nursing 320 final exam
abortion Correct Answers a. Spontaneous (miscarriage)
i. Pregnancy loss <20 weeks
1. First trimester (80%)-chromosomal abnormalities, teratogens,
infections, placenta
2. Second trimester- incompetent cervix
Symptoms/ types of abortions
i. Threatened- no dilation, spotting, cramping, backache
ii. Inevitable- cervix dilates
iii. Incomplete- tissue retained, heavy bleeding, pain
iv. Complete- all tissue expelled (best kind if you're going to
have one)
v. Missed- fetus dies, but not expelled (worst)
Management of Spontaneous abortion
i. Cerclage
ii. D&C to remove tissue from uterus
iii. Rho-gam if Rh-
iv. Emotional support
acrocyanosis Correct Answers bluish discoloration of hands
and feet as a result of poor circulation
active phase of labor (1st stage) Correct Answers 1. 4-7 cm
dilation
2. Fetus descends
3. Contractions q 3-5 minutes, lasting 40-70 seconds, moderate
intensity
4. 3-6 hours
,5. maternal behavior: increased anxiety/ pain, use relaxation
techniques
6. needs support person, epidural (no direct effect on baby),
biggest problem with epidural is maternal hypotension
amniocentesis Correct Answers i. Sterile procedure, needle
inserted into amniotic sac and guided by ultrasound
Risks
1. Maternal: bleeding, infection, labor
2. Fetal: death, injury, Rh incompatibility
Indications
1. Genetic/ chromosomal testing (>14 weeks), assess fetal lung
maturity (surfactant production), delivery decision
APGAR Correct Answers a. Assigned at 1 and 5 minutes
b. 5 physiological parameters (0-2 points)
i. HR=114, good cry, muscle flexion good, cries in response to
stimulation, body pink/ hands and feet blue in color
ii. Significance
1. 7-10: good condition
2. 4-6: fair condition, give O2, stimulation
3. 0-3: poor condition, needs resuscitation
betamethasone Correct Answers a. NOT a tocolytic
b. Glucocorticoid (steroid), IM administration x2 doses
c. Stimulates fetal lung maturity
d. Prevents RDS in newborn
e. Side effects: infection, pulmonary edema
, Biophysical Profile (BPP) Correct Answers Assessment of 5
fetal variables by ultrasound
1. Fetal breathing movements, body movements, tone, amniotic
fluid index, FHR reactivity
Scoring
1. 8-10 normal
2. 6 retest
3. 0-4 abnormal (very concerning, most likely will need a c-
section)
bottle feeding Correct Answers i. Commercial formulas: iron-
fortified, 20 cal/ oz
1. No cow's milk, mixed with water
ii. Difference from breast milk
1. 15-60 mL/ feeding
2. Bottle feeders tend to be a little heavier than breastfed
a. Evens out by age 2
3. 30 mL for 30 min
iii. Burping
1. During and after feeding
2. Spitting up is common
a. C-section babies tend to spit up more
b. Warning signs-projectile, green, other s/s of illness
(irritability, diarrhea, etc)
iv. Education
1. Formula preparation and storage
a. Room temp for 4 hours, in fridge for 4 days, in freezer for 4
months
2. Never prop bottle
3. Don't microwave-use warm water
abortion Correct Answers a. Spontaneous (miscarriage)
i. Pregnancy loss <20 weeks
1. First trimester (80%)-chromosomal abnormalities, teratogens,
infections, placenta
2. Second trimester- incompetent cervix
Symptoms/ types of abortions
i. Threatened- no dilation, spotting, cramping, backache
ii. Inevitable- cervix dilates
iii. Incomplete- tissue retained, heavy bleeding, pain
iv. Complete- all tissue expelled (best kind if you're going to
have one)
v. Missed- fetus dies, but not expelled (worst)
Management of Spontaneous abortion
i. Cerclage
ii. D&C to remove tissue from uterus
iii. Rho-gam if Rh-
iv. Emotional support
acrocyanosis Correct Answers bluish discoloration of hands
and feet as a result of poor circulation
active phase of labor (1st stage) Correct Answers 1. 4-7 cm
dilation
2. Fetus descends
3. Contractions q 3-5 minutes, lasting 40-70 seconds, moderate
intensity
4. 3-6 hours
,5. maternal behavior: increased anxiety/ pain, use relaxation
techniques
6. needs support person, epidural (no direct effect on baby),
biggest problem with epidural is maternal hypotension
amniocentesis Correct Answers i. Sterile procedure, needle
inserted into amniotic sac and guided by ultrasound
Risks
1. Maternal: bleeding, infection, labor
2. Fetal: death, injury, Rh incompatibility
Indications
1. Genetic/ chromosomal testing (>14 weeks), assess fetal lung
maturity (surfactant production), delivery decision
APGAR Correct Answers a. Assigned at 1 and 5 minutes
b. 5 physiological parameters (0-2 points)
i. HR=114, good cry, muscle flexion good, cries in response to
stimulation, body pink/ hands and feet blue in color
ii. Significance
1. 7-10: good condition
2. 4-6: fair condition, give O2, stimulation
3. 0-3: poor condition, needs resuscitation
betamethasone Correct Answers a. NOT a tocolytic
b. Glucocorticoid (steroid), IM administration x2 doses
c. Stimulates fetal lung maturity
d. Prevents RDS in newborn
e. Side effects: infection, pulmonary edema
, Biophysical Profile (BPP) Correct Answers Assessment of 5
fetal variables by ultrasound
1. Fetal breathing movements, body movements, tone, amniotic
fluid index, FHR reactivity
Scoring
1. 8-10 normal
2. 6 retest
3. 0-4 abnormal (very concerning, most likely will need a c-
section)
bottle feeding Correct Answers i. Commercial formulas: iron-
fortified, 20 cal/ oz
1. No cow's milk, mixed with water
ii. Difference from breast milk
1. 15-60 mL/ feeding
2. Bottle feeders tend to be a little heavier than breastfed
a. Evens out by age 2
3. 30 mL for 30 min
iii. Burping
1. During and after feeding
2. Spitting up is common
a. C-section babies tend to spit up more
b. Warning signs-projectile, green, other s/s of illness
(irritability, diarrhea, etc)
iv. Education
1. Formula preparation and storage
a. Room temp for 4 hours, in fridge for 4 days, in freezer for 4
months
2. Never prop bottle
3. Don't microwave-use warm water
