Nursing School OB Topic
What is polycythemia and its S/S?
A venous hematocrit above 65% and hemoglobin of more than 20g. S/S: respiratory distress, cyanosis, feeding difficulties, hypoglycemia, jitteriness, jaundice, ruddy skin color, seizures, and lethargy
Which condition may cause intrauterine asphyxia? Select all that apply. A. cord compression B. placental abruption (abruptio placentae) C. intrauterine growth restriction (IUGR) D. gestational diabetes E. group B streptococcus (GBS) infection
A, B, C Conditions such as cord compression, placental abruption, and intrauterine growth restriction alter uteroplacental blood flow and may cause intrauterine asphyxia. Gestational diabetes may cause fetal hyperinsulinemia, and group B strep infection may cause intrauterine infection or PROM/preterm labor.
A primigravida at 28 weeks' gestation comes to the clinic for a checkup. She tells the nurse that her mother gave birth to both of her children prematurely, and she is afraid that the same will happen to her. Which risk factors associated with preterm birth would the nurse discuss with the client? Select all that apply. A. history of previous preterm birth B. multiple gestation pregnancy C. large-for-gestational-age fetus D. uterine or cervical abnormalities E. previous cesarean birth
A, B, D The top three risk factors for premature birth are history of previous preterm birth, current multiple gestation pregnancy, and uterine or cervical abnormalities.
A nurse is caring for an infant born with an elevated bilirubin level. When planning the infant's care, what interventions will assist in reducing the bilirubin level? Select all that apply. A. Increase the infant's hydration. B. Stop breastfeeding until jaundice resolves. C. Offer early feedings. D. Administer vitamin supplements. E. Initiate phototherapy.
A, C, E Hydration, early feedings, and phototherapy are measures that the nurse should take to reduce bilirubin levels in the newborn. Stopping breastfeeding or administering vitamin supplements will not help reduce bilirubin levels in the infant.
A woman presents to her first postpartum visit reporting she does not feel well. Which findings would lead the nurse to suspect that she has developed endometritis? Select all that apply. A. pain on both sides of the abdomen B. leukocytosis C. odorless lochia D. hematuria E. flank pain
A,B Signs and symptoms of endometritis include lower abdominal tenderness or pain on one or both sides, foul-smelling lochia, and leukocytosis. Hematuria and flank pain would be associated with a urinary tract infection.
Respiratory distress in preterm infants is commonly caused? A. a deficiency of surfactant B. retained fluid in the lungs (wet lung syndrome) C. meconium aspiration D. pneumonia E. hypothermia F. anemia.
A,B,C,D,E,F All of the following are common causes of respiratory distress in preterm infants
Which measurement best describes postpartum hemorrhage? A. blood loss of 1,000 ml, occurring at least 24 hours after birth B. blood loss of 500 ml, occurring at least 24 hours after birth C. blood loss of 600 ml, occurring at least 24 hours after birth D. blood loss of 300 ml, occurring at least 24 hours after birth
A. Postpartum hemorrhage involves blood loss in excess of 1,000 mL within the first 24 hours of delivery.
Hypoglycemia in a neonate is is defined as a blood glucose value typically below..? A. 35-45 B. 50-60 C. 20-30 D. 80-100
A. 35-45 Hypoglycemia in a neonate is defined as blood glucose value typically below 35 to 45 mg/dL. The American Academy of Pediatrics (AAP) recommends intervening for a blood glucose less than 40 in the first 4 hours of life, and less than 45 at ages 4 to 24 hours
How does the nurse position the infant experiencing respiratory difficulty? A. on the stomach with the head lowered 30 degrees and head turned to the side B. on the left side with the head elevated 45 degrees C. on the right side with the head lower than the body D. on the back with the head elevated 15 degrees
D. Positioning the infant on the back allows bilateral lung expansion. Elevating the head 15 degrees enhances movement of the diaphragm. Positioning the infant on the side or on the stomach restricts lung expansion.
A nurse working with a woman in preterm labor receives a telephone report for the fetal fibronectin test done 10 hours ago. The report indicates an absence of the protein, which the nurse knows indicates: A. Infection is present B. No infection is present C. Vaccination is needed D. Birth is unlikely within the next 2 weeks
D. Birth is unlikely within the next 2 weeks Fetal fibronectin is a protein that helps the placenta and membranes attached to the uterine wall. A negative result (absence of fetal fibronectin) is a reliable indicator that birth is unlikely within 2 weeks following the test.
The nurse is teaching a client with newly diagnosed mastitis about her condition. The nurse would inform the client that she most likely contracted the disorder from which organism? A. Streptococcus pyogenes (group A strep) B. Escherichia coli C. group B streptococcus (GBS) D. Staphylococcus aureus
D. Staphylococcus aureus The most common cause of mastitis is S. aureus, transmitted from the neonate's mouth. Mastitis is not harmful to the neonate. E. coli, GBS, and S. pyogenes are not associated with mastitis. GBS infection is associated with neonatal sepsis and death.
True or false? The typical LGA newborn have poor motor skills and have difficulty in regulating behavioral states.
TRUE! The typical LGA newborn has a large body and appears plump and full faced. The increase in body size is proportional. However, the head circumference and body length are in the upper limits of intrauterine growth. These newborns have poor motor skills and have difficulty in regulating behavioral states. LGA newborns are more difficult to arouse to a quiet alert state
True or false? Maternal diabetes is commonly associated with LGA newborns. However, due to poor placental perfusion, the newborn may experience fetal growth restriction and be SGA.
True
Various medications are available to help control hemorrhage in the postpartum client. When reviewing the client's history, the nurse notes the client's history of asthma. Which medication if prescribed would the nurse question?
carboprost Carboprost is contraindicated with asthma due to the risk of bronchial spasms. Oxytocin should be given undiluted as a bolus injection, and methylergonovine should not be given to a woman who is hypertensive. Dinoprostone and methylergonovine can be used in pregnant clients with asthma, although should be used cautiously. Dinoprostone may cause hypotension, nausea/vomiting, diarrhea and temperature elevation.
A woman who has been in labor for a long time is currently vomiting. The nurse has suspects the woman has a fluid volume deficit. Which lab data supports this as the primary nursing diagnosis? Select all that apply. A. urine specific gravity 1.040 (elevated) B. serum potassium level of 4.0 mEq/L (4.0 mmol/L) C. moderate ketones in urine D. positive glucose in the urine E. yeast cells present in the urine
A, C The expected outcome of urinalysis is free of ketones; specific gravity is between 1.003 and 1.030; skin turgor and serum electrolyte levels are within acceptable parameters. Vomiting and diarrhea occasionally accompany labor; if these occur, they can add to fluid and electrolyte losses. High specific gravity of urine may be associated with dehydration, emesis, and excessive sweating, all possible with long labors. Ketonuria may be seen with vomiting and pregnancy. Ketones in the urine suggest starvation ketosis. Glucose present in the urine is termed glucosuria. Most commonly, this indicates diabetes mellitus.
What are the fetal risks associated with prolonged pregnancy? SATA A. Macrosomia B. Low birth weight C. Low Apgar scores D. Cephalopelvic disproportion
A, C, D Fetal risks associated with a prolonged pregnancy include macrosomia, shoulder dystocia, brachial plexus injuries, low Apgar scores, postmaturity syndrome, cephalopelvic disproportion, uteroplacental insufficiency, meconium aspiration, and intrauterine infection. Amniotic fluid volume begins to decline by 40 weeks' gestation, possibly leading to oligohydramnios.
During the newborn's assessment, which finding would lead the nurse to suspect that a large-for-gestational-age newborn has experienced birth trauma? A. asymmetrical movement B. temperature instability C. feeble sucking D. seizures
A. Asymmetrical movement A birth injury is typically characterized by asymmetrical movement. Temperature instability, seizures, and feeble sucking suggest hypoglycemia.
Describe the time frames for Postpartum Hemorrhage; Primary and delayed
Blood loss that occurs within 24 hours of birth is termed primary (immediate or early) postpartum hemorrhage; blood loss that occurs 24 hours to 12 weeks after birth is termed delayed (late) postpartum hemorrhage.
A client is admitted to the unit in preterm labor. In preparing the client for tocolytic drug therapy, the nurse anticipates that the client's pregnancy may be prolonged for how long when this therapy is used? A. 1 to 12 hours B. 1 to 7 days C. 2 to 7 days D. 1 to 2 months
C. 2 to 7 days During this time steroids can be given to promote fetal lung maturity.
A postpartum woman is developing a thrombophlebitis in her right leg. Which assessments would the nurse make to detect this? A. Blanch a toe, and count the seconds it takes to color again. B. Ask her to raise her foot and draw a circle. C. Assess for pedal edema. D. Bend her knee, and palpate her calf for pain.
C. Assess for pedal edema. Calf swelling, erythema, warmth, tenderness, and pedal edema may be noted and are caused by an inflammatory process and obstruction of venous return.
Excessive hemorrhage puts the client at risk for hypovolemic shock. Signs of impending shock include..
include a weak and rapid pulse, decreased blood pressure, tachypnea, and cool and clammy skin.
What is subinvolution of the uterus?
incomplete involution of the uterus or failure to return to its normal size and condition after birth. Typically, subinvolution occurs when the myometrial fibers of the uterus do not contract effectively, causing relaxation. *The clinical picture includes a postpartum fundal height that is higher than expected with a boggy uterus;