Intrapartum
Patient is 3cm, having irregular contractions about 5-20 minutes apart, and about to talk and breathe through contractions. The patient asks how she is progressing in labor. The nurse should inform the client that she is in ___ stage and/or phase of labor.
This is the expected location of the fundus on day 3 postpartum.
What is at the 2 -3 cm below the umbilicus?
This type of heat loss occurs when a newborn lies on a cold surface.
What is conduction?
At 1 minute of life, a newborn has a heart rate of 110 bpm, slow irregular respirations, extended extremities, a weak cry, and bluish hands and feet. Based on this assessment, what is the Apgar score, and what is the appropriate nursing response?
What is an Apgar score of 5? Continue stimulation, provide supportive respiratory care (e.g., blow-by oxygen or positive pressure ventilation if needed), and reassess at 5 minutes?
An Rh-negative mother delivers an Rh-positive newborn. When should Rhogam be administered postpartum, what is its purpose, and what could happen if it is not given?
What is Rhogam should be given within 72 hours postpartum? It works by preventing the formation of antibodies against Rh-positive fetal blood cells; without it, the mother may develop antibodies that can cause hemolytic disease of the fetus/newborn in subsequent pregnancies.
The provider comes in to check on the laboring patient's progress and based on her cervical exam suggested an amniotomy. What is this considered to be "doing" for the patient.
What is augmenting her labor?
Fundal massage
What is the first line treatment for postpartum hemorrhage? (also an assessment tool)
At 1 minute of life, a newborn has a heart rate of 130 bpm, a vigorous cry, good flexion of extremities, and bluish hands and feet. Based on this assessment, what is the Apgar score, and what is the appropriate nursing response?
A newborn born to a mother with opioid use disorder exhibits high-pitched crying, tremors, poor feeding, and increased muscle tone within 48 hours of birth. What condition do these signs indicate, and what are key nursing interventions?
What is Neonatal Abstinence Syndrome (NAS)? Perform frequent assessments using a standardized scoring tool (NAS or Finnegan score), provide a calm non stimulating environment, support feeding and hydration, administer medications as ordered, and educate the family
After a vaginal delivery with an episiotomy, what are the key nursing interventions to promote healing, prevent infection, and manage discomfort?
What are maintaining perineal hygiene with peri bottle water rinses, using ice packs initially to reduce swelling, administering prescribed pain medications, encouraging sitz baths after 24 hours, promoting proper positioning to reduce pressure.
The nurse places a gloved hand into the vaginal to push up on the presenting part.
What is umbilical cord prolapse?
Medications given to treat uterine atony in a women who HAS Asthma.
What is Pitocin, Misoprostol (Cytotec), and Methylergonovine (Methergine).
Immediately after a term newborn is delivered, they are crying and breathing spontaneously with good tone. What are the initial steps of newborn care, and which priority interventions help promote thermoregulation and bonding?
What is: dry and stimulate, bulb suction if needed, skin to skin with mother, apgar scores, place newborn identification on mother and baby.
A newborn develops jaundice within the first 12 hours of life, with rapidly rising bilirubin levels and few stools. How do you differentiate between pathologic and physiologic jaundice, and what clinical actions are warranted?
Pathologic jaundice occurs within 24 hours of birth, bilirubin levels rise quickly, and may indicate hemolysis typically from an ABO incompatibility requiring prompt evaluation and treatment with phototherapy.
Physiologic jaundice appears after 24 hours, bilirubin level rise gradually, and usually resolves without intervention -just with frequent feedings.
A breastfeeding woman is experiencing subsequent engorgement. The nurse should tell her she should this is caused by_____ and to help relieve this she should _____.
Caused by milk accumulation and increased blood flow; interventions include frequent breastfeeding or pumping, applying warm compresses before feeding, and gentle breast massage.
This maneuver is used by the nurse during a shoulder dystocia to widen the pelvis.
What is McRoberts Maneuver?
This phase of Rubin’s maternal adaptation occurs between 2–10 days postpartum and is characterized by increased independence, and a desire to learn and master infant care.
When teaching new parents about umbilical cord stump care, what instructions should you provide to promote healing and prevent infection, and what signs should they watch for that indicate complications?
What is keep the cord stump clean and dry, avoid submerging in water until it falls off, fold diapers below the stump, allow air exposure. Watch for redness, foul odor, swelling, or discharge which require immediate medical evaluation
A newborn at 2 hours of age, born to a diabetic mother, shows jitteriness, poor feeding, and lethargy. A blood glucose check reveals a level of 35 mg/dL. What condition is this, what blood glucose level is considered hypoglycemia in newborns, and what are appropriate nursing interventions?
What is hypoglycemia? Blood glucose less than 40 mg/dL; and interventions include feeding the infant promptly (breast or formula), monitoring glucose levels frequently, and administering IV glucose if symptomatic or persistent hypoglycemia occurs
You assess a postpartum patient and notice her fundus is displaced above the umbilicus to the right and is boggy on palpation. What is your priority nursing intervention?
What is having the patient void if able or straight cath if unable. EMPTY THE BLADDER and REASSESS the fundus
A laboring patient at 6 cm dilation suddenly reports severe abdominal pain, loss of contractions on the monitor, and you notice a prolonged drop in fetal heart rate with no recovery. On palpation, the uterus feels irregular in shape and difficult to locate. What obstetric emergency do you suspect, and what is your immediate nursing action?
What is uterine rupture? Initiate emergency response, administer oxygen, prepare for stat cesarean section?
A 3-day postpartum patient presents with a temperature of 101.6°F (38.7°C), foul-smelling lochia, uterine tenderness on palpation, and reports chills and malaise. What condition do you suspect, and what nursing actions are indicated?
What is endometritis? Notify the provider, obtain labs as ordered, administer prescribed antibiotics, monitor vital signs, and educate on infection signs?
Which three standard medications are routinely administered to healthy term newborns shortly after birth, and what is the primary purpose of each?
What are vitamin K (to prevent hemorrhagic disease of the newborn), erythromycin eye ointment (to prevent infection), and hepatitis B vaccine (to protect against hepatitis B infection)?
A newborn presents with a swollen, soft area on the scalp that crosses suture lines and resolves within a few days, while another newborn has a firm, localized scalp swelling that does not cross suture lines and may take weeks to resolve. What are these two conditions, how do you differentiate them?
What are caput succedaneum (swelling crossing suture lines, caused by pressure during delivery, resolves quickly) and cephalohematoma (subperiosteal hemorrhage, does not cross sutures, resolves over weeks)?
A new mother, 3 weeks postpartum, reports feelings of sadness, hopelessness, difficulty sleeping, and loss of interest in her baby. How do you differentiate postpartum depression from the “baby blues,” and what are the key nursing interventions?
What is postpartum depression involves more severe, persistent symptoms lasting beyond 2 weeks and affecting daily functioning, unlike baby blues which are milder and resolve within 2 weeks. Nursing interventions include screening using standardized tools (Edinburgh Postnatal Depression Scale), providing emotional support, referring for mental health services, and educating the family about signs and treatment options