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What is the recommended weight gain during pregnancy for a client with a BMI of 20?
11-20, 15-25, 25-35, 28-40
25-35 pounds
Overweight client recommendation: 15-25 pounds
Underweight = <18.5
Normal weight = 18.5–24.9
Overweight = 25–29.9
Obesity = BMI of 30 or greater
Name one breech fetal position: ________ breech
Breech (complete, frank, footling, double footling)
breech involves a presentation of the fetus buttocks
Near the third day postpartum, maternal breasts may feel very full of milk, firm, and painful. These are clinical manifestations of breast _________
engorgement
Which of the following causes painless bleeding during pregnancy? SATA
Incompetent cervix, spontaneous abortion, placental abruption, placenta previa
placenta previa
What is an indication for oxytocin in maternal care?
Stimulate contraction/labor
Also used in a contraction stress test
What week of gestation is the "age of viability"
20 weeks gestation
What are the primary and secondary forces of labor?
Primary forces are contractions that efface and dilate the cervix. Secondary forces are the bearing down or pushing from the client to expel the fetus
Newborns lose water weight almost immediately after birth. When do they return to their delivery weight?
1 week, 2 weeks, 4 weeks, 6 weeks
2 weeks
Newborns lose 5-6% of their body weight the first 3 days after delivery, and should gain this weight back by 2 weeks. The newborn should gain 1 oz per day during their first month of life
What type of jaundice occurs in the first 24 hours of life?
Pathologic -abnormal
What is magnesium sulfate used for?
relaxing uterine muscle/ treat pre-term birth
also used for seizure treatment
...and constipation
A client is currently 28 weeks pregnant. She has twins that were born at 39 weeks gestation, and a 2 year-old who was born at 32 weeks gestation. She has no history of miscarriage or abortion. What is her GTPAL?
G=3, T=1, P=1, A=0, L=3
Name three characteristics of "true labor"
changes in the cervix (dilation and effacement)
increase in frequency and strength
ambulation and relaxation techniques do not slow
pain starts in back moving to lower pelvis
What does APGAR stand for?
Appearance, Pulse, Grimace, Activity, Respiration
What is a stable score?
How is mastitis treated?
ABX treatment and continued breastfeeding, unless abscess has developed
What is an indication for betamethasone in maternal care?
A client reports her last menstrual period began on June 13, 2022. What is her expected date of delivery?
March 20, 2023
Name the three different fetal heart decelerations and their causes
Variable - Cord Compression
Early - Head compression
Late - Placental/Uteroplacental insufficiency
All of these involve fetal heart depression, late and variable are non-reassuring patterns
Lochia rubra and lochia serosa drainage is typically present how long after delivery?
2 weeks.
Rubra- up to 4 days
Serosa-up to day 10-14
What makes chronic hypertension different from preeclampsia
Chronic hypertension does not cause proteinuria, or edema. Preeclampsia also can progress to eclampsia, which is when the client experiences seizures
What is an indication for methotrexate in maternal care?
Methotrexate (a chemotherapy agent and immune-system suppressant) is used to treat cancer, autoimmune diseases, and ectopic pregnancies.
It stops rapid cell division
How often should prenatal visits be scheduled for a client with an uncomplicated pregnancy?
**2 guesses**
Monthly visits up to 28 weeks
q 2-3 weeks up to 36 weeks
q week until delivery
The recommended first nursing action for postpartum hemorrhage is to massage the fundus. Name three other interventions that would treat this complication.
Reposition
Administer oxygen
Insert foley
Oxytocic medications
IV fluids
In the fourth stage of labor your maternal assessment will involve multiple areas of the body. The acronym BUBBLE-HE will help you remember the most important ones. Can you name 4 out of the 8 letters in BUBBLE-HE?
Breast, Uterus, Bowel, Bladder, Lochia, Episiotomy, Homans sign, and Emotional status
How is toxoplasmosis transmitted?
Eating uncooked meat, and coming into contact with cat feces.
Toxoplasmosis is a parasitic infection caused by Toxoplasma gondii. People often get the infection from eating undercooked meat, or from contact with cat feces
What are synthetic prostaglandins used for during maternal care?
Synthetic prostaglandins are used for "cervical ripening" during labor induction. Used to soften the cervix and relax cervical muscles, helping with dilation.
Other cervical ripening medications: Dinoprostone, Mifepristone, Misoprostol