OB 2

The nurse admins IV magnesium sulfate to a client admitted with serve preeclampsia. The nurse identifies which classification of the medication? -diuretic -oxytocic -antihypertensive agent -central nervous depressant

-central nervous depressant

immediately after the third stage of labor, the nurse admins the prescribed oxytocin infusion. Which explanation would the nurse give the client for the purpose of this medication? -it is used to help with uterus contract -it is given to decrease uterine discomfort -it assists in the separation of the placenta -it helps stimulate the production of your breast milk

-it is used to help with uterus contract

The nurse admins 2 serial intramuscular injections of betamethasone to a woman at 32 weeks gestation admitted for preterm labor. The nurse explains to the client the medication it given to accomplish which purpose? -stop the process of labor -increase placental perfusion -stimulate surfactant production -reduce intensity of contractions

-stimulate surfactant production

which response would the nurse give to a new mother who asks if she needs to alter her diet to breast feed? -eat as you have been during your pregnany -drink a lot of milk the added calcium will help you make milk -your body produces the milk your baby need as a result of the vigrous suckling -you'll need greater amounts of the same foods you ve been eating and more fluids.

-you'll need greater amounts of the same foods you ve been eating and more fluids.

What action should the nurse implement when preparing to measure the fundal height of a pregnant client?

Have the client empty her bladder.

A client at 32-weeks gestation is diagnosed with preeclampsia. Which assessment finding is most indicative of an impending convulsion?

3+ DTR and hyperclonus

The nurse should explain to a 30-year-old gravid client that alpha fetoprotein testing is recommended for which purpose?

Screen for neural tube defects

the electronic fetal monitor on a client receiving an infusion of oxytocin (Pitocin) displays contractions every 2 minutes lasting 95 seconds. Which is the appropriate nursing action -stop the oxytocin infusion -admin oxygen at 8-10 l per min -increase the mainline fluid delivery rate to 150 ml/hr -prepare the client for the insertion of an intrauterine pressure catheter.

Stop the oxytocin infusion -the contraction pattern indication hyperstimulation of the uterus. Stopping the oxytocin infusion permits the relaxation of the uterus and perfusion of the placenta. oxygen cannot reach the placenta until the uterus is relaxed.

a client at 31 weeks gestation is admitted in preterm labor. Which class of medication would the nurse anticipate providing education for? -oxytocic -analgesic -corticosteroid -beta-adrenergic

a beta-adrenergic are tocoltic agents that my halt labor although only temporarily.

The nurse determines that a client's placenta has seperated during the 3rd stage of labor. Which clinical finding supports the nurse's conclusion? -a gush of blood -bogginess of the uterus -shrinkage of the uterus -an abrupt drop in blood pressure

a gush of blood

which intervention will be delayed until the newborn is 36 to 48 hours old? -vit K injection -test for blood glucose level -screening for phenylketonuria -test for necrotizing enerocolitis

-screening for phenylketonuria

The nurse is preparing a client with a term pregnancy who is in active labor for an amniotomy. What equipment should the nurse have available at the client's bedside?

A sterile glove An amniotic hook A Doppler

all women of childbearing age are advised to include at least 400 micrograms of folic acid in the daily diet to lessen the risk of neural tube defects in pregnancy. What should the nurse recommend to meet the recommendation? Select all that apply. -Vitamin A -Vitamin B6 -Vitamin B9 -Vitamin B12 -Legumes, dark-green leafy vegetables, and citrus fruits -Eggs, meat, and poultry

-Vitamin B9 -Legumes, dark-green leafy vegetables, and citrus fruits

Which prescribed medication would the nurse admin to a woman who is 30 weeks pregnant to promote maturity of the lungs in the fetus? -clomiphene -dinoprostone -betamethasone -methylergonovine

-betamethasone

which nutrient deficiency in the pregnant adolescents may result in decreased birthweight as a consequence of low bone mineral density in the fetus? -zinc -iron -calcium -folic acid

-calcium

Oxytocin is prescribed for a client in labor after a period of ineffective uterine contractions. What nursing interventions are most important if strong contractions that last 90 seconds or longer occur? Select all that apply. 1 Stopping the infusion 2 Turning the client on her side 3 Notifying the primary healthcare provider 4 Verifying the duration of contractions 5 Administering magnesium sulfate

1 Stopping the infusion 2 Turning the client on her side 3 Notifying the primary healthcare provider 4 Verifying the duration of contractions

which hypothalamic hormone would the nurse id as helping treat postpartum uterine atony and hemorrhage? -oxytocin -indomethacin -dinoprostone -methylergonovine

-oxytocin

which instuction would the nurse give to the pregnant client with anemia? -take an iron and calcium supplement together daily -drink OJ with an iron supplement -include fresh fruit at every meal -include 4 servings of calcium rich foods daily

-drink OJ with an iron supplement

which nutient would help the client a 6 weeks' gestation reduce the risk for neural tube defects in her baby? -niacin -folic acid -vit A -Vit B12

-Vit B12

a primipara about to be discharged with her newborn asks the nurse many questions regarding infant care. Which phase of maternal adjustment does this behavior illustrate? -let down -taking in -taking hold -early parenting

taking hold

a pregnant client with iron deficiency anemia is prescribed iron supplements daily. To help the client increase iron absorption the nurse would suggest the client eat foods high in which substance? -vit C -fat content -water content -vit B complex

-vit C

The nurse assesses a client admitted to the labor and delivery unit and obtains the following data: dark red vaginal bleeding, uterus slightly tense between contractions, BP 110/68, FHR 110 bpm, cervix 1 cm dilated and uneffaced. Based on these assessment findings, what intervention should the nurse implement?

Monitor bleeding from IV sites.The client is presenting with signs of placental abruption. Disseminated intravascular coagulation is a complication of placental abruption, characterized by abnormal bleeding. Invasive vaginal procedures can increase the abruption and bleeding.

which is the purpose of a vitamin K injection in a newborn? -it promotes conjugation of bilirubin -it promotes formation of red blood cells -it prevents destruction of red blood cells -it provides protection from hemorrhage

-it provides protection from hemorrhage

erythromycin ointment

administered to the eyes as prophylaxis to prevent gonococcal and chlamydia infection

After delivery, a client who received oxytocin to induce labor complains of tiredness and a spinning sensation. Which effect of oxytocin would the nurse infer from these symptoms? -amenorrhea -hypotension -hypertension -uterine atony

hypotension

Vitamin K

is admin via intramuscular injection to prevent hemorrhagic disease caused by vitamin K deficiency given at birth

which common indication for a cesarean birth would the nurse discuss in a class for expectants parents? -placenta previa -primary uterine inertia -cervical insufficiency -cephalopelvic disproportion

-cephalopelvic disproportion this is the most common indication for a first time cesarean birth.

The nurse identifies which physiological alteration associated with pregnancy that may change the client's response to medication? -decreased glomerular filtration rate -longer gastrointestinal emptying time -increased secretion of hydrochloric acid -development of fetal placental circulation

-longer gastrointestinal emptying time

The nurse is preparing an injection of vitamin K for the newborn. Which dosage and route will the nurse use? -1 to 1.5 mg given intramuscularly -.5 to 1 mg given intramuscularly -1 to 1.5 mg given subcutaneously -.5 to 1 mg given subcutaneously

-.5 to 1 mg given intramuscularly

A woman has been admin prostaglandin E2 as part of a treatment to induce labor. Which factor would the nurse use to determine whether an infusion with oxytocin would be continued? -an unripe cervix -1 contraction per minute -1 contraction every 3 mins cervix dilation increasing 2 cm/hour

-1 contraction every 3 mins

which med is used to prevent preterm labor? -oxytocin -nifedipine -ralxifene -clomphene

-nifedipine

which are the actions of oxytocin? -promotes milk ejection during lactation -controls uterine bleeding after delivery -induces labor when uterine contractions are weak -prevents uterine fibrosis in women of reproductive age -prevents high-risk intrauterine fetal positions before delivery

-promotes milk ejection during lactation -controls uterine bleeding after delivery -induces labor when uterine contractions are weak

which recommendation would the nurse make to a new breast feeding mother who asks how to care for her nipples? -put lanolin cream on the nipples after breastfeeding -apply vit e gel to the nipples before breastfeeding -use soap and water to clean the breasts and nipples at least once a day -spread breast milk on the nipples after the feeding and allow them to air-dry.

-spread breast milk on the nipples after the feeding and allow them to air-dry.

a client abuses alcohol during pregnancy. Which condtion would the nurse anticipate to see in the newborn? -stillbirth -heart defects -growth delay -multiple defects

-stillbirth

In evaluating the respiratory effort of a one-hour-old infant using the Silverman-anderson Index, the nurse determines the infant has synchronized chest and abdominal movement, just visible lower chest retractions, just visible xiphoid retractions, minimal and transient nasal flaring, and an expiratory grunt heard only on auscultation. What Silverman-Anderson score should the nurse assign to this infant?

4

which adverse effect would the nurse assess for after admin oxytocin to a client to stimulate labor? -edema -headache -confusion -blurred vision -uterine rupture

ALL

A client with no prenatal care arrives at the labor unit screaming, "The baby is coming!" The nurse preforms a vaginal examination that reveals the cervix is 3 cm dilated and 75% effaced. What additional information is most important for the nurse to obtain?

Date of last normal menstrual period. Evaluating the gestation of the pregnancy takes priority. If the fetus is preterm and the FHR is reassuring, the HCP may attempt to prolong the pregnancy and administer corticosteroids to mature the lungs of the fetus.

The healthcare provider prescribes terbutaline (Brethine) for a client in preterm labor. Before initiating this prescription, it is most important for the nurse to assess the client for which condition?

Gestational diabetes terbutaline increases blood glucose levels.

Cephalhematoma

Hematoma formation between the periosteum and skull with unilateral swelling it appears within a few hours of birth and can increase in size over the next few days it has a well defined outline it does not cross the suture line related to trauma to the head due to prolonged labor, forceps delivery, or use of vacuum extractor. can contribute to jaundice due to the large amounts of red blood cells being hemolyzed resolves within 3 months

which action would the nurse take when a client's membranes rupture while her labor is being augmented with an oxytocin infusion and variable decelerations in the fetal heart rate occur? -change the client's position -take the client's blood pressure -stop the client's oxytocin infusion -prepare the client for an immediate birth

change the client position variable declarations are usually result of cord compression; a change will relieve pressure on the cord

The nurse instructs a postpartum client on the admin of an iron supplement. Which drink selected by the client indicates the teaching was effective? -milk -water -cream soda -cranberry juice

cranberry juice

twenty fours hours after admission to the newborn nursery, a full term male infant develops localized edema on the right side of his head. Which answer accurately reflects the nurse's understanding of the variation of an accumulation of blood between the periosteum and the skull that does not cross the suture line?

A cephalohematoma, caused by forceps trauma and ma last up to 8 weeks

The nurse is assessing a client who is having a NEST at 41-weeks gestation. The nurse determines that the client is not having contractions, the FHR baseline is 144 bpm, and no FHR accelerations are occurring. What action should the nurse take?

Ask the client if she has felt any fetal movement.

a pregnant client has labor pains: however, upon assessment, the nurse finds the cervix is not dilated. which med would the nurse id that could be used to promote labor? -oxytocin -nifedipine -dinoprostone -methylergonovine

dinoprostone this induces cervical ripening.

a pregnant woman is diagnosed with intrauterine fetal death. Which would be the medication of choice for labor induction? -oxytocin -clomiphene -dinoprostone -methylergonovine

dinoprostone is a uterine stimulant indicated for uterine evacuation of fetal remains.

a client id'd as having a high risk pregnancy is about to undergo a contraction stress test (CST) which factor would compel the nurse to question this presciption? -blurred vision -vaginal bleeding -sickle cell diease -increasing hypertension

vaginal bleeding bleeding may indicate placenta previa or abruptio placentae which will be aggravated by contractions from the use of oxytocin.

which nursing intervention is appropriate to reduce the potentially harmful side effects of the phototherapy for a preterm neonate? -covering the trunk to prevent hypothermia -using shields on the eyes to protect them from the light -massging vit E oil into the skin to min drying -turning after each feeding to reduce exposure of each surface area.

-using shields on the eyes to protect them from the light

on the third postpartum day the nurse is preparing a breastfeeding mother of twins of discharge. Which statement by the client indicates a potential problem? -Ive been urinating large amounts ever since I gave birth -My flow is bright red with small brown clots the size of my thumb -my breasts feel full, heavy, tingly before I breastfeed the babies -I hope Ill stop being so hungry because I dont want to gain weight.

-My flow is bright red with small brown clots the size of my thumb Bright red lochia with thumb sized brown clots indicates subinvolution and requires further assessment.

The nurse prepares to admin vit K to a newborn. Which rationale explain why newborns are deficient in this vitamin -alterations in blood coagulation interfere with vit K production -a newborn's liver does not produce it immediately after birth -increased bilirubin levels interfere with vit K synthesis during the neonatal period -a newborn's intestinal tract does not synthesize it for several days after birth.

-a newborn's intestinal tract does not synthesize it for several days after birth.

The nurse is caring for a preterm neonate with physiological jaudice who requires phototherapy. Which is the physiological mechanism of the therapy? -stimulates the liver to dispose of the bilirubin -breaks down the bilirubin into a conjugated form -facilitates the execration of bilirubin by activating vitamin K -dissolves the bilirubin allowing it to be excreted by the skin

-breaks down the bilirubin into a conjugated form

Cytotec (misoprostol)

-used as a cervical ripening agent, and also used to control postpartum bleeding -Medication that may be used for medical management of a missed miscarriage inserted in the poster vaginal-oral admin not as effective.

The nurse attempts to help an unmarried teenager deal with her feelings following a spontaneous abortion at 8-weeks gestation. What type of emotional response should the nurse anticipate?

Grief related to her perceptions about the loss of this child.

caput succedaneum

diffuse edema of the fetal scalp that crosses the suture lines. reabsorbes within 1 to 3 days swelling of the soft tissues of the scalp as a result of pressure during labor

Which route would the nurse use to admin dinoprostone for the termination of pregnancy? -oral route -IV route -Intravaginal route -intramuscular route

intravaginal route dinoprostone is available as a suppository that is administered intravaginally.

which would the nurse identify as the most widely used off-label medication for cervical ripening and the enhancement of uterine muscle tone. -misoprostol -mifepristone -dinoprostone -methylergonovine

misoprostol

several minutes after a client receives an infusion of oxytocin for induction of labor the uterine monitor indicates contractions lasting 100 seconds with a frequency of 130 seconds. Which action would the nurse take next? - DC the infusion -checking the fetal heart rate -slowing down the oxytocin flow rate -turning the client on her left side.

- DC the infusion contractions lasting too long and occuring too frequently can lead to fetal hypoxia.

a client gives birth to an 8 lbs baby. 10 minutes after birth, the placenta has not yet separated. Which is the nurses' priority action at this time? -apply fundal pressure -admin a second dose of oxytocin -cont. to assess the client for signs of separation -prepare a consent form for manual removal of the placenta

-cont. to assess the client for signs of separation The 3rd stage of labor ( from birth to expulsion of the placenta) may last as long as 30 mins and still be within acceptable limits.

betamethasone 12 mg is prescribed for a client at 32 weeks gestation in active labor. Which response would the nurse give the client when asked why the medication is being given? -it increases cervical dilation -fetal lung maturity is accelerated -the risk of a precipitous birth is reduced -the potential for maternal hypertension is minimized.

-fetal lung maturity is accelerated

Early in the 9th month of pregnancy a client experiences painless vaginal bleeding secondary to a placenta previa. Which intervention would the client's plan of care include? -giving vit K to promote clotting -preforming a rectal exam to assess cervical dilation -admin an enema to prevent contamination during birth -placing the client in the semi fowler position to increase cervial pressure

-placing the client in the semi fowler position to increase cervial pressure placing in the semi fowler forces the heavy uterus to put pressure on the blood vessels at the side of the separating placenta controlling bleeding to some extrent.

a client in labor is receiving an oxytocin infusion. Which alteration in client status would the nurse recognize as an adverse reaction resulting from prolonged administration? -change in affect -hyperventilation -water intoxication -increased temperature.

-water intoxication oxytocin has an antidiuretics effect. acting to reabsorb water from glomerular filtrate possibly causing water intoxication.

which assessments and interventions are needed once an epidural catheter has been inserted? -maintain intravenous fluid admin -have oxygen available in case of hypotension -check the bladder for distention every 2 hours -position the client supine for ease of monitoring -monitor fetal heart rate and labor progress per hospital protocol -admin an oxytocin infusion to maintain the labor pattern.

-maintain intravenous fluid admin -have oxygen available in case of hypotension -check the bladder for distention every 2 hours -monitor fetal heart rate and labor progress per hospital protocol

which dietary habit in a pregnant woman would require the nurse to provide additional education? -drinking 1 L of water every day -taking a daily prenatal vitamin -avoiding deli meat and unwashed produce -drinking one small cup of caffeinated coffee each day.

-drinking 1 L of water every day

An amniotomy is performed on a client admitted for labor augmentation with oxytocin. Immedicably after the amniotomy the nurse assesses the fetal heart rate for at least 1 full minute for signs of which complication? -infection -uterine atony -umbilical cord prolapse -maternal hypertension

-umbilical cord prolapse The umbilical cord can slip down during after the amniotomy and be compressed between the fetal presenting parte and client's pelvis.

The nurse admins a medication to a pregnant woman to treat preterm labor: this medication requires an additional prescription for calcium gluconate to counter effects of the drug. Which med was admin? -nifedipine -indomethacin -betamethasone -magnesium sulfate

-magnesium sulfate to reduce magnesium toxicity caused , calcium gluconate should also be prescribed to counter effect this med.

When assessing a 7 month old infant the nurse advises the mother to avoid regular cow's milk. Which are valid reasons? -cows milk is not tolerated by infants -cows milk is a potential sourse of botulism toxin -cows milk increases the risk of milk product allergies -cows milk is a poor sourse of iron and vit C and E. -Cows milk is too concentrated for an infant's kidney's to manage

-cows milk increases the risk of milk product allergies -cows milk is a poor source of iron and vit C and E. -Cows milk is too concentrated for an infant's kidney's to manage

which situation is an indication for the nurse to anticipate admin an oxytocin infusion to a pregnant client? -hypertonic uterus -pelvic inflammatory disease -induction of labor at full term -cervical stenosis in a client who is in labor

-induction of labor at full term

which site would the nurse use to admin vit k to a newborn -deltoid muscle -rectus femoris -vastus lateralis -gluteus maximus

-vastus lateralis

while assessing a client during the forth stage of labor the nurse notes the perineral pad is soaked with approx. 75 ml of lochia rubra. which nursing action is the priority? -massage the uterine fundus -document the amount and type of lochia -accompany the client to the bathroom to empty her bladder -draw blood to test for hemoglobin and hematocrit levels

massage the uterine fundus massage of the uterine fundus is the intervention that will most rapidly address the problem of heavy bleeding.

which information regarding hormonal influences would the nurse understand when teaching a client about breastfeeding? -a high level of progesterone stimulates the secretion of oxytocin -a high level of estrogen stimulates the secretion of lactogenic hormones -milk secretion is controlled by oxytocin -suckling stimulates the pituitary gland to release oxytocin, which initiates the let-down reflex

suckling stimulates the pituitary gland to release oxytocin, which initiates the let-down reflex

which condition contraindicates oxytocin induction? -chorioamnionitis -post-term pregnancy -active genital herpes infection -hypertension associated with pregnancy

-active genital herpes infection

a client gives birth to a full term male with an 8/9 Apgar score. which would be included in the immediate nursing care of this newborn? -drying him off, assessing respirations and identifying him -applying an antibiotic to the eyes, administering vitamin K, and bathing him -aspirating the oropharynx, rushing him to the nursery, and stimulating him. weighing him, placing him in a crib and waiting until the mothers is ready to hold him.

-drying him off, assessing respirations and identifying him

a client who is 29 weeks pregnant has uterine contractions. Which med prescription would the nurse anticipate administering? -oxytocin -dinoprostone -indomethacin -methylergonovine

-indomethacin

which action identified by the student indicated to the nurse an understanding of oxytocin in a pregnant client at term? -ejection of milk -induction of labor -induction of abortion -control of uterine bleeding

-induction of labor

which action would the nurse take on finding that a client receiving oxytocin IV has a soft, boggy fundus a half-hour after a cesarean birth? -elevate the client's legs -massage the client's fundus -increase the client's oxytocin drip rate -examine the client's perineum for bleeding

-massage the clients fundus gentle massage stimulates muscle fibers, resulting in firming the tone of the fundus. to also helps expel and clots that may in interfering with contraction of the fundus.

a woman comes into the clinic and states that she is thinking about becoming pregnant. which can the woman do to improve the health of her baby before she becomes pregnant. -elimate coffee -start running 3 miles a day -start taking prenatal vit avoid fish in her diet.

-start taking prenatal vit

which information about lactogenesis would the nurse provide to a new mother? -oxytocin stimulates milk production -suckling stimulates the release of oxytocin -estrogen stimulates the secretion of lactogenic hormones' -placental separation stimulates the release of progesterone

-suckling stimulates the release of oxytocin

A 4-week-old premature infant has been receiving epoetin alfa (Epogen) for the last three weeks. Which assessment finding indicates to the nurse that the drug is effective?

Changes in apical hear rate from the 180s to the 140s.Epogen, given to prevent or treat anemia, stimulates erythropoietin production, resulting in an increase in RBCs, Since the body has not had to compensate for anemia with an increased heart rate, changes in heart rate from high to normal is on indicator that Epogen is effective

The nurse identifies crepitus when examining the chest of a newborn who was delivered vaginally. Which further assessment should the nurse perform?

Observe for an asymmetrical Moro reflex.

the nurse assesses a client in the labor room and finds the Bishop score for her cervical status is 6. Which med would be admin to this client? -oxytocin -dinoprostone -mifepristone -methylergonovine

dinoprostone

a client was admin oxytocin to induce labor but the client was not responsive to the treatment. Which oral uterine stimulant would the nurse id as the next choice in this condition? -misoprostol -mifepristone -dinoprostone -methylergonovine

misoprostol this is a oral stimulant that helps in inducing labor when the uterus is insensitive to oxytocin.

A pregnant woman comes to the prenatal clinic for an initial visit. In reviewing her childbearing history, the client indicate that she has delivered premature twins, one full-term baby, and has had no abortions. Which GTPAL should the nurse document in this client's record?

the prenatal clinic for an initial visit. In reviewing her childbearing history, the client indicate that she has delivered premature twins, one full-term baby, and has had no abortions. Which GTPAL should the nurse document in this client's record? 3-1-1-0-3

a client in her 36th week of gestation is admitted with vaginal bleeding, severe abdominal pain, a rigid fundus, and signs of impending shock. For which intervention would the nurse prepare? -a high forceps birth -an immediate Cesarean birth -insertion of an internal fetal monitor -admin of an oxytocin infusion

-an immediate Cesarean birth the clients signs and symptoms are those of a complete placentals separation (abruptio placentae) for which an immediate cesarean birth is the idea treatment

a client's cervix is dilated 3 cm and 50% effaced. Her membranes have ruptured: the amniotic fluid is clear and the fetal heart rate is stable. Which outcome would the nurse anticipate? -a prolonged second stage of labor -a difficult birth resulting from delayed effacement -birth of the fetus within a day -the simulation of labor with an oxytocin infusion

-birth of the fetus within a day

which factor may alter the absorption of meds taken orally during pregancy? -delayed gastrointestinal emptying -a reduced glomerular filtration rate -developing fetal placental circulation -increasing serum transaminases

-delayed gastrointestinal emptying

a resident primary health care provider in the birthing unit asks for the nurse to prepare for a vaginal exam on a client with a partial placenta previa in early labor. which action would the nurse take at this time. -preparing an IV piggyback of oxytocin -explaining why a vaginal exam should not be performed -obtaining an internal monitor to be applied during the exam -having equipment ready for fetal scalp pH after the exam.

-explaining why a vaginal exam should not be performed a vaginal exam may cause separation of the placenta, resulting in hemorrhage. it should not be performed.

after 8 hours postpartum the nurse determines that a clients fundus is 3 cm above the umbilicus and displaced to the right. Which statement is most significant in confirming the reason for the location of the uterus? -ive been so thirsty the past few hours -i went to the bathroom but I cant seem to urinate -ive changed my pad once since i got to my room -ive had a lot of contractions especially while i was nursing.

-i went to the bathroom but I cant seem to urinate this suggests urine retention.

Which meds would the nurse id as being used to induce labor in pregnant clients? -oxytocin -ergonovine -carboprost -misoprostrost -dinostone

-oxytocin -misroprostrost -dinostone

The first time parents of a newborn are concerned about red pinpoint dots on their infants face and neck. How would the nurse explain the finding? -the are obstucted sebaceous glands -they are excessive superficial capillaries -the cause is a decreased vit K level in the newborn -the cause is an increased intravascular pressure during birth.

-the cause is an increased intravascular pressure during birth.

For which adverse reaction caused by a prolonged oxytocin infusion to augment labor would the nurse monitor the client? -change in affect -hyperventilation -water intoxication -fever

water intoxication

Which action would the nurse take first when a client receiving oxytocin to augment labor begins to moan loudly and her contractions become more intense and prolonged, with little or no rest period between them? -cont the fetal monitoring -DC the oxytocin infusion -notify the primary health care provider -place the client in the knee-chest position

-DC the oxytocin infusion

a postpartum client receiving an infusion of oxytocin to stimulate labor asks the nurse why it is not being discontinued now that the baby is born. which response by the nurse is most appropriate? -it promotes the flow of lochia -the contractions prevent excessive bleeding -the oxytocin eases the discomfort of involution -the oxytocin enhances the healing of tissue in the uterus

the contractions prevent excessive bleeding

which clincial finding is most important for the nurse to assess if a client has had a precipitous birth? -sudden chilling -profuse bledding -decrease in heart rate -increased blood pressure

profuse bleeding a precipiate birth may be injurious to both mother and neonate.

Hemabate (Carboprost)

prostaglandin Dosage: 250 mcg injected into uterus Action: contraction of uterine muscle indication: uterine atony

a client who is having her labor induced with oxytocin has internal feta monitoring in place. Her contractions are occurring every 2 mins, are lasting 70 seconds and are reaching 65 mm HG on an intrauterine pressure catheter. The baseline fetal heart rate is 130 to 140 beats/min with variability of about 15 beats/min. The nurse notices that with the past two contractions the fetal heart rate began to drop during the peak of the contration to 110 beat/min where it remained for about 40 seconds before returning to baseline. What type of pattern is this? -bradycardia -late decelerations -early decelerations -variable decelerations

-late decelerations this begins during the peak of a contraction and continue after the contraction had ended.

which is the nurse's responsibility when a client's labor is being stimulated with an oxytocin? -checking the fetal heart rate every 2 hours -flushing the IV tubing if the flow slows -stopping the infusion if contractions become hypertonic -decreasing the infusion rate if hypertonic contractions continue for 15 mins

-stopping the infusion if contractions become hypertonic hypertonic contractions of the uterus if allowed to cont. can lead to nonreassuring fetal signs and uterine rupture; therefore the infusion should be DCd to stop the hypertonic contractions.

A client in active labor is admitted with preeclampsia. Which assessment finding is most significant in planning this client's care?

Patellar reflex 4 +indication of impending seizure

A woman who gave birth 48 hours ago is bottle-feeding her infant. During assessment, the nurse determines that both breast are swollen, warm, and tender upon palpation. What action should the nurse take?

Apply cold compresses to both for comfort.

which med would the nurse id as being use to induce spontaneous abortions? -oxytocin -estradiol -progestins -clomiphene

oxytocin

Whole milk cannot be substituted for formula because it does not meet an infant's requirements for which nutrients? -fat and calcium -vit C and iron -thiamine and sodium -protein and carbs

vit C and iron

A client at 32-weeks gestation comes to the prenatal clinic with complaints of pedal edema, dyspnea, fatigue, and a moist cough. Which question is most important for the nurse to ask this client?

Do you have a history of rheumatic fever?Clients with a history of rheumatic fever may develop mitral valve prolapse, which increases the risk for cardiac decompensation due to the increased blood volume that occurs during pregnancy, so obtaining information about this client's health history is a priority.

which is the first-line medication used to manage intrauterine fetal death? -dinoprostone -misoprostol -miefpristone methylergonovine

-dinoprostone is a synthetic derivative of the hormone prostaglandin E2. it is sue to manage intrauterine fetal death up to 28 weeks of gestational age.

A client in preterm labor has a dilated cervix, and birth appears inevitable, despite medication. Which med would the nurse anticipate prepare to admin to increase the chance of the newborn's survival? -misoprostol -nalbuphine HCL -betamethasone -carboprost tromethamine

betathasome enhances fetal lung maturity when admin before preterm birth.

which clinical finding during labor induction requires the nurse to DC the oxytocin infusion? -contraction occurring every 3 mins lasting 60 seconds -elevations of BP from 110/70 to 135/85 over 30 mins -rupture of membranes with amitotic fluid that contains threads of blood and mucus -several late fetal heart rate declarations that return to baseline after contraction is over

-several late fetal heart rate declarations that return to baseline after contraction is over late decelerations suggest uteroplacental insufficiency which is an indication that the oxytocin infusion should be stopped. cont. may compromise the fetus.

which complication would the nurse be alert for in a client receiving an oxytocin infusion to induce labor? -intense pain -uterine tetany -hypoglycemia -umbilical cord prolapse

-uterine tetany

The nurse will evaluate the client receiving oxytocin for which desired response? -limitation of the discomfort of the episiotomy -relaxation of the uterus us that it may be emptied -stimulation of the client's breasts so the breastfeeding may be started -prevention of the occurrence of profuse bleeding after placental separation

-prevention of the occurrence of profuse bleeding after placental separation oxytocin will cause the uterus to contract after the placenta has been expelled preventing hemmorrage.

The nurse is providing discharge teaching for a client who is 24 hours postpartum. The nurse explains to the client that her vaginal discharge will change from red to pink and then to white. The client asks, "What if I start having red bleeding after it changes?" What should the nurse instruct the client to do?

Reduce activity level and notify the healthcare provider.

One hour after giving birth to an 8- pound infant a client's lochia rubra has increased from small to large and her fundus is boggy despite massage. The client's pulse is 84 beats/minute and blood pressure is 156/96. The healthcare provider prescribes Methergine 0.2 mg IM x 1. What action should the nurse take immediately?

Call the healthcare provider to question the prescription.Methergine is contraindicated for clients with elevate blood pressure, so the nurse should contact the healthcare provider and question the prescription

which is the priority intervention for the nurse to perform on a client who is noted to have a relaxed and boggy uterus 1 hour after delivery? -massage the uterus until firm -check the client's blood pressure -obtain a prescription of oxytocin -notify the primary health care provider immediately

massage the uterus until firm immediate action to prevent excessive bleeding involves massaging the uterine fundus until its firm, which stimulates uterine muscle contraction.

a client wants to abort her pregancy after 4 months of gestation. For which oral medication would the nurse anticipate providing? -oxytocin -misoprostol -indomethacin -dinoprostone

misoprostol

The primary health care provider plans to perform a vaginal exam of a client with a partial placenta previa. Which would the nurse have available when the exam is performed? -one unit of freeze dried plasma -vit K and a syringe for injection -heparin sodium for IV infusion -2 units of typed and cross matched blood

-2 units of typed and cross matched blood

when discussing dietary needs during pregnancy a client tells the nurse that milk causes her to be constipated at times. Which would the nurse teach the client. -substitute a variety of cheeses for milk -replace fat-free or low fat milk for milk -increase intake of prenatal supplements and omit the milk -increase high fiber foods and water intake and cont drinking milk

-increase high fiber foods and water intake and cont drinking milk

An oxytocin infusion is prescribed to augment labor for a client with mild contractions that last 30 seconds and are 3-5 mins apart. Which is the priority nursing intervention at this time? -checking cervical dilation every hour -keeping the labor environment dark and quiet -infusing oxytocin by piggybacking into the primary line -positioning the client of the left side throughout the infusion

-infusing oxytocin by piggybacking into the primary line allows it to be DC if needed while permitting the vein to remain open by way of the primary IV line.

After the birth of her child, a mother tells the nurse I was told that my baby has to have an injection of vit K. Why is this necessary? Which response by the nurse is appropriate? -your baby needs the injection to promote development of red blood cells -an injection of vit K will help keep your baby from becoming jaundiced -newborns are deficient in vit K. This treatment will ensure adequate levels -a newborn's blood clots extremely rapidly this injection will help decrease the clotting time.

-newborns are deficient in vit K. This treatment will ensure adequate levels

which nursing intervention may help prevent cardiac decompensation in a laboring client with heart disease? -positioning her on the side with her head on a pillow -positioning her on the side with her shoulders elevated -admin the prescribed IV infusion of isotonic saline -admin the prescribed IV piggyback infusion of oxytocin

-positioning her on the side with her shoulders elevated The side lying postion, partially the left take the weight off large blood vessels increasing blood flow to the heart. elevating the shoulder relives pressure on the diaphragm.

caput succedaneum

A localized soft tissue edema of the scalp. It feels "spongy" and can cross the suture line. results from prolonged pressure of the head against the materal cervix during labor resolves within the first week of life

The nurse is preparing to give an enema to a laboring client. Which client requires the most caution when carrying out this procedure? A. A gravida 6, para 5 who is 38 years of age and in early labor. B. A 37-week primigravida who presents at 100% effacement, 3 cm cervical dilatation, and a -1 station. C. A gravida 2, para 1 who is at 1 cm cervical dilatation and a 0 station admitted for induction of labor due to post dates. D. A 40-week primigravida who is at 6 cm cervical dilatation and the presenting part is not engaged.

D.When the presenting part is ballottable, it is floating out of the pelvis. In such situation, the cord can descend before the fetus causing a prolapsed cord, which is a emergency situation.

Magnesium Sulfate

used for women with severe features of preeclampsia. the antidote is calcium gluconate side effects: maternal: nausea, flushing, diparesis, blurred vision, lethargy, hypocalcemia, depressed reflexes, respiratory depression arrest, cardiac dysthymias, decreased platelet aggregation circulatory collapse. assess deep tendon reflexes. as they may be absent.

betamethasone

a steroid given to women to accelerate fetal lung maturity, thereby decreasing the severity of respiratory distress syndrome and other complications of prematurity in the neonate. Treatment with antenatal corticosteroids reduces the risk of neonatal respiratory distress syndrome, cerebroventricular hemorrhage, necrotizing enterocolitis, and infectious morbidity in the neonate when used between 24-34 weeks gestation.

Methergine (Methylergonovine)

oxytocic/ergot alkaloids Dosage: PO 200-400 mcg every 6-12 hours for 2-7 days IM 200 mcg every 2-4 hours up to 5 doses. IV for emergencies only same as IM. Action: directly stimulates smooth and vascular muscles causing sustained uterine contractions Indications: prevent or treat PP hemorrhage/uterine atony subinbolution. contraindicated in hypertensive patients.

a pregnant woman with cervical stenosis has been admitted to the hospital for labor induction. Which med would the nurse anticipate on administering? -oxytocin -misoprostol -dinoprostone -ergot alkaloids

oxytocin -promotes labor by enhancing uterine contractions and thus can be used in pregnant women with cervical stenosis.

A lactating mother is administered oxytocin. The nurse understands which to be the function of oxytocin in this client? -it helps with the ejection of milk -oxytocin is used to induce labor -it can induce abortion -it helps control uterine bleeding after delivery

-it helps with the ejection of milk