Antepartum
A client's LMP was October 10. Using Naegele's rule, this is her estimated due date.
What is July 17 of next year? (Subtract 3 months, add 7 days.)
This stage of labor begins with complete cervical dilation (10 cm) and ends with birth of the newborn.
What is the second stage?
These are the three stages of lochia in order.
What are rubra (red), serosa (pink-brown), and alba (white-yellow)?
This is the expected respiratory rate range for a newborn.
What is 30 to 60 breaths/min?
New-onset hypertension (≥140/90) after 20 weeks of gestation with proteinuria is this condition.
What is preeclampsia?
A client is pregnant for the 4th time. She has had 1 term birth, 1 preterm birth, and 1 miscarriage at 8 weeks, and both children are living. This is her GTPAL.
What is G4 T1 P1 A1 L2?
This is the expected baseline fetal heart rate range.
What is 110 to 160 bpm?
The nurse finds a boggy uterus on the first fundal check. This is the first action.
What is to massage the fundus until firm?
The Apgar score is assessed at 1 and 5 minutes and includes these five components.
What are heart rate, respiratory effort, muscle tone, reflex irritability, and color?
The letters in HELLP syndrome stand for these.
What are Hemolysis, Elevated Liver enzymes, and Low Platelets?
These are the only three signs of pregnancy considered positive (diagnostic).
What are fetal heart tones heard by Doppler or fetoscope, fetal movement felt by the examiner, and visualization of the fetus on ultrasound?
These decelerations begin after the peak of the contraction and return to baseline after it ends. They indicate this problem.
What are late decelerations, indicating uteroplacental insufficiency? (Reposition left lateral, give oxygen, increase IV fluids, stop oxytocin, notify the provider.)
The fundus is above the umbilicus and deviated to the right. The nurse suspects this and should do this next.
What is a full bladder, and assist the client to void (or catheterize if unable)?
Vitamin K is given IM to the newborn for this reason, in this site.
What is to prevent hemorrhagic disease of the newborn, in the vastus lateralis?
Screening for gestational diabetes is typically done during this time frame.
What is 24 to 28 weeks of gestation?
This B vitamin is recommended before conception and in early pregnancy to reduce the risk of neural tube defects.
What is folic acid (folate)?
Abrupt, V-shaped drops in FHR that vary in timing with contractions are caused by this.
What is umbilical cord compression (variable decelerations)? (Change maternal position; amnioinfusion may be ordered.)
This acronym is used to assess the episiotomy or laceration site for healing.
What is REEDA (redness, edema, ecchymosis, discharge, approximation)?
A newborn is jittery and lethargic, feeds poorly, and has a high-pitched cry. The nurse suspects this and should check this first.
What is hypoglycemia, and check the blood glucose? (Risk factors: infant of a diabetic mother, SGA, LGA, preterm.)
Painless, bright red vaginal bleeding in the third trimester suggests this condition. This procedure is contraindicated.
What is placenta previa, and no vaginal examination?
A client at 24 weeks has a fundal height of 30 cm. The nurse should suspect these possible causes and report the finding.
What are multiple gestation, polyhydramnios, or a gestational age error? (From about 18 to 32 weeks, fundal height in cm should match gestational weeks within 2 cm.)
After rupture of membranes, the nurse sees the umbilical cord at the vaginal opening. This is the priority action.
What is to relieve pressure by lifting the presenting part off the cord with a sterile gloved hand, call for help, and place the client in knee-chest or Trendelenburg position? (Give oxygen and prepare for emergency cesarean birth.)
This is the most common cause of early postpartum hemorrhage.
What is uterine atony?
Jaundice appearing in the first 24 hours of life is classified as this.
What is pathologic jaundice? (Physiologic jaundice appears after 24 hours, typically days 2 to 3.)
Sudden, painful, dark red bleeding with a rigid, board-like abdomen suggests this.
What is abruptio placentae (placental abruption)?