ob practice B
pt is at 10 wks gestation and has normal BMI. teaching.
"I will likely need to use alternative positions for sexual intercourse."
A nurse is caring for a client who is at 36 weeks of gestation and has a positive contraction stress test. The nurse should plan to prepare the client for which of the following diagnostic tests?
Biophysical profile
A nurse is teaching a newly licensed nurse about collecting a specimen for the universal newborn screening.
"Ensure that the newborn has been receiving feedings for 24 hours PRIOR to obtaining the specimen."
Rhogam education for Rh- mom
"I will need this medicine if I have an amniocentesis" *rhogam is recommended following an amniocentesis because of the potential of fetal RBC's entering the maternal circulation
diaphragm education
leave it in 6 hrs after sex
40 wk pt getting misoprostol. education
"i can administer oxytocin 4 hrs after the insertion of this medication"
baby bath order
(HEAD TO TOE then diaper area) - wipe newborn's eyes from inner canthus outward - wash neck by lifting chin - cleanse the skin around umbilical cord stump - wash newborn's legs and feet - clean newborn's diaper area
car seat safety
- 45 degree angle - place the retainer clip at the level of the newborn's armpits
The nurse is preparing the client for surgery. Which of the following actions should the nurse take?
- Inform the client to be NPO prior to surgery - Insert an 18-gauge peripheral IV prior to surgery - Obtain a complete blood count - Verify a consent form is signed by the client Administer Rho(D) immune globulin prior to surgery is incorrect. The nurse should administer Rho D immune globulin after surgery. The client is Rh negative and could develop antibody formation if exposed to Rh positive blood.
need immediate follow up
- abdomen assessment (dull, lower right quadrant pain and tenderness) - vaginal spotting (dark red spotting and late period) - mensterual period (late 2 weeks) (not wheezing bc she has asmtha)
preeclampsia pt. no deep tendon reflex. what do?
- apply oxygen at 10 L by nonrebreather mask - discontinue mag infusion - administer calcium gluconate
newborn expected findings
- heart rate: 110-160 - temp: 97.7 to 99.5 - RR: 30 to 60 a min - weight: 2500 to 4000 g (5.5 lbs to 8.8 lbs)
priorities
1. increasing HR (90 -> 104) followed by 2. vaginal spotting
A nurse is caring for a client who is at 26 weeks of gestation and has epilepsy. The nurse enters the room and observes the client having a seizure. After turning the client't head to one side, which of the following actions should the nurse take immediately after the seizure?
Administer O2 via a nonrebreather mask
A nurse is performing a vaginal examination on a client who is in labor and observes the umbilical cord protruding from the vagina after calling for assistance which of the following actions should the nurse take next
Insert two gloved fingers into the vagina and apply upward pressure to the presenting part.
A nurse is caring for a client who is at 24 weeks of gestation and has a suspected placental abruption. Which of the following laboratory tests should the nurse expect the provider to prescribe?
Kleihauer-Betke test
lactation suppression nonpharmacological
apply cabbage leaves to breast
pt received carboprost for PP hemorrhage. adverse effect
hypertension
placenta previa pt
initiate continous external fetal monitoring
suspected condition. general malaise and chills. dark foul-smelling lochia. perineal edema. voiding lots. abdominal pain level 5.
endometritis - monitor: lochia amount and odor, temp (101 f) - actions: obtain a culture of vaginal fluid using a sterile swab, plan to administer IV antibiotics
cocaine use
abruptio placenta
suspected ectopic pregnancy pt actions
anticipated: - transvaginal ultrasound (to dx) - Repeat quantitative β-hCG level (to dx pregnancy) - Methotrexate IM (ends pregnancy) - blood typing (low h&h) Contraindicated: - Meperidine IM (no pain med stronger than acetaminophen bc of tubular rupture risk combined w methotrexate)
a nurse is reviewing the lab report of a newborn 24 hrs hold. which report?
blood glucose 30 (should be 40 to 45)
1 hr glucose screening
blood glucose of 130 to 140 is considered positive
severe preeclampsia symptom
blurred vision
clavicle fracture findings and erbs duchenne
clavicle fracture: - crepitus - absent moro reflex - yes palmar grasp reflex erb-duchenne paralysis: - limp rm with absent spontaenous movement - absent moro reflex - wrist flexion - palmar grasp reflex present
nonpharm engorgement treatment
cold cabbage leaves
end of 1st trimester doppler location for fetal heart tones
just above the symphysis pubis
A nurse is assessing fetal heart tones for a client who is pregnant. The nurse has determined the fetal position as left occipital anterior. To which of the following areas of the client's abdomen should the nurse apply the transducer in order to assess the maximum point of intensity of the fetal heart?
left lower quadrant
the pt is experiencing ectopic pregnancy as evidenced by
missed period, abnormal bleeding, and RLQ abdominal tenderness
plan of care for preeclampsia pt with mag sulfate infusion
monitor the FHR continuously
tubal ligation and sex life
procedure has no effect on sexual performance or adequacy
pt in preterm labor. receiving terbutaline.
"I will have blood tests because my potassium might decrease."
The nurse is planning to contact the provider regarding the newborn's status. Which of the following prescriptions regarding the newborn should the nurse anticipate? Medical History Newborn delivered by repeat cesarean birth at 40 weeks of gestation. Birth weight 3,515 g (7 lb 12 oz)Apgar scores 8 at 1 min and 9 at 5 min Maternal history of methadone use during pregnancy. Vital Signs 0700:Heart rate 156/min Respiratory rate 68/min Temperature 37.7° C (99.9° F) Oxygen saturation 97% on room air1100:Heart rate 174/min Respiratory rate 84/min Temperature 38.2° C (100.8° F) Oxygen saturation 98% on room air Physical Examination 1100:Newborn is inconsolable with a high-pitched cry. Newborn sucks vigorously on pacifier but breastfeeds poorly. Increased muscle tone with moderate to severe tremors when disturbed. Hyperactive Moro reflex noted. Mottled skin noted on extremities. Frequent sneezing. Several loose stools today. Diagnostic Results Maternal urine toxicology screen: positive for opiates (negative)
- Maintain a low-stimulus environment. - Initiate neonatal abstinence syndrome (NAS) scoring. - Administer scheduled doses of oral morphine.
which findings require immediate follow-up?
- temp 101 F - burning upon urination and low back pain/cramping - uterine contractions (shes 31 wks so this is a sign of preterm labor) and cervix 2 cm and effacement 80%
Medical History Gravida 1, Para 041 weeks of gestation Induction of labor due to postdates Nurses' Notes 1400:Client received epidural anesthesia for reports of a pain level of 7 on a scale of 0 to 10 from uterine contractions. Contractions occurring every 4 to 5 min, lasting 60 seconds, palpate moderate. FHR: Baseline 135/min, average variability, accelerations present, no decelerations noted. Oxytocin infusing at 8 milliunit/min. Rate last increased by 2 milliunits/min at 1330. 1415: Client r
1. administer fluid bolus 2. reposition client on side 3. apply o2 at 10 to 12 L/min by nonrebreather mask 4. elevate the client's legs
nurse teaching family bonding to family with a 7 yo child. how to get him to accept baby?
obtain a gift from the newborn to present to the sibling
newborn heel stick: how to minimize pain
place the newborn skin to skin on the caregiver's chest
A nurse is reviewing the medical record of a client who has postpartum and has preeclampsia which of the following laboratory results should the nurse report to the provider
platelets 50k (low)
traditional Hispanic cultural beliefs
protect the client's head and feet from cold air
hyperglycemia
reports increased urinary output
magnesium sulfate adverse effect
respiratory rate 10/min
spina bifida
sacral dimple
pt has parovirus b19 (fifth disease). which action
schedule an ultrasound exam
newborn suctioning education
stop suctioning when the newborn's cry sounds clear
taking hold phase
teach patient caregiver things like how to perform a newborn bath
29 wks gestation preterm labor. prescription for betamethasone. education
this medication stimulates fetal lung maturity
A nurse is caring for a client who is 36 weeks of gestation and has a prescription for an amniocentesis. For which of the following reasons should the nurse prepare the client for an ultrasound?
to locate a pocket of fluid
pt receiving pp discharge teaching. which should nurse report to doc?
unilateral breast pain
38 weeks at weekly prenatal visit. which report to doctor?
weight gain of 2.2 kg (4.8 lbs) above expected
