Antepartum
Of the following statements, the primary focus of the pregnant woman during the first trimester is...
A. “How is the baby’s heart today?”
B. “Is the baby growing at the right rate?”
C. “Since I am not eating much because of the morning sickness, is the baby malnourished?”
D. “Why are my breasts so tender?”
“Why are my breasts so tender?”
During the first trimester, the primary focus of the woman is on herself, not the fetus.
What is the most injurious result that could occur from preeclampsia? What drug prevents complications?
Magnesium sulfate
With abnormal uterine bleeding after delivery what is the priority nursing intervention?
Assess the fundus
What does the APGAR score assess?
What is the most common score?
Appearance (skin color)
Pulse
Grimace (reflex irritability)
Activity (muscle tone)
Respiration
8-9
GTPAL
Pt is here for her first prenatal visit. She delivered a previous infant at 35 weeks, 41 weeks, and had 1 miscarriage. She also had an ectopic pregnancy when she was 19.
G5T1P1A2L2
What medication you can anticipate administering to a mother who is Rh-, and at what point(s) in her pregnancy?
RhoGAM
28 weeks and within 72 hours after birth
What is the reversal agent for mag tox?
Calcium gluconate
What are the 3 steps in the attachment process?
Taking in
Taking hold
Letting go
Name the 4 ways that newborns lose heat.
Convection: flow of heat form the body surface to cooler surrounding air.
Conduction: transfer of body heat to cooler solid object in contact with the baby.
Radiation: transfer of heat to a cooler object not in contact with the baby.
Evaporation: loss of heart through conversion of liquid to vapor.
Name priority nursing interventions with spontaneous rupture of membranes
Assess FHR
Observe for cord prolapse
Note quality/quantity of amniotic fluid (color, odor) and time of occurrence
What would cause RhoGAM to be administered outside of 28 weeks and after birth?
Amniocentesis
Anytime fetal blood may mix with maternal blood
A patient comes in with a total placenta previa, as the nurse what do you prepare the patient for?
C-section
NO VAG EXAM
Describe lochia at:
1-3 days
3-10 days
10-14 days
1-3 days: rubra (red)
3-10 days: serosa (pink, brown-tinged)
10-14 days: alba (yellowish-white). Can last for 3-6 weeks
List the 3 safety teachings during postpartum stay.
Back to sleep
Carseat
Vaccinations
sbs
True or false?
False.
Nurses can witness consent but not obtain.
An ultrasound is done immediately prior to an amniocentesis to:
A. Determine fetal age.
B. Locate fetal and placental position.
C. Determine maternal blood pressure.
D. Determine amount of fetal movement.
What is B. Locate fetal and placental position.
Determining fetal and placental position is important prior to amniocentesis to prevent damage by the needle.
You’re observing a student nurse preparing to start pitocin on a laboring mother, the student attaches the IV bag of pitocin directly to the IV line, what do you do?
Stop the student and make sure the pitocin is hung piggy back.
Immediately after birth, the nurse can anticipate the fundus to be located:
A. At the umbilicus.
B. 2 cm above the umbilicus.
C. 1 cm below the umbilicus.
D. Midway between the symphysis pubis and umbilicus.
D. Midway between the symphysis pubis and umbilicus.
What is the localized swelling of the soft tissues of the scalp caused by pressure on head during labor that may cross over suture lines?
Caput Succedaneum
Cephalohematomas do not cross suture lines.
Name disadvantages of epidural analgesia?
Nursing interventions?
Maternal hypotension
Limited mobility
Can slow fetal descent
Urinary retention
Blood coagulation
Interventions: bolus of IV fluids prior to epidural, monitor VS
A pregnant woman comes in and has a blood pressure of 145/95, she is complaining of epigastric pain, and has been having nausea and vomiting for the past few hours. You also reports a nose bleed. You are most concerned about?
HELLP (hemolysis, elevated liver enzymes, and low platelet)
Name risks when mother has an induction of labor.
increased chance of:
Infection
Hypertonic uterine activity
Uterine rupture
Increased risk for c-section
pph
At 2-4 hours pp, the nurse can anticipate the fundus to be located:
At umbilicus or 1 fingerbreadth above
Name the different forms of jaundice.
Common treatment for jaundice.
Physiologic jaundice: normal hemolysis of RBCs
Breastfeeding "jaundice": dehydration/not enough breastfeeding
Breastmilk jaundice: Reduced production of diphosphoglucuronic acid (UDPGA) glucuronyl transferase inhibits conjugation of bilirubin
Pathologic jaundice: due to Rh incompatibility (mother - and fetus +), unconjugated bilirubin in newborn
Phototherapy
What are the two drugs given to a newborn in the immediate PP period?
Erthromycin: clamydia and gonnherra which cause neonatal blindness
Time period: after 1 hour so baby can see during time of alertness. Before 2 hours.
Vitamin K: to help with neonatal blood clotting. Because the liver is immature, not producing vitamin k. Circs cannot be given without vitamin K