OB Exam #1 Review Powerpoint

What are important concepts to teach a client who is attempting to latch their newborn and desires to effectively breastfeed?

*Hold the newborn at the level of the client's breasts *Point the newborn's nose to the client's nipple *Wait until the newborn open their mouth wide

What is the maximum amount of time that stage 3 of labor should last?

30 minutes

Delivery of a viable newborn occurs. You place the newborn on the client's chest and begin to calculate APGAR scores. You assess the following at 1 minute: heart rate 130, pink body and hands with cyanotic feet, weak cry, flexion of the arms and legs, active movement and crying when stimulated. What is the apgar score?

8- one off for weak cry and one off for color

Members of the L&D unit are reviewing principles of electronic fetal monitoring. Which facts are regarded as accurate? Select all that apply. a. The normal FHR is 110 - 160 bpm b.A FHR of 130 is considered fetal tachycardia c. An acceleration of the FHR from the baseline of 120 bpm to 135 bpm for 20 seconds is considered abnormal d. Accelerations in the FHR are considered a sign of fetal well-being e. A deceleration of the FHR may be benign, depending on when it occurs in relation to uterine contractions.

A, D, E

A client who is pregnant for the first time is dilated 2 cm and having contractions every 7 minutes. The client is groaning and sweating. Which of the following is the priority nursing action? A. Notify the client's healthcare provider. B. Assure the client that labor will be over soon. C. Assist the client with simple breathing and relaxation instructions.

Assist

What babies are at a higher risk for hypoglycemia?

Babies of mothers with poorly controlled diabetes, LGA/SGA

Which is an expected characteristic of amniotic fluid? Deep yellow color Clear, with small white particles Nitrazine test with acidic result Absence of ferning

Clear with white particles (fetal vernix/skin)

You admit the client to the triage unit for evaluation of possible labor. You begin to read over the prenatal records and discover that the client has no known allergies and current medications consist of PNV daily and ferrous sulfate (one tab daily). There is no significant prenatal history for this pregnancy and all labs and tests have been WNL. What subjective information would you ask?

Contractions- start, duration, frequency Bleeding Fetal Movement Any fluid leaking Pain

A 34 year old English speaking pregnant client is 39.3 weeks' gestation and presents to the OB unit stating that labor has started because contractions have been occurring since a cervical exam was performed in the clinic yesterday. Prenatal records reveal the following OB history: Primary LTCS at 35.6 weeks for pre-eclampsia and breech presentation VBAC delivery at 40.1 weeks - no complications Elective abortion at 6 weeks 2 living children What is the GTPAL? GP?

G4 T1 P1 A1 L2 G4 P2

What complication would you suspect if newborn is jittery, having difficulty feeding, and has a weak cry? What is the priority intervention?

Hypoglycemia, perform a blood glucose check on baby

The provider notes that the client has a 2nd degree lac that needs repairing. What is a priority intervention that will help with pain and swelling of the perineum?

Ice pack, Tucks Pads, Dermaplast, witch hazel

What are 4 signs and symptoms that may precede labor?

Lightening, bloody show, backache, PROM

On admission to the labor unit, a primigravida client at 38 weeks gestation states, "I need to urinate more now but at least I can breathe easier." The nurse is aware that this is likely due to which physiological process. Onset of labor Effacement Lightening Rupture of membranes

Lightening- occurs when the fetal head descends into the maternal pelvis, causing decreased pressure on the rib cage and increased pressure on the bladder. This creates increased ease of breathing and urinary frequency.

The client is recovering well on the postpartum unit and is now 24 hours post-delivery. What type of lochia would you expect at this time?

Lochia rubia

About 6 minutes after delivery of newborn the you notice a trickle of blood, the client feels another small contraction and you notice the cord lengthening. What is happening?

Placental separation/3rd stage of labor

A 33 year old client begins prenatal care at approximately 9 weeks' gestation. The client states that the have not had a menstrual cycle for at least 2 months. Amenorrhea is classified as what sign of pregnancy? a. Presumptive b. Positive c. Negative d. Probable

Presumptive- signs that are subjective to the women

A client does report a positive pregnancy test at home. As the nurse you know that a positive pregnancy test is what kind of sign of pregnancy? Presumptive Positive Negative Probable

Probable

A 35 year old G1 P0 is admitted to the L&D unit. The client reports intense rectal pressure. Which stage of labor is probable? First stage, latent Second stage Third stage Fourth stage

Second

Without doing a vaginal examination, a nurse concludes that a primigravida who has received no medications during labor is in transition. Which signs/symptoms would lead a nurse to that conclusion? The client yelled at her partner and vomited.

Strong and frequent contractions, fatigue, vomiting, and yelling.

Delivery of a viable newborn occurs. You place the newborn on the client's chest and begin to calculate APGAR scores. You assess the following at 5 minutes: centrally pink with acrocyanosis, heart rate 126, actively moving, strong cry, and sneezing with bulb suction What is the apgar score?

9- one off for coloring: acrocyanosis (blue hands/feet)

The nurse has just performed a sterile vaginal exam on a laboring client and reports the exam as 4 cm, 50%, -1. What does this represent? Effacement, station, and dilation Dilation, station, and fetal lie Dilation, effacement, and status of membranes Dilation, effacement, and station

Dilation, effacement, station.- Dilation is recorded as 0-10cm, effacement as 0%-100% and station as either +5 to -5

You find out that her LMP was November 18, 2018. Using Naegele's rule calculate the client's EDD.

EDD: August 25, 2019- Naegele's rule estimates the estimated date of delivery by the last menstrual period + 7 days, subtract 3 months, then add 1 year.

A sterile vaginal exam completed on a client revealed the presenting part to be the mentum. What is this presentation known as? Face presentation Breech presentation Vertex presentation Shoulder presentation

Face Presentation- mentum/chin