BSNC 5000 FINAL EXAM STUDYING QUESTIONS WITH CORRECT ANSWERS

BSNC 5000 FINAL EXAM STUDYING QUESTIONS WITH CORRECT ANSWERS what is severe eclampsia - Answer-blood pressure of 160/110 and 3.0g/mL +3 of proteinuria and can result in seizures - damage to liver - reduction in blood supply to placenta - dead placental fragments enter maternal blood stream = inflammation to liver - HELLP syndrome = hemolysis (reduced RBCs), elevated liver enzymes (indicates damage to liver and inflamm), low platelet count what is the relationship between inflammation and gestational hypertension - Answer-- no rise in BP for 20wks 140/90 - inflammation contributes to HTN by promoting endothelial dysfunction, vascular remodelling and oxidative stress - cytokines increase in HTN and contribute to vascular damage and resistance - impaired vasodilation and increased vasoconstriction = increased permeability -- increased swelling/inflammation causing increased BP what is the difference between gestational diabetes diet controlled and insulin dependent - Answer-Diet controlled - controlled by diet and exercise = insulin in body still works effectively Insulin dependent - diabetes that is controlled by diet, exercise, and use of insulin injections - maternal effects hypertension pre-eclampsia increased C/S risk development of type 2 DM - fetal effects hyperinsulinemia increased metabolic rate tissue hypoxia explain the four stages of labour - Answer-- stage 1: onset of regular contractions to full dilation of cervix - stage 2: fully dilated to birth of fetus full effacement and dilation latent/passive phase = contractions (primary powers) active phase = actively pushing, birthing stool, different positions (secondary powers - bearing down) - stage 3: birth of fetus to the delivery of placenta takes about 3-4 pushes what are the 5 factors affecting labour process - Answer-1. passenger 2. passageway 3. powers 4. position 5. psychological process of labour what is normal lochia - Answer-- rubra - no clots - pad change only needed every 4-5hr what are the risk factors for PPH - Answer-tone: - overdistended uterus - multiple gestations - macrosomia - uterine muscle exhaustion (rapid labour - prolonged labour - high parity - oxytocin use-induction) - intra-amniotic infection (fever, prolonged ROM) - uterine relaxing medications Tissue: - retained products - previous uterine surgery - multiple gestations - abnormal placenta - retained blood clots - atonic uterus - prolonged stages Trauma: - lacerations of cervix - vagina or perineum - extensions - lacerations from c/s - uterine invasion - episiotomy - assisted delivery - prolonged stages Thrombin: - pre-existing states - Hx liver disease signs and symptoms of a PPH - Answer--soft boggy fundus - lochia bright red - clots present - frequent pad changes - dizzy and lightheaded - low Hgb - weight of pad - high HR and RR low BP - sutures not intact nursing management for PPH - Answer-- bladder scan - indwelling or in/out catheter - fundal massage - monitor VS every 5-15min - CBC (hgb) - blood transfusion - oxytocin - O2 - IV bolus - NPO what are the elements of a postpartum assessment - Answer-B - breast and feeding U - uterus (fundus, perineum) B - bladder (have they gone) B - bowels (have they gone_ L - lochia (color, amount, clots) L - legs (DVT and pulses) E - emotion E - episiotomy and epidural what anticipatory guidance related to physiological and psychological changes that may occur in postpartum should be given - Answer-- mother involved with decision making - activities that enhance bonding (skin-2-skin) - positive re-inforcement with parenting skills - involve partner and family members - methods for infant crying - life-style and rest booklet - communicate feelings and explore them - mood swings are normal - discuss PPD - provide individualized support and information - emotional status - PURPLE crying what are recommendations for infant feeding - Answer-- breastfeed as soon as possible - it is encouraged to breastfeed for 2 years - save colostrum - only top up if baby is having troubles feedings - formula use not encouraged unless asked or medical reason - alternate breasts - feedings can help regulate sugars and body temp What is post partum blues - Answer-- temporary self resolving - occurs within 2-3 days postpartum - can last 2 weeks - hormone changes (rapid drop in estrogen and progesterone) what are the risk factors for PPB and PPD - Answer-- Hx depression - previous gravita with PPD or PPB - trauma - difficult birth - lack of social supports - stressful environment/abusive - unplanned or wanted pregnancy