Maternal 2

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what is the anthropoid pelvis

"ape-like" transverse and narrow may not accomodate fetal head

a nurse is caring for a client and partner during the second stage of labor. the clients partner asks the nurse to explain how to know when crowning occurs. how should the nurse respond

"the vaginal area will bulge as the babies head appears"

a nurse is caring for a client in the third stage of labor. what are some indications of placental seperation

-lengthening of the umbilical cord -appearance of dark blood from the vagina -fundus firm upon palpation

a nurse is admitting a client who is in labor and had HIV. Which of the following interventions should the nurse identify as contraindicated for this client

-vacuum extractor -forceps -internal fetal monitoring

how many glasses of fluid should a pregnant women drink daily fo maintain adequate hydration

8-10

What is hyperemesis gravidarum?

Excessive vomiting during pregnancy that results in starvation (ketonuria), dehydration, and acidosis.prolonged past 16 weeks.

what is the first action you should take

FHR

amniotic fluid is meconial stained- what would you do for the laboring client immediately

FHR monitoring

what is the tx for hyperemesis gravidarum

IV fluids (LR) pyridoxine (B6) and other vitamins as tolerated antimetics (zofran, metoclopramide) corticosteroids to treat refractory HG zofran

what would an increase in the HR on the fetal monitor be called

above 160: tachycardia below 110: bradycardia

what are some contraindications for a client who has HIV and is in labor

amniocentesis, episiotomy, internal fetal monitors, forceps, vaccum extraction, NO injections until after first bath, C SECTION if maternal viral load is over 1000 copies/ml

what can amniocentesis measure regarding fetal lungs

amniotic fluid is tested to determine whether the fetal lungs are mature enough to adapt to extrauterine life or if the fetus will have resp distress

what causes frequent urination during pregnancy

as the baby grows it presses down on the bladder

how would you go about asking your client about her menstrual history

ask her when the first day of her last period was, asked her when the first day of missed period was. just ask

why is a non stress test done

assessing for an intact fetal CNS during the 3 trimester

a nurse is caring for a client who is in labor and observes late decelerations on the electronic fetal monitor. what is the first action should the nurse take

assist the client in the left lateral position

a nurse is caring for a client who is 32 weeks of gestation and has a placenta previa. the nurse notes that the client is actively bleeding. which medication should the nurse expect the provider will prescribe

betamethasone

a nurse is providing care for a patient who is in preterm labor at 32 weeks gestation. which of the following medications should the nurse anticipate that the provider will prescribe to hasten lung maturity

betamethasone

what drug is given to a client who has placenta previa and is 30 weeks gestation

betamethasone and a coritcosteroid given 12-24 hours before birth

what would be danger sign of labor for a women in labor

bleeding, if fluid was not clear and it was a gush of fluid. meconium staining- a green color of amniotic fluid and it indicates the fetus has had a loss of rectal sphincter control and it can indicate fetal hypoxia

why is the BP of a 16 week pregnant women lower

blood volume is increased

what would you do if your client had a sudden gush of fluid from her vagina

check FHR rupture of membranes- labor is starting, patient will need exam baby should be born within 24 hours of membranes rupturing to prevent infection (preferable)

a nurse is caring for a client who is 40 weeks of gestation and reports having large gush of fluids from the vagina while walking from the bathroom. which of the following actions should the nurse check first

check the FHR

what color should normal amniotic fluid be

clear or tinted yellow

why doesnt amniotic fluid grow stagnant

constantly moving

what are some measures to help a client with nausea

crackers, dry toast, ginger ale, sprite, sea bands, nausea medicine

which nursing intervention is most effective in applying the gate control theory for relief of labor pains

cutaneous stimulation and massage

What does the Leopold Maneuver tell you? how do you do it?

determines the position of the baby through external palpitations of the maternal uterus through the abdominal wall.start at fundus and palpate for the spine and move down using palm

a nurse is caring for a patient who is receiving nifedipine fr prevention of preterm labor. the nurse should monitor the patient for which manifestation

dizziness

what is pica and what causes it

eating of non food items such as paint, low iron can be a cause of pica

how would you approach a client who is 12 weeks pregnant and still smoking

educate her about the risks of smoking on the fetus

what would cause an immediate need for an emergency c section

fetal distress (FHR decline, prolapsed cord, placenta abruption)

what instructions would you give to a pregnant client to observe the movements of a fetus assessment

fetal kicks

what is the most effective way to assess food intake during pregnancy

food diary/journal

what is an acoustic vibration device and why is it used during pregnancy

for acoustic sound stimulation, a specially designed acoustic stimulator is applied to mothers abdomen to produce a sharp sound which will startle or wake the baby. this is done if after 5 min of being NST without any accelerations

the 2 stage of labor would bring the client to be what

frightened, crying, screaming and anger

what would be the most appropriate thing to do for a dad who has been at bedside for 12 hours

give him a break, offer support and reassurance, encourage nutrition/hydration

treatment for constipation

increase fiber intake, bulk laxatives and regular exercise

what is the purpose of giving betamethasone

increase lung maturity

a nurse is completing an admission assessment for a client who is 39 weeks of gestation and reports fluid leaking from the vagina for 2 days. which of the following conditions is the client at risk for developing

infection

what would a client be in danger of when she reports to you she has been leaking fluid from her vagina for a few days

infection

a nurse is caring for a client who is pregnant and undergoing a nonstress test. the client asks why the nurse is using an acoustic vibration device. which of the following responses should the nurse make

it awakens the sleeping fetus

what happens to the GI system during labor

it slows down

what would you have the client with premature rupture of membranes of 16 weeks gestation do

keep a record of fetal counts

what position should the mom be in when is in labor and has an external monitor on

lateral sims- side lying

a nurse is caring for a client who is in preterm labor and is scheduled to undergo an amniocentesis. the nurse should evaluate which of the following tests to assess fetal lung maturity?

lecithin/ sphingomyelin (L/S) ratio

what is the name of the test used to measure fetal lung maturity and what is the normal ratio of this test

lecithin/ sphingomyelin (L/S) ratio, 2:1 ratio indicates fetal lung maturity

what are foods rich in iron

legumes, dried fruit, dark green leafy veggies, and meat

why is the preterm fetus more effected by medication than a full term fetus

lungs, kidneys, and liver are not developed

what is a good source of B12

meats

what should you ask the client on her first prenatal visit

menstrual history, hygiene, drug/alcohol, sexual activity

what is a nonstress test

most widely used technique for antepartum evaluation of fetal well being performed during the 3 trimester. the client pushes a button attached to the monitor whenever they feel a fetal movement. this allows to monitor the response of the FHR to fetal movement

should the pregnant client take aspirin, why or why not

no bc taking aspirin increases the risk of bleeding, aspirin prevents platelet aggregation

a patient who is 6 months pregnant complains of back pain, what would the nurse suggest for her

pelvic rock and exercise ball

after the delivery of the placenta, the uterus is sluggish to contract. what should be given to the client to help the uterus contract

pitocin

a nurse is caring for a client who is using patterned breathing during labor. the client reports numbness and tingling of the fingers. which action should the nurse take

place an oxygen mask over the clients nose and mouth

what are some factors of preterm labor

pre rupture membranes

what behavior from a spouse would exhibit acceptance of pregnancy

preparing clothing and sleeping arrangements for baby and coming to appointment

a nurse is caring for a client who is in the second stage of labor. the clients labor has been progressing, and a vaginal delivery is expected in 20 min. the provider is preparing to administer lidocaine for pain relief and perform an episiotomy. the nurse should know that which of the following types of regional anestheticc block to administered

pudendal

What is an amniocentesis?

recommended 15-20wks consists of transabdominal aspiration of amniotic fluid using an ultrasound guided needle and eval of fetal cells for genetic studies

what position should the client be in when she is pushing between contractions

resting position

a nurse is caring for a client who is in active labor. the client reports lower back pain. the nurse suspects that this pain is related to a persistant occiput posterior fetal position. which of the following nonpharmacological nursing interventions should the nurse recommend to the client

sacral counterpressure

what stage of labor does crowning occur

second stage

a client reports tingling of her fingers when she is doing patterned breahting. what should the nurse do

slow down breathing to prevent hyperventilation

what are some side effects of nifedipine

tachycardia, HA, nausea, lightheadedness/dizziness, flushing, heartburn, muscle cramps, constipation and cough

how would you explain to a pregnant client that her fetus wont drown in her uterus

the baby is suppled oxygen through the umbilical cord, the baby will not take its first breath until after delivery

what does crowning look like

the head of the baby is at the opening of the vagina

what would be the first action the nurse would do for a client in labor and has late d-cells on the monitor

turn pt on the left side

what prenatal test will be performed on the client who is 16 weeks pregnant

ultrasound, STI testing, blood glucose screening

what vitamin would the vegetarian women need to supplement during pregnancy

vitamin B12


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