Pregnancy/Labor
24-28 weeks
> 140
1) bed rest/elevation
2) Warm compression
3) NO massage
4) Monitor leg circumference
5) Fluid in take 2-3L
6) Smoking cessation
7) Subcutaneous Heparin
Name 3 newborn screening methods prior to discharge and how it would be evaluated ?
1) Bilirubin- Jaundice (poor feedings, yellowing of ski/eyes, lethargy)
2) Metabolic screening- newborn screening (poor feedings, lethargy, high-pitched cry, hypoglycemia, decrease urination)
3) Newborn Hearing Screening- performed prior to discharge.
2 hour old infant presents with high-pitched cry, incessant crying, increase in activity, nasal congestion, nasal flaring, increased work of breathing, uncoordinated sucking, and poor feeding
Which of the following medications is used for post partum hemorrhage
1) Misoprostolol
2) Magnesium Sulfate
3) Nifedipine
4) Bethamethasone
Assess uterine tone and bleeding
Warning signs during 1st trimester
Severe Vomiting (hyperemesis)
Diarrhea (infection)
Fever/chills (infection)
Abnormal cramping/bleeding (miscarriage/ectopic)
What would the nurse evaluate for in patient with retained placenta
Uterine atony, subinvolution, inversion, excessive bleeding/clots, malodorous lochia/discharge, elevated temperature
Circumcision care
1) Monitor for bleeding
2) Fan diaper
3) Pain management
4) Patient teaching: bathing precautions and watching for signs of infection
1 hour old infant found to display small eyes, flat mid-face, smooth philtrum, thin upper lip, small teeth, and the presence of a cleft palata
Which of the following are risk factors for the administration of Terbutaline?
1) Preeclampsia
2) Gestational Diabetes
3) Aortic Stenosis
4) Asthma
1, 2, 3. Should not be used in these conditions. Medication response is a beta-adrenergic agonist that is used a tocolytic (smooth muscle relaxant)
Monitor for symptoms of muscle weakness, lethargy, tremors, vomiting, dysrhytmias, tachycardia (hypoglycemia, hypokalemia, hypotension)
Warning signs during 2nd and 3rd trimester
Gush of fluid (amniotic) prior to 37 weeks
Vaginal bleeding (previa or abruption placentea) Previa is painless bleeding, Abruption is painfull
Abdominal pain (ectopic, labor, abruptio)
Changes in fetal activity (fetal distress)
Severe Headache (hypertension)
Elevate temp, dysuria (infection)
Blurred vision (HTN)
Epigastric pain (HTN)
Flushed, fruity breath, rapid breathing (hyperglycemia)
Clammy, pale, irritable, lightheaded (hypoglycemia)
A nurse is administering Ampillicin in a patient with chorioamnionitis. How will the nurse know that the medication has been effective?
Decreased temperature
Improvement in lethargy
Uterus rigid
Heart rate 80
Lochia without purulent or maladorous
Single most effective way to prevent neonatal hypoglycemia and temperature stabilization
Skin to skin
1 minute APGAR 5. Weak cry with increased work of breathing and need to be resuscitated. 5 minute APGAR remains at 5 despite resuscitation. What would be important to assess?
Blood glucose
What effect will the nurse see after the administration of Nifedipine.
Decrease/cessation of uterine contractions
Blocks calcium from entering smooth muscle, suppress contractions
What does the nurse need to monitor for with a patient with an epidural
Increased sedation/dizziness
Fall risk/injury
Respiratory depression
Hypotension
Allergic reaction
Fetal Heart Rate changes
A patient is being treated with Dicloxacillin for mastitis. What should the nurse evaluate for to ensure that treatment has been effective?
Absent of erythema to breast
Improvement in pain
Increase in infant latching and feeding tolerance
Decrease temp
Increase milk production
Vitamin K
Hep B Immunization
Erythromycin
3 minute old infant presents with sudden increased work of breathing, nasal flaring, tachypnea, retractions. APGAR 5 at 1 minute. Lungs reveal crackles. What would be important to evaluate for?
Meconium Aspiration
What benefit does bethamethasone provide and effect will the nurse see on patient?
Fetal lung maturation. Decreased need for oxygen and decreased risk of fetal respiratory distress
What would the nurse monitor in a patient who received an amniotomy?
fetal heart decelerations (cord compression)
Increased temperature, respiratory rate, chills, lethargy
What interventions can the nurse recommend in patient to prevent post partum depression?
Rest, sleep with baby sleeps
Self-care
Follow-up care
Social resources
Seek expert consultation
Healthy diet/lifestyle
Ways to improve/maintain neonatal hypoglycemia
Skin to skin, frequent feedings, temperature regulation measures
(jitteriness, twitching, lethargy, weak cry, increase respiratory effort, cyanosis, seizures)
12 hour old infant presents with poor feeding, inability to maintain temperature, intermittent increased work of breathing noted with nasal flaring and grunting. Mom had a prolonged labor with GBS status unknown. What would you be concerned about with this infant and how would you evaluate this?
Symptoms, lab values, BG, temperature, mom's history.
What benefit will the nurse see in a patient on a magnesium drip?
Decreased incidence of seizure or neurological change.
Magnesium Sulfate decreases CNS response to prevent seizures and control preeclampsia