correct answers
Labs before epidural Correct Answer--CBC to look at H&H, platelets,
WBC
-Infection and coagulopathy are contraindications
Concerns after insertion of an epidural Correct Answer--Marked
hypotension:
-Can slow the progress of labor
-Ineffective breathing pattern
-Inability to effectively push
-Headache (fixed with autologous blood patch)
-Safety/Falls as patient unable to get up and walk
If your patient has marked hypotension after an epidural is placed, what
should you do? Correct Answer--Monitor for impaired placental
perfusion on FHM
-Place side pillow
-IV fluid
-Supplemental O2
-Ephedrine
,What is the most common endocrine disorder in pregnancy? Correct
Answer--Diabetes Mellitus
-Due to the hormones of pregnancy, any form of DM is hard to control
even if pt is compliant with multidisciplinary care plan
When and how are patients screened for Gestational Diabetes Mellitus?
Correct Answer--GDM is screened for between 24-28 weeks
-Glucose Tolerance Test (GTT)
-If blood glucose more than 140, 3 hour GTT is ordered.
-If two out of 3 values are elevated, pt is considered gestational diabetic.
How is DM (GDM, Type I, and Type II) managed during pregnancy?
Correct Answer--GDM can often be managed with ADA diet
-Regular and NPH insulin (not long acting as thats hard to titrate)
-Oral DM medications not usually used
Is sugar a teratogen? Correct Answer-Yes
Fetal risks with maternal diabetes Correct Answer--Macrosomia (big
baby)
-Hydramnios (too much amniotic fluid)
-Ketoacidosis
-Hyperglycemia
-Hypoglycemia
-Dystocia
, -Sudden and unexplained stillbirth
-Congenital malformations in CVS (atrial or ventral septal defect more
common), CNS, and Skeletal system
How are fetuses monitoring in GDMs as they at risk for sudden,
unexplained death? Correct Answer--NST (fetal monitoring) twice a
week starting at 32 weeks
-Kick counts (come in for decreased fetal movement)
What is an ectopic pregnancy? Correct Answer--Fertilized ovum outside
of the uterus that proliferates
What is the priority nursing diagnosis for ectopic pregnancy? Correct
Answer--If the fallopian tube were to rupture, there is a risk for
hemorrhage. NANDA would be about shock not pain.
What medications are given for ectopic pregnancy? Correct Answer--
Methotrexate stops the fetal cells from proliferating if unruptured
-Salpingostomy vs salpingectomy is surgical treatment.
How is the progress off labor measured? Correct Answer-Dilation,
effacement, and station
What is dilation? Correct Answer-Cervix become wider.