03-22
to assess the presence of epstein pearls the nurse should assess which part of the neonate's body?
in the mouth (palette, gums, etc.)
the tear of the perineal skin and vaginal mucosa
laceration (first degree)
what type of deceleration is seen at the end of a contraction?
late
the type of deceleration when the fetal heart rate drops below baseline at the end of the contraction or after the end of the contraction
late deceleration (early=head compression, looks like a mirror image) (variable =cord compression and looks like a U or a V)
babinski
lateral aspect of sole of foot
otolani maneuver
legs abducted
barlow
legs adducted
in relation to breastfeeding, the milk ejection reflex is also known as
let down reflex
what is the line of darker pigmentation that extends from the symphysis pubis to the umbilicus?
linea nigra
what is the white or cream colored vaginal discharge that starts around day 11 postpartum and continues for 5 weeks after childbirth?
locchia alba
the drainage from the uterus and vagina after delivery of the baby during the postpartum period
lochia
a nurse teaches a woman wishes to become pregnant that if she assesses for Spinbarket she will be able to closely predict the time of ovulation, which technique should the client be told to use
look at vaginal discharge for elasticity and slipperiness (eggy)
to reduce risk of hypoglycemia in a term newborn weighing 2900 grams, what should the nurse do?
maintain temperature (or they will get old stress and go into hypoglycemia)
to decrease the possibility of a perineal laceration during delivery the nurse performs what intervention prior to initation of the delivery?
massage the perineum with mineral oil because it will help to stretch it
what is the blood test for neural tube defects that detect protein from the fetal liver and excreted in the mother's blood?
maternal fetal alpha-fetoprotein
a baby's first stool, black thick sticky tar-like, usually passed within the first 12 hours after birth, expect obtruion if not passed within 48 hours
meconium
cervidil and cytotec
medications that ripen the uterus (ripened cervix is short, centered, anterior and soft; use bishop score to determine this, score over 8 means it's ripe)
bluish/black pigmented areas usually found on the back and buttocks
mongolian spots
there is a baby in the nicu who is exhibiting signs of neonatal abstinence sydrome. which of the following meds is contraindicated for this neonate?
narcan
estimates the date of delivery adding one year, subtracting three months, and adding seven days to the first day of a woman's last menstrual period (LMP)
negele's rule
the time of birth through the first 28 days of life is termed
neonatal period
a mother asks the nurse which powder she should purchase to use on the baby's skin
never use powder
test that evaluated the fetal wellbeing that detects fetal heart response to fetal movements
non-stress test (the indirect measurement of uterine placental function, normal fetal heart rate is 110-160)
a baby's blood type in b-, the baby is at risk for hemolytic janudice. the mother has which of the following blood types?
o- (abo incompatability)
a neonate whos mother is hiv positive is admitted to the nicu. the nursing diagnosis is risk for infection related to perinatal exposure to hiv/aids, which of the following interventions should the nurse make in regards to this diagnosis?
obtain an order for anti-viral medication asap
what maneuver is seen when assessing for the "clunk"
ortolani maneuver (if there is a click it is genital hip dysplasia)
what is a classic sign of placenta previa?
painless bright red vaginal bleeding
name for the reflect when finger is placed on palm of infant hand and the baby grasps
palmar grasp
the softening of the cervix related to hypertrophy of the cervical glands
"gooey" goodwell's sign
the newborn admitted to the nursery has a positive direct coombs test. which of the following is an inappropriate action by the nurse?
"we're looking for jaundice" (combs test assesses for antibodies in the blood, it won't predict hypoglycemia, jitteriness, or change of temp)
1st trimester
1-12 weeks
the average heart rate for the neonate is
110-160 bpm
2nd trimester
13-26 weeks
number of arteries and veins in the umbilical cord
2 arteries, 1 vein
what is the number of weeks the woman is pregnant when the fundus is at the umbilicus?
20 weeks (12 weeks at symphysis pubis)
what is the number of chromosomes in one gamete (one ovum and one sperm)?
23
3rd trimester
27-40 weeks
what trimester is 26 weeks?
2nd trimester
the number of trimesters in in a normal pregnancy
3 trimesters
a client is seeking infertility counselling, which finding highly contributes to a couple's infertility?
36 year old woman which makes her AMA (advanced maternal age)
infants receive antibodies from the mother during which trimester and from breast milk?
3rd (IgA)
how many chromosomes are in a zygote?
46
scoring test performed at 1 minute then at 5 minutes, if score is less then 7 then it is probable that some measures need to be taken
APGAR score
which hormone would the nurse identify as being primarily responsible for the maturation of the ovarian follicle?
FSH (follicle stimulating hormone)
gamete intrafallopian fetal transport, what does this describe?
GIFT, fertilization takes place in the woman's body
crosses the placenta and provides passive immunity to bacteria and viruses?
IgG
complications of which birth weight variation; hypoglycemia, intrauterine asphyxia, birth injury
LGA (large for gestational age) (macrosomnia babies)
what is the position when the baby is coming out head first and the back of the head is pointing to the right and towards the front?
ROA (right occipital anterior)
a woman has decided to hire a doula to work with her during labor and delivery, what action would be appropriate for the doula to perform?
a back massage (they are not clinical or HCP)
a woman is in active labor and is being monitored electronically. she was administered Stadol 2 mg IM for pain, which FHR response should the nurse expect to see?
a decrease variability bc analgesics are CNS depressors
immediately following administration of an epidural the nurse should monitor for what?
a drop in the maternal BP
with fetal alcohol syndrome, which of the following findings would the nurse expect to find?
a flattened maxilla
term for the bluish coloration of the newborn's hands and feet
acrocyanosis
when during the latent phase should the nurse assess the fhr pattern of a low risk woman G1P0000? (sata)
after the vaginal exam, before administration of any meds, periodically at the end of contractions, before she ambulates, every 30 minutes
what does APGAR stand for
appearance, pulse, grimace, activity, and respirations
the nurse is caring for a woman who is 38 weeks pregnant and in active labor who had a vaginal exam one hour ago when the uterus was 50% and -3 station. her membrane ruptures spontaneously, what should the nurse assess for?
assess for a prolapses cord, expect to see variable deceleration
when evaluating the fetal heart rate tracing on a client in labor the nurse notes that there are fetal heart decelerations present, which of the following assessments must the nurse make at this time?
assess the relationship between the contractions and the decelerations
a 42 week gravida is delivering her baby. the amniotic fluid is green and thick. the baby fails to breathe spontaneously, which of the following actions should the nurse take?
assist with intubation
what is being assessed when stroking finger up bottom of the foot?
babinski
which of the following reasons would the nurse in the well-baby nursery report to the neonatologist that a newborn appears to be preterm?
baby has a 90-degree pre-window angle
chart to assess gestational age
ballard's score
what is produced by hemolysis (breakdown) of the RBCs?
bilirubin
a female african american baby has been admitted into the newborn nursery, which of the following physiological findings would the nurse assess as normal? (sata)
bloody discharge from the vagina (pseudomenstruation), purple/blue colored patches on the buttocks and torso, bilateral whitish discharge from the breasts
the term for a soft/squishy uterus
boggy uterus (can cause postpartum hemorrhage)
what does the 3rd B in BUBBLEE stand for?
bowels (breasts, uterus, bladder, bowels, locchia, episiotomy, emotions)
what are the painless uterine contractions occurring at irregular intervals that start early in pregnancy and get more frequent in the last trimester?
braxton hick's contractions
what is superficially deposited around the scapula, neck, axilla, and around the kidneys; has higher capacity for heat reduction via metabolism
brown fat
a nurse is caring for a laboring patient in transition. which of the following s/s would indicate that the woman is progressing into the 2nd stage of labor? (sata)
bulging perineum, increased bloody show, uncontrolled urge to push, inability to breathe through contractions
vaginal and rectum culture done between 35-37 weeks?
group-b strep
what is the color variation related to vasoconstriction on one side of the body and vasodilation on the other side of the body?
harlequin sign
syndrome from collection of fluid, like cone heads, it will settle down at 24 hours
capput
the nurse is discussing the neonatal blood screen test with the new mother. the nurse knows that further teaching is needed when the mother states which of the following diseases is included in the screening test?
cerebral palsy (cannot be found on blood test, results from injury)
what is the name given to the mucus membranes of the vulva, vagina, and cervix that become bluish due to increased vascularity?
chadwick's sign
most commonly fractured bone during delivery, associated with babies who are LGA and encounter should dystocia
clavicle
may lead to non-shivering thermogenesis and the oxidation of brown fat to produce heat
clod stress
19 year old with multiple sex partners is being counseled about the hep b vaccine, what should the nurse advise the client to receive?
complete series of 3 IM injections
visibility of the fetal head during delivery
crowning
a glucose level below 40 mg in a term infant is often used to indicate what?
hypoglycemia
correct order of the cardinal movements of labor
descent, flexion, internal rotation, extension, restitution, external rotation, expulsion
referred shoulder pain
ectopic prgnancy
in addition to breathing with contractions, what actions can help a woman in labor with the pain of the first stage of labor?
effleurage (light massage/stroking the tummy)
what is the incision in the perianal area made during delivery to aid in helping the baby out?
episiotomy
what is the term for a misplaced urethral opening in a male?
epispadies (dorsal) or hypospadias (ventral)
a woman is menstruating so what hormonal levels should the nurse expect to see
estrogen and other hormones are LOW
how often do you check fhr in a high risk patient?
every ten minutes
a woman has just arrived at the labor and delivery unit. in order to report the client's status to her health care provider, which of the following assessments does the nurse perform? (sata)
fhr, contraction pattern, vital signs
what is the name of the supplement used to prevent neural tube defects in pregnant women?
folic acid
during fetal development, what is the shunt that allows most of the blood that enters the right atrium to flow directly into the left atrium?
foramen ovale
what is the name for the upper part of the uterus?
fundus
what are these nursing managements for: closely monitor body temp and fluid/electrolyte balance, observe skin integrity, provide eye protection to avoid corneal injury, encourage parents to participate in the newborn's care to prevent parent-infant separation.
phototherapy
what therapy the newborn undergoing when it is laying under a heated lamp?
phototherapy (billilight)
term for extra fingers or toes
polydactly
what is labor lasting less than 3 hours considered?
precipitous labor
what is the name for the part of the fetus that lies closest to the entrance of the pelvis?
presentation (presenting)
a client is complaining of severe back pain, which would be the most effect pain reliever?
provide direct sacral pressure
nursing interventions for a cord prolapse
put in gloved finger and lift head to allow relief of cord pressure, put in tredenlenberg position to relive pressure, baby has 4 minutes to be delivered to avoid lack of oxygen
what is a contributing factor for an ectopic pregnancy?
recurrent pelvic infections
a full term newborn was just born, which nursing intervention is important to perform first?
remove wet blankets to prevent hypothermia
the staff on the maternity unit is developing a protocol for nurses to use when a baby is delivered and can't breathe spontaneously. which of the following should be included in the protocol as the first action for the nurse to take?
rub the back of the baby (tactile stimulation)
the identified vaginal discharge the first 2 days after childbirth
rubra locchia (serosa comes in around days 4-5)
why is endometriosis a risk factor for becoming infertile?
scarring surrounding the ends of your tubes makes it hard for sperm to fertilize the egg
a mother one day pp, with a 3 hour labor and spontaneous vaginal delivery questions the nurse bc her baby's face is purple. then the nurse notices that is petechie over the scalp and head and cheeks of the baby. the nurse's response should be based on what?
she had a precipitous or rapid labor
stretch marks
striae
a nurse is doing a newborn assessment on a new admission to the nursery, which of the following actions should the nurse make when evaluating the baby for development dysplasia of the hip? (sata)
the baby is not in a prone position, do ortolani and barlow tests
4 patients have been admitted to the neonatal nursery, which of the babies should the nurse assess first?
the baby with APGAR 9 and weight of 4660 grams (can cause hypoglycemia bc LGA)
dirty duncan side of the placenta is which side?
the maternal side (shiny shultze = baby)
a woman had a baby boy by normal spontaneous delivery 10 minutes ago. the nurse notes that a gush of blood was just expelled from the vagina and the umbilical cord lengthened, what should the nurse prepare for?
the placenta is about to be delivered
what is the maintenance of between heat loss and heat production?
thermoregulation
what is it called when the fallopian tubes are sterilized?
tubal ligation
bilirubin is released in the __________ form
unconjugated
VBAC
vaginal birth after cesarean section
b=newborns cannot synthesize what
vitamin k
a baby has been admitted to the nicu with diagnosis of symmetrical intrauterine growth restriction, which of the following maternal factors predisposed the baby to this diagnosis? (sata)
substance abuse, chronic htn, advanced maternal age
tonic neck
supine, head turned to one side and arm to the other
reduced surface tension in the alveoli and prevents collapse of the alveoli with expiration
surfactant
the location where the process of meiosis occurs
testes or ovaries
the nurse is about to assess the moro reflex. what does the nurse expect to see?
startle reflex (when the baby extends outward and knees flex)
rooting
stroking the cheek
herniation of the peritoneum and the abdominal content into the base of the umbilical cord, abdominal hernia evisceration through the abdominal wall, covered by peritoneum and amniotic membrane
omphalocele (cover w 4x4 and NS)
what is the menial infection of the oral cavity resulting in white plaques on the oral mucosa and are caused to bleed when touched?
oral candidiasis or thrush
a woman who received an iv analgesic 4 hours ago and has prolonged late decelerations during labor. she will deliver her baby shortly, which of the following is the priority action for the delivery room nurse to take?
page the neonatologist that is on call first
waxy substance that protects the baby inutero, more than usual means the baby is immature
vernix
presentation is head first and occurs in 96% of births
vertex (cephalic)
