OB HESI V2 QUESTIONS AND ANSWERS ALREADY PASSED

OB HESI V2 QUESTIONS AND ANSWERS ALREADY PASSED During the postpartum period a client tells a nurse that she has been having leg cramps. Which foods should the nurse encourage the client to eat? 1 Liver and raisins Cheese and broccoli 3 Eggs and lean meats 4 Whole-wheat breads and cereals cheese and broccoli need calcium A pregnant client with severe preeclampsia is receiving IV magnesium sulfate. What should the nurse keep at the bedside to prepare for the possibility of magnesium sulfate toxicity? 1Oxygen 2Naloxone 3Calcium gluconate 4Suction equipment calcium gluconate The antagonist of magnesium sulfate is calcium gluconate. Oxygen is ineffective if the action of magnesium is not reversed. Naloxone is unnecessary; it is an opioid antagonist. Suction equipment may be necessary if the client has excessive secretions after a seizure. The priority intervention is trying to prevent a seizure. A client arrives at the clinic in preterm labor, and terbutaline (Brethine) is prescribed. For what therapeutic effect should the nurse monitor the client? 1increased blood pressure and pulse 2Reduction of pain in the perineal area 3Gradual cervical dilation as labor progresses 4Decreased frequency and duration of contractions decreased frequency and duration of contractions Terbutaline sulfate (Brethine) is a β-mimetic that acts on the smooth muscles of the uterus to reduce contractility, which in turn inhibits dilation and the frequency and duration of contractions. Although terbutaline may increase blood pressure and pulse, this is a side, not a therapeutic, effect requiring frequent assessments. Terbutaline is not an analgesic. It should stop cervical dilation rather than increase it. greenish amniotic fluid indicates meconium in amniotic fluid and dr should be notified immediately pt on magnesium sulfide, what base line assessment is needed repsiration rate LOC is also affected but do not need a baseline hydatidiform mole causes extra large utereus lepolds maneuver on patient with placental previa expects high floating, presenting part A client's membranes rupture during labor. The nurse immediately assesses the electronic fetal heart rate. Variable decelerations lasting more than 90 seconds, followed by bradycardia, are observed on the monitoring strip. What does the nurse suspect as the cause of this change? 1Fetal acidosis 2Prolapsed cord 3Head compression 4uteroplacental insufficiency prolapsed cord This variable pattern with bradycardia is an ominous sign; it is indicative of cord compression, which can result in fetal hypoxia. Immediate intervention is required. Fetal acidosis occurs with uteroplacental insufficiency, not in response to a prolapsed cord. Early decelerations are associated with head compression and are benign. Late decelerations and tachycardia are associated with uteroplacental insufficiency, not a prolapsed cord. heart burn while pregnant don't take antacids with sodium A 36-year-old woman comes to the emergency department complaining of severe abdominal cramping and heavy bleeding. She informs the nurse that she is 10 weeks pregnant. Cervical examination reveals heavy bleeding; the cervical os is open and tissue is present. Which type of miscarriage is the client experiencing? 1Missed 2Complete 3Inevitable 4Threatened inevitable Miscarriage is inevitable because the cervical os has opened, heavy bleeding is occurring, and tissue is present with the bleeding. In a missed miscarriage, the fetus has died but the products of conception are retained in utero for as long as several weeks. There may be no bleeding or cramping, and the os is closed. In a complete miscarriage all fetal tissue has already passed and the cervix is closed; there may be slight bleeding. Symptoms of a threatened miscarriage include spotting and a closed cervical os. There may be mild cramping. blood in urine in catheter back during c-section indicates incisional nick in the bladder risk for hypotonic uterine dystocia twin gestation placental previa when the placenta covers the opening of the cervix most likely to have it is a 30y/0m g6p5 signs of a ruptured tubal pregnancy occur when 6 weeks into pregnancy this is when the fallopian tube is no longer able to get any larger megaloblastic anemia in pregnancy can cause neural tube defects mother needs to be started on folic acid supplements asap vaginal hematoma pain is severe and vagina feels full and heavy classification of magnesium sulfate CNS depressant pt. receiving lovenox for DVT, what sign is most concerning dyspnea when a patient is on magnesium sulfate keep room dark and quiet Taking-in Phase — For the first day or two after the birth, new mothers need extra food and rest. Cesarean mothers need even more rest. All new mothers also need "mothering" themselves so they can successfully mother their new babies. New fathers also may have difficulty adjusting to parenting. Partners can make a special effort to support each other during this big change in their lives. Taking-hold Phase — During this phase, parents focus on learning to care for their new baby. Temporary mood swings and feelings of vulnerability on the part of the new mother are not uncommon. Each partner may feel neglected as they become more involved with the baby, overlooking their partner's needs or feelings. Letting-go Phase — The couple will continue their relationship that they had before the birth of the baby. The older brothers and sisters get to know the baby at this time. magnesium sulfate and the importance of deep tendon reflexes indicates respiratory depression nursinging intervention for pt. with placental previa document amount of bleeding after internal fetal heart monitor placement dr listens to fetal heart rate for 1 full minute to monitor uterine cord prolapse risk factor for abruptio placentae hypertension positive Contraction stress test indicates Late decelerations of the fetal heart rate are occurring with each contraction. also uteroplacental insufficiency A nurse administers two serial intramuscular injections of betamethasone (Celestone) to a woman at 32 weeks' gestation who has been admitted in preterm labor. The nurse knows that this medication is given to: stimulate surfactant production. Corticosteroids stimulate surfactant production; they also have been shown to reduce the incidence of intraventricular hemorrhage. Betamethasone (Celestone) does not affect the labor process, increase placental perfusion, or affect the intensity of contractions. low lying placenta in third trimester puts mom at risk for painless vaginal bleeding pt. with pre-eclampsia is admitted, after vitals are taken what is next priority checking pt. reflexes chorionic villi sampling when can it be done 10 weeks and no later than 12 weeks magnesium sulfate: how to know when you have reached therapeutic level deep tendon reflexes +2 what to assess before administration of magnesium sulfate patellar reflexes and urinary output threatened abortion vaginal spotting, abdominal cramping, closed cervix vertex postion proper for delivery risk when undergoing IVF tubal pregnancy mom with mitral valve stenosis, ,what symptom indicates cardiac difficulties syncope for exertion what contraindicates pitocin herpes infection patient with eclampsia, when does risk for seizure decrease 48 hours postpartum folic acid in patient with sickle cell is important for compensating for a rapid turnover of red blood cells what is a danger sign for a mom with history of preterm mulit gestational neonatal deaths pelvic pressure type 1 diabetes in pregnancy puts mom at risk for hypertensive states what assessments are priority for pt with diagnosed abruptio placentae fundal height, vital sighs, skin color, urine output, FHR for patient with abuse what is priority action of the nurse develop a safety plan sign of preclampsia other than high blood pressure weight gain of 6 pounds in 1 month priority nursing intervention for pt admitted with abdominal pain and vaginal bleeding administer oxygen normal l/s ratio 2.0-2.5; shows fetal lung maturity creatinine should be between 0.4-0.9. if higher indicates kidney problems reason for increased pain in abruptio placentae concealed hemorrhage multiple UTI's can cause what preterm birth what kind of epidural is used for a pt with class 1 heart disease epidural regional increase alpha fetoprotein indicates spin bifid a or other neural turn defects new born baby eyes cross eyed normal for first 6 months as they are trying to foucs a preterm infant and maintaing body heat they do not have enough brown fat available to provide heat the key factors to a baby survival rate in the neonatal period gestational age and birth weight erbs palsy in newborn upper and lower nerves are stretched caused by injury to brachial plexus signs of hypoglycemia in newborn high-pitched cry, jitteriness, and irregular respirations silverson anderson score means indications if respiratory distress 0=no respiratory distress less than or equal to 7 means impending respiratory failure red tinged mucus in the diaper of a female new born is normal reaction to mothers hormones necrotizing enterocolitis (NEC): what will nurse expect to find as a complication Increased amount of residual gastric volume from earlier feedings when newborn has a meningocele priority nursing intervention is covering sac with sterile moist gauze giving o2 to a infant can cause what retinopathy of prematurity PKU test will not be done until the baby has enough milk for the test to be accurate circumoral pallor can indicate a cardiac problem when newborn is small for gestational age priority nursing intervention is to perform glucose test reading when newborns head circumference is 4cm smaller than chest circumference the infants head size is smaller than average when newborn has necrotizing enterocolitis (NEC) it is important to measure the abdominal girth frequently exstrophy effects the bladder and can cause separation of pubic bones when a newborn is receiving oxygen via hood the nurse is responsible to keep a hat on the infants head when pregnant with twins mom is at higher risk for hemorrhage due to uterine atony medication to strop pre-term labor a beta-adrenergic (has tocolytic agents) pt. arrives at high risk unit for delivery with abdominal pain and vaginal bleeding what does nurse do adminster oxygen when fetus makes a rapid decent the nurse worries about fetal head trauma primigravida in labor, priority nursing assessment is to monitor FHR positive CST result means the function of the placenta has diminished sitz baths promote vasodilation most spontaneous abortions occur due to embryonic defects what to avoid for a pt who is breastfeeding with PKU amino acids safest position for mom with prolapsed cord trandlenburg hypertension in pregnancy puts mom at risk for abruptio placentae premature rupture of membranes can lead to cord prolapse corticosteriods are given to moms 24-34 weeks for lung development