NUR 220 TEST 2 Questions With Complete Solutions
*Differential S&S of Placenta Previa (PP) and Abruptio
Placentae (AP)* (pg 413): Correct Answers -Onset: PP- Quiet
and sneaky. AP- sudden
-Bleeding: PP- external. AP- external or concealed
-Color of bleeding: PP- Bright red. AP- Dark Venous
-Anemia: PP- Equal to blood loss. AP- Greater than apparent
blood loss
-Shock: PP-Equal to blood loss. AP- Greater than apparent
blood loss
-Preclampsia/Eclampsia: PP-Absent. AP- may be present
-Pain: PP-only labor. AP- usually severe and steady
-Uterine tenderness: PP- absent. AP- present
-Uterine Tone: PP-soft and relaxed. AP- firm to stony hard
-Uterine Contour: PP- normal. AP- may enlarge and change
shape
-Fetal Heart Tones- PP- usually present. AP- present or absent
-Engagement: PP- absent. AP- may be present
-Presentation: PP-may be abnormal. AP- no relationship
*What does the nurse need to know if the membranes rupture*
Correct Answers *the time the membranes ruptured, the color,
the odor, and the amount*
Green/yellow in color= baby was stressed and passed stool
color should be clear
no odor
Action of Mag Sulfate Correct Answers decreases the amount
of acetylcholine so it blocks neuromuscular transmission
reducing the possibility of a seizure. As another benefit it
,relaxes smooth muscle found in heart and uterus decreasing BP
and helping with preterm labor
Action of Narcotic Analgesics- Correct Answers primary
action at sites in the brain, inhibits the transmission of pain
inpulses. N/V may be caused by stim of these chemoreceptors.
Advantages of Amniotomy: Correct Answers similar ctx as
spontaneous, no risk of hypertonus or rupture, does not require
intensive monitoring like oxytocin, EFM can be better obtained
by fetal scalp electrode, IUPC can be inserted, scalp blood, color
of fluid can be evaluated, less costly
Afterpains during postpartum period: Correct Answers -More
common in multiparas than in primiparas
-caused by INT uterine contractions
-admin of oxytocin increases pains, along with breastfeeding
-Lysine, an essential amino acid, can decrease the incidence of
pain following episiotomy. It is found in cheese, meat, fish,
eggs, soybeans, and nuts.
-warm water bottle placed against lower abdomen can reduce
pain
-mild analgesics (ibuprofen, oxycodone/acetaminophen) can be
taken 1 hour before BF to reduce pain or before bed time to
reduce pain and help mom sleep. Prescribed agents will not
harm the baby.
Amnioinfusion: Correct Answers technique by which warmed,
sterile NS or LR solution is introduced into the uterus through
an intrauterine pressure catheter.
,Amniotic fluid embolism- Correct Answers in the presence of a
small tear in the amnion or chorion high in the uterus, a small
amount of amniotic fluid may leak into the chorionic place and
enter the maternal system.
Amniotomy- Correct Answers artificial rupture of membranes.
Cervix must be at least 2 cm dilated.
Before the External Cephalic version is done what must be
performed? Correct Answers an ultrasound to locate the
placenta and to confirm fetal presentation
Breast exam: Correct Answers -don gloves
-assess the fit and support provided by the bra
-straps of bra need to be cloth and the back should have at least
3 rows of hooks to adjust for fit
-breasts assessed for size and shape and any abnormalities,
reddened or hot areas, or engorgement.
-breast lightly palpated for softness, slight firmness associated
with filling, firmness associate with engorgement, warmth and
tenderness.
-nipples assessed for fissures, cracks, soreness, and inversion
-if bottle feeding do not stimulate the breast
BUBBLE-HE assessment: Correct Answers Breasts, Uterus,
Bladder, Bowels, Lochia, Episiotomy, Homan's Sign, Emotional
Status
Butorphanol Tartrate (Stadol) Class: Correct Answers synthetic
agonist-antagonist opiod analgesic agent.
, Cervical Insufficiency- Correct Answers Painless dilatation of
the cervix without contractions because of a structural or
functional defect of the cervix. Also called incompetent cervix.
Cervical ripening- Correct Answers softening and effacing of
the cervix for dilation
Cervidil Route: Correct Answers inserted vaginally in posterior
vagina
changes in the cardiovascular system and blood values during
the postpartum phase: Correct Answers -Cardiac output
decreases to normal w/in 6-12 weeks
-failure of diuresis to occur in the immediate postpartum period
can lead to pulmonary edema and subsequent cardiac problems
-leukocytosis: 25000-30000
-Decreased H&H d/t fluid loss
-platelets decrease and return to normal by 6 weeks
Changes in the reproductive System during Postpartum phase:
Lochia- Correct Answers -Lochia rubra: dark red. Occurs for
the first 2-3 days. A few small clots is normal
-Lochia Serosa: pinkish color. Occurs on day 3-10
-Lochia Alba: creamy or yellowish discharge. Occurs when the
RBC component decreases gradually. Persists for an additional
week or 2.
Changes in the reproductive system during the postpartum stage:
Involution- Correct Answers the rapid reduction in size and
return of the uterus to a non-pregnant state.
*Differential S&S of Placenta Previa (PP) and Abruptio
Placentae (AP)* (pg 413): Correct Answers -Onset: PP- Quiet
and sneaky. AP- sudden
-Bleeding: PP- external. AP- external or concealed
-Color of bleeding: PP- Bright red. AP- Dark Venous
-Anemia: PP- Equal to blood loss. AP- Greater than apparent
blood loss
-Shock: PP-Equal to blood loss. AP- Greater than apparent
blood loss
-Preclampsia/Eclampsia: PP-Absent. AP- may be present
-Pain: PP-only labor. AP- usually severe and steady
-Uterine tenderness: PP- absent. AP- present
-Uterine Tone: PP-soft and relaxed. AP- firm to stony hard
-Uterine Contour: PP- normal. AP- may enlarge and change
shape
-Fetal Heart Tones- PP- usually present. AP- present or absent
-Engagement: PP- absent. AP- may be present
-Presentation: PP-may be abnormal. AP- no relationship
*What does the nurse need to know if the membranes rupture*
Correct Answers *the time the membranes ruptured, the color,
the odor, and the amount*
Green/yellow in color= baby was stressed and passed stool
color should be clear
no odor
Action of Mag Sulfate Correct Answers decreases the amount
of acetylcholine so it blocks neuromuscular transmission
reducing the possibility of a seizure. As another benefit it
,relaxes smooth muscle found in heart and uterus decreasing BP
and helping with preterm labor
Action of Narcotic Analgesics- Correct Answers primary
action at sites in the brain, inhibits the transmission of pain
inpulses. N/V may be caused by stim of these chemoreceptors.
Advantages of Amniotomy: Correct Answers similar ctx as
spontaneous, no risk of hypertonus or rupture, does not require
intensive monitoring like oxytocin, EFM can be better obtained
by fetal scalp electrode, IUPC can be inserted, scalp blood, color
of fluid can be evaluated, less costly
Afterpains during postpartum period: Correct Answers -More
common in multiparas than in primiparas
-caused by INT uterine contractions
-admin of oxytocin increases pains, along with breastfeeding
-Lysine, an essential amino acid, can decrease the incidence of
pain following episiotomy. It is found in cheese, meat, fish,
eggs, soybeans, and nuts.
-warm water bottle placed against lower abdomen can reduce
pain
-mild analgesics (ibuprofen, oxycodone/acetaminophen) can be
taken 1 hour before BF to reduce pain or before bed time to
reduce pain and help mom sleep. Prescribed agents will not
harm the baby.
Amnioinfusion: Correct Answers technique by which warmed,
sterile NS or LR solution is introduced into the uterus through
an intrauterine pressure catheter.
,Amniotic fluid embolism- Correct Answers in the presence of a
small tear in the amnion or chorion high in the uterus, a small
amount of amniotic fluid may leak into the chorionic place and
enter the maternal system.
Amniotomy- Correct Answers artificial rupture of membranes.
Cervix must be at least 2 cm dilated.
Before the External Cephalic version is done what must be
performed? Correct Answers an ultrasound to locate the
placenta and to confirm fetal presentation
Breast exam: Correct Answers -don gloves
-assess the fit and support provided by the bra
-straps of bra need to be cloth and the back should have at least
3 rows of hooks to adjust for fit
-breasts assessed for size and shape and any abnormalities,
reddened or hot areas, or engorgement.
-breast lightly palpated for softness, slight firmness associated
with filling, firmness associate with engorgement, warmth and
tenderness.
-nipples assessed for fissures, cracks, soreness, and inversion
-if bottle feeding do not stimulate the breast
BUBBLE-HE assessment: Correct Answers Breasts, Uterus,
Bladder, Bowels, Lochia, Episiotomy, Homan's Sign, Emotional
Status
Butorphanol Tartrate (Stadol) Class: Correct Answers synthetic
agonist-antagonist opiod analgesic agent.
, Cervical Insufficiency- Correct Answers Painless dilatation of
the cervix without contractions because of a structural or
functional defect of the cervix. Also called incompetent cervix.
Cervical ripening- Correct Answers softening and effacing of
the cervix for dilation
Cervidil Route: Correct Answers inserted vaginally in posterior
vagina
changes in the cardiovascular system and blood values during
the postpartum phase: Correct Answers -Cardiac output
decreases to normal w/in 6-12 weeks
-failure of diuresis to occur in the immediate postpartum period
can lead to pulmonary edema and subsequent cardiac problems
-leukocytosis: 25000-30000
-Decreased H&H d/t fluid loss
-platelets decrease and return to normal by 6 weeks
Changes in the reproductive System during Postpartum phase:
Lochia- Correct Answers -Lochia rubra: dark red. Occurs for
the first 2-3 days. A few small clots is normal
-Lochia Serosa: pinkish color. Occurs on day 3-10
-Lochia Alba: creamy or yellowish discharge. Occurs when the
RBC component decreases gradually. Persists for an additional
week or 2.
Changes in the reproductive system during the postpartum stage:
Involution- Correct Answers the rapid reduction in size and
return of the uterus to a non-pregnant state.
