OB practice HESI
Which position increases cardiac output in a client with cardiac disease?
Lateral position
Position for patient placed on bedrest with increased risk for preterm labor
Lie on the side with head raised on small pillow -- bed rest keeps pressure of fetal head off of the cervix. Side-lying position keeps the gravid uterus from impeding blood flow through major vessels thus maintaining uterine perfusion
Effleurage
Light, continuous-stroking massage movement applied with fingers and palms in a slow and rhythmic manner.
adverse affect of administering Vitamin K to newborn
Pain, edema, erythema
Cardiac disease with lowest maternal mortality risk
Patent ductus arteriosus
why is multiple-gestation high risk?
Perinatal mortality is two to three times more likely than in single births can cause Uterine Atony
Exstrophy of the bladder also is associated with
Pubic bone malformation
immediate nursing action with a patient admitted with abdominal pain and heavy vaginal bleeding
START IV
Which intervention is delayed until the newborn is 36 - 48 hours old?
Screening for phenylketonuria
What risk to the fetus is associated with a maternal diagnosis of chorioamnionitis?
Sepsis, Bacteremia, Pneumonia, Cerebral palsy (CP), Respiratory distress syndrome (RDS)
Uteroplacental insufficiency
Side lying position, give O2 second
Score 1 Respiration
Slow, weak cry
signs of abnormal infant breathing
Stridor, mottling, bradypnea, nasal flaring, expiratory grunting
Morning sickness disappears by the end of which month?
Third Month
STI caused by protozoa
Trichomoniasis
What complication is common in Vitro fertilization?
Tubal pregnancy
testing for preeclampsia
Urine dipstick positive for protein
What should the nurse recommend for post-cesarean gas pain?
Walking around the room
Which technique is appropriate for an OB client with a foreign airway obstruction
Chest thrusts
Why provide warm, humidified oxygen to a preemie?
Cold stress
with contractions, 15 beats/min decel below baseline lasting 15 seconds (variable)
Cord compression -- Intervention: Change maternal position
What happens after birth that increases the risk for cardiac decompensation in a client with a compromised cardiac system?
Extravascular fluid is remobilized into the vascular compartment
Immediate nursing action when clients membranes rupture spontaneously
Assess the FHR
newborn with small, flat pink spots on the nape of the neck
Nevi
immediatley after birth, where is fundus?
2 cm below the umbilicus during first several postpartum hours the uterus will rise slowly to just above the level of the umbilicus
lochia alba
6 weeks after birth
The ear and pinnae spring back
@ 36 weeks
Chadwick sign
bluish discoloration of cervix that occurs normally in pregnancy at 6 to 8 weeks' gestation
complication of spontaneous abortion
hemorrhage
complication with abruptio placentae
hemorrhage which leads to hypovolemic shock
Risks associated with diabetes in pregnancy
hypertensive disorders, polyhydramnios,
Let-down reflex
i will apply warm packs and massage my breasts before each feeding
Babinski reflex
immature neuromuscular system causes dorsiflexion of big toe and fanning of rest of toes.
NST (non-stress test)
increase in fetal heart rate called accelerations are a sign of fetal well=being
precipitate birth
increased maternal morbidity rate, because hemorrhage and infection may occur as a result of the trauma of a rapid, forceful birth in a contaminated field.
Retained abortion
lifeless products of conception are retained
instruction for BSE
squeeze nipple to examine discharge: serous or bloody discharge is pathological and must be reported
How to suction a term neonate with bulb syringe
suction mouth before nostrils
PT. ed for taking bisphosphonates
take on an empty stomach in the morning
what action should the nurse take to confirm ROM
test the leaking fluid with nitrazine paper
why does jaundice occur in a newborn?
the expected physiological breakdown of fetal red blood cells and the inability of the newborn's liver to conjugate the resulting bilirubin.
manifestations of Hypoglycemia
tremors, apnea, cyanosis, poor suckling ability
Pt eduation to releive symptoms of a yeast infection
use a sitz bath
Threatened Abortion
vaginal bleeding at 12 weeks gestation with audible fetal heart rate and closed cervix
when finding a saturated pad, always ask first ....
when did you last change the perineal pad?
small, flat pink spots on the nape of the neck
Nevi
hyperreflexia in severe pre-eclampsia
indicates central nervous system irritability, a sign of worsening condition which could lead to seizures
when cervix is dilated
inevitable abortion
Risk factors for an infant developing jaundice
infection, prematurity, breast-feeding, maternal diabetes
lochia serosa
thinner, brown pinkish discharge, lasts about 2 weeks
patient with dizziness and tingling of the hands
means respiratory alkalosis, from hyperventilating, breathing into cupped hands or a paper bag
What type of lochia would you expect to observe on a client's pad on the third day after a vaginal delivery
moderate Lochia rubra
Priority nursing intervention during admission of primigravida in labor
monitoring fetal heart rate
sudden sharp pain in abdomen, fetal hyperactivity, fundal tenderness and small amount of dark-red bleeding
partial placental abruption
incomplete abortion
parts of the pregnancy tissues are expelled and parts remain in the uterus
Patient education for episiotomy care
perform perineal care after toileting until healing occurs to prevent infection
Why is multiple-gestation pregnancy considered a high risk?
perinatal mortality is two to three times more likely
high-risk nutritional practice when a pregnant client is anemic
pica
Necrotizing enterocolitis risk factor
polycythemia - places the preterm infant at risk for NEC
smoking affect on newborn
low birth weight
How much calcium to take daily?
1000 mg
which time during the menstrual cycle is the optimal time to achieve pregnancy
14 days before the next period is expected
charcateristics of down syndrome
21 Trisomy: - Simian crease - stubby fingers - small ears - hypotonic muscles
How long is ovum viable after ovulation?
24 hours
for which period of time is the ovum capable of being fertilized after ovulation?
24-36 hours
when would a client with type 1 diabetes expect to increase her insulin dosage?
24th and 28th week of gestation -- at the end of 2nd tri, insulin needs increase,
Breast tissue is not palpable until
33 weeks
Creases of the palms and soles are not clearly defined until after the
37th week
a zero-degree square window sign is present in an infant at
40-42 weeks gestation
Healthy hematocrit level in newborn
45-65%
Monitor infant for jaundice when mother has blood type -
Blood Type O
what considerations for a client considering oral contraceptives
Blood clots, heart disease, breast cancer, impaired liver function, undiagnosed vaginal bleeding, smoking more than 15 cigs per day
Heart tones heard around umbilicus
Breech presentation
incomplete abortion
when part of the fetus or placenta remains in the uterus after the procedure
When can the heartbeat be detected?
Doppler ultrasound 10-12 weeks
At which week does embryo become a fetus?
During 8th week of pregnancy
red rash consisting of small papules on the face, chest, and back of the newborn
Erythema toxicum
Naegele's Rule
add 7 days to LMP, subtract 3 months, add 1 year
Plan of care for a client who is being treated for a sexually transmitted infection and reports fever and irregular bleeding?
analgesics, abdominal palpation, CBC, culture of the cervical canal, adminstration of antibiotics as prescribed, teaching about negative effects of douching
POC for patient with large painful varicose veins
assess for signs of thrombophlebitis
what differentiates true labor from false labor
cervical dilation
vernix caseosa
cheeslike substance that protects the skin, is secreted by the fetus' skin toward end of pregnancy.
What symptoms indicate infection in pregnant client?
chills, fever, diarrhea, flank pain, burning on urination
FOLIC ACID in pregnancy
deificiency can cause neural tube defects. foods with at least 100 mcg of folate are black-eyed peas, breakfast cereal
Alpha-fetoprotein (AFP)
detects neural tube defects
Milia
distended sweat (eccrine) glands that looks like white heads on. the infants nose
caput succedaneum
edema of the fetal scalp that crosses the suture lines
Plan of care for patient who took carbamazepine during first trimester
evaluation of a neural tube defect
early neonatal weight loss in first 3 days of life
excretion of accumulated excess fluids
tonic neck reflex
healthy newborn, lying in supine position with head turned to one side and flexed on the opposite side. (Fencing position)
Nursing intervention for late decelerations
position client on the left side -- Placental perfusion
Risks associated with advance maternal age
preterm labor, multiple gestation, chromosomal anomalies, bleeding in first trimester
physiologic changes after an amniotomy (artificial rupture of membranes) is performed
progressive dilation and effacement
offspring of men of advanced paternal age are at an increased risk for
schizophrenia
sensory simulation strategy for nonpharm pain relief
selecting focal point, and beginning breathing techniques
menorrhagia
severe bleeding during menstrual periods
Lochia rubra lasts
3 days, up to 7
Nursing instruction for a client in preparation for ultrasonography at the end of her first trimester?
Increase fluid intake for 1 hour before the procedure.
