2177 exam

Esophageal atresia

(narrowing) congenitally interrupted esophagus

Cervical Insufficiency treatment

- Bed rest, pelvic rest, avoidance of heavy lifting - Cervical cerclage

First period of reactivity

- Birth to 30 minutes after birth - Newborn is alert, moving, may appear hungry • Period of decreased responsiveness - 30 minutes to 120 minutes old - Period of sleep or decreased activity • Second period of reactivity - 2 to 8 hours - Newborn awakens and shows an interest in stimuli

Therapeutic management of GTD (Gestational Trophoblastic disease)

- Immediate evacuation of uterine contents (D&C) - Long-term follow-up and monitoring of serial hCG levels

amniotic fluid embolism

- emergency - hypotension, hypoxia

EDD

- nagle's rule - subtract 3 months, add a year and 7 days

Gestational Trophoblastic disease

- spectrum of neoplastic disorders originating in the placenta - gestational tissue present, but not viable Two types - Hydatidiform mole - Choriocarcinoma

Parents must use a forward-facing car seat with harness and top tether until the child weights at least: __ kg

18 kg

Lactating women: return dependent on breastfeeding frequency and duration; anywhere from

2 to 18 months

Toddler vision continues to progress and should be

20/50 to 20/40 in both eyes

Stomach capacity of

30 to 90 mL; variable emptying time of 2 to 4 hours

normal blood pressure for newborn

50-75 systolic 30-45 disastolic

voidings/day for baby

6-8 considered normal

Nonlactating women: return of menstruation

7 to 9 weeks after birth

dystocia

Abnormal or difficult labour

Mild pre-eclampsia management

Bed rest, daily BP monitoring and fetal movement counts - Hospitalization; IV magnesium sulfate during labour

Question: As the nurse enters the room of a newly admitted primigravid client diagnosed with severe preeclampsia, the client begins to experience a seizure. The nurse should do which in order of priority from first to last? All options must be used. a) Call for immediate assistance. b) Turn the client to her side. c) Assess for ruptured membranes. d) Maintain airway.

Call for immediate assistance.,Turn the client to her side.,Maintain airway.,Assess for ruptured membranes.

Which of the following senses is least developed at the time of birth? Smell Taste Touch Vision

D - Vision

dilation and curettage

Doctors perform dilation and curettage to diagnose and treat certain uterine conditions — such as heavy bleeding — or to clear the uterine lining after a miscarriage or abortion.

The nurse notices that a client who has just given birth is short of breath, is ashen in color, and begins to cough. She becomes limp on the birthing table. What do you do?

Establish unresponsiveness Ask staff to activate emergency response system Begin compressions Open airway using head tilt-chin lift Give 2 breaths.

Severe pre-eclampsia management

Hospitalization; oxytocin and magnesium sulfate; preparation for birth

Amnioinfusion indications

Indications - Severe variable decelerations due to cord compression - Oligohydramnios due to placental insufficiency - Postmaturity or rupture of membranes - Preterm labour with premature rupture of membranes - Thick meconium fluid

magnesium sulfate is for

Magnesium sulfate is the drug of choice for prevention of seizures in the pre-eclamptic woman, or prevention of recurrence of seizures in the eclamptic woman, as demonstrated in two large clinical studies

A postpartum client's husband calls the nurse and says, "My wife feels funny." The nurse enters the room and notes blood gushing from the client's vagina, pallor, and a rapid, thready pulse. What should be the nurse's first intervention?

Massage the fundus.

The nurse is working in the labor and child birth unit when a mother with active herpes simplex virus-Type 2 (HSV-2) appears in active labor. Which adjustment in the plan of care is anticipated?

Prepare the mother for a cesarean section

imperforate anus

Rectum ending in blind pouch or fistulas between rectum and perineum

Nursing management for blood incompatibility:

RhoGAM at 28 weeks

Eclampsia management

Seizure management, magnesium sulfate, antihypertensive agents; birth once seizures controlled

abrupto placenta

Separation of placenta leading to compromised fetal blood supply

An infant typically has adult levels of blood glucose by:

Two days postpartum

While performing a complete assessment of a term neonate, which finding would alert the nurse to notify the health care provider (HCP)? a) expiratory grunt b) prominent xiphoid process c) respiratory rate of 45 breaths/min d) red reflex in the eyes

a

asphyxia

a condition arising when the body is deprived of oxygen, causing unconsciousness or death; suffocation

eclampsia

a condition in which one or more convulsions occur in a pregnant woman suffering from high blood pressure, often followed by coma and posing a threat to the health of mother and baby.

tracheoesophageal fistula

abnormal communication between trachea and esophagus

hydroxyzine

absence of nausea

UTI management

antibiotics and fluids

Which finding provides the most evidence that a fetus might have a gastrointestinal tract anomaly?

b) increased amount of amniotic fluid

Hydatidiform mole

benign neoplasm of the chorion, mole has no fetal tissue - "empty egg" that fertilizes and dies

ductus arteriosus

between pulmonary arteries and aorta

mastitis management

breast emptying and antibiotics

metritis management

broad-spectrum antibiotics

A client presents to an obstetrics triage unit with bright red vaginal bleeding that has saturated a peripad over the last hour. The nurse observes the fetal heart rate, which shows a baseline of 130 beats/min, decreasing to 100 beats/min for 60 seconds, and then returning to 130 beats/min. No contractions are present. Which are the priority nursing interventions?

c) Ask the client the time of her last oral intake and prepare to start an intravenous (IV) line.

amnioinfusion for a primigravid client at term who is diagnosed with oligohydramnios. What does the nurse explain to the client is the primary purpose of this procedure?

c) It decreases the frequency and severity of variable decelerations.

epispadias

is a rare type of malformation of the penis in which the urethra ends in an opening on the upper aspect (the dorsum) of the penis. It can also develop in females when the urethra develops too far anteriorly.

habitual abortion

keeps happening

Placenta previa

placenta goes over the cervical opening, causes bleeding - painless, recurrent bleeding - Monitoring of maternal-fetal status • Vaginal bleeding; pad count • Avoidance of vaginal exams • FHR - Support and education: fetal movement counts, effects of prolonged bed rest (if necessary); signs and symptoms to report - Preparation for possible cesarean birth

nevus flameus

port wine stain

Lochia goes from

rubra, serosa, alba

molding

shaping of baby's head going through the birth canal

Preschoolers are particularly susceptible to urinary tract infection. What aspect development contributes to this heightened risk?

shortness of urethra

Inhalation of particulate meconium with amniotic fluid into lungs; secondary to hypoxic stress

suctioning

vernix caseosa

thick white substance

24. The primary health care provider (HCP) prescribes *betamethasone* for a 34-year-old multigravid client at 32 weeks' gestation who is experiencing preterm labor. Previously, the client has experienced one infant death due to preterm birth at 28 weeks' gestation. The nurse explains that this drug is given for which reason?

to enhance fetal lung maturity

Conduction

transfer of heat from object to object when the two objects are in direct contact

Choriocarcinoma

triploid (2 sperm)

HELLP

• Hemolysis, elevated liver enzymes, low platelets • Nursing assessment: similar to that for severe pre- eclampsia; laboratory test results • Nursing management: same as for severe pre- eclampsia

Transient Tachypnea of the Newborn (TTN)

• Mild respiratory distress; pulmonary liquid removed slowly or incompletely; resolution by 72 hours of age • Nursing Assessment - Maternal sedation or cesarean birth; tachypnea, expiratory grunting, retractions, laboured breathing, nasal flaring, mild cyanosis; respiratory rates possibly 100 to 140; barrel- shaped chest; slightly decreased breath sounds - Oxygenation - Supportive care - IV fluids or gavage feedings - Supplemental oxygen - Neutral thermal environment

Three groups of jaundice based on mechanism of accumulation of bilirubin

• Overproduction • Decreased conjugation • Impaired excretion

Postpartum Psychosis

Surfaces within 3 weeks of giving birth; sleep disturbances, fatigue, depression, hypomania

Physical forces leading to increased release of ________ critical for changes involved in transition to extrauterine life

catecholamines

caput succedaneum

collection of serous fluid across the suture line

oligohydramnios

deficiency of amniotic fluid

The nurse should explain to the client that the decreased variability is most likely caused by which factor?

effects of analgesic medication

In which order do these maneuvers occur?

engagement,descent,flexion,internal rotation

severe preeclampsia is in early active labor. The client's blood pressure is 164/110 mm Hg. Which finding would alert the nurse that the client may be about to experience a seizure?

epigastric pain

fertilization occurs in the

fallopian tube (close to ovaries)

Convection

flow of heat from body surface to cooler surrounding air or to air circulating over a body surface

nursing management for hemorrhage

fundal massage

Gastroschisis

herniation of abdominal contents through abdominal wall defect (no peritoneal sac)

foramen ovale

in between atria closes bc increase in pressure

Metritis

infection of endometrium, decidua, and adjacent myometrium

mastitis

inflammation of the breasts, resulting in flu like symptoms to treat: - rest - antibiotics - continued breastfeeding

cephalhematoma

involves collection of blood and does not cross the suture line

An initial sign the nurse should recognize as indicating hypoglycemia in a neonate is:

lethargy

Radiation:

loss of body heat to cooler, solid surfaces in close proximity but not in direct contact

Evaporation:

loss of heat when a liquid is converted to a vapour

The client asks, "What causes the baby to be so large?" The nurse's response is based on the understanding that fetal macrosomia is usually related to which factor?

maternal hyperglycemia

tocolytic

meds to suppress premature labour

erythema toxicum

newborn rash

platypelloid

not favourable oval horizontally

uterine rupture

obstetric emergency marked by fetal bradycardia - urgent c section

stork bites

or salmon patches - superficial red marks - usually occur from - disappear within first year

Puerperium:

period after delivery of placenta, lasting for 6 weeks

Postpartum or Baby Blues vs postpartum depression

postpartum or baby blues- 2 weeks postpartum depression- beyond 6 weeks and worsening

Vitamin C is required to

promote blood clot and collagen formation

bladder exstrophy

protrusion of bladder onto abdominal wall • Separation of rectus muscles and symphysis pubis • Boys also with epispadias • Initial bladder closure within 48 hours of birth; further reconstruction at age 2 to 3 years

Which of the following organ systems reaches adult levels of function earliest? Musculoskeletal Renal Respiratory

renal

Assessment of a term neonate at 2 hours after birth reveals a heart rate of less than 100 bpm, periods of apnea approximately 25 to 30 seconds in length, and mild cyanosis around the mouth this would be what?

respiratory arrest

Is the following statement true or false? Hearing ability in the toddler should be equivalent to that of an adult

true

Omphalocele

umbilical ring defect with evisceration of abdominal contents into external peritoneal sac

anthropoid

usually adequate oval vertically

Oligohydramnios

• Amniotic fluid <500 mL • Therapeutic management: serial monitoring; amnioinfusion and birth for fetal compromise • Nursing assessment: risk factors, fluid leaking from vagina • Nursing management: continuous fetal surveillance; assistance with amnioinfusion, comfort measures, position changes

polyhydramnios

• Amniotic fluid >2,000 mL • Therapeutic management: close monitoring; removal of fluid, indomethacin (decreases fluid by decreasing fetal urinary output) • Nursing assessment: risk factors, fundal height, abdominal discomfort, difficulty palpating fetal parts or obtaining FHR • Nursing management: ongoing assessment and monitoring; assisting with therapeutic amniocentesis

Factors predisposing to heat loss

- Thin skin; blood vessels close to the surface - Lack of shivering ability; limited stores of metabolic substrates (glucose, glycogen, fat) - Limited use of voluntary muscle activity - Large body surface area relative to body weight - Lack of subcutaneous fat; little ability to conserve heat by changing posture - No ability to adjust own clothing or blankets - Infants cannot communicate

Hallmark sign of ectopic pregnancy

- abdominal pain with spotting within 6-8 weeks after missed menses Laboratory and diagnostic testing: transvaginal ultrasound, serum beta hCG; additional testing to rule out other conditions

quickening

- feeling the baby move

Abrupto placenta- Nursing Assessment

- risk factors - bleeding -* pain (knife-like,* uterine tenderness, contractions) - fetal movement and activity decreased - FHR and lab tests Nursing management - Tissue perfusion: left lateral position, strict bed rest, oxygen therapy, vital signs, fundal height, continuous fetal monitoring

The expected heart rate in a healthy newborn is: 80 to 100 BPM 100 to 120 BPM 120 to 140 BPM 140 to 160 BPM

C

cerclage

Cervical cerclage, also known as a cervical stitch, is a treatment for cervical incompetence or insufficiency, when the cervix starts to shorten and open too early during a pregnancy causing either a late miscarriage or preterm birth. Usually the treatment is done in the second trimester of pregnancy, for a woman who had either one or more late miscarriages in the past.[1]