? Offer the patient the bedpan Notify the MD Encourage the patient to push Evaluate the progress of labor

Evaluate the progress of labor

These contractions are often irregular and do not get closer together. These contractions may stop with movement such as walking.

False labor

The most common cause of decreased variability in the FHR that lasts 30 minutes or less is: Umbilical cord compression Head compression during contractions Fetal hypoxemia Fetal sleep cycles

Fetal sleep cycles

While providing care to a patient in active labor, the nurse should instruct the woman that: In a sitting or squatting position, her abdominal muscles will have to work harder. The supine position commonly used in the United States increases blood flow. Frequent changes in position will help relieve her fatigue and increase her comfort. The "all fours" position, on her hands and knees, is hard on her back.

Frequent changes in position will help relieve her fatigue and increase her comfort

The nurse caring for the laboring woman should understand that early decelerations are caused by: Placental-utero insufficiency Umbilical cord compression Head compression of the fetus during contractions Spontaneous rupture of membranes

Head compression of the fetus during contractions

A 20-year old patient states that the at-home pregnancy test this morning was positive. Which of the following comments by the nurse is appropriate at this time: "Congratulations, and you and your family must be very happy." "Have you told the baby's father yet?" "Please tell me when your last menstrual period was." "How do you feel about the results?"

How do you feel about the results?

Jana purchased an over the counter pregnancy test. The results were positive. The hormone responsible for a positive pregnancy test is: 1. Estrogen 2. Testosterone 3. Lactogen 4. Human chorionic gonadotropin

Human chorionic gonadotropin (hCG)

A patient who is lying in the supine position while in active labor is receiving an intravenous oxytocin (Pitocin) infusion and has external monitors in place. Using the monitoring strip below, identify the appropriate nursing interventions. Select all that apply. Have the patient push in short bursts IV fluid bolus Turn the patient on her side Turn off the oxytocin infusion Increase the rate of the oxytocin infusion

IV fluid bolus Turn the patient on her side Turn off the oxytocin infusion

Combinations of pharmacologic and nonpharmacologic measures increased pain relief and create a more positive birth experience-such as what?

IV narcotics Nitrous oxide

The nurse would expect which maternal cardiovascular finding during labor? Decreased blood pressure Increased cardiac output Decreased white blood cell (WBC) count Decreased pulse rate

Increased cardiac output

The process of your baby settling or lowering into your pelvis just before labor. May feel the need to urinate more with this.

Lightening

When taking a pregnant woman's BP, what position should be avoided?

Lying flat on back, because baby is heavy and laying on the vena cava

A woman in labor has just received an epidural block. The most important nursing intervention is to: Monitor the fetus for possible tachycardia. Limit parenteral fluids. Monitor the maternal pulse for possible bradycardia. Monitor the maternal blood pressure for possible hypotension.

Monitor the maternal blood pressure for possible hypotension.

The nurse evaluating the fetal monitor tracing of the patient, who is in active labor. Suddenly, the nurse sees the FHR drop from its baseline of 125 down to 80. The nurse repositions the mother, provides oxygen, increases intravenous (IV) fluid, and performs a vaginal exam. The cervix has not changed. Three minutes have passed, and the fetal heart rate remains in the 70s. What additional nursing measures should the nurse first take? Repeat the uterine resuscitation measures again Start Pitocin Notify the care provider immediately, get help and have the operating room ready Insert a Foley catheter

Notify the care provider immediately, get help and have the operating room ready

Which statement reflects the concept of ethnocentrism? Tomorrow is just as important as today. Religion largely defines a culture's world view. Nursing care should respect the culture of others. Our health care practices are the best in the world.

Our health care practices are the best in the world.

What measures should the nurse implement to provide intrauterine resuscitation? Select the best response that indicates the priority of actions that should be taken, starting with the most important. Call the provider, reposition the mother, and perform a vaginal exam Perform a vaginal exam, reposition the mother, and provide oxygen via face mask Reposition the mother, increase IV fluid, and provide oxygen via face mask Administer oxygen to the mother, increase IV fluid, and notify the care provider

Reposition the mother, increase IV fluid, and provide oxygen via face mask

The nurse providing newborn stabilization must be aware that the primary side effect of maternal narcotic analgesia in the newborn is: Bradycardia. Respiratory depression. Acrocyanosis. Tachypnea.

Respiratory depression

A woman has requested an epidural for her pain. She is 5 cm dilated and 100% effaced. The baby is in a vertex position and is engaged. The nurse increases the woman's intravenous fluid for a preprocedural bolus. She reviews her laboratory values and notes that the woman's hemoglobin is 12 g/dL, hematocrit is 38%, platelets are 67,000, and white blood cells (WBCs) are 12,000/mm3. Which factor would contraindicate an epidural for the woman? She is too far dilated. She is septic. She has thrombocytopenia. She is anemic.

She has thrombocytopenia.

A patient is in the transition phase of labor. Which of the following maternal behaviors should the nurse most expect to observe? Feelings of elation that labor is almost over. Cheerful, talkative, and seeking information. A little apprehensive and uncertain Significantly restless and irritable.

Significantly restless and irritable

What are contraindications for birth control pills containing both estrogen and progesterone? A woman who desires a regular menstrual cycle A teenager with acne Smokers over age 35 Breastfeeding women Family history of stroke, heart disease or blood clots

Smokers over age 35 Breastfeeding women Family history of stroke, heart disease or blood clots

The nurse has received report regarding her patient in labor. The woman's last vaginal examination was recorded as 3 cm, 30%, and -2. The nurse's interpretation of this assessment is that: The cervix is 3 cm dilated, it is effaced 30%, and the presenting part is 2 cm above the ischial spines. The cervix is effaced 3 cm, it is dilated 30%, and the presenting part is 2 cm above the ischial spines. The cervix is effaced 3 cm, it is dilated 30%, and the presenting part is 2 cm below the ischial spines. The cervix is dilated 3 cm, it is effaced 30%, and the presenting part is 2 cm below the ischial spines.

The cervix is 3 cm dilated, it is effaced 30%, and the presenting part is 2 cm above the ischial spines.

What happens in the Second Stage of Labor? A. The woman dilates from 8cm to 10 cm. B. The placenta separates from the uterus. C. The fetus is delivered. D. The women is complete and pushing.

The woman is complete and pushing

You see a woman in Triage who has bruises on her arm and face but will not admit that her husband has harmed her. You must fill out a report sheet of suspected suspicious injury as a mandated reporter. True False

True

These contractions come at regular intervals and get closer together as time goes on. (Contractions last about 30 to 70 seconds.) These contraction continue even with movement.

True labor

A woman at 30 weeks' gestation assumes a supine position for a fundal measurement. She begins to complain about feeling dizzy and nauseated. Her skin feels damp and cool. What is the nurse's first action? 1. Assess respiratory rate and effort 2. Provide an emesis basin 3. Elevate legs 20 degrees 4. Turn the woman on her side

Turn the woman on her side

What is the best bed position for assessing a postpartum client's fundus? Trendelenberg Woman flat in bed Head and Knees elevated semi-fowlers

Woman flat in bed

Which occurrence is associated with cervical dilation and effacement? a. Bloody show c. Lightening b. False labor d. Bladder distention

a. Bloody show

A woman who is 36 weeks' pregnant is informed by the nurse that a danger sign at this time could be: Constipation. Occasional heart palpitations. Edema in the ankles and feet at the end of the day. Alteration in the pattern of fetal movement.

alteration in the pattern of fetal movement

Which statement is the best rationale for assessing maternal vital signs between contractions? a. During a contraction, assessing fetal heart rates is the priority. b. Maternal circulating blood volume increases temporarily during contractions. c. Maternal blood flow to the heart is reduced during contractions. d.

b. Maternal circulating blood volume increases temporarily during contractions.

The nurse recognizes that a woman is in true labor when she states: a. "I passed some thick, pink mucus when I urinated this morning." b. "My bag of waters just broke." c. "The contractions in my uterus are getting stronger and closer together." d. "My baby dropped, and I have to urinate more frequently now."

c. "The contractions in my uterus are getting stronger and closer together."

The nurse teaches a pregnant woman about the characteristics of true labor contractions. The nurse evaluates the woman's understanding of the instructions when she states, "True labor contractions will: a. Subside when I walk around." b. Cause discomfort over the top of my uterus." c. Continue and get stronger even if I relax and take a shower." d. Remain irregular but become stronger."

c. Continue and get stronger even if I relax and take a shower."

When planning the care for a laboring woman whose membranes have ruptured, the nurse recognizes that the woman's risk for _______________ has increased. Excess bleeding premature delivery infection prolapse

infection

The most important nursing intervention after the injection of epidural anesthesia is monitoring: urinary output. contractions. maternal blood pressure. intravenous infusion rate.

maternal blood pressure

What stimulates uterine contractions during pregnancy?

oxytocin

Which symptom is considered a first-trimester warning sign and should be reported immediately by the pregnant woman to her health care provider? Vaginal bleeding Nausea with occasional vomiting Fatigue Urinary frequency

vaginal bleeding