Going Viral
What vaccinations are recommended during pregnancy and which are contraindicated?
Recommended: flu and tdap and RSV in RSV /flu season
Contraindicated: MMR
What does NAS stand for?
Neonatal Abstinence Syndrome
A nurse is caring for a 2 hr postpartum patient experiencing several clots and has a deviated fundus. What is the first action the nurse should take?
Massage the uterus
Your newborn patient is breathing at a rate of 52 breaths per minute with periodic apnea episodes of about 5 seconds. The infant is 5 hours old, pink, and has acrocyanosis. What is the nurses next action?
a. administer oxygen
b. continue to routinely monitor the newborn
c. place the infant in an isolette on a pulse ox
d. ask the physician for an arterial blood gas
Continue to routinely monitor the newborn
How does cervical insufficiency differ from preterm labor?
Cervical insufficiency involves cervical dilation without uterine contractions
pre-term labor includes regular uterine contractions that lead to cervical change
True or false, A cesarian birth should be scheduled as soon as the water breaks if the mother is currently experiencing an outbreak of herpes simplex 2 virus.
False, a cesarian section should be scheduled before the patient goes into labor and an emergency c-section should be performed if the patient ruptures.
What is the name of the position if the fetus has fully extended its head and is presenting with its chin.
Mentum
A nurse is assessing an infant that is 12 hours old and notices mild jaundice on the face and trunk. What is the first priority?
The nurse should notify the provider and obtain stat bilirubin level (blood serum)
A nurse is caring for a preterm newborn on oxygen therapy. What is a potential complication for this infant on oxygen therapy?
Retinopathy
What causes the hypervolemic state in pregnancy and why is it important?
Maternal blood volume increases by 30-50 to support the growing fetus and meet oxygen demands, nutrient demands, and compensate for blood loss during labor
True for False, GBS cultures should be obtained at 28-30 weeks of gestation
False, cultures should be obtained between 35-37 weeks.
Which of the following nursing actions should the RN identify as contraindicated when caring for a newborn with a mother who has narcotic abuse disorder?
Tight swaddling, small frequent feedings, skin to skin, frequent assessment and stimulation
Frequent assessment and stimulation
What is the primary cause of early postpartum bleeding and how is it manifested?
Uterine atony, a relaxed and boggy uterus
What are the key indicators for transferring a patient from a home birth to a hospital setting?
Temp above 38C, prolonged labor, abnormal fetal heart rate, meconium, unexpected bleeding
If your patient is allergic to Penicillin and GBS positive, what antibiotics can you give?
Cefazolin (for low risk allergy), Clindamycin, Vancomycin
Which of the following clinical manifestation in the newborn indicates mag sulfate toxicity due to mag therapy?
Respiratory and neuromuscular depression
Jaundice of the newborn in the first 24 hours of life is considered ___________
pathologic
What marks the beginning and the end of the first stage of labor?
It starts with onset of consistent contractions and dilation, and it ends when the patient is complete
When should the temperature of a client with ruptured membranes be assessed during the second stage of labor?
Every hour
Can you list three signs/symptoms of Fetal Alcohol syndrome in the newborn?
Tachypnea, nasal flaring, retractions, irritability, tremors, poor feeding, vomiting, continued crying
I should not give this medication to my patient if she has postpartum bleeding and a history of asthma and why?
Hemabate
It can cause bronchoconstriction and bronchospasm
How does the closure of fetal circulatory shunts contribute to the newborns extrauterine life and what are their names (3)
it redirects blood flow to the lungs and liver
ductus arterioles, foramen ovale, ductus venosus
What key factors should the nurse assess during uterine contractions to evaluate the labor process?
Intensity, duration, frequency, and presence of relaxation between contractions