OB HESI EAQ

After the rupture of membranes, the umbilical cord may prolapse if

The fetal head does not engage immediately, and this can lead to fetal compromise. The perineal area should be inspected at this time and frequently thereafter for evidence of cord prolapse.

At 12 weeks gestation, Once the cervix is dilated the.

abortion is inevitable

A mother whose newborn infant son has a cleft lip and palate asks how to feed her baby because he has difficulty suckling. What information should the nurse provide concerning safe feeding technique for this infant?

"Give him brief rest periods and frequent burpings during feedings so he can get rid of swallowed air." This is a congenital defect, prevents the infant from creating a tight seal with the lips to facilitate suckling. As a result, the infant swallows large amounts of air when feeding. The mother should be taught to provide frequent rest periods and to burp the infant often to expel excess air in the stomach. Infants with cleft lip and palate should be held upright during feedings. Newborn infants cannot chew and do not make chewing movements.

A pregnant client comes to the emergency department because of vaginal bleeding. The nurse asks the client to estimate how heavy the bleeding is. What is the best gauge for the client to use?

*Determining the amount of blood lost in relation to her usual menstrual flow gives the client a familiar gauge with which to estimate the amount of bleeding she is experiencing*. The presence of clots does not indicate the amount of bleeding. Changes in fetal activity may indicate a problem, but there is no relationship to the amount of bleeding. Weakness is a subjective symptom and may not reflect blood loss.

What should be included in a plan of care to limit the development of hyperbilirubinemia in the breastfed neonate?

*More frequent breastfeeding* stimulates more frequent *evacuation of meconium*, thereby preventing resorption of bilirubin into the circulatory system. Phototherapy is the treatment for hyperbilirubinemia, and it is maintained continuously; it does not prevent the development of hyperbilirubinemia. It is not necessary to feed the infant formula. Early breastfeeding tends to keep the bilirubin level low by stimulating gastrointestinal activity. Increasing water intake does not limit the development of hyperbilirubinemia, because only small amounts of bilirubin are excreted by the kidneys. Topics

A large newborn may be the result of

*gestational diabetes*; it is necessary to check the neonate for hypoglycemia, because maternal glucose is no longer available. The nurse should do more than document the findings; the primary healthcare provider should be notified after the serial glucose readings are taken. Placing the infant in a heated crib is indicated if the temperature is low and the newborn needs additional warmth. The infant may be hypoglycemic and require the glucose in an oral feeding immediately.

. An increase of -----per day is the recommended caloric increase for breastfeeding mothers.

500 calories

An infant born in a birthing center is being transferred to a regional neonatal intensive care unit because of respiratory distress. Which nursing action best promotes parent-infant attachment?

Allowing parents to hold infant before departure Because seeing and touching the newborn infant are species-specific behaviors for human attachment, allowing the parents to hold the infant will promote bonding. Although encouraging the parents to call the infant by name is a useful action, holding and touching will promote bonding more effectively. After touching and holding, having a picture of their infant in the intensive care unit contributes most to bonding. Actual holding and touching promote bonding more than just hearing about the infant's progress.

Spotting at week 12, exam travels reveals closed cervix

Because the cervix is closed, this is considered a threatened abortion.

An infant born with *hydrocephalus* will be discharged after insertion of a *ventriculoperitoneal shunt*. Which common complication should the nurse instruct the parents to report if it occurs at home?

Fever accompanied by decreased responsiveness This is the greatest postoperative hazard for children with shunts for hydrocephalus. Violent involuntary muscle contractions may occur as the result of an infected shunt; however, it is not the most common sign of an infectious process. The peritoneum absorbs cerebrospinal fluid adequately; ascites is not a problem.

A preterm neonate admitted to the neonatal intensive care nursery exhibits muscle twitching; seizures; cyanosis; abnormal respirations; and a short, shrill cry. Which complication does the nurse suspect?

Intracranial hemorrhage

While mopping the kitchen floor, a client at 37 weeks' gestation experiences a sudden sharp pain in her abdomen with a period of fetal hyperactivity. When the client arrives at the prenatal clinic, the nurse examines her and detects fundal tenderness and a small amount of dark-red bleeding. What does the nurse conclude is the probable cause of these clinical manifestations?

Partial abruptio placenta Typical manifestations of abruptio placentae are sudden sharp localized pain and small amounts of dark-red bleeding caused by some degree of placental separation. True labor begins with regular contractions, not sharp localized pain. There is no pain with placenta previa, just the presence of bright-red bleeding. There are no data to indicate that the client sustained an injury.

complications related to weight gain in preg are rare when weight gain is more than 25 to 30 lb (11.3 kg to 13.6 kg) in an uncomplicated pregnancy.

There is no specific number of pounds that the client should gain, but a low-calorie diet is contraindicated.

A newborn is being treated with phototherapy for hyperbilirubinemia. What is the nurse's role when providing phototherapy?

Turning the baby every 2 hours The infant's position is changed every 2 hours to expose all skin surfaces to the phototherapy for maximum effect. Measuring the bilirubin level every 2 hours is not necessary. The infant may be removed from the lights for feeding and the eye patches removed to assess the eyes for irritation. The lights will dry the cord more quickly, which is a desirable effect.

Weight gain during preg is necessary to ensure

adequate nutrition for the fetus.

caput succedaneum

diffuse edema of the fetal scalp that crosses the suture lines. reabsorbes within 1 to 3 days

A sudden sharp increase in weight may indicate

fluid retention related to preeclampsia.

Portions of the products of conception will have to be passed for a diagnosis of

incomplete abortion.

During labor, The lateral position relieves back pain because

it removes pressure from the back.

The lifeless products of conception are retained in a

missed abortion. The definition of a missed abortion is when the fetus dies but is retained in the uterus for at least 2 months.

An increase of ----per day is the recommended caloric increase for adult women to meet the increased metabolic demands of pregnancy.

of 300 calories

Eyes with sclerae visible above the irises occur with

progressively increasing intracranial pressure, usually before shunt insertion. For hydrocephalus.

To help promote comfort during labor. The sitting position

relieves back pain because it removes pressure from the back.

The knee-chest position may help relieve back pain during labor because it

removes pressure from the back.

Low back pain is aggravated when the client is in the

supine position because of increased pressure from the fetus on the lumbar and sacral regions.

After an *incomplete abortion*, a client tells the nurse that although her primary healthcare provider explained what an incomplete abortion was, she did not understand. What is the best response by the nurse

when the fetus is expelled but other parts of the pregnancy remain in the uterus. A correct and simple definition answers the question and fulfills the client's need to know. Telling the client not to focus on the topic any more denies the client's right to know. Telling the client to ask her primary healthcare provider for the answer is an abdication of the nurse's responsibility; the nurse can independently reinforce information and correct misconce

The client should be pushing with each contraction; with the head at +3 station, each push

will bring more of the *caput* into view at the vaginal opening.