OB practice HESI

Which position increases cardiac output in a client with cardiac disease?

Lateral position

Position for patient placed on bedrest with increased risk for preterm labor

Lie on the side with head raised on small pillow -- bed rest keeps pressure of fetal head off of the cervix. Side-lying position keeps the gravid uterus from impeding blood flow through major vessels thus maintaining uterine perfusion

Effleurage

Light, continuous-stroking massage movement applied with fingers and palms in a slow and rhythmic manner.

adverse affect of administering Vitamin K to newborn

Pain, edema, erythema

Cardiac disease with lowest maternal mortality risk

Patent ductus arteriosus

why is multiple-gestation high risk?

Perinatal mortality is two to three times more likely than in single births can cause Uterine Atony

Exstrophy of the bladder also is associated with

Pubic bone malformation

immediate nursing action with a patient admitted with abdominal pain and heavy vaginal bleeding

START IV

Which intervention is delayed until the newborn is 36 - 48 hours old?

Screening for phenylketonuria

What risk to the fetus is associated with a maternal diagnosis of chorioamnionitis?

Sepsis, Bacteremia, Pneumonia, Cerebral palsy (CP), Respiratory distress syndrome (RDS)

Uteroplacental insufficiency

Side lying position, give O2 second

Score 1 Respiration

Slow, weak cry

signs of abnormal infant breathing

Stridor, mottling, bradypnea, nasal flaring, expiratory grunting

Morning sickness disappears by the end of which month?

Third Month

STI caused by protozoa

Trichomoniasis

What complication is common in Vitro fertilization?

Tubal pregnancy

testing for preeclampsia

Urine dipstick positive for protein

What should the nurse recommend for post-cesarean gas pain?

Walking around the room

Which technique is appropriate for an OB client with a foreign airway obstruction

Chest thrusts

Why provide warm, humidified oxygen to a preemie?

Cold stress

with contractions, 15 beats/min decel below baseline lasting 15 seconds (variable)

Cord compression -- Intervention: Change maternal position

What happens after birth that increases the risk for cardiac decompensation in a client with a compromised cardiac system?

Extravascular fluid is remobilized into the vascular compartment

Immediate nursing action when clients membranes rupture spontaneously

Assess the FHR

newborn with small, flat pink spots on the nape of the neck

Nevi

immediatley after birth, where is fundus?

2 cm below the umbilicus during first several postpartum hours the uterus will rise slowly to just above the level of the umbilicus

lochia alba

6 weeks after birth

The ear and pinnae spring back

@ 36 weeks

Chadwick sign

bluish discoloration of cervix that occurs normally in pregnancy at 6 to 8 weeks' gestation

complication of spontaneous abortion

hemorrhage

complication with abruptio placentae

hemorrhage which leads to hypovolemic shock

Risks associated with diabetes in pregnancy

hypertensive disorders, polyhydramnios,

Let-down reflex

i will apply warm packs and massage my breasts before each feeding

Babinski reflex

immature neuromuscular system causes dorsiflexion of big toe and fanning of rest of toes.

NST (non-stress test)

increase in fetal heart rate called accelerations are a sign of fetal well=being

precipitate birth

increased maternal morbidity rate, because hemorrhage and infection may occur as a result of the trauma of a rapid, forceful birth in a contaminated field.

Retained abortion

lifeless products of conception are retained

instruction for BSE

squeeze nipple to examine discharge: serous or bloody discharge is pathological and must be reported

How to suction a term neonate with bulb syringe

suction mouth before nostrils

PT. ed for taking bisphosphonates

take on an empty stomach in the morning

what action should the nurse take to confirm ROM

test the leaking fluid with nitrazine paper

why does jaundice occur in a newborn?

the expected physiological breakdown of fetal red blood cells and the inability of the newborn's liver to conjugate the resulting bilirubin.

manifestations of Hypoglycemia

tremors, apnea, cyanosis, poor suckling ability

Pt eduation to releive symptoms of a yeast infection

use a sitz bath

Threatened Abortion

vaginal bleeding at 12 weeks gestation with audible fetal heart rate and closed cervix

when finding a saturated pad, always ask first ....

when did you last change the perineal pad?

small, flat pink spots on the nape of the neck

Nevi

hyperreflexia in severe pre-eclampsia

indicates central nervous system irritability, a sign of worsening condition which could lead to seizures

when cervix is dilated

inevitable abortion

Risk factors for an infant developing jaundice

infection, prematurity, breast-feeding, maternal diabetes

lochia serosa

thinner, brown pinkish discharge, lasts about 2 weeks

patient with dizziness and tingling of the hands

means respiratory alkalosis, from hyperventilating, breathing into cupped hands or a paper bag

What type of lochia would you expect to observe on a client's pad on the third day after a vaginal delivery

moderate Lochia rubra

Priority nursing intervention during admission of primigravida in labor

monitoring fetal heart rate

sudden sharp pain in abdomen, fetal hyperactivity, fundal tenderness and small amount of dark-red bleeding

partial placental abruption

incomplete abortion

parts of the pregnancy tissues are expelled and parts remain in the uterus

Patient education for episiotomy care

perform perineal care after toileting until healing occurs to prevent infection

Why is multiple-gestation pregnancy considered a high risk?

perinatal mortality is two to three times more likely

high-risk nutritional practice when a pregnant client is anemic

pica

Necrotizing enterocolitis risk factor

polycythemia - places the preterm infant at risk for NEC

smoking affect on newborn

low birth weight

How much calcium to take daily?

1000 mg

which time during the menstrual cycle is the optimal time to achieve pregnancy

14 days before the next period is expected

charcateristics of down syndrome

21 Trisomy: - Simian crease - stubby fingers - small ears - hypotonic muscles

How long is ovum viable after ovulation?

24 hours

for which period of time is the ovum capable of being fertilized after ovulation?

24-36 hours

when would a client with type 1 diabetes expect to increase her insulin dosage?

24th and 28th week of gestation -- at the end of 2nd tri, insulin needs increase,

Breast tissue is not palpable until

33 weeks

Creases of the palms and soles are not clearly defined until after the

37th week

a zero-degree square window sign is present in an infant at

40-42 weeks gestation

Healthy hematocrit level in newborn

45-65%

Monitor infant for jaundice when mother has blood type -

Blood Type O

what considerations for a client considering oral contraceptives

Blood clots, heart disease, breast cancer, impaired liver function, undiagnosed vaginal bleeding, smoking more than 15 cigs per day

Heart tones heard around umbilicus

Breech presentation

incomplete abortion

when part of the fetus or placenta remains in the uterus after the procedure

When can the heartbeat be detected?

Doppler ultrasound 10-12 weeks

At which week does embryo become a fetus?

During 8th week of pregnancy

red rash consisting of small papules on the face, chest, and back of the newborn

Erythema toxicum

Naegele's Rule

add 7 days to LMP, subtract 3 months, add 1 year

Plan of care for a client who is being treated for a sexually transmitted infection and reports fever and irregular bleeding?

analgesics, abdominal palpation, CBC, culture of the cervical canal, adminstration of antibiotics as prescribed, teaching about negative effects of douching

POC for patient with large painful varicose veins

assess for signs of thrombophlebitis

what differentiates true labor from false labor

cervical dilation

vernix caseosa

cheeslike substance that protects the skin, is secreted by the fetus' skin toward end of pregnancy.

What symptoms indicate infection in pregnant client?

chills, fever, diarrhea, flank pain, burning on urination

FOLIC ACID in pregnancy

deificiency can cause neural tube defects. foods with at least 100 mcg of folate are black-eyed peas, breakfast cereal

Alpha-fetoprotein (AFP)

detects neural tube defects

Milia

distended sweat (eccrine) glands that looks like white heads on. the infants nose

caput succedaneum

edema of the fetal scalp that crosses the suture lines

Plan of care for patient who took carbamazepine during first trimester

evaluation of a neural tube defect

early neonatal weight loss in first 3 days of life

excretion of accumulated excess fluids

tonic neck reflex

healthy newborn, lying in supine position with head turned to one side and flexed on the opposite side. (Fencing position)

Nursing intervention for late decelerations

position client on the left side -- Placental perfusion

Risks associated with advance maternal age

preterm labor, multiple gestation, chromosomal anomalies, bleeding in first trimester

physiologic changes after an amniotomy (artificial rupture of membranes) is performed

progressive dilation and effacement

offspring of men of advanced paternal age are at an increased risk for

schizophrenia

sensory simulation strategy for nonpharm pain relief

selecting focal point, and beginning breathing techniques

menorrhagia

severe bleeding during menstrual periods

Lochia rubra lasts

3 days, up to 7

Nursing instruction for a client in preparation for ultrasonography at the end of her first trimester?

Increase fluid intake for 1 hour before the procedure.