OB review CMS
a nurse in a prenatal clinic is collecting data from 4 clients. which of the following findings is the nurse mandated to report to the provider?
***dysuria***
a nurse is collecting data from a client who had a vaginal delivery 12 hours ago. which of the following findings should the nurse report to the provider?
***hemoglobin 10***
a nurse is caring for a client who is at 41 weeks gestation. the nurse should understand that which of the following findings can indicate that prenatal complication in this client?
***maternal infection*** postpartum bleeding and vaginal tears
a nurse is caring for a client who is 4hr postpartum, the nurse notes 4 saturated perennial pads in the past hour, which of the following actions should the nurse take first?
***perform fundal assessment?*** -massage the fundus
a nurse is collecting data from a new born who was born at 34 weeks gestation. the new borns mother received betamethasone prior to delivery, which of the following finding should indicated to the nurse that the medication was effective for the new born?
***respiratory 60 (normal 26-65)***
a nurse is reinforcing teaching with a client who has gestational diabetes mellitus. which of the following finding should the nurse include in the teaching as a manifistation for hypoglycemia?
***weakness sensation*** **sweating***, shakiness, hunger, blurred vision, and dizziness -glucose below 60mg
a nurse is collecting data from a new born who is 4 hour old. which if the following findings should the nurse report to the provider?
**HR 115 not ok** or 150 is ok? temp?
Late deceleration of FHR
Place client in side-lying position, insert IV catheter and increase fluids, discontinue pitocin, administer 02 -Gradual decrease in FHR with onset of deceleration to nadir >30 seconds. Onset of the decleration occurs after the beginning of the contraction, and the nadir of the contraction occurs after the peak of the contraction -might need emergent C-Section
Preterm Spontaneous rupture of the membrane
Refers to rupture of the membranes occurring prior to the onset of labour and can occur from 37 weeks of gestation onwards. Patient goes into labor! -Monitor FHR d/t risk umbilical cord prolapse
a nurse is preparing to administer a vaccine to a client who is at 6 weeks of gestation. which of the following vaccines is going to be contraindicated for the client?
Rubella (live vaccine can harm the baby)
a nurse is reinforcing preoperative teaching with a client who is schedule for cesarean birth. which of the following clients statement indicates understanding of the teaching?
my nurse may need to massage my uterus after surgery
a nurse is reinforcing teaching about potential pregnancy complications with a client who is at 14 weeks of gestation. which of the following manifestations should the nurse include?
nasal congestion
a nurse is reinforcing teaching with a client who has perineal ketunoria and is currently pregnant. which of the following statement should the nurse make prior to checking.
plan to check your urine for ketones daily
abruptio placentae
premature separation of the placenta from the uterine wall -typically present with bleeding, uterine contractions, and fetal distress
dietary teaching for patient who is breastfeeding
protein-rich foods, such as lean meat, eggs, dairy, beans, lentils and seafood low in mercury
adverse effect Magnesium Sulfate
(rash; hives; itching; breathing difficulties; chest tightness; or swelling of the mouth, face, lips, or tongue) Dizziness, flushing, or faintness. Irregular heartbeat. Muscle paralysis or muscle weakness.
a nurse in a postpartum unit is reinforcing teaching with a client about breast feeding. which of the following statement by the mother indicates understanding about the teaching?
***-I will remove my baby from the breast by inserting my finger in the side of his mouth.***
a nurse is reinforcing teaching with a client who is recieveing NIFEDIPINE for preterm labor. which of the following is an ADVERSE EFFECT of this medication?
***Dizziness***, ***flushing***, weakness, swelling ankles/feet, constipation, and ***headache***
a nurse is collecting data from an adolescent who is post-Op following a Cesarean birth and is receiving Morphine for pain. which of the following finding is the nurse priority?
***blurred vision*** urinary retention BP 105/62 ****Respiratory Rate 11****
a nurse in a postpartum unit is caring for client who delivered vaginally 24hrs ago. which of the following should the nurse expect to find and collect in the data?
-***colostrum expressed from the breasts***
a nurse is reinforcing teaching with a mother who is bottle feeding her new born with formula. which of the following should the nurse include in the teaching?
-***prepare formula can be in fridge up to 48hrs*** *** refrain from refrigerate formula for up to 4hrs reuse***
a nurse is caring for a client who inquires about available method of contraception, which of the following should the nurse collect?
-***social economic status***
inverted nipples
-Inverted nipples appear to go inside your breast - Roll your nipple between your fingers to help it stick out
a nurse is reinfrocing teaching which a client about their newborn umbilical cord. which of the following statement by the client indicated an understanding bout the teaching?
-Keep the cord clean and dry. The drier the cord, the sooner it will fall off. -Use a cotton swab dipped in alcohol to clean around the base of the cord three times a day or when soiled with urine or stool. You may continue to apply alcohol even after the stump falls off until the area is dry. -Do not give your baby a tub bath until the cord falls off and the area looks healed. This will take seven to 10 days. Give him or her a sponge bath instead. -Roll the diaper as low as you can so that when the baby kicks, the diaper does not hit the cord.
Transdermal contraceptive patch
-Mechanism of action, efficacy, contraindications and side effects are similar to those of oral contraceptives; -continuous levels of progesterone and estradiol; -applied to lower abdomen, upper outer arm, buttock or upper torso; -applied on the same day ones a week for 3 weeks followed by 1 week without the patch
Episiotomy care
-Perineal care; (wait 24hrs)fill a squeeze bottle with warm water and an ounce of povidone/iodine solution; lavage perineum with several squirts and blot dry instead of rubbing; avoid anal area -Use sitz baths -apply ice packs right after the birth -take ibuprofen for pain -Keep the area around the stitches clean and dry REPORT: episiotomy, lacteration or incision pain that does not resolve with analgesics/ could smelling drainage, redness, or incision pain
A nurse is caring for a client who reports discomfort due to after pain following breastfeeding, which of the following actions should the nurse take?
-Put ice packs or cool compresses on engorged breasts after feedings. -Gently massage the sore area before nursing. -Get plenty of rest and fluids. -Some mothers with cracked or sore nipples find that pumping for 2 to 3 days allows their nipples to heal
a nurse is reinforcing discharge teaching about a newborn care with a postpartum client. which of the following instructions should the nurse include?
-The remaining cord should fall off and heal within 1-3 weeks. -Your newborn's first bowel movements (stool) will be sticky, greenish-black and tar-like (meconium). This is normal.
a nurse is preparing to administer betasiodona which of the following precautions should the nurse take?
-administer medication into Deltoid? -administer medication 12hr after birth administer medication with 22 (25?)in needle -check the mothers Rh factor prior to administration?
A nurse in a postpartum unit is reinforcing teaching about a newborn home safety with a client. which of the following statements indicates understanding about the teaching?
-baby sleep on its back -give baby pacifier to sleep -no blankets, pillows, small objects in the crib -no smoking around baby
a nurse in a prenatal clinic is reinforcing teaching with a group of women about the use of acupressure to relieve discomfort during labor, which of the following instructions should the nurse include in the teaching? 28:05 audio
-finger pressure and massages on the meridian sites -may stimulate uterine contractions -releases endorphins -Acupressure is a non-invasive method which is used to augment labor, provide pain relief, and shorten delivery time.
a nurse is reinforcing teaching about Rh (sensitazion) hemoglobin?. which of the reinforcements (immunizations?) should the nurse include if the test comes (combs test?) out positive?
-positive Coombs test only indicates that an Rh-positive fetus has a possibility of being harmed -RHOgam -something about 7-8weeks?
a nurse is preparing to collect specimen for a new born screening, which of the following actions should the nurse take?
-use an antiseptic to puncture the inner aspect of the new borns heal
a nurse is caring for a client who is 24hrs postpartum, the nurse should expect to palpate the fundus at which of the bodies location?
1cm below the umbilicus
stages of labor
1st: dilating stage 3 phases: Latent (0-3cm) Active (4-7cm) Traditional (8-10cm w/ urge to push) 2nd stage: delivery 3rd: placental delivery 4th: recovery- primary goal to prevent hemorrhage from uterine atony, 1st void within 1 hour and then q2-3 hrs, Rhogam
a nurse is collecting data from a newborn who is receiving phototherapy. Which of the following is a finding is an indication of dehydration?
3-5% body weight loss sunken eyes depressed fontanelles
baby reflexes
Automatic responses to stimuli. *Sucking and Grasping* *Moro Reflex:* Startle response. *Rooting Reflex:* Baby turns to search and suck when cheek is touched. *Babinski Reflex:* Toes fan out when sole of foot is touched.
Newborn vitals
Bp: 60/40-80/50 Temp: 97.7-98.9 ( 36.5-37.2) anything lower than 36.5 hypothermia/increase RR RR-30-60 HR-100-160
indication for Carboprost injection:
Carboprost is used to treat severe bleeding after childbirth (postpartum). Carboprost is also used to produce an abortion by causing uterine contractions.
medication for chlamydia
Doxycycline, erythromycin, Azithromycin, newborns receive prophylactic eye care
Iron supplementation in pregnancy
Ferrous Sulfate; 30 mg during 2nd and 3rd trimester; Taken between meals, not with milk, tea, or coffee
a nurse is reviewing the laboratory data for a client who is at her first prenatal visit. the client is at 10 weeks of gestation, which of the following manifestations should the nurse report to the provider? 36:00 audio
Hct 38 GOOD hemoglobin 14 GOOD. -Koternuria of 14 ^ NOT GOOD -RBC normal range 4.2 to 5.4
elevated alpha fetoprotein in pregnancy
High levels of AFP may suggest the developing baby has a neural tube defect such as spina bifida or anencephaly. High levels of AFP may also suggest defects with the esophagus or failure of your baby's abdomen to close. However, the most common reason for elevated AFP levels is inaccurate dating of the pregnancy.
a nurse is a antepartum unit is assisting with the care of a client who who suffered Preeclampsia, and is receiving IV magnesium sulfate therapy. which of the following adverse effect should the nurse look for and report to the provider?
HypoReflexia
a nurse is collecting data from a client at a 6 week postpartum check up. the client tell the nurse, "I am breastfeeding and would like to use a birth control pill". which following statements should the nurse make?
You may want to delay using a birth control pill that contains estrogen for a few weeks because estrogen may decrease your milk supply.
a nurse is receiving change of shift report for 4 new borns, which of the following newborns should she attempt to see first?
a new born who has blue has and feet with an axillary temp 36c (96.8 F).
a nurse is collecting data from a term new born who is 12 hours old. which should the nurse report to the provider?
abdominal breathing regular respirations * LOOK INTO THIS QUESTEION
date of delivery
add 9 month and 7days to the LMP or subtract 3 months and add 7 days to the LMP date
a nurse is preparing to assist with performing Leopold maneuvers on a new client who is 38 weeks of gestation. which of the following plans should the nurse plan to take?
ask the client to empty bladder prior to procedure
a nurse is assisting client with a stress test
ask the patient to press the handle button when she feels fetal movement (Pt may need to empty bladder)
a nurse is collecting data from a client receiving Epidural anesthesia , which of the following findings indicate an adverse effect of this method of pain management?
backache soreness where the needle is inserted ***urinary retention*** ***hypotension*** respiratory depression
a nurse is reinforcing teaching about risk factors in preeclampsia with a group of clients who are pregnant. which of the following risk factors should the nurse include in the teaching?
chronic hypertension (HB)
a nurse is teaching about observations with the parents of a new born.... secretion with bulb syringe.
compress the bulb syringe and gently place the tip into one of your baby's nostrils. ... Slowly release the bulb so that it draws mucus or fluid out of your baby's nose. Once the bulb has expanded, remove it from your baby's nose. ... Repeat if needed.
a nurse is reinforcing teaching with a client who is breast feeding her 6 day old new born. the nurse should explain the new born stool should have which of the following characteristic?
consistency of mustard(yellow color), may be seedy or curdy
a nurse in a postpartum unit is caring for a client who is breastfeeding who is experiencing Breast Engorgement. which of the following interventions should the nurse plan to implement comfort for this client?
continue to breastfeed or pump frequently to relieve "fullness." Apply warm, wet compresses and gently massage breasts 10 minutes before feeding to help with milk flow.
a nurse is assisting with the care of a client who received DINOPROSTONE or PHYTONADIONE which of the following findings indicate the effectiveness of the medication?
dinoprostone dilated open cervix (cervical ripening). but if its PHYTONADIONE(vitamin K) it help with prevention of bleeding.
a nurse is collecting data from a client who is at her 12 week prenatal visit and reports experiencing morning sickness all the time. the nurse should suspect Hyperemesis gravidarum based on what of the clinical findings?
dry mucus membrane
a nurse is collecting data from a client who is 12 hours postpartum following a vaginal delivery. the nurse should identify what finding as the priority?
excessive bleeding
a nurse working in an antepartum clinic is collecting data from a client who is 32 weeks of gestation and has been receiving routine prenatal care, which of the following finding should the nurse expect?
fetal heart rate 140
a nurse is assisting with the care of client who is receiving magnesium sulfate IV bolus. which of the finding should the nurse report to the provider immediately??
flushing weak, shallow breathing
a nurse is collection data from a new born who was born 2hrs ago, which of the following findings should the nurse report to the provider?
hypotonia (weak muscle tone)?
a nurse is reinforcing teaching at the prenatal visit about importance of adequate folic acid intake with a client who is at 12weeks of gestation. which of the following client statement indicates understanding of the teaching?
it will reduce my Baby from having spinal cord defect
a nurse in the postpartum unit is reinforcing discharge teaching about new born care and safety with the client. which of the following statements should the nurse include In the teaching?
keep your babies crib away from windows with blinds
a nurse is reinforcing teaching about safety precaution to take when driving a car with a client who is in the 1st trimester of pregnancy. which of the following instructions should the nurse include in the teaching?
make sure seatbelt is placed below the belly (not across the abdomen) -shoulder harness to fit snuggly across the center of shoulder and chest
a nurse is caring for a term newborn 15min following delivery. which of the following actions should the nurse take to meet the newborns need at this time?
making sure baby is breast fed
a nurse is reviewing the result of an hour glucose screen test for a client who is a 24weeks gestation. the client glucose value is 130. what should the following actions should the nurse take?
pt might have diabetes ***pt will need another glucose test*** inform the provider
a nurse is reinforcing teaching of a car seat safety with a parent of a child. which of the statements made by the parent shows understanding of the teaching?
retainer clip or chest clip should be at armpit level or across the nipple line
hyperemesis gravidarum
severe nausea and vomiting in pregnancy that can cause severe dehydration in the mother and fetus -dry mucus membranes
a nurse is reinforcing instructions with a client about how to minimize nausea in the first trimester of pregnancy. which of the following instructions should the nurse give to the client?
slice of dry toast
a nurse is collecting data of a new born shortly after birth, which of the following immediate should the nurse identify as Hydrocele?
swelling in the scrotum
a nurse is collecting data from a client who is at 34 weeks gestation who has hyperglycemia, which of the following manifestations should the nurse expect?
thirst frequent urination
a female client presents to a health clinic experiencing a sudden onset of high fever, and faintness. during her admission history, the client states that she uses a diaphragm. based on this finding the nurse should recognize the client has developed which of the following?
toxic shock syndrome
a nurse is collecting data from client who is receiving TERBUTALINE to treat preterm labor. which of the following findings should the nurse report to the provider?
tremor, nervousness, dizziness, headache, drowsiness
a nurse is reinforcing teaching with a client who is to start an oral contraceptives. which of the following should the nurse instruct the client to monitor and report to the provider?
visual changes
a nurse at a prenatal clinic is reinforcing teaching with a client who is at 20weeks gestation and has a low calcium level. which of the following food should the nurse instruct to increase in her diet?
yogurt
