Maternal 2
what is the anthropoid pelvis
"ape-like" transverse and narrow may not accomodate fetal head
a nurse is caring for a client and partner during the second stage of labor. the clients partner asks the nurse to explain how to know when crowning occurs. how should the nurse respond
"the vaginal area will bulge as the babies head appears"
a nurse is caring for a client in the third stage of labor. what are some indications of placental seperation
-lengthening of the umbilical cord -appearance of dark blood from the vagina -fundus firm upon palpation
a nurse is admitting a client who is in labor and had HIV. Which of the following interventions should the nurse identify as contraindicated for this client
-vacuum extractor -forceps -internal fetal monitoring
how many glasses of fluid should a pregnant women drink daily fo maintain adequate hydration
8-10
What is hyperemesis gravidarum?
Excessive vomiting during pregnancy that results in starvation (ketonuria), dehydration, and acidosis.prolonged past 16 weeks.
what is the first action you should take
FHR
amniotic fluid is meconial stained- what would you do for the laboring client immediately
FHR monitoring
what is the tx for hyperemesis gravidarum
IV fluids (LR) pyridoxine (B6) and other vitamins as tolerated antimetics (zofran, metoclopramide) corticosteroids to treat refractory HG zofran
what would an increase in the HR on the fetal monitor be called
above 160: tachycardia below 110: bradycardia
what are some contraindications for a client who has HIV and is in labor
amniocentesis, episiotomy, internal fetal monitors, forceps, vaccum extraction, NO injections until after first bath, C SECTION if maternal viral load is over 1000 copies/ml
what can amniocentesis measure regarding fetal lungs
amniotic fluid is tested to determine whether the fetal lungs are mature enough to adapt to extrauterine life or if the fetus will have resp distress
what causes frequent urination during pregnancy
as the baby grows it presses down on the bladder
how would you go about asking your client about her menstrual history
ask her when the first day of her last period was, asked her when the first day of missed period was. just ask
why is a non stress test done
assessing for an intact fetal CNS during the 3 trimester
a nurse is caring for a client who is in labor and observes late decelerations on the electronic fetal monitor. what is the first action should the nurse take
assist the client in the left lateral position
a nurse is caring for a client who is 32 weeks of gestation and has a placenta previa. the nurse notes that the client is actively bleeding. which medication should the nurse expect the provider will prescribe
betamethasone
a nurse is providing care for a patient who is in preterm labor at 32 weeks gestation. which of the following medications should the nurse anticipate that the provider will prescribe to hasten lung maturity
betamethasone
what drug is given to a client who has placenta previa and is 30 weeks gestation
betamethasone and a coritcosteroid given 12-24 hours before birth
what would be danger sign of labor for a women in labor
bleeding, if fluid was not clear and it was a gush of fluid. meconium staining- a green color of amniotic fluid and it indicates the fetus has had a loss of rectal sphincter control and it can indicate fetal hypoxia
why is the BP of a 16 week pregnant women lower
blood volume is increased
what would you do if your client had a sudden gush of fluid from her vagina
check FHR rupture of membranes- labor is starting, patient will need exam baby should be born within 24 hours of membranes rupturing to prevent infection (preferable)
a nurse is caring for a client who is 40 weeks of gestation and reports having large gush of fluids from the vagina while walking from the bathroom. which of the following actions should the nurse check first
check the FHR
what color should normal amniotic fluid be
clear or tinted yellow
why doesnt amniotic fluid grow stagnant
constantly moving
what are some measures to help a client with nausea
crackers, dry toast, ginger ale, sprite, sea bands, nausea medicine
which nursing intervention is most effective in applying the gate control theory for relief of labor pains
cutaneous stimulation and massage
What does the Leopold Maneuver tell you? how do you do it?
determines the position of the baby through external palpitations of the maternal uterus through the abdominal wall.start at fundus and palpate for the spine and move down using palm
a nurse is caring for a patient who is receiving nifedipine fr prevention of preterm labor. the nurse should monitor the patient for which manifestation
dizziness
what is pica and what causes it
eating of non food items such as paint, low iron can be a cause of pica
how would you approach a client who is 12 weeks pregnant and still smoking
educate her about the risks of smoking on the fetus
what would cause an immediate need for an emergency c section
fetal distress (FHR decline, prolapsed cord, placenta abruption)
what instructions would you give to a pregnant client to observe the movements of a fetus assessment
fetal kicks
what is the most effective way to assess food intake during pregnancy
food diary/journal
what is an acoustic vibration device and why is it used during pregnancy
for acoustic sound stimulation, a specially designed acoustic stimulator is applied to mothers abdomen to produce a sharp sound which will startle or wake the baby. this is done if after 5 min of being NST without any accelerations
the 2 stage of labor would bring the client to be what
frightened, crying, screaming and anger
what would be the most appropriate thing to do for a dad who has been at bedside for 12 hours
give him a break, offer support and reassurance, encourage nutrition/hydration
treatment for constipation
increase fiber intake, bulk laxatives and regular exercise
what is the purpose of giving betamethasone
increase lung maturity
a nurse is completing an admission assessment for a client who is 39 weeks of gestation and reports fluid leaking from the vagina for 2 days. which of the following conditions is the client at risk for developing
infection
what would a client be in danger of when she reports to you she has been leaking fluid from her vagina for a few days
infection
a nurse is caring for a client who is pregnant and undergoing a nonstress test. the client asks why the nurse is using an acoustic vibration device. which of the following responses should the nurse make
it awakens the sleeping fetus
what happens to the GI system during labor
it slows down
what would you have the client with premature rupture of membranes of 16 weeks gestation do
keep a record of fetal counts
what position should the mom be in when is in labor and has an external monitor on
lateral sims- side lying
a nurse is caring for a client who is in preterm labor and is scheduled to undergo an amniocentesis. the nurse should evaluate which of the following tests to assess fetal lung maturity?
lecithin/ sphingomyelin (L/S) ratio
what is the name of the test used to measure fetal lung maturity and what is the normal ratio of this test
lecithin/ sphingomyelin (L/S) ratio, 2:1 ratio indicates fetal lung maturity
what are foods rich in iron
legumes, dried fruit, dark green leafy veggies, and meat
why is the preterm fetus more effected by medication than a full term fetus
lungs, kidneys, and liver are not developed
what is a good source of B12
meats
what should you ask the client on her first prenatal visit
menstrual history, hygiene, drug/alcohol, sexual activity
what is a nonstress test
most widely used technique for antepartum evaluation of fetal well being performed during the 3 trimester. the client pushes a button attached to the monitor whenever they feel a fetal movement. this allows to monitor the response of the FHR to fetal movement
should the pregnant client take aspirin, why or why not
no bc taking aspirin increases the risk of bleeding, aspirin prevents platelet aggregation
a patient who is 6 months pregnant complains of back pain, what would the nurse suggest for her
pelvic rock and exercise ball
after the delivery of the placenta, the uterus is sluggish to contract. what should be given to the client to help the uterus contract
pitocin
a nurse is caring for a client who is using patterned breathing during labor. the client reports numbness and tingling of the fingers. which action should the nurse take
place an oxygen mask over the clients nose and mouth
what are some factors of preterm labor
pre rupture membranes
what behavior from a spouse would exhibit acceptance of pregnancy
preparing clothing and sleeping arrangements for baby and coming to appointment
a nurse is caring for a client who is in the second stage of labor. the clients labor has been progressing, and a vaginal delivery is expected in 20 min. the provider is preparing to administer lidocaine for pain relief and perform an episiotomy. the nurse should know that which of the following types of regional anestheticc block to administered
pudendal
What is an amniocentesis?
recommended 15-20wks consists of transabdominal aspiration of amniotic fluid using an ultrasound guided needle and eval of fetal cells for genetic studies
what position should the client be in when she is pushing between contractions
resting position
a nurse is caring for a client who is in active labor. the client reports lower back pain. the nurse suspects that this pain is related to a persistant occiput posterior fetal position. which of the following nonpharmacological nursing interventions should the nurse recommend to the client
sacral counterpressure
what stage of labor does crowning occur
second stage
a client reports tingling of her fingers when she is doing patterned breahting. what should the nurse do
slow down breathing to prevent hyperventilation
what are some side effects of nifedipine
tachycardia, HA, nausea, lightheadedness/dizziness, flushing, heartburn, muscle cramps, constipation and cough
how would you explain to a pregnant client that her fetus wont drown in her uterus
the baby is suppled oxygen through the umbilical cord, the baby will not take its first breath until after delivery
what does crowning look like
the head of the baby is at the opening of the vagina
what would be the first action the nurse would do for a client in labor and has late d-cells on the monitor
turn pt on the left side
what prenatal test will be performed on the client who is 16 weeks pregnant
ultrasound, STI testing, blood glucose screening
what vitamin would the vegetarian women need to supplement during pregnancy
vitamin B12
