final exam

see-saw respirations

When assessing a newborn, the nurse determines that the newborn is most likely experiencing respiratory distress syndrome (RDS) based on which finding?

Chronic maternal hypertension is an unlikely factor because chronic fetal stress tends to increase lung maturity

Which condition would place a neonate at the least risk for developing respiratory distress syndrome (RDS)?

venous hematocrit 70% polycythemia is a venous hct < 65%

Which lab finding on the 2 hour preterm infant is concerning?

the child of a client who admits to drinking a liter of alcohol daily during the pregnancy

Which newborn would the nurse suspect to be most at risk for intellectual disability due to the mother's actions during pregnancy?

transient tachypnea of the newborn

Which respiratory disorder in a neonate is usually mild and runs a self-limited course?

Gastroschisis

_________ refers to a herniation of abdominal contents through an abdominal wall defect.

Hyatidiform Mole

a 46-year-old comes to the ED with severe nausea, BP 150/90, and prune juice (brown) color discharge pregnancy test is positive. Based on her age and assessment findings you suspect?

women with chlamydia should also ask their partners to be treated

a G4P3 comes for her prenatal visit and the nurse is teaching her about her new Chlamydia diagnosis. which should be included?

abstinence

a newborn of a substance abusing mother who demonstrates neurologic and physical behaviors associated with withdrawal is experiencing neonatal ________ syndrome

asphyxia

a newborn who fails to establish adequate, sustained respiration after birth is experiencing_____________.

false

a newborn with transient tachypnea typically requires mechanical ventilation

helps in stimulating lung development in the per-term infant

a woman is experiencing per-term labor and asks why is she on Betamethasone. The best response by the nurse would be?

pre-gestational (overt) diabetes becomes pregnant

a woman with type I or II diabetes who

gestational diabetes during pregnancy

any degree of glucose intolerance that has onset or diagnosed

RDS

baby may be born with under developed lungs and have

hydatidiform mole (molar pregnancy)

benign proliferative growth of the placental trophoblast in which the chorionic villi develop into edematous, cystic, avascular transparent vesicles that hang in a grapelike cluster

0 = no response 1+ = diminished 2+ = NORMAL 3+ = increased 4+ = hyperactive

deep tendon reflex grading

neural tube cardiac kidney/renal

during the first trimester congenital issues are link with poor maternal glycemic control before conception are;

hydramnios

excessive amniotic fluid A nurse is caring for a child born with a tracheoesophageal fistula. Which finding during pregnancy would have caused the nurse to suspect this might be present?

false

fetal alcohol syndrome is rarely preventable

a score of more than 2 = fetal pulmonary maturity a score less than 2= pulmonary immaturity and subsequent to RDS.

fetal lung maturity measurement are;

II and is viral

genital herpers is most often type____ and is _____

HELLP syndrome

hemolysis, elevated liver enzymes, low platelets

true

meconium may be passed in utero secondary to hypoxic stress.

Chlymydia

most common sexually transmitted bacterial infection in North America; often occurs with no symptoms and is treated only after it has spread

oligohydramnios

not enough amniotic fluid

"I'm sorry." "I'm so sad for your loss." "I know this must be terribly hard for you." "How are you managing all of this?" "What can I do for you?" "Talk as long as you want. I have plenty of time." "You don't have to say anything at all."

nursing management: grieving process what to say

chronic hypertension gestational hypertension pre-eclampsia eclampsia chronic hypertension HELLP Syndrome

what are hypertensive disorders in pregnancy?

mom a and infant (fetus) is O+, RH- mother lacks the RH antigen so the antigen - antibody reaction can occur and RH antibodies of mother can attack fetal RBC

what fetus is at risk for hemolytic disease?

high estrogen and progesterone levels stimulate increased insulin production by maternal pancreas and increased tissue response to insulin

what happens in normal pregnancy?

antenatal testing in pregestational diabetes timing

what testing is used to test NST and BPP(biophysical profile) c-section is considered if EFW > 4500grams

performed by amniocentesis after the 35th week of pregnancy

when is fetal lung maturity checked for maturity?

stop

when necrotizing enterocolitis is suspected in a newborn, it is necessary to immediately _______ enteral feedings.

Dull backache could indicate PTL (Preterm Labor)

which finding would concern the nurse caring for a patient with 4 hours post cerclage placement?

15 years old primagravida her age and GI status increase her risks

which pt is at highest risk eclampsia?

increased secretion of these placental hormones causes increased insulin resistance and decreased glucose tolerance.

why do some women develop insulin resistance?

elicit clonus

•Although brisk or hyperactive reflexes are common during pregnancy, clonus is a sign of neuromuscular irritability that usually reflects severe pre-eclampsia.

edema

Caput succadeuam refers to _______ on the head which occurs as a result of pressing against the dilating cervix during the birth process.

excessive vomiting during pregnancy

What is hyperemesis gravidarum?

high pitch cry frequent yawning and sneezing loose, watery stools

A newborn in the observational nursery demonstrates signs of neonatal abstinence syndrome. What findings would correlate with this diagnosis? Select all that apply.

tremors frequent yawning nasal flaring

A nurse is assessing a newborn. The nurse suspects that the newborn was exposed to drugs while in utero based on which findings? Select all that apply

Ineffective thermoregulation related to decreased amount of subcutaneous fat

A nurse is caring for a preterm newborn born at 29 weeks' gestation. Which nursing diagnosis would have the highest priority?

Temperature instability

A nurse is concerned that a 1-day-old newborn is becoming ill and may be septic. What sign of distress would validate the nurse's concerns?

ectopic pregnancy

A pregnancy outside of the womb, usually in a fallopian tube

Fluid and electrolyte balance biggest priority.

A pregnant patient at 16 weeks gestation is diagnosed with hyperemesis gravidarum. Which issue should be a priority when planning her care?

Candida albicans tx

Amphotericin B (systemic), nystatin (oral thrush, esophagitis)

false

Cephalohematoma usually require surgical correction

Candida albicans

Curable (RTI) caused by a yeast-like fungus, related to a change in vaginal PH is called?

Hydatidiform mole treatment

D&E -vacuum that stuff out test hCG levels until gone do not get pregnant for 1 year

maternal hypertension

What would the nurse suspect as a cause of meconium aspiration syndrome (MAS) after reviewing the maternal history of a client whose newborn is diagnosed with MAS?

macrosomia/intrauterine growth restriction UGR, demise growth abnormalities polyhydraminios fetal demise

Here are some risk factors related to diabetic pregnancy. Risk to the fetus?

cardiac anomalies respiratory distress in newborn neural tube defects cardia anomalies

If glucose levels in a pre gestational dm woman before and during pregnancy are not well controlled, what fetal outcomes can occur?

Hypertensive disorders of pregnancy are not painful or obvious to the patient in most cases. •It can develop and progress rapidly. •Abnormal weight gain, blood pressure, and urine dip for protein during prenatal visits are often the first indications of a problem. •Patient reports of headache, visual changes, epigastric pain, decreased fetal movement.

Importance of prenatal care

imperforate anus

In completing the newborn assessment checklist, the nurse documents a meconium stool. This documentation rules out which condition?

As the disease worsens, the infant develops signs and symptoms of septic shock (respiratory distress, temperature instability, lethargy, hypotension, and oliguria). Nurses need to be suspicious of this condition in caring for this preterm infant.

Necrotizing Enterocolitis

Meconium Aspiration Syndrome (MAS)

Observe the newborn with MAS for a barrel-shaped chest with an increased anterior-posterior chest diameter, prolonged tachypnea, progression of respiratory distress, intercostal retractions, end-expiratory grunting, and cyanosis.

MAGNESUIM SULFATE

Slows down contractions and suppression of irregular heartbeat after a MI., which prevents seizures in our pregnant patient.

rheumatic fever

Streptococcus pyogenes

metformin/glyburide

The RN was educating a patient who had diabetes on the importance of monitoring her sugar and making sure she does not take this medication because of possible placental crossover, which are

Gently wipe the nares and posterior pharynx before the first breath.

The labor and birth nurse notes copious green-stained amniotic fluid with the rupture of the membranes during the birth of a postterm infant. Which action should the nurse perform first?

"It's a good idea to stop drinking alcohol 3 months before trying to get pregnant."

The nurse is assessing a toddler at a well-child visit and notes the following: small in stature, appears mildly developmentally delayed; short eyelid folds; and the nose is flat. Which advice should the nurse prioritize to the mother in response to her questions about having another baby?

Hypocalcemia

The nurse is examining the morning laboratory results of the newborns of mothers with diabetes. Which report finding should the nurse prioritize?

Maternal predisposing factors for the development of necrotizing enterocolitis (NEC) include preeclampsia, maternal sepsis, uterine hypoxia

The nurse reviews the antenatal chart of a mother with a newborn diagnosed with necrotizing enterocolitis. What would the nurse expect to find in the chart because it correlates with the diagnosis?

is heralded by the development of feeding intolerance, abdominal distention, and bloody stools in a preterm infant receiving enteral feedings.

The onset of NEC (necrotizing Enterocolitis)

omphalocele

herniation at the umbilicus (a part of the intestine protrudes through the abdominal wall at birth)

hyper-insulin delay lung maturation risk= RDS respiratory distress syndrome

hyper-insulinemia = increased sized or macrosomia

less surfactant produced

if the fetus is making a lot of insulin

hyperbilirubinemia

is exhibited as jaundice.

Candida albicans signs and symptom

itching inflammation of vulva burn during urination thick white cottage cheese discharge

true

periventricular- intraventricular hemorrhage is a common problem of preterm infant

Perinatal asphyxia, MAS, maternal smoking, maternal obesity, hypocalcemia, maternal asthma, pneumonia, congenital heart defects, metabolic disorders such as hypoglycemia, hypothermia, hypovolemia, hyperviscosity, acute hypoxia with delayed resuscitation, sepsis, and RDS.

persistent pulmonary hypertension of the newborn

(high risk pregnancy) examples; age, race, weight, BMI,, Occupation, lifestyle, smoking, drugs use

person related risk factors are factors related to the person herself things she may or may not be able to change

ectopic pregnancy treatment

pregnancy test, a transvaginal ultrasound, priority is to control bleeding, no action, treatment with methotrexate, surgery to remove the pregnancy from the tube (salpingectomy, salpingostomy)

true

respiratory distress syndrome occurs in premature infants due to a lack surfactant in the lungs

how ofter do you smoke tobacco and drink alcohol? have you had any past surgery?

risk factors r/t infertility questions to be ask are?

if the pancreas cannot respond to increase demands blood glucose rises.

so how can these placental hormones affect the pregnant patient in the latter half of pregnancy?

glass

the chest x-ray of a newborn with respiatory distress syndrome typically shows a ground_______ pattern

false

the infant of a diabetic mother usually experiences hyperglycemia after birth

true

the most common cranial nerve trauma involves the facial nerve.

gestational hypertension, placental implantation, placental perva, abruption, preeclampsia, multiple gestation

these are factors associated with the pregnancy that increase the risk examples are;

BV symptoms? tx?

thin grayish which d/c, fishy odor, itching, burning, + diff, + squamous epitheal cells tx - flagyl

Subinvolution of the uterus

uterus remains enlarged with continued lochia discharge and can result in postpartum hemorrhage give oxytocin or methylergonovine