repro part 2 prepU
Lenugo
fine downy hair of the newborn
full bladder may displace
uterine fundus to the left or right of the abdomen
A woman has been diagnosed as having gestational hypertension. Which symptom for this condition is the most typical?
blood pressure elevation
The nurse is required to assess a client for HELLP syndrome. Which are the signs and symptoms of this condition? Select all that apply.
epigastric pain upper right quadrant pain hyperbilirubinemia nausea edema malaise
When preparing to obtain a neonatal screening test for phenylketonuria (PKU), the nurse understands that the neonate must have been fed what to ensure reliable results?
initial formula or breast milk at least 24 hours before the test
The nurse is caring for a client suspected to have a uterine rupture. The nurse predicts the fetal monitor will exhibit which pattern if this is true?
late decelerations
What would be the physiologic basis for a placenta previa?
low placental implatation
What terminology would the nurse use to document a newborn who weighs 4,000 grams (8.8 lb) or more at birth?
macrosomia
A client at 27 weeks' gestation is admitted to the obstetric unit after reporting headaches and edema of her hands. Review of the prenatal notes reveals blood pressure consistently above 136/90 mm Hg. The nurse anticipates the health care provider will prescribe magnesium sulfate to accomplish which primary goal?
prevent maternal seizures
After a lengthy labor, a primigravid client gives birth to a healthy newborn boy with a moderate amount of skull molding. What information would the nurse include when explaining to the parents about this condition?
usually lasts a day or two
The nurse makes a home visit to a 3-day-old full-term neonate who weighed 3,912 g (8 lb, 10 oz) at birth. Today the neonate, who is being bottle-fed, weighs 3,572 g (7 lb, 14 oz). Which instruction should the nurse give to the mother?
Continue feeding every 3 to 4 hours since the weight loss is normal.
Which action is most appropriate when noting small, shiny white specks on the neonate's gums and hard palate during assessment?
Continue monitoring because these spots are normal. (epstein's pearls)
A nurse visits a client at home on the 10th postpartum day. When assessing the client's uterus, which finding requires further evaluation?
a fundus palpable at the umbilicus
The nurse has been assigned to care for several postpartum clients and their neonates on a birthing unit. Which client should the nurse assess first?
a primiparous client at 2 hours postpartum who gave birth to a term neonate vaginally
A client has come to the office for a prenatal visit during her 24th week of gestation. On examination, it is noted that her blood pressure has increased to 146/94 mm Hg. Her urine is negative for proteinuria. Blood pressure assessment at 20 weeks' gestation was 142/92 mm Hg and urine was negative for protein. Blood pressure readings at previous visits ranged from 120/76 mm Hg to 126/80 mm Hg. The nurse suspects which condition?
gestational hypertension
A novice nurse asks to be assigned to the least complex antepartum client. Which condition would necessitate the least complex care requirements?
gestational hypertension
As part of the respiratory assessment, a nurse observes the neonate's nares for patency and mucus. The information obtained from this assessment is important because
neonates are obligate nose breathers.
The nurse is admitting a client at 23 weeks' gestation in preparation for induction and delivery after it was determined the fetus had died secondary to trauma. When asked by the client to explain what went wrong, the nurse can point out which potential cause for this loss?
placental abruption
After a regular prenatal visit, a pregnant client asks the nurse to describe the differences between abruptio placentae and placenta previa. Which statement should the nurse include in the teaching?
"Placenta previa causes painless, bright red bleeding during pregnancy due to an abnormally implanted placenta that is too close to or covers the cervix; abruptio placentae is associated with dark red painful bleeding caused by premature separation of the placenta from the wall of the uterus before the end of labor."
A client has been admitted to the hospital with a diagnosis of severe preeclampsia. Which nursing intervention is the priority?
Confine the client to bed rest in a darkened room.
A multiparous client whose fundus is firm and midline at the umbilicus 8 hours after a vaginal birth tells the nurse that when she ambulated to the bathroom after sleeping for 4 hours, her dark red lochia seemed heavier. Which information would the nurse include when explaining to the client about the increased lochia on ambulation? `
The increased lochia occurs from lochia pooling in the vaginal vault.
A client's membranes have just ruptured. Her fetus is presenting breech. Which action should the nurse do immediately to rule out prolapse of the umbilical cord in this client?
assess fetal heart sounds
A pregnant woman is admitted to the hospital with a diagnosis of placenta previa. Which action would be the priority for this woman on admission?
assessing fetal heart tones by use of an external monitor
Coombs test
a test for the presence of anti-Rh factor antibodies in the blood (this is often given to pregnant women that are Rh- to see if they will mount an immune response against the blood of their fetus)
A postpartum mother has the following lab data recorded: a negative rubella titer. What is the appropriate nursing intervention?
administer rubella vaccine before discharge
A client in her 20th week of gestation develops HELLP syndrome. What are features of HELLP syndrome? Select all that apply.
low platelet count elevated liver enzymes hemolysis
A primary care provider prescribes intravenous tocolytic therapy for a woman in preterm labor. Which agent would the nurse expect to administer?
magnesium sulfate
On examination of an African newborn, the nurse notes a macular, blue-black area of pigmentation near the buttocks. Which of the following actions of the nurse is appropriate?
normal in africians
When assessing an 18-year-old primipara who gave birth under epidural anesthesia 24 hours ago, the nurse determines that the fundus is firm but to the right of midline. Based on this finding, the nurse should further assess for which complication?
urinary retention
Which finding is considered normal in the neonate during the first few days after birth?
weight loss then return to birth weight
When a woman in labor has reached 8 cm dilation, the nurse notices the fetal heat rate suddenly slows. On perineal inspection, the nurse observes the fetal cord has prolapsed. The nurse's first action would be to:
place her in knee-chest position
The nurse is monitoring a client in labor who has had a previous cesarean section and is trying a vaginal birth with an epidural. The nurse observes a sudden drop in blood pressure, increased heart rate, and deep variable deceleration on the fetal monitor. The client reports severe pain in her abdomen and shoulder. What should the nurse prepare to do?
prepare client for c section
A client presents to the emergency department reporting regular uterine contractions. Examination reveals that her cervix is beginning to efface. The client is in her 36th week of gestation. The nurse interprets the findings as suggesting which condition is occurring?
preterm labor
Which assessment finding should a nurse interpret as abnormal for a 38-week gestation neonate who is 1 hour old?
slight yellowish hue to the skin
A nurse is conducting an assessment of a neonate born 3 hours ago. Which finding makes the nurse suspect a congenital hip dislocation?
unequal gluteal folds
Which instructions should the nurse give to a client after noting a white, cheese-like substance on the neonate's body creases?
allow it to remain on skin
On the second postpartum day after a cesarean birth, the client reports having gas pains. What should the nurse should instruct the client to do?
ambulate more often
A nurse is teaching a postpartum client who has decided to breast-feed her neonate. She has questions regarding her nutritional intake and wants to know how many extra calories she should eat. What number of additional calories should the nurse instruct the client to eat per day? Record your answer using a whole number.
500
A nurse places a neonate with hyperbilirubinemia under a phototherapy lamp, covering the eyes and gonads for protection. The parents asked the nurse to tell them how their baby will benefit from having phototherapy done. Which statement by the nurse is the most appropriate response about phototherapy?
"Phototherapy decreases the serum unconjugated bilirubin level."
While the nurse is conducting a teaching session on breast-feeding, a client asks why she should put her newborn to the breast within the first 30 minutes of birth. The nurse's best response will be
"The neonate will be responsive and eager to suck at this time."
A primiparous client who underwent a cesarean birth 30 minutes ago is to receive Rho(D) immune globulin. The nurse should administer the medication within which time frame after birth?
72
The nurse is preparing to administer vitamin K intramuscularly to a term neonate of a primipara who has just given birth. After explaining the purpose of the drug to the mother, which statement by the mother indicates effective teaching?
"Vitamin K will help my baby's blood to clot properly."
A nurse has been assigned to assess a pregnant client for placental abruption (abruptio placentae). For which classic manifestation of this condition should the nurse assess?
"knife-like" abdominal pain with vaginal bleeding
A primiparous client planning to breastfeed her term neonate born vaginally asks, "When will my 'real' milk come in?" The nurse explains to the client that after birth, breasts begin to produce milk within what time period?
2-4 days
The nurse is caring for a client after experiencing a placental abruption (abruptio placentae). Which finding is the priority to report to the health care provider?
45 ml urine output in 2 hours
A primipara at 36 weeks' gestation is being monitored in the prenatal clinic for risk of preeclampsia. Which sign or symptom should the nurse prioritize?
A dipstick value of 2+ for protein
After teaching a mother about the neonate's positive Babinski's reflex, the nurse determines that the mother understands the instructions when she says that a positive Babinski's reflex indicates which factor?
immature CNS
Which postoperative intervention should a nurse perform when caring for a client who has undergone a cesarean birth?
Assess uterine tone to determine fundal firmness.
The nurse is orientating in the Labor and Delivery unit and asks her preceptor how to differentiate a client with preeclampsia from one with eclampsia. Which symptoms would the preceptor describe to the new nurse as indicative of severe preeclampsia? Select all that apply.
Blood pressure above 160/110 mm Hg Nondependent edema Hyperactive deep tendon reflexes
Twelve hours after a vaginal birth with epidural anesthesia, the nurse palpates the fundus of a primiparous client and finds it to be firm, above the umbilicus, and deviated to the right. What should the nurse do next?
Encourage the client to ambulate to the bathroom and void.
A pregnant woman has been admitted to the hospital due to preeclampsia with severe features. Which measure will be important for the nurse to include in the care plan?
Institute and maintain seizure precautions.
While preparing to provide neonatal care instructions to a primiparous client who gave birth to a term neonate 24 hours ago, what should the nurse include in the client's teaching plan?
Milia are white papules from plugged sebaceous ducts that disappear by age 2 to 4 weeks.
A primiparous client expresses concern, asking the nurse why her neonate's eyes are crossed. Which information would the nurse include when teaching the mother about neonatal strabismus?
Neonates commonly lack eye muscle coordination.
When assessing a client who gave birth 24 hours ago, the post partum nurse expects to find the top of the client's fundus at which anatomic location?
One fingerbreadth below the umbilicus
A woman in labor suddenly reports sharp fundal pain accompanied by slight dark red vaginal bleeding. The nurse should prepare to assist with which situation?
Premature separation of the placenta
A G3P2 woman at 39 weeks' gestation presents highly agitated, reporting something "came out" when her membranes just ruptured. Which action should the nurse prioritize after noting the umbilical cord is hanging out of the vagina?
Put her in bed immediately, call for help, and hold the presenting part of the cord.
A neonate born by elective cesarean birth weighs 7 lb, 3 oz. (3,267 g). The nurse places the neonate under the warmer unit. In addition to routine assessments, the nurse should closely monitor this neonate for which sign?
Respiratory distress caused by lack of contractions
A term neonate's mother is O-negative, and cord studies indicate that the neonate is A-positive. Which finding indicates that the neonate developed hemolytic disease?
Signs of kernicterus
A nurse is performing a neurologic assessment on a 1-day-old neonate in the nursery. Which findings indicate possible asphyxia in utero? Select all that apply.
The neonate's toes do not fan out when soles of the feet are stroked. The neonate doesn't respond when the nurse claps her hands above him. The neonate displays weak, ineffective sucking.
While caring for a neonate 2 days after birth, the nurse observes a swelling on the neonate's head that does not cross the cranial suture line. What should the nurse tell the client about the swelling?
The swelling will resolve without treatment by 6 weeks of age.
During the admission assessment of a female neonate, a nurse notes a large lump on the neonate's head. Concerned about making the correct assessment, the nurse differentiates between caput succedaneum and a cephalohematoma based on the knowledge that
a cephalohematoma doesn't cross the suture lines.
A nurse is assessing pregnant clients for the risk of placenta previa. Which client faces the greatest risk for this condition?
a client who had a myomectomy to remove fibroids
Vernix
a greasy deposit covering the skin of a baby at birth.
The nurse is assisting a client who has just undergone an amniocentesis. Blood results indicate the mother has type O blood and the fetus has type AB blood. The nurse should point out the mother and fetus are at an increased risk for which situation related to this procedure?
baby developing postbirth jaundice
Kernicterus
bilirubin staining of the basal ganglia of the brain
A high-risk pregnant client is determined to have gestational hypertension. The nurse suspects that the client has developed preeclampsia with severe features based on which finding?
blurred vision
Which finding would the nurse expect as common for a multiparous client giving birth to a viable neonate at 41 weeks' gestation with the aid of a vacuum extractor?
caput succedaneum
A postpartum client gave birth 6 hours ago without anesthesia and just voided 100 ml. The nurse palpates the fundus two fingerbreadths above the umbilicus and off to the right side. What should the nurse do first?
catheterize the client
While caring for a multiparous client 4 hours after vaginal birth of a term neonate, the nurse notes that the mother's temperature is 99.8°F (37.2°C), the pulse is 66 bpm, and the respirations are 18 breaths/min. Her fundus is firm, midline, and at the level of the umbilicus. What should the nurse do?
continue to monitor client's vitals
What should the nurse expect to find in a premature female neonate born at 30 weeks' gestation who is small for gestational age?
fine, downy hair over the upper arms and back
A client is at the end of her first postpartum day. The nurse is assessing the client's uterus. Which finding requires further evaluation?
fundus two fingerbreadths above the umbilicus
A nurse is assessing a client on the second postpartum day. Upon palpation, the nurse discovers that the fundus is deviated to the right. To further investigate this finding, what should the nurse ask the client?
have you voided recently?
In the fourth stage of labor, a full bladder increases the risk of what postpartum complication?
hemorrhage
The health care provider (HCP) prescribes an intramuscular injection of vitamin K for a term neonate. The nurse explains to the mother that this medication is used to prevent which problem?
hemorrhage
The nurse should be especially alert for what problem when caring for a term neonate, who weighed 10 lb (4,500 g) at birth, 1 hour after a vaginal birth?
hypoglycemia
While assessing a male neonate whose mother desires him to be circumcised, the nurse observes that the neonate's urinary meatus appears to be located on the ventral surface of the penis. The health care provider (HCP) is notified because the nurse suspects which complication?
hypospadias
A primipara calls the birthing unit 3 days after a vaginal birth. She tells the nurse that she is bottle-feeding and her breasts are swollen and painful. Which instructions would be appropriate?
ice packs for 20 mins every 3-4 hours
A nurse completes the initial assessment of a newborn. According to the due date on the antenatal record, the baby is 12 days postmature. Which of the following physical findings contradicts the estimated gestational age of the newborn?
increased amount of vernix
A nurse caring for a 3-day-old neonate notices that he looks slightly jaundiced. Physiologic jaundice is caused by which characteristic?
large immature liver
The nurse is assessing a neonate born to a mother with type 1 diabetes. Which finding is expected?
large size
During a routine prenatal visit, a client is found to have proteinuria and a blood pressure rise to 140/90 mm Hg. The nurse recognizes that the client has which condition?
mild preeclampsia
When the nurse accidentally bumps the bassinet, the neonate throws out its arms, hands opened, and begins to cry. The nurse interprets this reaction as indicative of which reflex?
moro reflex
While assessing a 2-hour-old neonate, a nurse observes that the neonate has acrocyanosis. Which nursing action should the nurse perform at this time?
nothing- it is normal
A 32-year-old gravida 3 para 2 at 36 weeks' gestation comes to the obstetric department reporting abdominal pain. Her blood pressure is 164/90 mm Hg, her pulse is 100 beats per minute, and her respirations are 24 per minute. She is restless and slightly diaphoretic with a small amount of dark red vaginal bleeding. What assessment should the nurse make next?
palate fundus and check fetal heart rate
A woman in labor has sharp fundal pain accompanied by slight vaginal bleeding. What would be the most likely cause of these symptoms?
premature separation of the placenta
The nurse is admitting a client in labor. The care provider determines that the fetus is in a transverse lie and not responsive to Leopold maneuvers. What intervention should the nurse provide for the client?
prepare client for c section
The nurse is caring for a client on her second postpartum day. The nurse should expect the client's lochia to be
red and moderate
A woman in labor is at risk for abruptio placentae. Which assessment would most likely lead the nurse to suspect that this has happened?
sharp fundal pain and discomfort between contractions
A breastfeeding primiparous client who gave birth 8 hours ago asks the nurse, "How will I know that my baby is getting enough to eat?" Which guideline should the nurse include in the teaching plan as evidence of adequate intake?
six to eight wet diapers by the fifth day
Twenty-four hours after a client has given birth, the nurse documents that involution is progressing normally after palpating the client's fundus at which location?
slightly below the level of the umbilicus
A nurse is assessing a neonate born 1 day ago to a client who smoked one pack of cigarettes daily during pregnancy. Which finding is most common in neonates whose mothers smoked during pregnancy?
small size for gestational age
Which observation is expected when the nurse is assessing the gestational age of a neonate born at term?
sole creases covering the entire foot
What would the nurse expect to find during the physical examination of a preterm male neonate born at 28 weeks' gestation?
thin, wasted appearance
milia
tiny white bumps, or small cysts on the skin
A woman in active labor with a history of two previous cesarean births is being monitored frequently as she tries to have a vaginal birth. Suddenly, the woman grabs the nurse's hand and states, "Something inside me is tearing." The nurse notes her blood pressure is 80/50 mm Hg, pulse rate is 130 bpm and weak, the skin is cool and clammy, and the fetal monitor shows bradycardia. The nurse activates the code team because the nurse suspects the client may be experiencing which complication?
uterine rupture
A 3-day-old neonate is receiving phototherapy with an overhead bilirubin light to treat jaundice. What measure should the nurse include in the plan of care?
vital signs every 2-4 hours
