Midterm Review
Latent phase is ___-___cm dilated
0-3
client has been confirmed to be pregnant. She gives a history of two previous full-term normal pregnancies. How will the nurse classify the client's pregnancy history 1 G3, P0 2 G3, P2 3 G2, P1 4 G2, P3
2
A nurse is conducting a class for a group of couples about subfertility. When describing the causes of subfertility, which cause would the nurse include as being most common? 1 pelvic inflammatory disease 2 anovulation 3 excessive exercise 4 excess body weightf
2 anovulation- absence of ovulating
A client in her third trimester reports to the nurse shortness of breath when sleeping. The nurse informs the client that this is normal and occurs because the growing fetus puts pressure on the diaphragm. Which measure should the nurse suggest to help alleviate this problem? 1 Avoid overeating. 2 Lie on a firmer mattress. 3 Use extra pillows. 4 Avoid spicy food.
3
A nurse is assessing a postterm newborn. Which finding would the nurse correlate with this gestational age variation? 1 moist, supple, plum skin appearance 2 abundant lanugo and vernix 3 thin umbilical cord 4 absence of sole creases
3
Immediately following an epidural block, a pregnant patient's blood pressure suddenly falls to 90/50 mmHg. What action should the nurse take first? 1 Place the patient supine. 2 Raise the head of the bed. 3 Ask the patient to take deep breaths. 4 Turn onto the left side or raise the legs.
4
test used to estimate gestational age, Most accurate at 12-20 hrs and is based on sum of neuromuscular and physical maturity score the higher the number the more mature.
Ballard test
True of False You can breast feed while taking Methotrexate?
False
__________ and __________ are commonly ordered for childbirth pain.
Tylenol and Ibuprofen
APGAR stands for? A normal score is?
appearance, pulse, grimace, activity, respiration normal score is 7-10
Worsened vision, blurred vision, or dry eyes may occur as a result of hormonal changes. However flashing lights, _________ spots, or _________ vision should be reported
blind or bright spots, double vision
Women on antiseizure medications should take 4 mg ________ daily, beginning 3 months before conception.
Folic Acid
___________ Can cause oligohydramnios, placental abruption, and intrauterine growth restriction for the fetus. Can impact maternal organ systems causing renal damage, pulmonary edema, impaired liver function, cerebral edema, and thrombocytopenia.
Preeclampsia
Treatment goals for intrahepatic cholestasis? Medication treatment= _______
Treatment goals include minimizing itching, reducing concentration of bile acid, and induced delivery at 36 to 37 weeks Ursodiol
Most common chromosomal disorder is?
Trisomy 21 (Down Syndrome)
Cocaine is linked to placental __________
abruption
fetal hypoxia will have a pH to indicate respiratory _________.
acidosis
When the client reports that her lips and fingers are tinging, the nurse is correct to understand that she is __________. To correct this the nurse instructs the client to slow the breathing. A paper bag or cupped hands is the correct nursing action
hyperventilating.
Which sign appears early in a neonate with respiratory distress syndrome? 1 Bilateral crackles 2 Pale gray skin color 3 Tachypnea more than 60 breaths/minute 4 Poor capillary filling time (3 to 4 seconds)
3
active phase is ____-___cm dilated
3-7
Transition Phase is dilated ___-___cm Delivery prep begins. Contractions are ___-___ min lasting ____-____
8-9 cm 1-2 minutes lasting 40-60 seconds.
Between the pulmonary artery and the descending artery is the embryonic and fetal structure of the __________. This structure allows for blood to be shunted directly between the pulmonary artery and the descending aorta, bypassing the lungs
Ductus Arteriosus
cervical insufficiency is something that can happen in the second trimester and does what?
premature dilation of the cervix
fetal fibronectin test
preterm labor is very unlikely is woman has a negative test
Signs of preterm labor
uterine contractions, cramps, constant or irregular low backache, pelvic pressure
When the fetus is at a ______ station, it is at the level of the ischial spines and said to be engaged.
0
A client has opted to receive epidural anesthesia during labor. Which of the following interventions should the nurse implement to reduce the risk of a significant complication associated with this type of pain management? 1 Administration of 500 mL of IV Ringer's lactate 2 Administration of 1000 mL of IV glucose solution 3 Move the woman into a supine position 4 Administration of aspirin
1
A client in preterm labor is receiving magnesium sulfate IV and appears to be responding well. Which finding on assessment should the nurse prioritize? 1 Depressed deep tendon reflexes 2 Tachypnea 3 bradycardia 4Elevated blood glucose
1
A multigravid client has been in labor for several hours and is becoming anxious and distressed with the intensity of her frequent contractions. The nurse observes moderate bloody show and performs a vaginal examination to assess the progress of labor. The cervix is 9 cm dilated. The nurse knows that the client is in which phase of labor? 1 transition phase 2 latent phase 3 active phase 4 early phase
1
A woman is taking vaginal progesterone suppositories during her first trimester because her body does not produce enough of it naturally. She asks the nurse what function this hormone has in her pregnancy. What should the nurse explain is the primary function of progesterone? 1 maintains the endometrial lining of the uterus during pregnancy 2 ensures the corpus luteum of the ovary continues to produce estrogen 3 contributes to mammary gland development 4 regulates maternal glucose, protein, and fat levels
1
Assessment for surfactant level via LS ratio in the amniotic fluid is a primary estimation of fetal maturity. The purpose of surfactant is to: 1 Prevent alveoli from collapsing on expiration. 2 Increase lung resistance on inspiration. 3 Encourage immunologic competence of lung tissue. 4 Promote maturation of lung alveoli.
1
During the assessment of a laboring client, the nurse learns that the client has cardiovascular disease (CVD). Which assessment would be priority for the newborn? 1 respiratory function 2 heart rate 3 temperature 4 urine output
1
The nurse is assessing a small-for-gestational age (SGA) newborn, 12 hours of age, and notes the newborn is lethargic with cyanosis of the extremities, jittery with handling, and a jaundiced, ruddy skin color. The nurse expects which diagnosis as a result of the findings? 1 polycythemia 2 hyperglycemia 3 hypercalcemia 4 hyponatremia
1
The nurse is teaching new parents the best way to prevent hypothermia. Which mechanism would the nurse include when explaining about the newborn's primary method of heat production? 1 nonshivering thermogenesis 2 thermoregulation 3 thermoconduction 4 shivering thermogenesis
1
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
The nurse is concerned that a new mother is developing a postpartum complication. What did the nurse most likely assess in this patient? 1 Absence of lochia 2 Red-colored lochia for the first 24 hours 3 Lochia that is the color of menstrual blood 4 Lochia appearing pinkish-brown on the fourth day
1 Lochia should never be absent during the first 1 to 3 weeks because absence of lochia may indicate postpartal infection.
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, 2, 3
The 2nd stage of childbirth Starts and ends when?
10 cm dilated. actively pushing. ends with birth of baby.
A client has presented in the early phase of labor, experiencing abdominal pain and signs of growing anxiety about the pain. Which pain management technique should the nurse prioritize at this stage? 1 Immersing the client in warm water in a pool or hot tub 2 Practicing effleurage on the abdomen 3 Administering a sedative such as secobarbital or pentobarbital 4 Administering an opioid such as meperidine or fentanyl
2
A patient who is 2 months pregnant is concerned about frequent urination. What should the nurse instruct the patient about this occurrence? 1 This means urine is more concentrated. 2 It is caused by pressure on the bladder from the uterus. 3 The fetus is adding urine to the patient's bladder. 4 There is a decrease in the glomerular cells of the kidney.
2
The nurse is giving a newborn his first bath. What should the nurse prioritize? 1 Give the sponge bath in the baby's bed. 2 Wash off all traces of blood and leave the vernix in place. 3 Use a soap such as hexachlorophene to prevent infection. 4 Apply talcum powder to the buttocks after washing.
2
The nurse is caring for a client in the transition phase of the labor process. Which client statement requires nursing action? 1 "My contractions are really intense now." 2 "My lips and fingers are tingling." 3 "My mouth and lips are so dry." 4 "I feel burning in my perineum."
2 When the client reports that her lips and fingers are tinging, the nurse is correct to understand that she is hyperventilating.
The ______ stage may be present when the mother feels the urge to push
2nd
A nurse is caring for a client who has just given birth. What is the best method for the nurse to assess this client for postpartum hemorrhage? 1 by assessing skin turgor 2 by assessing blood pressure 3 by frequently assessing uterine involution 4 by monitoring hCG titers
3
A nurse is caring for a preterm newborn who has developed rapid, irregular respirations with periods of apnea. Which additional assessment finding should the nurse identify as an indication of respiratory distress syndrome (RDS)? 1 Deep inspiration 2 Expiratory lag 3 Sternal retraction 4 Inspiratory grunt
3
An 18-year-old pregnant woman asks why she has to have a routine alpha-fetoprotein serum level drawn. You explain that this 1 is a screening test for placental function. 2 tests the ability of her heart to accommodate the pregnancy. 3 may reveal chromosomal abnormalities. 4 measures the fetal liver function.
3
The nurse is aware that labor pain and contractions can lead to all of the following EXCEPT 1 Hyperventilation 2 Decreased blood flow to the uterus 3 Respiratory acidosis 4 Fatigue and sleep deprivation
3
When examining a newborn's eyes, the nurse would expect which assessment? 1 follows your finger a full 180 degrees 2 has a white rather than a red reflex 3 follows a light to the midline 4 produces tears when he cries
3
How can the nurse best counsel a patient with pyrosis? 1. "It is important to continue to eat three meals a day." 2. "Chest pain is common and is not a concern in pregnancy." 3 "Avoid lying down 2 hours after eating." 4 "Avoid sleeping in an upright position."
3 Pyrosis means heartburn
A nurse is caring for several women in labor. The nurse determines that which woman is in the transition phase of labor? 1 contractions every 5 minutes, cervical dilation 3 cm 2 contractions every 3 minutes, cervical dilation 5 cm 3 contractions every 2½ minutes, cervical dilation 7 cm 4 contractions every 1 minute, cervical dilation 9 cm
4
The nurse, assessing the lochia of a client, attempts to separate a clot and identifies the presence of tissue. Which observation would indicate the presence of tissue? 1 yellowish-white lochia 2 foul-smelling lochia 3 easy to separate clots 4 difficult to separate clots
4
Women who are obese in pregnancy are at higher risk for developing all of the following EXCEPT 1 Macrosomia 2 Pregnancy-induced hypertension 3 Gestational diabetes 4 Neural tube defects 5 Cesarean birth
4
During pregnancy mild hyperventilation and sense of dyspnea occurs resulting in a state of respiratory __________. Diaphragm elevates about 5 cm during pregnancy to accommodate this change.
Alkalosis.
Antibiotics to give for PPROM cause of risk of infection?
Ampicillin, Gentamycin
+4 station means what?
At the station +4, the fetus is being born. The priority nursing action is to have a blue bulb or suction device for airway clearance and an infant warmer ready.
some Warning signs of pregnancy
Bleeding/ cramping Decreased fetal movements Headache Edema of hands and face Visual changes Pain Symptoms of infection. painful urination, foul odor, yellowish discharge
Heat loss is best minimized by the nurse in the delivery room when the infant is: A. Dried, dressed in a onesie, and swaddled in a warm blanket. B. Dried and passed to family members for assessment and bonding. C. Dried, placed on the mother's chest, and covered in a warm blanket. D. Wrapped in a blanket and placed in the prewarmed warmer.
C
___________ is edema that resolves in a few days; it crosses the midline. __________ is a subperiosteal collection of blood that does not cross suture lines. __________ presents as a fluctuant mass that crosses suture lines. Which one is the most dangerous.
Caput succedaneum is edema that resolves in a few days; it crosses the midline. Cephalohematoma is a subperiosteal collection of blood that does not cross suture lines. ... Subgaleal hemorrhage presents as a fluctuant mass that crosses suture lines. Subgaleal hemorrhage is the most dangerous
Intrahepatic cholestasis is a very serious condition that causes? Most common sign and symptom is itching on _____ and ________.
Caused by impaired bile flow from liver. Bile acid are toxic to baby Itchy on palms and soles.
_______________ resolves on its own in a few days. It's a little collection of blood between the skull and the periosteum. That's a layer of connective tissue that covers the bone. Usually not dangerous but can be a risk factor for jaundice so monitoring babe is important.
Cephalhematoma
the sign that has Bluish purple discoloration of the cervix, vagina, and labia during pregnancy as a result of increased vascular congestion.
Chadwicks sign
"Mask of Pregnancy" Darkens with sun exposure and disappears after pregnancy
Chloasma
A poorly controlled diabetes is a higher risk for _________ defects
Congenital abnormalities.
After the amniotic sac has ruptured, the barrier to infection is gone, and an ascending infection is possible. In addition, there is a danger of ___________.
Cord prolapse
After ovulation, the ovarian follicle is called a ____________
Corpus Luteum.
A nurse notices a patient has heavy lochia on her pad. The uterus is firm and midline. What should the nurse do next? A. Gently massage the fundus. B. Notify the charge nurse immediately. C. Document this expected finding. D. Ask the patient when she last changed her pad.
D
A patient diagnosed with preeclampsia had a severe headache, 2+ protein in the urine, hyperreflexes, and was started on magnesium sulfate. Current assessment findings include a severe headache, slurred speech, and hyporeflexes. What should the nurse do next? A. Reassess the patient in 1 hour. B. Notify the charge nurse immediately. C. Document current assessment findings. D. Turn off the magnesium sulfate infusion.
D
Women whose pancreases cannot keep up with increased insulin demands develop gestational _________.
Diabetes
_____________ refers to A red rash with white papules and red macules that may occur over any part of the body but most commonly occurs on the trunk
Erythema toxicum
Ointment give to newborns to decrease risk of Ophthalmia neonatorum
Erythromycin
Increased __________ causes congestion of mucus membranes. This congestion can cause swelling of pharynx, trachea, larynx, while engorged capillaries may cause frequent nose bleeds. which can be normal
Estrogen
__________l—short acting (1-2 hours), may cause maternal or neonatal respiratory depression. (give at 7-8 cm) Don't give past 8 cm cause it can go to the baby. Especially do not during pushing
Fentanyl
__________ is the protein produced by the fetal membranes that leaks into the vaginal secretions if uterine activity, infection of cervical effacement occurs. This protein is tested for patients who may be at risk for preterm labor. It can have false positives, but if negative then that can be reassurance labor is not going to happen for at least the next 2 weeks.
Fibronectin test
______________ is responsible for maturing the ovarian that will release egg for fertilization.
Follicle- stimulated hormone (FSH)
GTPAL G stand for _______T Stands for ________P stands for ______A stands for ________L stands for ______
G=Gravidity- number of total pregnancy regardless of outcome)T-Term- number of pregnancies that was considered full term (37 Weeks +)P=Preterm- number of births that ended preterm (20-36 &6 Weeks)A=Abortion- Spontaneous (miscarriage) or elective before 20 weeks.L=Living (number of living children)
Newborn With a Group B Streptococcus-Positive Mother are treated with what antibiotic typically?
Gentamicin
_____________ = is a disease that is known as Molar pregnancy. it is a nonviable mass of trophoblastic tissue.
Gestational Trophoblastic Disease (GTD)
Sign that means softening of the cervix
Goodell's sign
The medical staff will try to prolong preterm labor a day or two in order to give Betamethosone twice IM 12 hours apart for what reason?
Helps mature the lungs
Maternal _________ is associated with higher rate of poor pregnancy outcomes including intrauterine growth restriction, stillbirth, preeclampsia, and stroke.
Hypertension
Difference between hypertension and preeclampsia?
Hypertension is without proteinurea. where preeclampsia is associated with protein in the urine.
Complications for Lupus patients include __________, ________, and ______death
Hypertension, blood clots, and material death
Marcosomia babies are at risk for ___________ and _________
Hypoglycemia. polycythemia (excess RBC)
If BMI is less than 18.5 you should gain _____ If BMI is 18.5-24.9 (average weight) you gain _____ If BMI 25-30 (overweigh)_____ lbs. If BMI greater than 30 BMI (Obese) is _____lbs
If BMI is less than 18.5 you should gain 28-40 If BMI is 18.5-24.9 (average weight) you gain 25-35 If BMI 25-30 (overweight) 15 to 25 lbs. If BMI greater than 30 BMI (Obese) is 11-20 lbs.
In response to GnRH, the anterior pituitary releases ______________ and ________________ hormones
In response to GnRH, the anterior pituitary releases follicle-stimulated hormone (FSH) and luteinizing hormone (LH).
_____________, which is the most common and most favorable fetal position for birth.
Left occiput anterior position or LOA Right occiput anterior position is also a good position. basically want the baby occiput anterior.
Reddish or red-brown vaginal discharge that occurs immediately after childbirth; composed mostly of blood. last 3-4 days.
Lochia Rubra
Yellow or white. WBC, serum, mucus, and bacteria. can last 2-4 weeks
Lochia alba
Pinkish/brown, Debris, old blood, wbc, and serum . Lasts day 4-14 postpartum
Lochia serosa
Interventions for deceleration of variable, late, or prolonged include:
Maternal position change. Discontinuing oxytocin infusion. Administering oxygen 8 to 10 L by nonrebreather mask. Correcting hypotension if present. Notifying the provider.
________ hypertension is a systolic blood pressure between 140 and 159 mm Hg and/or a diastolic between 90 and 109 mm Hg. _________ hypertension is a systolic blood pressure greater than 160 mm Hg and diastolic blood pressure greater than 110 mm Hg.
Mild to moderate Severe
Small white sebaceous glands on the skin is known as
Milia
What are the High risk associated with cervical insufficiency? Treatment options include __________ supplementation and ________ procedure.
Miscarriage or premature birthMaternal progesterone supplementation and cervical cerclage.
Folic acid deficiency during pregnancy increases the risk for __________ defects
Neural tube defects.
__________ is one of the most widely used and studied medications among the calcium-channel blockers to suppress preterm contractions
Nifedipine
-ultra sound record movement, doppler measures fetal HR, assess fetal well being looks for 2 accelerations of fetal heart tones (FHT) in 20 minutes of at least 15 BPM. Should reach 15 BPM for at least 15 seconds x2 in 20 minutes.
Non stress test
The _________ is a simple, noninvasive way of checking on your baby's health. The test records your baby's movement, heartbeat, and contractions. It notes changes in heart rhythm when your baby goes from resting to moving, or during contractions if you're in labor
Non stress test
____________ = Decrease in anmiotic fluid that may cause fetal anomalies or premature rupture of membranes.
Oligohydramnios
_________ is produced by the posterior pituitary and has a role in producing contractions, postpartum uterine contraction, and milk ejection.
Oxytocin
_________ organ is responsible for increasing islet of Langerhans during pregnancy. When it can not keep up then gestational diabetes occurs.
Pancreas
The type of jaundice that occurs before 24 hours after birth and can be associated with hemolysis
Pathological
Risk for ectopic pregnancy?
Pelvic infections or previous ectopic pregnancy
Infants that are born ________ are at higher risk for pathological jaundice.
Preterm
The hormone that increases the flexibility of the pubic symphysis during pregnancy is
Relaxin
Signs of fetal hypoxia
Restlessness Pallor TACHYCARDIA- early sign. Elevated BP Use of accessory muscles Nasal flaring Tracheal tugging Adventitious lung sounds Grunting on expiration
These are example of what? Blood pressure (BP): A systolic BP of 160 mm Hg or higher and/or a diastolic BP of 110 mm Hg or higher on two occasions at least 4 h apart in the absence of antihypertensive treatment Thrombocytopenia: platelet count > 100,000 Impaired liver function: liver enzymes twice the normal concentration and/or severe right upper quadrant or epigastric pain that does not improve with analgesics Progressive renal insufficiency: doubling of serum creatinine and/or serum creatinine level (>1.1 mg/dL) Pulmonary edema New-onset cerebral or visual changes: headaches, blurred vision, blind spots, etc
Severe preeclampsia
The 3rd stage of childbirth starts and ends when?
Starts after the birth of the child and ends with birth of the placenta
____________ can occur from the pressure of the pregnant uterus when the woman lies on her back. Recommend a side-lying position
Supine Hypotension
TACO of ROM
T- time A- amount C- color O- odor
The most common side effect of spinal and epidural anesthesia is ___________, which can lead to fetal _________cardia, decelerations, or fetal distress.
The most common side effect of spinal and epidural anesthesia is hypotension, which can lead to fetal bradycardia, decelerations, or fetal distress.
The shot given to newborns to decrease neonatal hemorrhage.
Vitamin K
Bluish tint to the hands and feet, particularly when cold, due to immature circulation is known as
acrocyanosis
Malignant hyperthermia is a risk factor when a person receives ________drugs.The antidote is _________
anesthetic drugs. Dantrolene Sodium
_________ (stress hormone) levels increase in the second trimester of pregnancy and may promote lung and neurologic development.
cortisol
The uterus of a woman with a molar pregnancy must be evacuated by _________ and ________- if the products of conception do not pass spontaneously
dilation and curettage
unilateral lower quadrant/ pelvic pain, rigid tender abdomen, missed period, bleeding. these are signs of _________ pregnancy
ectopic pregnancy
____________________ disease, in which a fertilized egg fails to develop properly, leading to a nonviable mass of trophoblastic tissue.
gestational trophoblastic disease
When estrogen and progesterone levels are low, the hypothalamus is stimulated to produce ___________________ hormone
gonadotropin-releasing hormone (GnRH).
Insulin needs ______ steadily beginning in the second half of pregnancy
increase
Tocodynamometer is used for?
instrument measuring uterine contractions during childbirth
The best position for supine hypotensive syndrome
left lateral position or with feet slightly elevated
Reports of severe back pain are associated with a persistent __________ ___________ position due to the pressure of the fetal head on the woman's sacrum and coccyx.
occiput posterior
The rooting reflex refers to a baby's tendency to
open the mouth in search of a nipple when touched on the cheek
Signs of infant hypoglycemia
poor feeding poor tone jitteriness Tachypnea tachycardia lethargy week high pitch cry
The corpus luteum produces large amounts of ___________ and a smaller amount of __________, which maintain the uterine lining for implantation.
progesterone, estrogen
Preeclampsia diagnosed when a patient has hypertension (≥ 140/90 mm Hg) on two occasions at least 4 hours apart and has ____________ in the urine
protein
Assess wounds for ? (REEDA)
redness, edema, ecchymosis, discharge, and approximation.
Moro reflex is also known as the ___________ reflex
startle reflex
for trauma place a wedge under the women's hip to minimize ________________.
supine hypotension
Between 16th and 36th week of pregnancy the size of the uterus (in centimeters) from the symphysis pubis to the fundus should equal the number of ______?
weeks gestation. (plus or minus 2 so for example 28 weeks gestation should equal 26-30 centimeters)
vBreast tenderness is one of the earliest discomforts in pregnancy. Encourage a __________
well fitting supportive bra
A nursing student accurately explains induction of labor by stating which of the following: 1 Pitocin is used with a favorable Bishop score to mimic natural labor contractions. 2 Pitocin is used to cause uterine tachysystole and therefore the birth of the baby. 3 Cervical ripening is indicated when a Bishop score is 8 or higher. 4 Pitocin is most effective when the cervix is firm, posterior, and closed.
1
Which laboratory test results would the nurse consider as a normal finding in a newborn soon after birth? 1 white blood cells: 5,000/mm3 2 hemoglobin: 17.5 g/dL 3 platelets: 400,000/uL 4 red blood cells: 3,500,000/uL
2
A pregnant woman with a history of mitral stenosis is to be prescribed medication as treatment. Which of the following medication classes would the nurse expect the patient to begin taking? 1 anticoagulant 2 diuretic 3 antihypertensive 4 antineoplastic
1
A nurse is providing care to a client in labor. A pelvic exam reveals a vertex presentation with the presenting part tilted toward the left side of the mother's pelvis and directed toward the anterior portion of the pelvis. When developing this client's plan of care, which intervention would the nurse include? 1 implementing measures for a vaginal birth 2 preparing the client for a cesarean birth 3 assisting with artificial rupture of the membranes 4 instituting continuous internal fetal monitoring
1
Stadol (butorphanol) is used for?
-used for Pain management -narcan DOES NOT reverse Stadol effects -Can be used throughout labor [should not be given within 1 hour before delivery]
A mother has come to the clinic with her 13-year-old daughter to find out why she has not started her menses. After a thorough examination and history, genetic testing is prescribed to rule out which abnormality?1 Turner syndrome 2 Klinefelter's syndrome 3 fragile X syndrome 4 cri du chat syndrome
1
A nurse is assessing a client's lochia every 15 minutes for the first hour during the fourth stage of labor. Which finding would the nurse expect to assess? 1 moderate lochia rubra with a fleshy odor 2 lochia alba saturating at least 3 pads 3 lochia rubra with large clots 4 lochia rubra saturating two pads
1
A nurse is aware that the newborn's neuromuscular maturity is typically completed within 24 hours after birth. Which assessment would the nurse be least likely to complete to determine the newborn's degree of maturity? 1 Moro reflex 2 square window 3 popliteal angle 4 scarf sign
1
A nurse is developing the plan of care for a small for gestational age newborn. Which action would the nurse determine as a priority? 1 Preventing hypoglycemia with early feedings 2 Observing for newborn reflexes 3 Promoting bonding between the parents and the newborn 4 Monitoring vital signs every 2 hours
1
A pregnant woman with sickle cell anemia is very concerned her infant will also develop the disease and questions the nurse about that possibility. Which is the best response from the nurse? 1 Both parents have to carry the trait. 2 There is a good chance the infant will inherit the disease from the mother. 3 The infant inherits the disease from the father. 4 If the mother goes into a crisis while pregnant, the baby will develop sickle cell anemia.
1
A premature infant develops respiratory distress syndrome. With this condition, circulatory impairment is likely to occur because with increased lung tension, the: 1 ductus arteriosus remains open. 2 foramen ovale closes prematurely. 3 aorta or aortic valve strictures. 4 pulmonary artery closes.
1
A woman arrives at the office for her 4-week postpartal visit. Her uterus is still enlarged and soft, and lochial discharge is still present. Which nursing diagnosis is most likely for this client? 1 Risk for fatigue related to chronic bleeding due to subinvolution 2 Risk for infection related to microorganism invasion of episiotomy 3 Risk for impaired breastfeeding related to development of mastitis 4 Ineffective peripheral tissue perfusion related to interference with circulation secondary to development of thrombophlebitis
1
A woman relates to the nurse that she understands that dietary fat is bad for her and that she should avoid it during pregnancy. How should the nurse respond? 1 Fats are essential during pregnancy, and vegetable oils are a good source. 2 Fats are essential during pregnancy, and fish such as marlin and orange roughy are good sources. 3 Fats are not essential during pregnancy and thus are optional. 4 Fats should be avoided during pregnancy.
1
After assessing a client's progress of labor, the nurse suspects the fetus is in a persistent occiput posterior position. Which finding would lead the nurse to suspect this condition? 1 reports of severe back pain 2 lack of cervical dilation past 2 cm 3 fetal buttocks as the presenting part 4 contractions most forceful in the middle of uterus rather than the fundus
1
Before becoming pregnant, a woman's heart rate averaged 72 beats per minute. The woman is now 15 weeks pregnant. The nurse would expect this woman's heart rate to be approximately: 1 85 beats per minute. 2 90 beats per minute. 3 95 beats per minute. 4 100 beats per minute.
1
During the initial prenatal visit, the nurse performs what assessment to guide teaching about nutrition during pregnancy? 1 prepregnancy BMI 2 current weight 3 height and bone structure 4 hemoglobin level
1
Most cultures have their own beliefs surrounding pregnancy and prenatal care of the woman. A nurse is assigned to a family that is newly immigrated and alone in the community. The patient needs bedrest and help with her activities of daily living. One cultural issue that needs to be assessed is 1 The role of the male partner in giving care to his wife 2 Traditions surrounding water temperature in health care 3 The sleeping arrangement in this family 4 The meaning of pregnancy in this family
1
Over the past 20 weeks, the following blood pressure readings are documented for a pregnant client with chronic hypertension: week 16 - 124/86 mm Hg; week 20 - 138/90 mm Hg; week 24 - 140/92 mm Hg; and week 28 - 142/94 mm Hg. The nurse interprets these findings as indicating which classification of her blood pressure? 1 mild hypertensive 2 normotensive 3 prehypertensive 4 severe hypertensive
1
The nurse has admitted a small for gestational age infant (SGA) to the observation nursery from the birth room. Which action would the nurse prioritize in the newborn's care plan? 1 Closely monitor temperature. 2 Assess for hyperglycemia. 3 Monitor intake and output. 4 Observe feeding tolerance.
1
The nurse is analyzing the readout on the EFM and determines the FHR pattern is reassuring based on which recording? 1 Acceleration of at least 15 bpm for 15 seconds 2 Increase in variability by 27 bpm 3 Deceleration followed by acceleration of 15 bpm 4 Decrease in variability for 15 seconds
1
The nurse is assessing the laboring client to determine fetal oxygenation status. What indirect assessment method will the nurse likely use? 1 external electronic fetal monitoring 2 fetal blood pH 3 fetal oxygen saturation 4 fetal position
1
The nurse is caring for a 28-year-old client after the delivery of a healthy neonate. What would the nurse expect to find when assessing this client's fundus? 1 Fundus 1 cm above the umbilicus 1 hour postpartum 2 Fundus 1 cm above the umbilicus on postpartum day 3 3 Fundus palpable in the abdomen at 2 weeks postpartum 4 Fundus slightly to right; 2 cm above umbilicus on postpartum day 2
1
The nurse is describing fetal circulation to new parents and how the circulation changes after birth. The nurse describes a structure that allows the pulmonary circulation to be bypassed, but that shortly after birth this structure should close. Which structure is the nurse describing? 1 ductus arteriosus 2 foramen ovale 3 ductus venosus 4 umbilical vessels
1
The nurse is making a follow-up home visit to a woman who is 12 days postpartum. Which finding would the nurse expect when assessing the client's fundus? 1 cannot be palpated 2 2 cm below the umbilicus 3 6 cm below the umbilicus 4 10 cm below the umbilicus
1
The nurse is preparing a new mother to be discharged home after an uncomplicated delivery. Which type of lochia pattern should the nurse point out needs to be reported to her primary care provider immediately during the discharge teaching? 1 moderate lochia serosa on day 4 postpartum, increasing in volume and changing to rubra on day 5 2 moderate flow of lochia rubra on day 3 postpartum, changing to serosa on day 5 3 lochia progresses from rubra to serosa to alba within 10 days 4 moderate lochia rubra on day 3, mixed serosa and rubra on day 4, light serosa on day 5
1
The nurse is teaching a client who is diagnosed with preeclampsia how to monitor her condition. The nurse determines the client needs more instruction after making which statement? 1 "If I have changes in my vision, I will lie down and rest." 2 "I will weigh myself every morning after voiding before breakfast." 3 "I will count my baby's movements after each meal." 4 "If I have a severe headache, I'll call the clinic."
1
The results of a woman's quadruple marker screen show that her alpha-fetoprotein (AFP) blood level is more than twice the value of the mean for that gestational age. The nurse recognizes that this finding is most strongly associated with: 1 a neural tube disorder. 2 a trisomy disorder. 3 a chromosomal disorder. 4 Down syndrome.
1
When caring for a client in the third stage of labor, the nurse notices that the expulsion of the placenta has not occurred within 5 minutes after birth of the infant. What should the nurse do? 1 Nothing. Normal time for stage three is 5 to 30 minutes. 2 Notify the primary care provider of the problem. 3 Increase the IV tocolytic to help in expulsion of the placenta. 4 Do a vaginal exam to see if the placenta is stuck in the birth canal.
1
When teaching a class of new parents about the needs of their newborn, the nurse explains that the newborn's voiding is a good indicator that he or she is getting enough fluids. The nurse determines that the teaching was successful when the parents state which number of voiding per day as a good indicator of adequate fluids? 1 6 to 8 2 4 to 6 3 8 to 10 4 2 to 4
1
When the membranes of a pregnant patient rupture during labor, the nurse determines that the patient and fetus are in danger. What did the nurse assess at the time of membrane rupture? 1 Meconium-stained amniotic fluid 2 Fetus presenting in an LOA position 3 Maternal pulse of 90 to 95 beats/min 4 Blood-tinged vaginal discharge at full dilation
1
Which nursing action is a priority when the fetus is at the +4 station? 1 Have a blue bulb suction and an infant warmer ready 2 Have a tocometer and a patient gown ready 3 Provide lubricating jelly and an internal monitor 4 Prepare for an immediate cesarean section
1
Which statement is true regarding analgesia versus anesthesia? 1 Analgesia only reduces pain, but anesthesia partially or totally blocks all pain in a particular area. 2 Decreased FHR variability is a common side effect when regional anesthesia is used. 3 Regional anesthesia should be given with caution close to the time of birth because it crosses the placenta and can cause respiratory depression in the newborn. 4 Hypotension is the most common side effect when systemic analgesia is used.
1
As part of her physical examination of a pregnant client, the nurse examines the woman's breasts. Which are healthy breast changes that indicate pregnancy? Select all that apply. 1 areolae darken 2 overall breast size increases 3 blue streaking of veins becomes prominent 4 montgomery tubercles become prominent 5 breasts become softer in consistency 6 hard, painless lumps form
1, 2, 3, 4
A nurse is assessing a client with postpartal hemorrhage; the client is presently on IV oxytocin. Which interventions should the nurse perform to evaluate the efficacy of the drug treatment? Select all that apply. 1 Assess the client's uterine tone. 2 Monitor the client's vital signs. 3 Assess the client's skin turgor. 4 Get a pad count. 5 Assess deep tendon reflexes.
1, 2, 4
The nurse is caring for a client who had been administered an anesthetic block during labor. For which risks should the nurse watch in the client? Select all that apply. 1 incomplete emptying of bladder 2 bladder distention 3 ambulation difficulty 4 urinary retention 5 perineal laceration
1, 2, 4
A newborn is experiencing cold stress. Which findings would the nurse expect to assess? Select all that apply. 1 respiratory distress 2 decreased oxygen needs 3 hypoglycemia 4 metabolic alkalosis 5 jaundice
1, 3, 5
A newly wed young adult patient tells the nurse that she hopes to become pregnant soon. What should the nurse recommend to this patient to support the 2020 National Health Goals for pregnancy? Select all that apply. 1 Stop smoking. 2 Increase exercise. 3 Eat a healthy diet. 4 Reduce work hours. 5 Limit alcohol intake.
1, 3, 5
A 24-year-old primigravida client at 39 weeks' gestation presents to the OB unit concerned she is in labor. Which assessment findings will lead the nurse to determine the client is in true labor? 1 The contraction pains are 2 minutes apart and 1 minute in duration. 2 The client reports back pain, and the cervix is effacing and dilating. 3 The contraction pains have been present for 5 hours, and the patterns are regular. 4 After walking for an hour, the contractions have not fully subsided.
2
A 26-year-old new mother says to her nurse, "I am so disappointed. I gained 25 pounds with my baby. Just what the doctor said I should gain. But after I had my baby I only lost 12 pounds." What is the best response by the nurse? 1 "I see that you are bottle-feeding your baby. You would lose your weight faster if you were breast-feeding." 2 "It is normal to lose between 12 and 14 pounds after the baby delivers. You should be back to your pre-pregnancy weight by the time your baby is about 6 months old." 3 "I know you are anxious to lose all your 'baby fat.' Get yourself on a good diet and you will be down to your original weight in no time." 4 "Remember, it took 9 months for you to gain all this weight. It won't disappear in just a couple of days."
2
A postpartum client comes to the clinic for her routine 6-week visit. The nurse assesses the client and suspects that she is experiencing subinvolution based on which finding? 1 nonpalpable fundus 2 moderate lochia serosa 3 bruising on arms and legs 4 fever
2
A postpartum mother has the following lab data recorded: a negative rubella titer. What is the appropriate nursing intervention? 1 No action needed. 2 Administer rubella vaccine before discharge. 3 Assess the rubella titer of the baby. 4 Notify the health care provider.
2
A woman who is 8 months' pregnant comes to the clinic with urinary frequency and pain on urination. The client is diagnosed with a urinary tract infection (UTI). Which medication would the nurse anticipate the physician will prescribe? 1 tetracycline 2 amoxicillin 3 bactrim 4 septra
2
A woman with a history of systemic lupus erythematosus comes to the clinic for evaluation. The woman tells the nurse that she and her partner would like to have a baby but that they are afraid her lupus will be a problem. Which response would be most appropriate for the nurse to make? 1 "It's probably not a good idea for you to get pregnant since you have lupus." 2 "Be sure that your lupus is stable or in remission for 6 months before getting pregnant." 3 "Your lupus will not have any effect on your pregnancy whatsoever." 4 "If you get pregnant, we'll have to add quite a few medications to your normal treatment plan.
2
A woman's obstetrician prescribes vitamin K supplements for a client who is on antiepileptic medications beginning at 36 weeks' gestation. The mother asks the nurse why she is taking this medication. The nurse's best response would be: 1 vitamin K helps in keeping the placenta healthy. 2 antiepileptic therapy can lead to vitamin K-deficient hemorrhage of the newborn. 3 administration of vitamin K aids in lung maturity of the fetus. 4 The antiepileptic medications can cause the mother's platelets to drop.
2
A young woman experiencing contractions arrives at the emergency department. After examining her, the nurse learns that the client is at 33 weeks' gestation. What treatment can the nurse expect this client to be prescribed? 1 bronchodilators 2 tocolytic therapy 3 muscle relaxants 4 anti-anxiety therapy
2
Which assessment finding indicates to the nurse that a newborn has hip subluxation? 1 Inward rotation of the right foot 2 Inability of the right hip to abduct 3 Crying on straightening of the right leg 4 Drawing of the legs underneath while prone
2
During a routine antepartal visit, a pregnant woman reports a white, thick, vaginal discharge. She denies any itching or irritation. Which action would the nurse do next? 1 Notify the healthcare provider of a possible infection. 2 Tell the woman that this is entirely normal. 3 Advise the woman about the need to culture the discharge. 4 Check the discharge for evidence of ruptured membranes.
2
During a routine prenatal visit, a client at 36 weeks' gestation states she has difficulty breathing and feels like her pulse rate is really fast. The nurse finds her pulse to be 100 beats per minute (increased from baseline readings of 70 to 74 beats per minute) and irregular, with bilateral crackles in the lower lung bases. The nurse would develop a plan of care identifying interventions to promote which area as the priority? 1 tissue perfusion 2 gas exchange 3 activity 4 anxiety
2
In women with cardiac failure, the maternal blood pressure becomes insufficient to provide an adequate supply of blood to the placenta. The infant will likely experience some undesired effects, including which of the following? 1 hypoglycemia 2 low birth weight 3 hyperglycemia 4 high birth weight
2
Nausea and vomiting are common reports during pregnancy. What nutritional action can be used to lessen nausea and vomiting? 1 limiting carbohydrate intake 2 limiting intake of heavy, greasy foods 3 increasing fluid intake 4 drinking liquids with meals
2
The LVN/LPN will be assessing a postpartum client for danger signs after a vaginal birth. What assessment finding would the nurse assess as a danger sign for this client? 1 presence of lochia rubra 2 fever more than 100.4° F (38° C) 3 fundus is above the umbilicus 4 fundus is firm
2
The nurse administers Rho(D) immune globulin to an Rh-negative client after birth of an Rh-positive newborn based on the understanding that this drug will prevent her from: 1 becoming Rh positive. 2 developing Rh sensitivity. 3 developing AB antigens in her blood. 4 becoming pregnant with an Rh-positive fetus.
2
The nurse is assessing a client who is 14 hours postpartum and notes very heavy lochia flow with large clots. Which action should the nurse prioritize? 1 Assess her blood pressure. 2 Palpate her fundus. 3 Have her turn to her left side. 4 Assess her perineum.
2
The nurse is making a home visit to a woman who is 5 days postpartum and has no reports. Which finding would concern the nurse and warrant further investigation? 1 uterus 5 cm below umbilicus 2 lochia rubra 3 edematous vagina 4 diaphoresis
2
The nurse would be alert for possible placental abruption during labor when assessment reveals which finding? 1 macrosomia 2 gestational hypertension 3 gestational diabetes 4 low parity
2
To assess the sociocultural aspects of the family of an adolescent in an ambulatory clinic, about which of the following would you ask? 1 His mother's attitude toward citizenship 2 His family structure 3 His mother's occupation 4 The adolescent's education level
2
To screen for chromosomal disorders, a 39-year-old woman is scheduled for a circulating cell-free DNA test. What type of test is this? 1 skin biopsy 2 blood specimen collection 3 ultrasound 4 urine specimen collection
2
hen caring for a woman in her sixth month of pregnancy, she reports her plans to nurse for at least two to three years like the rest of the women in her family. Based upon your knowledge you: 1 Advise her to be careful who she discusses this with as many will consider that a type of reportable child abuse 2 Document her report but do nothing as this is a cultural belief that should be respected 3 Encourage her to start the baby on formula after the first year as recommended by many physicians 4 Discuss how painful this will be once the baby has teeth
2
Apnea in a newborn up to _____ seconds can be considered normal. Apnea more than that is considered a sign of respiratory distress
20 seconds
A pregnant client arrives for her first prenatal appointment. She reports her previous pregnancy ended at 19 weeks, and she has 3-year-old twins born at 30 weeks' gestation. How will the nurse document this in her records? 1 G2 T2 P1 A0 L2 2 G2 T1 P1 A1 L1 3 G3 T0 P1 A1 L2 4 G3 T2 P2 A0 L1
3
A pregnant patient is concerned that the baby is going to drown in the uterus because of the fluid. What should the nurse respond about fetal respiration? 1 "You are breathing for the baby." 2 "The baby's lungs can accommodate all of the fluid." 3 "Oxygen is provided to the baby through the placenta." 4 "The baby's breathing is very minor until delivery."
3
A pregnant woman of Jewish descent comes to the clinic for counseling and tells the nurse that she is worried her baby may be born with a genetic disorder. Which disease does the nurse identify to be a risk for this client's baby based on the family's ancestry? 1 sickle cell anemia 2 b-thalassemia 3 Tay-Sachs 4 Down syndrome
3
A preterm infant is experiencing cold stress after birth. For which symptom should the nurse assess to best validate the problem? 1 shivering 2 hyperglycemia 3 apnea 4 metabolic alkalosis
3
During an exam, the nurse notes that the blood pressure of a client at 22 weeks' gestation is lower, and her heart rate is 12 beats per minute higher than at her last visit. How should the nurse interpret these findings? 1 The heart rate increase may indicate that the client is experiencing cardiac overload. 2 The blood pressure should be higher since the cardiac volume is increased. 3 Both findings are normal at this point of the pregnancy. 4 Combined, both of these findings are very concerning and warrant further investigation.
3
During which time is the nurse correct to document the end of the third stage of labor? 1 Following fetal birth 2 When pushing begins 3 At the time of placental delivery 4 When the mother is moved to the postpartum unit
3
On an Apgar evaluation, how is reflex irritability tested? 1 tightly flexing the infant's trunk and then releasing it 2 dorsiflexing a foot against pressure resistance 3 flicking the soles of the feet and observing the response 4 raising the infant's head and letting it fall back
3
The health care provider approves a labor plan which includes analgesia. The client questions how analgesia will help her pain during labor. Which answer is best? 1 "The analgesia will limit your ability to be out of bed without assistance." 2 "The analgesia will block pain sensation and limit your ability to push." 3 "The analgesia will reduce the sensation of pain for a limited period of time." 4 "The analgesia will allow for a pain-free birth experience."
3
The new mother is holding her infant, speaking softly and gently stroking the baby's face. She giggles and asks the nurse why the baby turns toward her finger when she strokes the cheeks. The nurse should explain that this is which common newborn reflex? 1 Moro 2 Tonic neck 3 Rooting 4 Sucking
3
The nurse caring for a client in preterm labor observes abnormal fetal heart rate (FHR) patterns. Which nursing intervention should the nurse perform next? 1 application of vibroacoustic stimulation 2 tactile stimulation 3 administration of oxygen by mask 4 fetal scalp stimulation
3
The nurse is monitoring a laboring client with continuous fetal monitoring and notes a decrease in FHR with variable deceleration to 75 bpm. Which intervention should the nurse prioritize? 1 Administer oxygen. 2 Increase her IV fluids. 3 Change the position of the client. 4 Notify the primary care provider.
3
The nurse is preparing to assist with a pudendal block. The nurse predicts the client is at which point in the labor process? 1 Early stage labor 2 Before dilation only 3 Just before birth 4 Just after birth
3
When assessing a newborn, the nurse determines that the newborn is most likely experiencing respiratory distress syndrome (RDS) based on which finding? 1 peripheral cyanosis 2 slightly diminished breath sounds 3 see-saw respirations 4 respiratory distress occurring by 6 hours of age
3
Metabolic rate increases 10% to 20% during pregnancy. To meet increased metabolic needs, the woman should consume ______-_____ additional calories per day.
350-450
The nurse is caring for a client who has been in labor for the past 8 hours. The nurse determines that the client has transitioned into the second stage of labor based on which sign? 1 Emotions are calm and happy. 2 Frequency of contractions are 5 to 6 minutes. 3 Fetus is at -1 station. 4 The urge to push occurs.
4
A 17-year-old primigravida with type 1 diabetes is at 37 weeks gestation comes to the clinic for an evaluation. The nurse notes her blood sugar has been poorly controlled and the health care provider is suspecting the fetus has macrosomia. The nurse predicts which step will be completed next? 1 Scheduling the woman for induction of labor today. 3 Allowing her to continue without plans for delivery. 3 Scheduling a cesarean delivery at 39 weeks. 4 Preparing for amniocentesis and fetal lung maturity assessment
4
A client in her 29th week of gestation reports dizziness and clamminess when assuming a supine position. During the assessment, the nurse observes there is a marked decrease in the client's blood pressure. Which intervention should the nurse implement to help alleviate this client's condition? 1 Keep the client's legs slightly elevated. 2 Place the client in an orthopneic position. 3 Keep the head of the client's bed slightly elevated. 4 Place the client in the left lateral position.
4
A neonate has been administered a prescribed dose of vitamin K. What outcome would most clearly indicate to the nurse that the medication has had the intended effect? 1 The infant remains free of bleeding 2 The infant's jaundice resolves 3 The infant's hemoglobin level increases 4 The infant remains free of infection
4
A woman has been diagnosed as having gestational hypertension. Which symptom for this condition is the most typical? 1 increased perspiration 2 weight loss 3 susceptibility to infection 4 blood pressure elevation
4
During which state of Brazelton's Neonatal Behavioral Assessment Scale would be the best time for new parents to interact with their newborn? 1 Drowsy state 2 Active alert state 3 Light drowsy state 4 Quiet alert state
4
The client is 32 weeks pregnant and has been referred for biophysical profile (BPP) after a nonreassuring nonstress test (NST). Which statement made by the client indicates that the nurse's explanation of the procedure was effective? 1 The BPP is a diagnostic procedure whereby a needle is inserted into the amniotic sac to obtain fluid. 2 The BPP is a blood test to detect placental problems. 3 The BPP is a screening for neural tube defects. 4 The BPP is an ultrasound that measures breathing, body movement, tone, and amniotic fluid volume.
4
The client may spend the latent phase of the first stage of labor at home unless which occurs? 1 The client passes the bloody show 2 The contractions vary in length and intensity 3 The client begins back labor 4 The client experiences a rupture of membranes
4
The nurse is assessing a newborn's vital signs and notes the following: HR 138, RR 42, temperature 97.7oF (36.5oC), and blood pressure 78/40 mm Hg. Which action should the nurse prioritize? 1 Report tachypnea. 2 Recheck blood pressure in 15 minutes. 3 Put warming blanket over infant. 4 Document normal findings.
4
The nurse is assessing a pregnant client with a known history of congestive heart failure who is in her third trimester. Which assessment findings should the nurse prioritize? 1 regular heart rate and hypertension 2 increased urinary output, tachycardia, and dry cough 3 shortness of breath, bradycardia, and hypertension 4 dyspnea, crackles, and irregular weak pulse
4
The nurse is emphasizing the importance of adequate rest and sleep with a pregnant patient. Which position should the nurse suggest the patient use? 1 On the back with a pillow under the head 2 On the stomach with a pillow under her breasts 3 On the back with a pillow under the knees and hips 4 On the side with the weight of the uterus on the be
4
When a client is counseled about the advantages of epidural anesthesia, which statement made by the counselor would indicate the need for further teaching? 1 "Epidural anesthesia is more effective than opioid analgesia in providing pain relief." 2 "You can continuously receive epidural anesthesia until you have the baby, and even afterward if you need it." 3 "If you end up having a cesarean, the epidural can be used for anesthesia during surgery." 4 "You have no trouble walking around and using the bathroom after you receive the epidural."
4
When assessing newborns for chromosomal disorders, which assessment would be most suggestive of a problem? 1 bowed legs 2 slanting of the palpebral fissure 3 short neck 4 low-set ears
4
Which action would be priority for the nurse to complete immediately after the delivery of a 40-week gestation newborn? 1 Swaddle the infant and place in the bassinet. 2 Complete a full head-to-toe assessment. 3 Assess the newborn's glucose level. 4 Dry the newborn and place it skin-to-skin on mother.
4
Which assessment findings are most prominent in the infant with Tetralogy of Fallot and significant pulmonary stenosis? 1 Irregular heart rate, fatigue, pink tinged skin 2 Dry mucous membranes, poor urine output 3 Poor weight gain, nausea, decreased muscle tone 4 Dyspnea on limited exertion, fatigue, cyanosis
4
Which factor would contribute to a high-risk pregnancy? 1 blood type O positive 2 first pregnancy at age 3 history of allergy to honey bee pollen 4 type 1 diabetes
4
Which genetic condition is caused by a small gene mutation that affects protein structure, producing hemoglobin S? 1 Marfan syndrome 2 hemophilia 3 Tay-Sachs disease 4 sickle cell anemia
4
Which of these cardiac variations, if found in the client who is pregnant, should the nurse recognize as a normal finding in pregnancy? 1 Split S1S2 2 Premature ventricular contractions 3 S4 (atrial gallop) 4 Soft systolic murmur
4
Which response is most appropriate for a client with diabetes who wants to breast-feed but is concerned about the effects of breastfeeding on her health? 1 Diabetic clients who breast-feed have a hard time controlling their insulin needs 2 Diabetic clients shouldn't breast-feed because of potential complications 3 Diabetic clients shouldn't breast-feed; insulin requirements are doubled 4 Diabetic clients may breast-feed; insulin requirements may decrease from breast-feeding
4
Normal time frame for placenta to be birthed after baby
5-30 minutes
Because a new pregnancy following GTD could make it difficult to determine whether a rise in beta hCG is the normal rise to be expected from the new pregnancy or an indicator of GTN, the nurse should advise the woman to avoid getting pregnant again for at least ___ months to ____ year after the end of the molar pregnancy
6 months to 1 year
Which of the following recommendations should the nurse make to the patient with diabetes who is interested in becoming pregnant. A. "Achieving excellent glycemic control now will help ensure positive pregnancy outcomes." B. "Because of your diabetes, you will not be able to deliver vaginally." C. "Pregnancy risks for diabetic mothers are caused by macrosomic infants."
A
patients at risk of preeclampsia may be advised to take __________ and ___________ (what kind of medication)?
Aspirin and calcium supplementation
A pregnant woman with an asthma exacerbation tells the nurse she stopped taking her medication because she didn't want it to affect her baby. What is the best response by the nurse? A. "You are right to stop taking any medications while you are pregnant." B. "You should still take your asthma medication while you are pregnant to help control your asthma." C. "You should only take your asthma medications when you have an exacerbation." D. "You probably won't need your medication because asthma always improves with pregnancy."
B
_____________ primarily used to speed up lung development in preterm fetuses. It stimulates the synthesis and release of surfactant (2), which lubricates the lungs, allowing the air sacs to slide against one another without sticking when the infant breathes.
Betamethosone (corticosteroid
A test that assess five variables; fetal breathing, fetal movement, fetal tone, amniotic fluid volume, and fetal reaction
Biophysical profile (BPP)
Determines maternal readiness for labor by evaluating whether the cervix is favorable by rating cervical dilation, effacement, consistency, position, and station
Bishops score
Infants of mothers who take antiseizure medications are at increased risk for __________.
Bleeding. The last month of pregnancy the patient will likely be prescribed vitamin K.
Inheritance pattern of Down Syndrome
Most cases of Down syndrome are not inherited. When the condition is caused by trisomy 21, the chromosomal abnormality occurs as a random event during the formation of reproductive cells in a parent
A medication used for postpartum is _______ and should be used cautiously for hypertensive patients postpartum as they are associated with increased blood pressure readings.
NSAIDS
A patient who is 10 weeks pregnant complains of nausea, vomiting, fatigue, and breast tenderness. Recommendations by the nurse should include: A. Looking for over-the-counter medications to help with nausea and fatigue during pregnancy. B. Notifying the provider if the patient experiences severe headache or vision changes such as blurred or double vision after 20 weeks. C. Letting the doctor know if the patient is unable to keep any food down, experiences weight loss, and is dehydrated. D. Eating small, frequent meals; napping frequently; and wearing a supportive, well-fitting bra.
D
Risks of amniotic fluid volume disorders include which of the following? A. Preterm delivery B. Umbilical cord prolapse C. Variable decelerations in the fetal heart rate D. All of the above
D
________________ is the number one cause of congenital anomalies.
Diabetes
______ attend births as support people. They are not responsible for the delivery itself but for anticipating and responding to a family's nonmedical needs during birth. They provide emotional and physical, but also informational, support. Although most serve as labor support people, some also care for families in the postpartum period. Abortion support offers support to a women electing to terminate pregnancy
Doulas
In the embryonic (and later the fetal) circulation, oxygenated blood moves from the umbilical vein to the inferior vena cava via the _______ ___________, where it mixes with deoxygenated blood from the abdomen and lower extremities
Ductus venosus
Newborn Medications include ___________ medication is to lower canthus of the eye so that the baby wont get gonorrhea or chlamydia of the eye. _____________ injection- to help with clotting factor because their gut does not have the bacteria to produce it yet. ___________- vaccination that should be given within 12 hours of birth of an infected mother or before discharge of non infected mother
Erythromycin eye ointment - the lower canthus of the eye so that the baby won't get gonorrhea or Chlamydia. Vitamin K injection - Clotting factors (because their guts don't have bacteria to produce it) Hepatitis B
What is one of the first things the nurse should implement to a newborn to decrease hypoglycemia.
Feed the baby.
A test that shows the amount of glucose that sticks to the red blood cell It reflects glucose exposure over the previous 3 months Normal ranges? diabetic %?
Hemoglobin A1C Normal is 4% to 5.6%. Diabetic diagnosis is 6.5% so above 5.6% can be considered pre-diabetic and at risk
HEELP Syndrome stands for?
Hemolysis Elevated Liver Enzymes Low Platelet count
The vaccine given to babies before discharge with mothers consent?
Hepatitis B
What causes increased risk for kernicterus? With use of ___________ kernicterus is rare.
Higher the level of serum blirubin increases the risk of kernicterus. WIth use of RhoGAM kernicterus is rare.
_____________ refers to the Area of bluish-black pigmentation that can appear like a bruise; more common in infants with darker skin and on the back and buttocks, but may also appear in infants with lighter skin and on other parts of the body
Mongolian spots
The first stage of labor is the usually the longest and consist of what 3 phases?
Latent, Active, Transition
Cortisol levels increase in the second trimester of pregnancy and may promote ________ and neurologic development.
Lung
autoimmune disease that is a chronic inflammatory collagen disease affecting connective tissue (skin or joints)
Lupus
___________ levels peak approximately 14 days before menses to cause ovulation
Luteinizing hormone (LH)
Most common risk factors of pre-gestational diabetes type 1 is ___________ and _____________.
Macrosomic Fetus, Congenital anomalies
Oxytocin Side/ Adverse Effects
Maternal Side Effects: Cardiovascular: dysrhythmias, chest pain, hypertension Neurological: seizures Respiratory: dyspnea Gastrointestinal: nausea/vomiting Genitourinary: Severe uterine cramping, uterine rupture Fetal Side Effects: Cardiovascular: bradycardia, ectopic rhythms Neurological: intracranial hemorrhage Respiratory: hypoxia, asphyxia
Risk for Neonatal Hypoglycemia
Maternal diabetes Maternal obesity Gestational age < 37 wk Gestational age > 42 wk Newborn is large for gestational age Intrauterine growth restriction Admission to the neonatal intensive care unit Perinatal stress
nevi means? Macules means? Choloasma means? are these common in pregnancy?
Moles= NEVI Freckles- Macules Choloasma- mask of pregnancy. darkens with sun exposure and disappears after pregnancy. YES. they are normal and common in pregnancy
Therapeutic hypothermia may be used as an effective neuroprotective therapy. It is begun within 6 hours of birth and last for 72 hours for infants of at least 36 weeks of gestation. This method is used for what neonatal disease?
Neonatal Encephalopathy
________________- is a brain injury causing disturbed neurologic function manifested as seizure or a reduced level of consciousness. It is thought to be caused by perinatal asphyxia.
Neonatal encephalopathy (NE)
Uncontrolled hypothyrodism could compromise __________ development in fetus.
Neurological
A nonblanchable discoloration of the skin mostly found on the neck and face that is typically flat and pink at birth but darkens and becomes textured with time is known as
Nevus flammeus (port-wine stain)
the type of jaundice that affecting newborns. It manifests 48 to 72 hr after birth, last only a few days, and does not require therapy.
Physiological
The 4th stage of childbirth starts and stops when?
Starts after the birth of the placenta and ends after 4 hours or when mom is clinically stable
____________ may indicate hypothermia, hypoglycemia, respiratory distress syndrome, or sepsis.
Tachypnea. hypothermia, hypoglycemia and respiratory distress syndrome typically go hand in hand.
When an infant is doing phototherapy nurse should monitor ___________, _________ status, and exposure time during the phototherapy.
Temperature and hydration status
Progesterone, Terbuteline, and Nifedipine are used in preterm labor for why?
To prolong labor as much as possible to give baby time to mature
8-10cm dilation Contractions: regular, very strong, frequency of 2-3 minutes, duration is 45-90 seconds, client may have nausea and vomiting and become irritable These findings can indicate what phase of labor?
Transition
_____________ is defined as either five or more or six or more contractions every 10 minutes for a half hour.
Uterine tachysystole is defined as either five or more or six or more contractions every 10 minutes for a half hour.
VEAL CHOP
V- Variable C- Cord Comphression E- Early Decels H- Head Compression (this is good) A- Accelerations O - OK L-Late Decels P - Placenta
By the end of the first week, the stool of breastfed infants is ___________ and __________ and is passed 4 to 8 times per day.
Yellow and seedy
tocolytic therapy refers to agents that ?
agent that stops or delays premature labor and contractions
Which symptoms indicate that the client has begun the transition phase of labor? Select all that apply. 1 Increase in bloody show 2 The woman is more quiet and introverted 3 The client states an urge to push 4 Irritability and restlessness may occur 5 The client may begin to cry 6 Hyperventilation may occur
all but 2
To reduce the risk of preeclampsia, women at high risk may be advised to start taking an ____________ and _____________ to decrease risk.
aspirin and calcium supplementation to decrease risk.
inheritance of sickle cell anemia
autosomal recessive. Sickle cell anemia is inherited in an autosomal recessive pattern, which means that both copies of the gene in each cell have mutations
. Chronic HTN is before _____ weeks pregnancy Gestational HTN if after _____ weeks pregnancy
before 20 weeks. After 20 weeks
A molar pregnancy grows at an abnormally rapid rate and produces an abnormally high level of ______
beta hcg
A pregnant woman will normally experience a _______ in her blood pressure during the second trimester. An __________ in the heart rate of 10 to 15 beats per minute on average is also normal, due to the increased blood volume and increased workload of other organ systems. Hormonal changes cause the blood vessels to dilate, leading to a lowering of blood pressure.
decrease in BP Increase in HR
____________ refers to A transient condition in which one side of the body is blanched, whereas the other is erythematous
harlequin sign
Infants displaying signs of _________, such as jitteriness, temperature instability, apnea, tachypnea, tachycardia
hypoglycemia
__________ = profuse, whitish mucus discharge from the uterus and vagina. can be normal during pregnancy.
leukorrhea.
Pattern of pale and dark splotchiness that occurs with cold is known as?
mottling
vHeartburn is common during pregnancy and caused by hormonal factors, reduced peristalsis, and pressure from abdominal cavity. Teach women to: o Avoid _____ foods and excess liquids with meals. o Avoid ____________ after eating. o Avoid eating 3 hours before sleep.
o Avoid fatty foods and excess liquids with meals. o Avoid lying down after eating. o Avoid eating 3 hours before sleep.
o Late decelerations caused by poor _____________ o Variable decelerations caused by ________ compression. o Early decelerations are benign changes caused by _________ compression during contractions. o Prolonged decelerations are decreases in ______ of at least 15 bpm that last 2 to 10 minutes.
o Late decelerations caused by poor placental perfusion. o Variable decelerations caused by cord compression. o Early decelerations are benign changes caused by head compression during contractions. o Prolonged decelerations are decreases in FHR of at least 15 bpm that last 2 to 10 minutes.
For low risk patients o Prenatal care appointments should be every ____ weeks until week 28. o Appointments should be every ____ weeks between 28 and 36 weeks' gestation. o After 36 weeks' gestation, patients should be seen ________ for prenatal care.
o Prenatal care appointments should be every 4 weeks until week 28. o Appointments should be every 2 weeks between 28 and 36 weeks' g gestation. o After 36 weeks' gestation, patients should be seen weekly for prenatal care.
Magnesium sulfate is used for?
prevent seizures in preeclampsia Neuro protection given before 34 weeks to prevent cerebral palsy
when late deceleration shows up on a external fetal monitor. Which action should the nurse perform first?
reposition the patient
____________ pattern of breathing seen in complete (or almost) complete) airway obstruction. As the patient attempts to breathe, the diaphragm descends, causing the abdomen to lift and the chest to sink. The reverse happens as the diaphragm relaxes.
seesaw breathing
____________ occurs because of Dizziness and a drop in blood pressure caused when the mother is in a supine position and the weight of the uterus, infant, placenta, and amniotic fluid compress the inferior vena cava, reducing return of blood to the heart and cardiac output.
supine hypotension
___________ is a medication used to delay preterm labor. It is in a class of drugs called betamimetics, which help prevent and slow contractions of the uterus.itis primarily used when doctors need to delay birth for several hours or days in order to allow the child to mature more before being born
terbutaline
Most common medication to treat hyperthyroidism in pregnancy is?
thioamides (Methimazole and proplthiouracil (PTU)
