Test 2

What defines true labor?

cervical change

The Bishop score is used to assess the status of the _____ in determining its response to _____.

cervix induction

What is term for inflammation of the fetal membranes?

chorioamnionitis

List four warning or danger signs during pregnancy.

- Bleeding - Hypertension - Excessive vomiting - Edema

If a woman tests positive for TB, what two tests confirm the diagnosis?

- Tuberculin skin test - serum Interferon Gamma Release Assay, more commonly known as a QuantiFERON-TB Gold (QFT-G) T-spot test

It is recommended that all women of childbearing age take ___ mg of folic acid daily. If they have a folate deficiency, they should take ___ mg daily.

0.4 0.8

When a female is immunized for rubella, she should wait at least ____month(s) before becoming pregnant.

1

Fill in the blanks regarding rubella and immunizations during pregnancy: 1. When a woman of childbearing age is immunized, she should not get pregnant for at least ___ month after the immunization. 2. The vaccine is offered during the postpartum period to non-immune women. It is not given during pregnancy because it is a live ______ form of the virus.

1. 1 2. attenuated

Fill in the blanks regarding frequency, duration, and interval of contractions: 1. Contractions occurring more often than every ____ minutes may reduce fetal oxygen supply and should be reported. 2. Persistent contraction durations longer than ___ seconds may reduce fetal oxygen supply and should be reported. 3. Persistent contraction intervals shorter than ___ seconds may reduce fetal oxygen supply.

1. 2 2. 90 3. 60

Tell whether the following descriptions of pain or associated with placenta previa or abruptio placentae: 1. There is a gradual or abrupt onset of pain and uterine tenderness, there is also possibly low back pain. 2. There is no pain, other than from normal uterine contractions as in labor.

1. Abruptio placentae 2. Placenta previa

Tell whether the following birth practice is related to Chinese, Arabic, or Mexican American culture: 1. You must not pause in the doorway if you're walking in during labor because it is thought to delay birth 2. Prefers privacy 3. May value one sex of newborn over the other 4. May avoid beans postpartum 5. May wear protective amulets 6. Prefers caregivers not to use first name of woman 7. May believe supine position is best for fetus 8. Prefers all doors and windows to be unlocked because it is thought to use the passage of infant 9. Often views keeping body covered as very important 10. May not shower postpartum and may only prefer to ambulate two bathroom

1. Chinese 2. Mexican American 3. Arabic 4. Mexican American 5. Arabic 6. Chinese 7. Mexican American 8. Chinese 9. Arabic 10. Mexican American

Match the following pregnancy terms with their correct definitions: 1. Frequency 2. Duration 3. Intensity 4. Interval a. Time of relaxation b. How long contractions last c. How often contractions occur d. The strength of the contraction

1. c 2. b 3. d 4. a

An infant born to an HIV infected mother has a ___ to ____ percent chance of acquiring HIV.

20 40

Match the following types of blocks with their correct definitions: 1. Epidural Block 2. Subarachnoid Block (Spinal) 3. Pudendal Block a. This is used for vaginal births, although its use has become less common as the popularity of the epidural block has increased. It provides adequate anesthesia for an episiotomy and for most low forceps births. It does not block pain from contractions and, similar to local infiltration, is given just before birth. b. The dura is punctured with a thin (25-to 27-gauge) spinal needle. A few drops of spinal fluid confirm entry into the subarachnoid space. The local anesthetic drug is then injected. A much smaller quantity of the drug is needed to achieve anesthesia. c. The physician or nurse anesthetist penetrates the epidural space with a large needle (16-to 18-gauge). A fine catheter is threaded into the epidural space through the bore of the needle. A test dose is used to check placement of the catheter.

1. c 2. b 3. a

Match the following terms with their correct definitions: 1. Pain threshold 2. Pain tolerance a. The least amount of sensation that a person perceives is painful b. The amount of pain one is willing to endure

1. a 2. b

Fill in the blanks regarding how an infant is infected with the herpes virus during pregnancy: 1. The virus _____ into the uterus after the membranes rupture. 2. The infant has direct contact with _____ lesions during vaginal delivery.

1. ascends 2. active

Match the following fontanelles with their correct descriptions: 1. Anterior fontanelle 2. Posterior fontanelle a. Tiny, triangular depression formed by the intersection of three sutures (one sagittal and two lambdoid) b. Diamond-shaped area formed by the intersection of four sutures (frontal, sagittal, and two coronal)

1. b 2. a

Match the following stages of placenta previa with their correct definitions: 1. Marginal 2. Partial 3. Total a. Partially cover cervical opening b. Approaches, but does not reach, the cervical opening c. completely covers the cervical opening

1. b 2. a 3. c

Match the following P's with their correct definition: 1. Powers 2. Passage 3. Passenger 4. Psyche a. The fetus, placenta, amniotic membrane's, and amniotic fluid b. The forces that caused the cervix to open and that propel the fetus downward through the birth canal (uterine contractions and the mothers pushing efforts) c. A woman's perception of the process and her mental state d. The mothers bony pelvis and the soft tissues (cervix, muscles, ligaments, and fascia) of her pelvis and the perineum

1. b 2. d 3. a 4. c

Match the following fetal heart rate variabilities to their correct definitions: 1. Baseline variability 2. Moderate variability 3. Marked variability 4. Absent variability a. This occurs when there are more than 25 beats of fluctuation over the FHR baseline. b. This describes fluctuation or constant change in the baseline FHR above and below the baseline in a 10 minute window. c. This is less than a 6 bpm change from the baseline for a 10 minute period. d. This is defined as changes of a 6 bpm to 25 bpm from the baseline FHR, and it is desirable because it indicates good oxygenation of the central nervous system and fetal well-being.

1. b 2. d 3. a 4. c

Match the following types of presentation with their correct definitions: 1. Vertex 2. Military 3. Brow 4. Face 5. Frank Breech 6. Full Breech 7. Footling Breech a. Head partially extended, unstable b. Head fully flexed; most favorable c. One or both feet first d. Head fully extended (face first) e. Legs and butt in birth canal (both feet and buttocks first) f. Head neither flexed nor extended g. Legs tucked up in button down (butt first)

1. b 2. f 3. a 4. d 5. g 6. e 7. c

Match the following intensities of contractions with their correct definitions: 1. Mild 2. Moderate 3. Firm a. Fundus can be indented with the fingertips but with more difficulty; the fundus of the uterus feels similar to the chin b. The funds cannot be readily in dented with the fingertips; the fundus of the uterus feels similar to the forehead c. The fundus is easily indented with the fingertips; the fundus of the uterus feels similar to the tip of the nose

1. c 2. a 3. b

Match the following terms with their correct definitions: 1. Lie 2. Attitude 3. Presentation a. Flexion or extension: normal is flexed head and arms/legs - compact.ovoid b. The part that is entering the pelvis first (normal is headfirst or cephalic) c. How the fetus is oriented to moms spine (should be longitudinal versus transverse/oblique)

1. c 2. a 3. b

Match the following stages of abruptio placentae with their correct definitions: 1. Partial 2. Marginal 3. Central 4. Total a. Detachment at the edge of placenta b. Detachment of the center surface of placenta; the edges stay attached c. Detachment of part of placenta d. Complete detachment of placenta

1. c 2. a 3. b 4. d

Match the following dysfunctional labor patterns with their correct definitions: 1. Tachysystole 2. Hypotonic Labor Dysfunction 3. Dystocia 4. Shoulder Dystocia a. this is a term used to describe a difficult labor b. this occurs when contractions are weak and ineffective c. Uterine contraction frequency of more than once every 2 minutes, or five or more contractions within 10 minutes with duration longer than 90 seconds, or resting interval between contractions less than 60 seconds d. this usually occurs when the fetus is large, and the shoulders become impacted above the mother's symphysis pubis

1. c 2. b 3. a 4. d

Match the following terms with their correct definitions: 1. Gestational hypertension 2. Preeclampsia 3. Eclampsia 4. Chronic hypertension 5. Preeclampsia with superimposed chronic hypertension a. Presence of hypertension before 20 weeks gestation; usually hypertension last beyond 12 weeks postpartum b. Development of hypertension in a previously normotensive woman after 20 weeks gestation with renal involvement leading to proteinuria c. Development of hypertension (BP greater than 140/ 90 mmHg) in a previously normotensive woman after 20 weeks gestation d. Chronic hypertension that has a new occurrence of proteinuria or occurrence of thrombocytopenia and increased liver enzymes e. Development of hypertension in a previously normal tensive woman after 20 weeks gestation with CNS involvement causing seizures

1. c 2. b 3. e 4. a 5. d

Fill in the blanks regarding the areas that are used in the Bishop score: 1. Dilation of the _____ (cm) 2. _____ of the cervix 3. Length of the _____ 4. Cervical _____ (%) 5. Position of the cervix 6. Station of the ______ part related to the ischial spine.

1. cervix 2. consistency 3. cervix 4. effacement 6. presenting

Tell whether the following situation are indications or contraindications for inducing labor: 1. GH 2. Infection within the uterus 3. Placenta previa 4. Abnormal fetal presentation 5. Placental insufficiency 6. Abnormal size or structure of the mother's pelvis 7. Fetal problems, such as slowed growth, prolonged pregnancy, or fetal/maternal blood incompatibility 8. Fetal death 9. Active herpes infection externally or in the birth canal, which the infant can acquire during birth 10. Previous classic cesarean section

1. indication 2. indication 3. contraindication 4. contraindication 5. indication 6. contraindication 7. indication 8. indication 9. contraindication 10. contraindication

Fill in the blanks regarding the factors that distinguish childbirth pain from other types of pain: 1. It is a part of a _____ birth process. 2. The woman has several _____ to prepare for pain management. 3. It is self-_____ and rapidly declines after birth.

1. normal 2. months 3. limiting

Fill in the blanks regarding basic structure of the fetal head: 1. The fetal head is composed of several bones separated by strong connective tissue, called _____. 2. A wide area, called a _____, is formed where the sutures meet.

1. sutures 2. fontanelle

The pregnant woman with heart disease should call her healthcare provider is her pulse rate is > ___ beats per minute and/or her respiratory rate is > __ breaths per minute at rest.

100 25

What is the baseline fetal heart rate range?

110-160

How long before delivery should Terbutaline be discontinued in order to avoid side effects in the newborn?

2 hours

The glucose tolerance test (GTT) is routinely done at __ to __ weeks gestation.

24 28

Treatment and nursing care for women who are Rh negative with Rh positive babies include preventing antibodies by giving the immune globulin (RhoGAM) to the RH negative mother at __ weeks and within ___ hours after delivery.

28 72

An infant born to a TB positive mother is treated prophylactically for ____ months.

3

Each contraction diverts ___ to ___ mL of blood from the uterus to the circulatory system.

300 500

The FDA recommends that you should limit the use of Magnesium to fewer than ___ to ___ days because the fetus can develop low blood calcium, bone problems, and respiratory depression with prolonged use.

5 7

An appropriate blood glucose level for any patient is ___ to ___ mg/dL.

60 120

How long does it take to determine if a baby is truly HIV positive?

A period of 3 to 6 months is needed to identify infants who are truly infected.

When are women who are a high risk for hepatitis B screened during pregnancy?

All women should be screened for hepatitis B during the course of prenatal care, and the screening should be repeated during the third trimester for women in high-risk groups.

How is Group B streptococcus (GBS) contracted by a newborn?

Although she is colonized with the organism, the woman is usually asymptomatic, but the infant may be infected through contact at birth with vaginal secretions.

List the S/S of tuberculosis.

An adult with tuberculosis presents with fatigue, weakness, loss of appetite and weight, fever, and night sweats.

Which type of anticoagulant is NOT used during pregnancy and why?

Anticoagulants such as warfarin (Coumadin) may cause fetal anomalies and are not given during pregnancy.

Describe the treatment for this Group B streptococcus (GBS).

Any GBS-positive urine culture is considered a cause for antibiotic treatment during pregnancy, and the newborn is treated with antibiotics at birth.

What is the term for a system that is used to evaluate the infants condition in response to resuscitation that was provided at birth?

Apgar

Why is insulin (Humalog) the preferred drug for gestational diabetes mellitus?

Because both oral agents often require supplemental injectable insulin to maintain adequate glucose control, injectable insulin is the preferred drug to lower blood glucose levels during pregnancy.

Why may a C-section be indicated in a woman with GDM?

Because macrosomia (large fetal size) is a common complication of GDM, close monitoring of the fetus during labor is essential, and cesarean delivery may be indicated

Why are falls common during pregnancy?

Because of the woman's altered sense of balance

Describe the difference in bleeding related to placenta previa and abruptio placentae.

Bleeding in placenta previa is obvious, usually bright, and may be profuse. Bleeding with abruptio placenta is visible dark vaginal bleeding or concealed bleeding within the uterus. Enlargement of the uterus suggest that blood is accumulating within the cavity.

What kind of contractions are irregular and begin during early pregnancy? They continue to intensify as full-term approaches. They often become regular and uncomfortable, leading many women to believe that labor has started.

Braxton Hicks contractions

What does CPD stand for and what does it mean?

Cephalopelvic disproportion This means that passage is not adequate.

Why are pregnant women more susceptible to yeast infections?

Changes in the vaginal secretions that occur during pregnancy can increase the risk of developing a vaginal infection. The high estrogen levels present during pregnancy thicken the vaginal mucosa and increase secretions that have a high glycogen content. This makes the woman susceptible to yeast infections and other microorganisms.

Where is the microorganism toxoplasmosis found?

Contact with cat feces and raw meat and transmitted through the placenta

_____ is a complex disorder that may complicate abruptio placentae. The large blood clot that forms behind the placenta consumes clotting factors, which leaves the rest of the mothers body deficient in these factors. She may bleed from her mouth, nose, incisions, or venipuncture sites because the clotting factors are depleted.

Disseminated intravascular coagulation (DIC)

How often should the nurse check the blood sugar of a woman with GDM during labor?

During labor, blood glucose levels are assessed hourly, and the insulin dose is adjusted accordingly.

Based on the information below, what do you think is the diagnosis for this patient? The woman has a history of a missed menstrual period and often complains of lower abdominal pain, sometimes accompanied by light vaginal bleeding. She had a sudden severe onset of lower abdominal pain, vaginal bleeding, and signs of hypovolemic shock. She also complains of shoulder pain.

Ectopic pregnancy with fallopian tube rupture

What is the term for the technique that stimulates the large diameter nerve fibers that inhibit painful stimuli traveling through the small diameter fibers? This is when a woman strokes her abdomen in a circular movement or a figure 8 movement on her leg during contractions.

Effleurage

Describe the difference between episodic changes and periodic changes in the FHR.

Episodic changes or changes in the FHR that are not associated with uterine contractions. They are brief and quickly returned to baseline. Periodic changes are temporary changes in the baseline rate associated with uterine contractions to quickly return to baseline.

Most of the time, where does an ectopic pregnancy (tubal pregnancy) occur?

Fallopian tubes

True or False: Tuberculosis is a disease that has almost been eradicated from the U.S.

False

T/F (correct if false): Ectopic pregnancies can be saved if they are caught early.

False: No ectopic pregnancy can be saved, they all result in termination.

T/F (correct if false): To ensure correct placement of the epidural block, a test dose is administered. If there is a reaction, the physician knows that the block is in the right place.

False: No reaction is indicative of correct placement of the epidural.

T/F (correct if false): The first pregnancy is always affected by the Rh factor.

False: The first pregnancy is rarely affected, but after that it can become an issue.

T/F (correct if false): During pregnancy, the placenta allows maternal and fetal blood to mix.

False: The placenta allows maternal and fetal blood to be close enough to exchange oxygen and waste products without actually mixing, so the maternal and fetal blood do not mix.

T/F (correct if false): The Apgar score is a good predictor of future intelligence or abilities and disabilities.

False: This is not a predictor of future intelligence or abilities and disabilities.

T/F (correct if false): Violence often de-escalates during pregnancy.

False: Violence often escalates during pregnancy.

True or False: Monitoring of the newborn's blood sugar during the first hours after birth is not necessary.

False: Blood glucose levels of newborns are monitored closely in the first 24 hours of life.

True or False: Breastfeeding is contraindicated in a woman with active genital herpes lesions.

False: Breastfeeding is safe if there are no lesions on the breasts.

True or False: Rubella is not given in the postpartum period.

False: It is given in the postpartum period because it is a live attenuated (weakened) form of the virus.

True or False: Pregnant woman are screened for HIV only if they are at high risk for the disease.

False: It is recommended for all prenatal patients.

True or False: It is the nurse's responsibility to contact and inform all sexual partners of a woman with an STI.

False: It is the person who has the infection as well as the health departments responsibility.

Which fetal heart tracing occurs when the fetal heart rate is less than 110 bpm for 10 minutes or longer?

Fetal bradycardia

Which fetal heart rate tracing occurs when the fetal heart rate is greater than 160 bpm that last 2 to 10 minutes or longer?

Fetal tachycardia

Describe the characteristics of the red blood cells in folic acid-deficiency anemia.

Folic acid deficiency is characterized by large, immature RBC's (megoblastic anemia).

The test to monitor blood sugar levels over a period of several weeks to months is called the _____ test.

Glycosylated hemoglobin (HgbA1c)

In the "Nutrition Considerations" list of foods recommended during pregnancy, what is the one type of food that contains all the necessary nutrients to prevent anemia of any kind?

Green leafy veggies

The leading cause of perinatal infection with a high mortality rate is _____.

Group B streptococcus (GBS)

Name the two ways that the pregnant woman's body makes ample glucose available to the fetus.

Hormones (estrogen and progesterone), an enzyme (insulinase) produced by the placenta, and increased prolactin levels have two effects: 1. Increased resistance of cells to insulin 2. Increased speed of insulin breakdown

When a woman complains of dizziness, tingling, and numbness around her mouth which may also include spasms of her fingers and feet, what should you observe for?

Hyperventilation

What is important to watch for when observing a mothers breathing?

Hyperventilation. This is sometimes a problem and the woman is breathing rapidly.

How does congestive heart failure (CHF) in the mother affect the fetus?

If the mother's heart cannot meet these increased demands of pregnancy, congestive heart failure results, and the fetus is affected by reduced placental blood flow.

When and why do women get hyperglycemic and hypoglycemic during pregnancy?

If the woman cannot increase her insulin production, she will have periods of hyperglycemia (increased blood glucose levels) as glucose accumulates in the blood. Because the fetus continuously draws glucose from the mother, maternal hypoglycemia (low blood glucose) can occur between meals and during the night.

What is the treatment of choice for abruptio placentae?

Immediate cesarean delivery because of the risk for maternal shock, clotting disorders, and fetal death

Describe how a woman with GDM should manage exercise during pregnancy.

In GDM, exercise can help control blood glucose levels, and diet and exercise can minimize the need for insulin. Hypoglycemia can occur if the woman exercises when the effects of the last insulin dose are at peak. Hyperglycemia can occur if the woman exercises when the effects of the last dose of insulin have decreased. Therefore, blood glucose levels should be monitored before, during, and after exercise, and a hard candy should be on hand to deal with hypoglycemia.

Compare/contrast uterine consistency in placenta previa and abruptio placentae.

In placenta previa, the uterus is soft with no abnormal contractions or irritability. With abruptio placentae the uterus feels firm and board like, may be irritable, with frequent and brief contractions.

Describe the treatment of the infant of a mother with hepatitis B.

Infants born to women who are positive for hepatitis B should receive a single dose of hepatitis B immune globulin (for temporary immunity right after birth) followed by hepatitis B vaccine (for long-term immunity).

List the sexually transmitted infections (STIs) that pregnant women may acquire.

Infections that are typically transmitted sexually are syphilis, gonorrhea, chlamydia, trichomoniasis, and condylomata acuminata (genital warts), and HSV.

What is the name of the preferred oral hypoglycemic drug given during pregnancy?

Injectable insulin

Name two substances that interfere with iron absorption and should not be taken at the same time as iron supplements.

Iron should not be taken with milk or antacids because calcium impairs absorption.

What is it called when the fetus settles into the pelvic inlet and the fundus no longer presses on the diaphragm?

Lightening

Foods with high amounts of vitamin ___ should be avoided by a patient on heparin therapy.

K

______ can be rapidly fatal to a fetus and is usually associated with an infection.

Ketoacidosis

What are the two main DOCs used for tocolysis?

Magnesium Sulfate Terbutaline

List the factors in a woman's history that are linked with diabetes mellitus.

Maternal obesity (greater than 90 kg or 198 lb.) Large infant (greater than 4000 g or about 9 lb.) Maternal age older than 25. Previous unexplained stillbirth or infant having congenital abnormalities. History of GDM in a previous pregnancy. Family history of DM. Fasting glucose more than 126 mg/dL or post meal glucose more than 200 mg/dL.

In an ectopic pregnancy, if the tube has not ruptured and the healthcare provider is choosing to use medical therapy, what medication will they likely use? Why?

Methotrexate It inhibits cell division in the embryo and allows it to be reabsorbed.

Types of insulin NOT given to pregnant women at dinnertime are ___ and _____ because of hypoglycemia.

NPH lente

When can the mother start to push?

ONLY when the cervix is completely dilated

What hormone helps to make contractions greater? This hormone also lets milk come out of the nipples for breast-feeding. It is called the love hormone (because it helps with bonding), and it is secreted from the anterior pituitary gland.

Oxytocin

Which hormone is used for induction or augmentation of labor?

Oxytocin

What are the three "P's" associated with diabetes mellitus?

Polydipsia: thirst increases Polyuria: excretion of large amounts of glucose-bearing urine Polyphagia: eating large amounts of food

What are the four P's of birth?

Powers Passage Passenger Psyche

Why are UTIs more common during pregnancy?

Pregnancy alters this self-cleaning action, as pressure on urinary structures keeps the bladder from emptying completely and the ureters dilate and lose motility under the relaxing effects of the hormone progesterone. Urine that is retained in the bladder becomes more alkaline, providing a favorable environment for the growth of microorganisms.

What is the name of the ONLY insulin that may be administered intravenously?

Regular insulin is the only type given intravenously.

Which skin stimulation technique involves firm pressure against the lower back to help relieve some of the pain is back labor? This is something a partner can do, and the woman should tell her partner where to apply the pressure and how much to apply.

Sacral pressure

What are two things you would teach a pregnant woman about UTI prevention?

Sexual intercourse mildly irritates the bladder and urethra, which can promote a UTI. Urinating before intercourse reduces irritation; urinating afterward flushes urine from the bladder. Using water-soluble lubricant during intercourse can also reduce periurethral irritation. Pregnant women should be taught the signs and symptoms of cystitis and pyelonephritis so that they will know to seek treatment at once.

Which type of block characterizes loss of all movement and sensation below the area of the block?

Subarachnoid (Spinal) Block

_____ is administered to stop uterine contractions within minutes.

Terbutaline

What is the recommended hepatitis B immunization schedule in infants?

The Centers for Disease Control and Prevention (CDC) recommends routine immunization with hepatitis B vaccine for all newborns (infants born to carrier mothers and to noncarrier mothers) at birth and at ages 1 to 2 months and 6 to 18 months.

Describe the size and color of the red blood cells in iron deficiency anemia.

The RBC's are small (microcytic) and pale (hypochromic) in iron-deficiency anemia.

Why is shoulder dystocia an emergency?

The fetus needs to breathe. The head is out, but the chest cannot expand.

Describe how a newborn can be infected with the herpes virus.

The infant is infected in one of the following ways: 1. The virus ascends into the uterus after the membranes rupture. 2. The infant has direct contact with infectious lesions during vaginal delivery.

What are three ways an infant can acquire HIV?

The infant may be infected in one of the following three ways: - Transplacentally - Through contact with infected maternal secretions at birth - Through breast milk

What is the main concern regarding a VBAC?

The main concern is that the uterine scar will rupture, which can disrupt the placental blood flow and cause hemorrhage.

What happens if the maternal and fetal blood factors differ?

The mothers body will produce antibodies to destroy the foreign fetal red blood cells.

Name three tests during pregnancy that check placental function.

The non-stress test, contraction stress test, and biophysical profile provide information about how the placenta is functioning.

How can the nurse assist in the case of a shoulder dystocia?

The nurse can apply downward, firm pressure just above the the symphysis pubis (suprapubic pressure) to push the shoulders toward the pelvic canal.

List two important topics a woman with GDM needs to be taught.

The woman has taught how to select appropriate foods for the prescribed diet. The woman who takes insulin may experience episodes of hypoglycemia or hyperglycemia. The woman is taught how to recognize and respond to each condition, and family members are included in the teaching.

Briefly describe the ideal diet of a woman with GDM.

The woman is counseled to avoid single large meals with high amounts of simple carbs. A balanced food intake is divided among meals and at least three or four snacks throughout the day to maintain stable blood glucose levels. Foods that release glucose slowly are preferred to avoid rapid changes in blood glucose. The bedtime snack is important to avoid hypoglycemia.

Which skin stimulation technique involves heat application with a warm blanket or a glove filled with warm water? This can also include a cool cloth on the face or warm showers when permitted.

Thermal stimulation

Why are cold treatments for bruising and swelling contraindicated in neonate use?

These are not used because they would cause hypothermia.

T/F: Magnesium Sulfate is not a very effective tocolytic, but it is used to protect the fetus from developing cerebral palsy.

True

True or False: A UTI can cause preterm labor.

True

True or False: Diabetes mellitus can affect the blood vessels of the placenta during pregnancy.

True

True or False: Exclusively breastfed babies have a decreased incidence of diabetes mellitus later in life.

True

True or False: GDM usually resolves quickly after birth.

True

True or False: Infection with cytomegalovirus may be asymptomatic in the woman but causes serious problems in the infant.

True

True or False: Normal cardiovascular changes may not be tolerated by the pregnant woman with heart disease.

True

True or False: Some women have bacteria in their urine but no S/S of a UTI.

True

True or False: Standard precautions should be used with every maternity patient.

True

True or False: A C-section is the preferred method of delivery for a woman with heart disease.

True: C-section is preferred because it carries less risk for infection or respiratory complications that would further tax the impaired heart.

Describe the changes in insulin dosage that may need to be made in each trimester and the reason for the changes.

Typically, insulin dosages may have to be reduced to avoid hypoglycemia in the first trimester, when nausea decreases appetite and physical activity may be reduced. In the second trimester, increasing placental hormones increases insulin resistance, and the dosage of insulin may have to be increased. Insulin requirements may decrease again at 38 weeks gestation. GDM resolves promptly after birth, when the insulin antagonistic effects of pregnancy cease.

What is the medical treatment for both cystitis and pyelonephritis?

UTIs are treated with short-term oral antibiotics. Asymptomatic bacteriuria is treated with oral antibiotics for 10 days. Pyelonephritis is treated with multiple antibiotics, initially administered intravenously. Cystitis in pregnant women is treated with a full 7 days of antibiotic therapy.

How does a fetus get erythroblastosis fetalis?

When the maternal anti-Rh antibodies cross the placenta and destroy the fetal urethra sites, this results.

From the following, choose the correct diversion and distraction method that involves the woman listening to her favorite music or relaxation recordings in order to divert the woman's attention from the pain. a. Music b. Focal point c. Imagery d. Television

a

Which of the following stages of labor begins because hormonal changes cause the woman to excrete excess body water? a. Weight loss b. Rupture of the membranes c. The bloody show d. Energy spurt

a

Tell whether the following aspects are related to placenta previa or abruptio placentae: a. Premature separation of normally implanted placenta b. Abnormal implantation of the placenta in the lower uterus c. Can have a partial, marginal, central, or total detachment of the placenta d. Can have marginal, partial, or total covering of the cervical opening

a. Abruptio placentae b. Placenta previa c. Abruptio placentae d. Placenta previa

Define anemia, including Hgb parameters.

a. Anemia is the reduced ability of the blood to carry oxygen to the cells. Hemoglobin levels that are less than 10.5 g/dL in the second trimester and that are less than 11 g/dL in the first and third trimesters indicate anemia during pregnancy.

List three S/S of excessive anticoagulation.

a. Bruising without reason b. Petechiae (tiny red spots on the skin) c. Nosebleeds d. Bleeding from the gums when brushing the teeth

Describe the S/S of a UTI.

a. Burning with urination b. Increased frequency/urgency of urination c. A normal or slightly elevated temperature

Name three measures to avoid exposure to toxoplasmosis that a pregnant woman should be taught.

a. Cook all meat thoroughly b. Wash hands and all kitchen surfaces after handling raw meat c. Avoid touching the mucous membranes of the eyes or mouth while handling raw meat

Describe the S/S of pyelonephritis.

a. High fever or chills b. Flank pain or tenderness c. Nausea and vomiting

What are two factors that place the mother and baby at risk for Group B streptococcus (GBS)?

a. If the woman has a longer labor b. premature rupture of membranes

List the problems in the newborn caused by infection with toxoplasmosis.

a. Low birth weight b. Enlarged liver and spleen c. Jaundice d. Anemia e. Inflammation of eye structures f. Neurological damage

List the S/S of CHF

a. Orthopnea (having to sit upright to breathe more easily) b. Persistent cough, often with expectoration of mucus that may be blood-tinged c. Moist lung sounds because of fluid within lungs d. Difficulty breathing on exertion e. Palpitations f. Fatigue or fainting on exertion g. Severe pitting edema of the lower extremities or generalized edema h. Changes in fetal heart rate indicating hypoxia or growth restriction if placental blood flow is reduced

List the destructive effects of maternal rubella exposure on the fetus/infant.

a. Rubella occurring in very early pregnancy can disrupt the formation of major body systems, whereas rubella acquired later is more likely to damage organs that are already formed. b. Some effects of rubella on the embryo or fetus include: Microcephaly (small head size), Intellectual impairment, Congenital cataracts, Deafness, Cardiac defects, IUGR

What are five important aspects of treatment of a pregnant woman with heart disease?

a. She needs more frequent antepartum visits to determine how her heart is coping with the increased demands of pregnancy. b. Excessive weight gain must be avoided because it adds to the demands on her heart. c. Preventing anemia with adequate diet and supplemental iron prevents a compensatory increase in the heart rate, which would add to the strain on the woman's heart. d. The priority of care is to limit physical activity to decrease the demands made on the heart. e. The limitation of activity can range from frequent rest periods to strict bed rest, depending on the degree of heart impairment. A woman on prolonged bed rest for any reason has a greater risk for forming venous thrombi (blood clots) and should be monitored for 12 weeks after recovery.

Name two forms of genetic anemia that may be seen in pregnant women.

a. Sickle Cell Disease: abnormal hemoglobin that causes erythrocytes to become distorted into a sickle (crescent) shape during episodes of hypoxia or acidosis. b. Thalassemia: genetic trait that causes an abnormality in one of two chains of hemoglobin, the alpha or beta chain.

Describe two topics you would teach a woman who needs iron supplementation.

a. The woman is taught which foods are high in iron and folic acid to help her prevent or treat anemia. b. She is taught how to take supplements so that they are optimally effective (For example: the nurse explains that although milk is good to drink during pregnancy, it should not be taken at the same time as the iron supplement, or the iron with not be absorbed as easily. Foods high in vitamin C may enhance absorption.)

What does TORCH stand for?

a. Toxoplasmosis b. Other infections c. Rubella d. Cytomegalovirus e. Herpes simplex virus

Women who are diabetic before pregnancy have a greater risk of having a newborn with a congenital _____ than a woman who develops GDM.

anomaly

The ____ ____ diameter changes according to the position of the babies head, and the measurement goes from the forehead to the ____.

anterior posterior occiput

From the following diversion and distraction methods, which one involves the woman fixing her eyes on a picture, object, or simply a particular spot in the room? a. Music b. Focal point c. Imagery d. Television

b

Which of the following stages of labor involves Repsher of the amniotic sac before labor begins? This is also the stage where infection is more likely if many hours elapsed between this stage and the birth because the amniotic sac seals the uterine cavity against organisms from the vagina. a. Weight loss b. Rupture of the membranes c. The bloody show d. Energy spurt

b

From the following list, choose the five factors that are evaluated at the one and five minute mark after birth (these are ranked in order of importance): a. PERRLA b. Heart rate c. Skin color d. Muscle tone e. Orientation f. Reflex response to suction or gentle stimulation on the soles of feet g respiratory effort

b, c, d, f, g

Newborn injections should be delayed until after the infant's first ____.

bath

To prevent a UTI a woman should void ____ and ____ sex!

before after

The main transverse diameter of the fetal head is the _____ _____, which is measured between the points of the two parietal bones on each side of the head (ear to ear over the top of the head). This diameter ______ ___ change.

biparietal diameter does not

Of the following diversion and distraction methods, which involves the woman learning to create a tranquil mental environment by imagining that she is in a place of relaxation and peace? a. Music b. Focal point c. Imagery d. Television

c

What instrument uses suction to the fetal head when applied so that the health care provider can assist the mother's expulsive efforts? a. Speculum b. Suction Machine c. Vacuum Extractor d. Forceps

c

Which of the following stages of labor involves the cervix softening, effacing, and dilating slightly. When these events occur, the mucous plug that has sealed a uterus during pregnancy is dislodged from the cervix, tearing small capillaries in the process. a. Weight loss b. Rupture of the membranes c. The bloody show d. Energy spurt

c

What should you always have on hand when doing Magnesium Sulfate therapy?

calcium glutinate

Stress compound secreted from the adrenal glands are called __________, and they inhibit uterine contractions and divert blood flow from the placenta.

catecholamines

What can occur if there is a large quantity of amniotic fluid?

cord prolapse

Choose the diversion and distraction method that involves a woman enjoying a program. This does not mean that she watches the program, but it provides background noise that reduces intrusive sounds. a. Music b. Focal point c. Imagery d. Television

d

What instrument has curved blades that fit around the fetal head without unduly compressing it? a. Vacuum Extractor b. Fetal Heart Monitor c. Speculum d. Forceps

d

Which of the following stages of labor involves the woman suddenly nesting before labor? a. Weight loss b. Rupture of the membranes c. The bloody show d. Energy spurt

d

What can happen if the baby is born during Magnesium Sulfate therapy?

drowsiness and resuscitation may be needed

Because overdose of Magnesium Sulfate can cause cardiorespiratory problems, how often are VS recorded?

every hour

Signs and symptoms of anemia include being easily ____ and having little _____.

fatigued energy

The pregnant woman should monitor for _____ in her urine.

glucose

Labor is induced if continuing the pregnancy is _____ for the woman or the fetus.

hazardous

In general, use of narcotic analgesics is avoided if birth is expected within an ____. Why?

hour The infant may experience respiratory depression that may require interventions such as administration of Naloxone.

The blood test to check for antibodies to a specific disease is called an _____ test.

immunoglobulin

The two drugs used to treat TB are _____ and _____.

isoniazid rifampin

Newborn _____ is the main complication of GDM.

macrosomia (> 4000 g/9 lbs.)

Rh incompatibility occurs only if the woman is Rh _____, and the baby is Rh _____.

negative positive

The name of the specialist who cares for newborn infants with complications is _____.

neonatologist

Ectopic pregnancies occur when the fertilized ovum (zygote) is implanted _____ the uterine cavity.

outside

Frequent changing of _____ relieves muscle fatigue and strain. In addition, it also can promote the normal mechanisms of labor.

position

The combined efforts of what move the baby down?

pushing and contractions

Cervical _____ is the physical softening of the cervix that leads to effacement and dilation.

ripening

Where is Terbutaline administered?

subcutaneously

Contractions cause the cervix to _____ and _____.

thin dilate

____ is the inhibition of myometrial uterine contractions.

tocolysis

T/F (correct if false): Cesarean birth is not necessary if there are no active herpes lesions on the genitals. Breast-feeding is safe if there are no herpes lesions on the breasts.

true

T/F (correct if false): Gestational hypertension usually returns to normal within 6 to 12 weeks postpartum.

true