Holistics unit 3: Pregnancy, labor, and postpartum
How do screen a newborn of a mother with diabetes for hypoglycemia?
testing the heel with a glucose-oxidase strip
The nurse assesses the frequency of a clients contractions by timing them from the beginning of a contraction until which time in the contraction?
the beginning of the next contraction
A client at 7 weeks gestation reports to the prenatal nurse that she is sick every morning with nausea and vomiting and that she does not think she can tolerate is throughout her pregnancy. The nurse assures her that this is a common occurrence in early pregnancy and will probably disappear by the end of which month?
third month
what nursing intervention is appropriate to reduce the harmful side effects that could be cause by phototherapy?
using shields on the eyes to protect them from the light
Which response by the nurse is appropriate when a client admits to substance abuse during pregnancy and ask the nurse not to inform the baby's father?
What do you think the reaction of the baby's father will be?
A client in active labor becomes very uncomfortable and asks the nurse for pain medication. Nalbuphine is prescribed. Which is the action of this medication?
acting on opioid receptors
Which physiologic occurrence after birth indicates to the nurse that the placenta is beginning to separate from the uterus and is ready to be expelled?
an appearance of a sudden gush of blood
While the nurse is caring for a client in active labor whose fetus is at station 0, the clients membranes rupture spontaneously. The nurse determines that the fluid is clear and odorless. What is the nurses next action?
assessing the FHR
After performing a vaginal exam on a client in labor, the nurse determines that the cervix is dilated 2cm and 80% effaced, and that the presenting part is at 0 station. Where is the presenting part?
at the level of the ischial spine
According to the U.S. food and drug administration pregnancy risk categories, which category of drugs may cause minimal risk to the fetus? A, B, C, or D
b
Which situation is an indication for an oxytocin infusion? A. hypertonic uterus B. pelvic inflammatory disease C. induction of labor at full term D. Cervical stenosis in a client who is in labor
c
During the examination of a client in labor, the nurse determines that the cervix is dilated to 4cm. Which stage of labor will the nurse document in the record?
first stage
The four essential components of labor are passenger, powers, passageway, and position. Passageway refers to the bony pelvis. Which type of pelvis is considered the most favorable for a vaginal delivery?
gynecoid
what factor is associated with hyperemesis gravidarum?
high levels of chorionic gonadotropin
After a clients baby is born, the client reports to the nurse, "I'm so cold and i cant stop shaking." Which would be the best nursing response?
ill get you some warm blankets to help make the chill go away
The nurse performs leopold maneuvers on a laboring client and determines that the fetus is in the left occiput anterior (LOA) position. Where would the nurse place the transducer of the electronic fetal monitor to assess fetal heart rate (FHR)?
left lower quadrant
What side should a woman sleep on when pregnant?
left-side laying position
What hormone can cause ovulation and promote lactation?
oxytocin
What color is lochia discharge on the 6th day?
pinkish brown
What is a woman who is pregnant for the 1st time called?
primigravida
What is the first movement felt by a pregnant mother called?
quickening
What organism causes mastitis?
staphylococcus aureus
A postpartum client who was receiving an intravenous infusion of oxytocin to stimulate labor ask the nurse why it is not being discontinued now that the baby is born. Which response would the nurse give?
the oxytocin prevents excessive bleeding
What information does the nurse suggest to be included in the updated plan of care for the mother who plans to bottle-feed the newborn?
using tap water to mix powdered formula per instructions
Where is vitamin k administered in a newborn?
vastus lateralis
Which task would the nurse delegate to an unlicensed health care worker?
vital signs on a client 4 hours after delivery
When can FHR be heard?
week 10-12 gestation with a doppler week 16-20 with ultrasound stethoscope
When is it most important for a female to be aware of potential structural damage to the fetus due to the ingestion of drugs?
when planning to become pregnant
Which is the best time to administer Rho(D) immune globulin?
within 72 hours of birth if the infant is Rh positive
What is the action of tocolytic?
inhibits labor and maintains a pregnancy
What is the definition of the 2nd stage of labor?
it ends at the time of the birth
Which fetal location does the +1 station describe?
just below the ischial spines
When can you expect to feel the baby move?
18-20 weeks
Where is the expected fundal location 3 days postpartum of a cesarean birth?
3 fingerbreadths below umbilicus
A pregnant woman reports nausea and vomiting during the 1st trimester of pregnancy. The nurse explains to the client that an increase in which hormone is the precipitating cause of the nausea and vomiting?
Chorionic gonadotropin
A pregnant client has a family history of down syndrome. Which prenatal test provides the earliest diagnosis with rapid test results?
Chorionic villus sampling (CVS)
At 14 weeks gestation multigravida is receiving blood work for alpha-fetoprotein analysis. She asks the nurse, "What does this test mean?" Which fetal physiologic abnormality may this test detect?
neural tube defects
Why do newborns need vitamin K after birth?
newborns are deficient in vitamin K and this will protect your baby from bleeding
Using the GTPAL system, determine the obstetric history in this example. The client is 38 weeks into her fourth pregnancy. Her 3rd pregnancy, a twin gestation, ended at 32 weeks with a live birth, her 2nd pregnancy ended at 38 weeks with a live birth, and her 1st pregnancy ended at 18 weeks.
G4, T1, P1, A1, L3 (g-total pregnacies, t- term pregnancies, p-preterm pregancies, a-abortions, l-living babies)
A couple who recently emigrated from Israel report to the prenatal nurse that they are concerned about a genetic disease that is prevalent in the jewish population. Which genetic screening test would the nurse teach the couple about because it is likely to be recommended by the health care provider?
Tay-sachs disease
What color does a nitrazine strip change with amniotic fluid with a pH of 7.5
deep blue
What is the normal heart rate of a baby in active labor between contractions?
110-160 BPM
Will taking aspiring while pregnant cause Reye syndrome?
No, this syndrome occurs in children taking aspirin
If one child has cystic fibrosis, what are the chances of the next child having it also?
There is a 25% chance the baby will be affect and a 50% chance the baby will be a carrier
What system in the body goes through the most changes during pregnancy?
cardiovascular system
what cervical changes are observed during pregnancy?
cervical tip becoming soft, volume of cervical muscle increasing, and elasticity of cervical collagen rich connective tissue
Three weeks after delivery, a client develops a deep vein thrombosis in her left leg. She is admitted to the hospital for bed rest and anticoagulant therapy. Which anticoagulant would be utilized in this situation?
continuous infusion of heparin
Which request for a laboring client's medical information would the nurse deny?
department supervisor with no direct or indirect care duties
A pregnant woman is being induced because she is past her due date. Which drug would be administered to the client to soften the cervix and promote labor?
dinoprostone
a primigravida client who is 38 weeks gestation is undergoing a nonstress test. The nurse determines that the baseline fetal heart rate is 130-140 bpm. It rises to 160 on 2 occasions and 157 once during a 20 minute period. Each of the episodes in which the heart rate is increased last 20 seconds. Which action would the nurse take?
discontinuing the test because the pattern is normal
which goal would the burse identify for the client who has dysmenorrhea?
easing the pain of the clients menstruation
Which technique would the nurse suggest to a laboring woman's partner that involves gently stroking the woman's abdomen in rhythm with her breathing during a contraction?
effleurage
What outcome is desired for the intrapartum client during the 3rd stage of labor?
firmly contracted uterine fundus
