Nurs 202 – Unit Exam 2

NURS 202 – UNIT EXAM 2 CONTENT Chapter 10 Assessment of High Risk Pregnancy (ATI Ch. 4) a. Appropriate timing for specific prenatal testing In most cases monitoring begins by 32-34 weeks of gestation and continues regularly until birth. b. Biophysical Profile: rationale/scoring A total score of 10 out of 10 or 8 out of 10 with normal fluid is considered normal. A score of 6 is considered equivocal, and a score of 4 or less is abnormal [1,3, 6]. A score of less than 8 indicates the fetus may not be receiving enough oxygen. c. MSAFP/triple marker: analysis of results d. Amniocentesis: teaching; when to call your provider This procedure is done with a needle. Inserted trans abdominally. Use ultrasound to guide it. Amnotic fluid and fetal cells are withdrawn. It is performed 14-20 weeks of gestration. Assesing fetus for infection. In 3rd trimester its for fetal lung maturity. It is 99% accurate. We need to know and teach the procedure to client. Tell them that we need a full bladder espically if 20 weeks less than gestation. Explain the use of local anisthetics. Provide comfort measures and emotional support. Prep the abdomen with antiseptic. Assess fetal well being pre and post procedure. Asses mom and fetal heart rate during the procedure. For mom being on back watch for supine hypertension. Label any specimens that are obtained. 2 big that we want to do is obstruct the client to watch for when they go home. Report any fluid leaking, abdominal pain, bleeding, decreased fetal movement, or fever/any signs of infection. Also, make sure to administer RHD immunoglobin to RH negative women post procedure. Do this because the blood can cross the blood to placenta and attack the baby. Mixing of blood. e. Risk factors and assessments f. Nonstress test: procedure/results Non invasive antepartum eval of fetal well being. Do this a lot to check fetal well being. Very common test. Fetal movemtn and fetal heart rate accelerateion correlate with oxygenation. Observed in the fetus through reacitivty of fetal heart rate. Looking for in this test: women is in semi followers position, ultra sound in place. Fetal heart rate is measured for 20 minutes can be up to 40 goal is to obtain 2 fetal heart rate acceleration of 15bpm and need to last 15 seconds each. Results are either reactive or non reactive. Pre term fetus less than 32 weeks may .....................................CONTINUED........................................................