UWorld Maternity prepartum newborn POst Partum

cabbage leaves ( se coloca en mastitis, es algo frio)

hojas de repollo

Precipitous birth

imminent birth

uncoil

unwind or untwist (desenrollar)

voiding

urination

Detection of a fetal heart rate is possible using a Doppler by

using a Doppler by 10-12 weeks gestation

Cornstarch

yes (maicena)

Decreased fetal movement is a potential warning sign of fetal compromise (ie, impaired oxygenation), which may precede fetal death (Option 2). The nurse prioritizes assessment of client reports of decreased fetal movement to evaluate fetal well-being (eg, nonstress test)

(Option 1) Leg cramps commonly occur in the third trimester, especially at night, due to the weight of the gravid uterus applying pressure to nerves affecting calf muscles. Home interventions include stretching legs, massaging calves, and increasing fluid intake.

Rh immune globulin (eg, RhoGAM) is administered to all Rh-negative pregnant clients at 28 weeks gestation and within 72 hours postpartum, as well as after any maternal trauma, to prevent the development of permanent Rh antibodies. RhoGAM is not effective once sensitization has occurred.

(Option 1) Perineal group B streptococcal cultures are routinely obtained at 35-37 weeks gestation to determine the need for antibiotics during labor to prevent neonatal infection.

This is due to the infant's inability to create suction and pull milk or formula from the nipple

( Esto se debe a la incapacidad del infante para crear succión y extraer leche o fórmula del pezón.)

ascertain

(CERCIORARSE)

Client who gardens and eats homeground vegetables

(Cliente que cultiva y come verduras caseras.)

Client voiding 600 ml in 8 hours.

(Cliente vaciando 600 ml en 8 horas.)

She is screaming and bearing down with every contraction

(Ella grita y soporta con cada contracción.)

Contraction are *lessened* after resting

(La contracción se *reduce* después de descansar)

Contractions increase despite comfort measures

(Las contracciones aumentan a pesar de las medidas de confort.)

(Option 2) In addition to routine newborn care, infants born to HIV-positive clients should receive ART at birth and for at least 4-6 weeks after birth to reduce the chance of developing HIV infection. Infants are tested for HIV infection at birth and again at age 1 and 4 months. Identification of HIV-negative status requires 2 consecutive negative results at age ≥1 month and ≥4 months

(Opción 2) Además de la atención rutinaria del recién nacido, los bebés nacidos de clientes VIH positivos deben recibir tratamiento antirretroviral al nacer y durante al menos 4-6 semanas después del nacimiento para reducir la posibilidad de desarrollar una infección por VIH. A los bebés se les realiza la prueba de infección por VIH al nacer y nuevamente a los 1 y 4 meses de edad. La identificación del estado VIH negativo requiere 2 resultados negativos consecutivos a la edad ≥ 1 mes y ≥4 meses

If the infant continues to exhibit signs of hypoglycemia and/or blood glucose levels are <40-45 mg/dL (2.2-2.5 mmol/L) after feeding, the pediatrician should be notified (Option 3). Further treatment, such as oral or IV glucose, may be required.

(Option 1) A hypertrophied pancreas is very sensitive to blood glucose levels. Oral glucose administration would cause massive release of insulin and produce rebound hypoglycemia. Feeding the newborn with breast milk or formula would be sufficient in most situations.

For clients currently living in a Zika-affected area, proper mosquito precautions (eg, insect repellant containing DEET) and safe sex practices (eg, barrier methods) should be utilized, and routine Zika testing may be provided.

(Option 1) Although this statement is true, it does not provide education on avoiding Zika infection. Waiting until symptoms are present does not address preventing fetal exposure and possible birth defects.

Epidural anesthesia, an elective procedure for pain relief in labor, may be contraindicated in clients with uncorrected hypotension, coagulopathies (eg, extremely low platelets, clotting disorders), or infection at the epidural site. Low platelets in pregnancy may occur as part of HELLP syndrome (hemolysis, elevated liver enzymes, low platelets) or for idiopathic reasons (eg, gestational thrombocytopenia). Clients with low platelets (especially <100,000/mm3 [100 × 109/L]) are at risk for bleeding at the epidural puncture site, which may lead to hematoma formation, spinal cord compression, and subsequent neurologic dysfunction (Option 3).

(Option 1) Blood type and Rh factor have no effect on epidural anesthesia. (Option 2) Hemoglobin <11 g/dL (110 g/L) or hematocrit <33% (0.33) defines anemia in the first and third trimesters of pregnancy. These trimester-specific values account for the physiologic anemia of pregnancy caused by the dilution of blood due to increased plasma volume. However, anemia is not a contraindication to epidural anesthesia. (Option 4) White blood cell count in nonpregnant clients is normally 5,000-10,000/mm3 (5.0-10.0 x 109/L) but may be elevated up to 15,000/mm3 (15.0 x 109/L) in pregnant clients, usually due to an increase in neutrophils. This client's count is within the normal range for pregnancy. Educational objective: Contraindications to epidural anesthesia include uncorrected maternal hypotension, coagulopathies (eg, low platelets), and infection at the epidural insertion site.

Feeding every 3-4 hours; more frequent feedings may be tiring for the infant and the mother. Some infants may need to be fed more frequently if they are not consuming adequate amounts of formula.

(Option 1) Bottle should be pointed down, away from the cleft, in order to prevent formula from flowing back into the nose area. This backflow would cause nasal regurgitation, and milk or formula may commonly escape through the nose. This is dangerous and the infant will sneeze or cough in order to clear the nose.

The nurse's primary responsibilities during shoulder dystocia include performing the McRoberts maneuver (ie, sharp flexion of maternal thighs toward abdomen to widen space between pubic bone and sacrum) and applying suprapubic pressure (ie, downward pressure applied to maternal pubic bone to dislodge fetal shoulder) (Option 4).

(Option 2) Fundal pressure is contraindicated, as it may wedge the fetal shoulder further into the symphysis pubis or cause uterine rupture.

(Option 1) Abdominal pain with an ectopic pregnancy may start out as mild, dull, and one-sided, and progress to severe and generalized as the pregnancy grows. However, a ruptured ectopic pregnancy is more dangerous than an unruptured ectopic pregnancy.

(Option 2) Pelvic inflammatory disease increases the risk for ectopic pregnancies. Although this important piece of the client's history raises suspicion for a diagnosis of ectopic pregnancy, it is not the most concerning finding.

A foul odor of lochia suggests endometrial infection. This client has an increased risk of infection due to her prolonged labor, which involved multiple cervical examinations. The odor of lochia is usually described as "fleshy" or "musty." A foul smell warrants further evaluation. Other signs of endometrial infection are maternal fever, tachycardia, and uterine pain/tenderness.

(Option 3) Major signs and symptoms of endometrial infection include temperature above 100.4 F (38.0 C); chills; malaise; excessive uterine tenderness; and purulent, foul-smelling lochia. During the first 24 hours postpartum, the temperature is normally elevated; temperature above 100.4 F (38 C) requires further evaluation.

(Option 1) Adequate calcium intake is especially important during the last trimester for mineralization of fetal bones and teeth, but it does not prevent NTDs.

(Option 3) Organ meats (eg, liver) may contain moderately high levels of folate but are consumed more for their high iron content, which can promote red blood cell formation and prevent maternal anemia.

(Option 1) Hypertension is a sign of preeclampsia. Hydralazine (Apresoline), methyldopa (Aldomet), or labetalol (Trandate) is used to lower blood pressure (BP) if needed (usually considered when BP is >160/110 mm Hg).

(Option 3) Proteinuria is a symptom of preeclampsia. Control of hypertension and delivery will reduce the protein level. Magnesium sulfate is not prescribed to decrease proteinuria.

(Option 2) Current guidelines recommend that pregnant women avoid travel to Zika-affected areas completely. In addition, mosquitoes are not the only mode of transmission for the virus.

(Option 3) Zika virus can affect women in all stages of pregnancy.

(Option 3) Dependent edema in the lower extremities is common in the third trimester due to decreased venous return (gravid uterus pressure on vena cava), especially with prolonged sitting/standing. This is not a priority over decreased fetal movement.

(Option 4) As the uterus rises in the third trimester, the diaphragm is prevented from allowing full lung expansion, causing dyspnea, especially with exertion.

(Option 3) Testing for rubella immunity is performed in the first trimester; nonimmune mothers receive the measles-mumps-rubella vaccine in the immediate postpartum period.

(Option 4) Serum alpha-fetoprotein is a blood test to screen for fetal neural tube defects.

(Option 1) Maternal fatigue or decreased energy is common after birth and while caring for a newborn. The nurse can reassure the client that sleeping when the newborn sleeps is a good strategy as normal newborn sleep and feeding habits may require the client's attention frequently day and night.

(Options 2 and 4) Postpartum blues ("baby blues") is a common, milder form of depression characterized by emotional lability, sadness, anxiety, and difficulty sleeping. However, the client's ability to function properly is not affected, and symptoms subside within 2 weeks without treatment. If symptoms persist after 2 weeks, further assessment may be necessary.

Nonverbal cues related to *coping* in labor

(Señales no verbales relacionadas con el afrontamiento en el parto.)

lengthening of cord

(alargamiento de cuerda)

Threatened miscarriage

(amenaza de aborto)

threatened

(amenza)

despite

(apesar de)

Augmentation

(aumento)

bathe the infant

(bañar el infant)

bathe the infant

(baño)

gush of blood

(chorro de sangre)

discourage

(desalentar)

entre, en lugar de con, comidas

(entre, en lugar de con, comidas)

coping skills

(habilidades de afrontamiento).

wetness

(humedad)

tilt

(inclinación)

cornstarch

(maizena)

pushy and rude

(molesta y ruda)

bother me

(molestarme)

Calves muscle

(musculos pantorrilla)

stillborn baby

(nacido muerto)

Swollen breasts

(senos hinchados)

walking up a flight of stairs

(subiendo un tramo de escaleras)

flight of stairs

(tramo de escalera)

a client who has decided to *relinquish* her newborn to an adoptive parent?

(¿Un cliente que ha decidido *renunciar* a su recién nacido a un padre adoptivo?)

These infants swallow large amounts of air during feeding and so need to be burped more often to avoid stomach distension and regurgitation (Option 2).

Feeding slowly over 20-30 minutes reduces the risk of aspiration and promotes adequate intake of formula.

Non-reassuring patterns

-Fetal Tachicardia, bradycardia. -saltatory variability. -late decel. -variable deceleration. short and long term varieble reduced.

A type and screen to determine blood type and Rh status is appropriate due to the potential for excessive blood loss and need for blood transfusion (Option 1).

Fetal well-being is assessed via continuous electronic fetal monitoring to help determine appropriate timing for birth (Option 2).

values or ranges of laboratory MG

1.5 - 2.5

(Option 3) During pregnancy, a collection of secretions forms a *"mucous plug"* in the cervical canal, acting as a protective barrier.

Although the client may notice expulsion of the *mucous plug* in the days preceding labor, it is not necessarily a sign of labor.

VEAL CHOP

A: accels. O: okay. Document

In women with poorly controlled diabetes mellitus during pregnancy, the fetus is subjected to high blood glucose levels. Fetal hyperglycemia leads to insulin hypersecretion by the fetus, which promotes abnormal growth and storage of excess calories as fat (macrosomia)

After birth, the infant is no longer exposed to the mother's high blood glucose levels, but a transient hyperinsulinemic state will persist for several days, during which the infant is susceptible to developing hypoglycemia

brow

forehead

Breast engorgement is often painful. The management of engorgement varies based on the client's breastfeeding status; for clients who choose not to breastfeed, treatment focuses on managing symptoms while promoting reduced milk production. Comfort measures include:

Applying ice packs to both breasts for 15-20 minutes every 3-4 hours to reduce blood flow and swelling Applying chilled, fresh cabbage leaves to both breasts, replacing with fresh leaves after they wilt. The mechanism of action is unclear but may be related to the cool temperature or to phytoestrogens from the leaves (Option 4). Taking an anti-inflammatory analgesic (eg, ibuprofen) as directed to reduce pain Maintaining firm breast support (eg, supportive bra, breast binder) until milk flow is diminished

Folic acid. Excellent sources 100+ mcg/½ cup

Asparagus Turnip/mustard greens Fortified breakfast cereal Cooked dried beans Liver (2 oz cooked)

Postpartum vaginal bleeding that saturates a perineal pad in <1 hour is considered excessive. This client saturated a perineal pad in 20 minutes.

Based on the nurse's assessment, the boggy fundus indicates uterine atony. The fundus is also elevated above the umbilicus and deviated to the right, indicating a distended bladder.

Breech birth position

Common abnormal birth position in which a baby enters the birth canal feet-, legs-, or buttocks-first.

VEAL CHOP

E: early deceleration. . H: head compression Normal.. Monitoring Document

(Option 3) Initially, a client with an ectopic pregnancy may report typical early pregnancy symptoms, such as morning sickness. Nausea and vomiting are not uncommon in ectopic pregnancies, and gastrointestinal distress may worsen after rupture.

Educational objective: An ectopic pregnancy may rupture prior to diagnosis, causing life-threatening maternal hemorrhage. Symptoms of a ruptured ectopic pregnancy include hypotension, tachycardia, dizziness, and referred shoulder pain. Ruptured ectopic pregnancy is a surgical emergency requiring immediate intervention.

(Option 4) Feeding should take about 20-30 minutes. The infant may be working too hard and tire out if feeding takes 45 minutes or more. In addition, the extra work of feeding will burn up calories that are needed for growth.

Educational objective: Children with cleft palates are at increased risk for inadequate intake as well as aspiration. Actions to promote intake and reduce aspiration risk include feeding in an upright position, pointing the nipple away from cleft, feeding over no more than 20-30 minutes, using special nipples or bottles, and feeding every 3-4 hours. The infant should be burped at regular intervals to reduce gastric distension.

(Option 4) Although cold stress may exacerbate existing hypoglycemia, warming the room is not the best initial intervention. Feeding this infant is the priority as there are early clinical signs of hypoglycemia

Educational objective: Hypoglycemia can occur in infants born to mothers with gestational diabetes due to elevated insulin levels and consumption of stored glucose. The most common sign of hypoglycemia is jitteriness or tremors. The newborn should be fed breast milk or formula immediately.

(Option 4) The WBC count is normally elevated during the first 24 hours postpartum (up to 30,000/mm3 [30.0 x 109/L]). Leukocyte levels that are not decreasing require further evaluation.

Educational objective: Signs of endometrial infection include elevated temperature, chills, malaise, excessive pain, and foul-smelling lochia. During the first 24 hours postpartum, temperature and WBC count are normally elevated. Fever and leukocyte counts that do not decrease require further evaluation.

fortified grain products

Educational objective: Women who are planning to become pregnant should consume 400-800 mcg of folic acid daily to prevent neural tube defects (eg, spina bifida, anencephaly). Food options that are rich in folic acid include fortified grain products (eg, cereals, bread, pasta) and green, leafy vegetables.

Cardinals movement of fetus

Engagement. Descendent. Flexion. Internal rotation. Extension. External rotation. Expulsion.(Delivery.)

Testing vaginal secretions with a nitrazine pH test strip can help differentiate between amniotic fluid, which is alkaline, and normal vaginal fluids or urine, which are acidic. A yellow, olive, or green color suggests that amniotic membranes are intact. A bluish color suggests probable rupture of membranes (ROM).

However, the presence of blood or semen may result in a false positive, as serum and prostatic fluid are alkaline. A client history of recent sexual intercourse should alert the nurse to notify the health care provider that nitrazine results may be falsely positive due to the presence of semen in the vagina

Precipitous birth occurs when labor lasts <3 hours from contraction onset until birth. Signs of imminent birth include involuntary pushing/bearing down with contractions, grunting, or report of sensations of having a bowel movement.

If a client arrives at the hospital in second-stage labor (ie, pushing), the nurse rapidly assesses whether birth is imminent by applying gloves and observing the perineum for bulging or crowning of the presenting fetal part (Option 1).

Methylergonovine [Methergine] is contraindicated for clients with high blood pressure (eg, preeclampsia, preexisting hypertension) because the primary mechanism of action is vasoconstriction.

If administered to a hypertensive client, it can lead to further blood pressure elevation, seizure, or stroke (Option 1).

During pregnancy, the mother and fetus have separate blood supply mechanisms. However, disruption of this separation can occur at delivery or when trauma results in fetomaternal hemorrhage (eg, placental abruption after a motor vehicle collision).

If an Rh-negative mother (eg, O negative blood type) is exposed to Rh-positive fetal blood (if the father is Rh positive), the pregnant client develops antibodies to the Rh antigen (ie, Rh sensitization), placing the current fetus and all future pregnancies at risk for serious complications (eg, hemolytic anemia). An indirect Coombs test is performed to screen for Rh sensitization any time hemorrhage secondary to placental abruption is suspected (eg, maternal trauma) (Option 2).

Postpartum hemorrhage (PPH) due to uterine atony is exacerbated by conditions that cause overdistension of the uterus (eg, macrosomia, multiple gestation, multiparity).

If excessive bleeding persists after initial interventions (eg, firm fundal massage, oxytocin bolus), second-line uterotonic drugs (eg, carboprost, methylergonovine, misoprostol) may be given.

causes peripheral vasodilation, which may produce significant hypotension (ie, systolic blood pressure <100 mm Hg, ≥20% decrease from baseline). If a client exhibits hypotensive symptoms (eg, lightheadedness, nausea) while receiving epidural anesthesia, the nurse should first assess blood pressure to confirm the presence of hypotension before intervening (Option 3).

If hypotension is present, initial nursing interventions include administering an IV fluid bolus to increase blood volume and positioning the client in the left lateral position to alleviate pressure on the vena cava.

Placenta previa is an abnormal implantation of the placenta resulting in partial or complete covering of the cervical os (opening). The condition is diagnosed by ultrasound.

In clients reporting painless vaginal bleeding after 20 weeks gestation, placenta previa should be suspected. Placenta previa found early in pregnancy may resolve by the third trimester, but women with persistent placenta previa or hemorrhage require cesarean birth.

Women who are planning on becoming pregnant should consume 400-800 mcg of folic acid daily. Food options that are rich in folic acid include fortified grain products (eg, cereals, bread, pasta) and green, leafy vegetables (Option 2).

Inadequate maternal intake of folic acid during the critical first 8 weeks after conception (often before a woman knows she is pregnant) increases the risk of fetal neural tube defects (NTDs), which inhibit proper development of the brain and spinal cord.

(Option 2) In addition to routine newborn care, infants born to HIV-positive clients should receive ART at birth and for at least 4-6 weeks after birth to reduce the chance of developing HIV infection.

Infants are tested for HIV infection at birth and again at age 1 and 4 months. Identification of HIV-negative status requires 2 consecutive negative results at age ≥1 month and ≥4 months

If bladder distension cannot be resolved with spontaneous voiding, in-and-out (I&O) catheterization may be indicated, especially if the client:

Is unable to ambulate to the restroom or void into a bedpan (Option 3). Has not voided within 6-8 hours after delivery or removal of the indwelling urinary catheter after cesarean delivery. Has difficulty emptying bladder completely (ie, voiding <100 mL frequently).

A pudendal nerve block infiltrates local anesthesia (ie, lidocaine) into the areas surrounding the pudendal nerves that innervate the lower vagina, perineum, and vulva. When birth is imminent, a pudendal block provides the best pain relief with the least maternal/newborn side effects and could be administered quickly by the health care provider.

It does not relieve contraction pain but does relieve perineal pressure when administered in the late second stage of labor (Option 4). In clients without an epidural, pudendal blocks may be used in preparation for forceps-assisted birth or laceration repair.

VEAL CHOP

L: late deceleration. P: placental deficiency. STOP: Turn, O2, d/c. Pitocin, notify dr

Preeclampsia is a systemic disease characterized by hypertension and proteinuria after the 20th gestational week with unknown etiology. Eclampsia is the onset of convulsions or seizures that cannot be attributed to other causes in a woman with preeclampsia. Delivery is the only cure for preeclampsia-eclampsia syndrome.

Magnesium sulfate is a central nervous system depressant used to prevent/control seizure activity in preeclampsia/eclampsia clients. During administration, the nurse should assess vital signs, intake and output, and monitor for signs of magnesium toxicity (eg, decreased deep-tendon reflexes, respiratory depression, decreased urine output). A therapeutic magnesium level of 4-7 mEq/L (2.0-3.5 mmol/L) is necessary to prevent seizures in a preeclamptic client.

Perinatal transmission of HIV infection can occur from mother to baby anytime during the antepartum, intrapartum, or postpartum periods.

Maternal antiretroviral therapy (ART) during pregnancy is imperative for decreasing viral load (amount of virus detectable in maternal serum) and decreasing risk of transmission to the fetus.

Fetal movement is a sign of fetal health and indicates an intact fetal central nervous system. Fetal movement may occur numerous times per hour during the last trimester of pregnancy, although the client may not perceive every movement.

Multiple factors (eg, maternal substance abuse, medications, fasting, fetal sleep) can affect fetal movement. However, fetal movements should not decrease as the fetus increases in size.

Nonsteroidal anti-inflammatory drugs (NSAIDs) (eg, ibuprofen, indomethacin, naproxen) inhibit prostaglandin synthesis and can be taken to decrease pain and inflammation or to reduce fever. NSAIDs are pregnancy category C in the first and second trimesters and pregnancy category D in the third trimester.

NSAIDs must be avoided during the third trimester due to the risk of causing premature closure of the ductus arteriosus in the fetus (Option 4). During the first and second trimesters, NSAIDs should be taken only if benefits outweigh risks and under the supervision of a health care provider (HCP).

risk factor preterm birth

Non-Hispanic black women have the highest rates

Non-reassuring patterns (son emergencias)

Notify Dr

Intrauterine fetal demise, or stillbirth, is the birth of an infant who is not alive. The nurse can assist with the perinatal bereavement process by using therapeutic communication, encouraging the parents and family to hold the infant, and providing privacy.

Parents and family members may wish to help bathe and dress the infant, and should be encouraged to view and hold the body before discharge to the funeral home (Options 1 and 4).

physiologic anemia of pregnancy

Pregnant women experience a 40%-45% increase in total blood volume during pregnancy to meet the increased oxygen demand and nutritional needs of the growing fetus and maternal tissues. Because the increase in plasma volume is greater than the increase in red blood cells, a hemodiluted state called physiologic anemia of pregnancy occurs, and is reflected in lower hemoglobin and hematocrit values. It is also normal for the white blood cell count to increase during pregnancy; counts can be as high as 15,000/mm3 (15.0 x 109/L).

Late decelerations occur after the onset of a uterine contraction and continue beyond its end. The lowest point (nadir) occurs near the end of the contraction before the fetal heart rate gradually returns to baseline. Late decelerations occur when fetal oxygenation is compromised (eg, uteroplacental insufficiency, uterine tachysystole, hypotension). Immediate steps to correct late decelerations include:

Stopping oxytocin if it is being administered (Option 5) Repositioning the client to the left/right side Administering oxygen by face mask (Option 1) Administering an IV bolus of isotonic fluid (eg, lactated Ringer solution, 0.9% saline) as needed (Option 2)

Perinatal mood disorders may occur at any time during pregnancy but are often precipitated in the postpartum period by the sudden drop in estrogen and progesterone levels after birth. Clients with postpartum depression may feel intense and persistent irritability, anxiety, anger, guilt, and sadness.

Such feelings may affect the ability to care for the newborn or themselves. A client showing irritability and disinterest in caring for the newborn should be further assessed for postpartum depression and offered a referral for follow-up care.

Bulk-forming fiber supplements

Suplementos de fibra de formación masiva

mucus plug

Tapon mucoso

Large-bore IV access is established in anticipation of fluid resuscitation and administration of blood products (Option 3).

The client should also be monitored frequently for any changes in bleeding via pad counts (Option 4)

The nurse may initially observe the fetal head retracting back toward the maternal perineum after birth of the head (ie, turtle sign).

The condition is frequently associated with macrosomia (fetal weight >8 lb 13 oz [4000 g]) secondary to gestational diabetes mellitus.

Clients attempting vaginal birth after cesarean (VBAC) have a slightly increased risk for uterine rupture due to previous surgical scarring of the uterus. Clients desiring VBAC are usually encouraged to wait for spontaneous onset of labor rather than undergo induction and are monitored closely throughout labor and delivery.

The first sign of uterine rupture is usually abnormal fetal heart rate (FHR) patterns. Other manifestations include constant abdominal pain, loss of fetal station, and sudden cessation of uterine contractions (Option 1). Hemorrhage, hypovolemic shock, and maternal tachycardia may occur if severe rupture occurs unrecognized.

The normal range for serum glucose in a newborn at day 1 is 40-60 mg/dL (2.2-3.3 mmol/L); however, no standard definition for newborn hypoglycemia currently exists. Treatment plans are based on clinical signs and overall status of the infant

The most common sign of low blood glucose is jitteriness or tremors. If the blood glucose is low, newborns should be fed immediately with formula or breast milk (Option 2).

If the health care provider is not present, the nurse stays with the client, ensures safe client positioning (eg, not standing or on the toilet), and is prepared to act as a birth attendant.

The nurse may direct others to perform needed actions (eg, contact provider, assess fetal heart tones, initiate IV access).

Supine hypotensive syndrome results from compression of the maternal inferior vena cava by the large gravid uterus in mid to late pregnancy when the client is in the supine position.

The venous return is reduced, causing maternal hypotension from reduced cardiac output. The client can also report feeling dizzy and faint. The first step is to rectify the cause by turning the client laterally while still strapped on the backboard.

The nurse should offer to obtain handprints and footprints, cut a lock of the infant's hair, and photograph the infant (Option 5).

These keepsakes are often precious mementos for grieving families who must leave the hospital without a child. However, none of these actions should be forced if the parents decline.

Postpartum urinary retention is commonly related to decreased bladder sensation (eg, due to regional anesthesia, prolonged labor, or perineal trauma) and postpartum diuresis.

Urinary retention can cause bladder distension, which may be noted by a displaced and/or boggy uterus, or by a palpable bladder.

Hold the infant in an upright position, which promotes passage of formula into the stomach and decreases the risk of aspiration (Option 3). Tilt the bottle so that the nipple is always filled with formula. Point down and away from the cleft.

Use special bottles and nipples, including cross-cut and preemie nipples and assisted delivery bottles. These devices allow formula to flow more freely, decreasing the need for the infant to create suction. Using a squeezable bottle allows the caregiver to apply pressure in rhythm with the infant's own sucking and swallowing (Option 5).

VEAL CHOP

V- variable decels C-cord compression E- early decels H- head compression A- accelerated O- ok L- late decels P-placenta

VEAL CHOP

V: variable deceleration. C: cord compression Reposition. STOP: O2, notify dr

VEAL CHOP

V: variable decels C: cord compression Reposition, O2, notify dr E: early decels H: head compression Normal A: accels O: okay L: late decels P: placental deficiency Turn, O2, d/c Pitocin, notify dr

placenta previa

Vaginal examinations are contraindicated. pelvic rest. cesarean birth is planned for after 36 weeks gestation and prior to the onset of labor.

large bore IV access (Acceso IV de gran calibre)

What is key in the initial management of shock?

(Option 5) Digital vaginal examinations are contraindicated in the presence of vaginal bleeding of unknown origin.

When placenta previa is present, manual manipulation of the cervix can damage placental blood vessels, causing subsequent bleeding that can progress to hemorrhage. Clients with placenta previa are on pelvic rest (ie, no intercourse, nothing per vagina).

Zika virus is transmitted via mosquitoes, sexual contact, and infected bodily fluids. Zika causes viral symptoms (eg, low-grade fever, arthralgias) and has been shown to cause microcephaly, developmental dysfunction, and encephalitis in babies born to Zika-infected women.

Women who are attempting to conceive and those who are pregnant are encouraged to avoid travel to areas affected by Zika until after birth (Option 4).

uterine rupture

a tear in the wall of the uterus

Naegele's Rule

add 7 days to first day of LMP, subtract 3 months, and add 1 year

craving

an intense desire for something

counterpressure

application of pressure to the sacrum during contractions

Quickening, the awareness of fetal movements, occurs around

around 18-20 weeks gestation in primigravidas and at 14-16 weeks in multigravidas.

clearance for sexual activity

autorización para la actividad sexual

fair

equitable (justo)

(Option 3) Amnioinfusion

is administered through an intrauterine pressure catheter to relieve variable decelerations, not late decelerations; variable decelerations are usually caused by cord compression secondary to loss of amniotic fluid (eg, after rupture of membranes, because of oligohydramnios).

Amnioinfusion

is administered through an intrauterine pressure catheter to relieve variable decelerations, not late decelerations; variable decelerations are usually caused by cord compression secondary to loss of amniotic fluid (eg, after rupture of membranes, because of oligohydramnios).

What is key in the initial management of shock?

large bore IV access (acceso IV de gran calibre)

Pica is the abnormal, compulsive craving for and consumption of substances normally not considered nutritionally valuable or edible. Common substances include ice, cornstarch, chalk, clay, dirt, and paper. Although the condition is not exclusive to pregnancy,

many women only have pica when they are pregnant. Pica is often accompanied by iron deficiency anemia due to insufficient nutritional intake or impaired iron absorption. However, the exact relationship between pica and anemia is not fully understood. The health care provider would likely order hemoglobin and hematocrit levels to screen for the presence of anemia.

bother me

molestarme

morning sickness

nausea and vomiting associated with pregnancy

morning sickness

nausea during the first few months of pregnancy due to increased estrogen and progesterone without vomiting.

tiny blood

pequeña sangre

shrink (meredith)

psychiatrist

boggy uterus

risk for uterine atony --> massage now

mementos

souvenirs

talkative

talking a lot

perinatal mood disorders

the blues. postpartum depression. postpartum psychosis.

lie

the position of the fetus described by the relationship of the long axis of the fetus to the long axis of the mother