Assessment/Labor/PP
What four things are assessed to determine the presence of a DVT?
1. Pain
2. Warmth
3. Redness
4. Swelling
An Afghani patient insists on covering their infant's head with blankets over the basinet and you're worried about SIDS. What would be an appropriate response from the nurse?
"While it may be your culture to cover your child in this way, it can increase the amount of CO2 accumulated around your child's mouth/nose and increase the risk for SIDS."
Educate the patient about the risks and document the education and their response.
List signs and symptoms if increased ICP's in newborns/infants and children
Newborns and infants: bulging fontanels, increased head circumference, high-pitched cry, distended scalp veins, irritability, bradycardia, and respiratory changes
Children: increased irritability, vomiting, headache, nausea, diplopia, seizures, bradycardia, and respiratory changes
While feeding a 7-month-old infant, who has Tetralogy of Fallot, you notice the infant's skin begins to have a bluish tint and the breathing rate has increased. Your immediate nursing action is to?
•A. Continue feeding the infant and place the infant on oxygen.
•B. Stop feeding the infant and provide suction.
•C. Stop feeding the infant and place the infant in the knee-to-chest position and administer oxygen.
•D. Assess the infant’s heart rate and rhythm.
C. Stop feeding the infant and place the infant in the knee-to-chest position and administer oxygen.
What is the most important intervention to decrease the risk of necrotizing enterocolitis in a preterm infant?
Initiating feedings as soon as possible. Feeding type with depend on respiratory stability.
What must a nurse do if a patient is bleeding heavily?
1. Bring the patient to bed
2. Massage the fundus
3. Obtain vitals/assess/give medications ordered
4. Contact the provider
list the signs and symptoms for shaken baby syndrome
•Vomiting, poor feeding
•Respiratory distress
•Bulging fontanels
•Retinal hemorrhages
What is the most effective way to decrease the risk of infection?
Hand washing
What are some signs and symptoms associated with hypoplastic left heart syndrome? (select all that apply)
a) cyanosis
b) tachycardia
c) warm hands and feet
d) poor feeding
e) dyspnea
a,d,e
What medications are used for asthma?
•Short acting beta, agonists (albuterol) – acute exacerbations
•Long-acting beta agonists – (salmeterol) – used to prevent exacerbations
•Inhaled corticosteroids – (fluticasone) – daily as preventative measures
A woman is 9 cm dilated and asking for pain medication. Why can't she have IV pain medication?
It causes respiratory depression in the newborn.
Why must clients with AB- blood have their baby's blood type ran after delivery?
Because they will need RhoGAM if the baby is Rh + to ensure no complications with future pregnancies.
List nursing interventions to decrease ICP
•Head midline, head elevated, promote venous drainage
•Body alignment neutral
•Avoid flexion and extension
•Avoid coughing, blowing nose
•Avoid straining to stool – stool softener
Why does a women's need for insulin increase during pregnancy?
Changes in her hormones creating insulin resistance.
What medications are used for postpartum hemorrhage? (Know what the contraindications are for each medication).
Oxytocin
TXA
Hemabate
Methergine
Misoprostol
What treatments are given for women who are experiencing:
A threatened miscarriage
An inevitable miscarriage
A incomplete miscarriage
Threatened: Bed rest for 48 hours and pelvic rest for 2 weeks.
Inevitable: Cannot be stopped. Obtain ultrasound and deliver if no heartbeat.
Incomplete: Has retained products, needs a D&C.
Hallucinations, paranoia, rambling or illogical speech are signs and symptoms of what condition?
Schizophrenia
What medications are used to treat severe preeclampsia?
Magnesium Sulfate and a medication for induction of labor (Misoprostol &/or oxytocin).
How do you diagnose transient tachypnea?
Tachypnea and chest x-ray
What instructions should be given to someone with CF in regard to their enzymes?
Given with all meals and snacks. Not on hot foods or in hot milk. Increase dosage when eating high fat foods. Can swallow or sprinkle.
How do we teach patients to treat STD's during pregnancy?
Both partners should be tested and treated until the antibiotic is gone. Condoms should be used until there is a test of treatment.
List the assessments of a Cast neurovascular assessment
Cast neurovascular assessment
•Sensation
•Skin temperature
•Skin color
•Capillary refill
•Pulses
•Movement
What are the diagnostic tests for
1. Chronic HTN
2. Gestational HTN
3. Preeclampsia
4. Preeclampsia with severe features
5. HELLP
6. Eclampsia
1. BP 140/90 x 2 (4 hours apart) before 20 weeks
2. BP 140/90 x 2 (4 hours apart) after 20 weeks
3. HTN & P/C ratio 0.3 or greater
4. Preeclampsia & BP 160/110 &/OR Headache that doesn't go away with eat/sleep/meds
5. Hemolysis, Elevated Liver enzymes, Low Platelets
6. Seizures
Why is it so important to control a woman's asthma during pregnancy?
To decrease the risk of IUGR, preterm labor, and significant asthma attacks.
The posterior fontanel should be closed by this time?
2-3 months