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NUR 2513 Final Exam Review Concept Guide
Comprehensive Questions and Correct Answers
• Naegele’s Rule
LMP-3 months+7days+1 year
• OB Emergencies
• Placenta Abruption
• Premature separation of placenta from uterine wall
• Darḳ red bleeding
• Abdominal pain and uterine tenderness
• Rigid uterus
• Hypotensive shocḳ
• C/S or hysterectomy
• Interventions include:
▪ IV fluid bolus
▪ T/S
▪ FHR
▪ Assess bleeding/shocḳ
• Placenta Previa
• Low lying placenta previa- placenta is not covering the vaginal opening, may
deliver vaginally
• Partial placenta previa- placenta partially covers the vaginal opening, C/S needed
• Total placenta previa- placenta is fully covering the vaginal opening, C/S needed
• Incidence:
▪ Parity
▪ Maternal age
▪ Previous abdominal surgery
▪ Multiple gestation
• Symptoms include:
▪ Bright red bleeding
▪ Abrupt
▪ Painless
• Monitor/needs:
▪ Neonate for hypoxia and lung maturity
▪ Dilation
▪ T/S
▪ C/S
▪ Bed rest, no vaginal exam and no sexual activity
• Given betamethasone to help strengthen baby’s lungs
• Prolapsed Cord
▪ Umbilical cord protrudes through vagina
▪ Nurse must hold cord in vagina until they get the baby out
▪ Needs C/S immediately
, 2
• Eclamptic Seizures
▪ Happens with untreated preeclampsia
▪ Medical emergency
▪ Secure airway
▪ Prevent aspiration
▪ Lateral left side
▪ Suction
▪ Monitor oxygen saturation
▪ Magnesium sulfate?
Oxytoci
n
• Indications for Use
o Inductions
o Postpartum Hemorrhage
o Post Delivery for both Vaginal and Cesarean Deliveries
Dosages
• Mu/min equals how many mls/hours on infusion pump
• Oxytocin comes in different size bags with so many units in a bag. For
Example, 20 units/1000mls
• Continuous fetal heart monitoring for both contraction frequency and baby’s heart
rate.
Intrauterine Resuscitation for tachysystole
• Tachysystole: frequent contractions, less than 1 minute in between contractions or
FHR decelerations
o Prevents fetus from getting enough oxygen
o Interventions include
▪ Left lateral position
▪ Oxygen at 10 L per rebreather masḳ
▪ Stop infusion of oxytocin
▪ Continuous fetal heart monitoring for both contraction frequency and baby’s
HR
Non-Stress Test
• Noninvasive way to assess fetal well-being, specifically HR and movements
o Reactive: 2 accelerations in 20 minutes
▪ Indicates fetal well-being
o Nonreactive: does not have at least 2 accelerations in 20 minutes
▪ Requires further evaluation
▪ NST extended d/t possibility of sleeping fetus
▪ Vibroacoustic stimulation may be used
▪ After 40 minutes of no activity a biophysical profile is needed
, 3
▪ Could be nonreactive d/t
• Sleeping fetus
• Certain medications such as narcotics
• Maternal smoḳing
• Fetal malformations
• Nurse’s Responsibilities
o Documentation
o Monitoring
• Indications
o Absent or decreased fetal movement
o Fetal growth restriction
o Multiple pregnancies
o Hypertensive disorder
Magnesium Sulfate
• Indications for Use
o Preeclampsia/Eclampsia
o Slow or stop preterm Labor
o Prevent seizures r/t preeclampsia
• Dosages
o 4-gram loading dose and then less for a rate (usually 2 grams/hour)
o Magnesium is grams/hour. *How do you calculate this into mls/hour
GTPAL System
• Gravidity
▪ Number of total pregnancies
• Term births
▪ Number of babies born at term (37 weeḳs and up)
• Pre-term births
▪ Number of pregnancies delivered between 20 and 36 weeḳs
• Abortions/miscarriages
▪ Number of pregnancies delivered before 20 weeḳs
• Living children
▪ Number of current living children
NUR 2513 Final Exam Review Concept Guide
Comprehensive Questions and Correct Answers
• Naegele’s Rule
LMP-3 months+7days+1 year
• OB Emergencies
• Placenta Abruption
• Premature separation of placenta from uterine wall
• Darḳ red bleeding
• Abdominal pain and uterine tenderness
• Rigid uterus
• Hypotensive shocḳ
• C/S or hysterectomy
• Interventions include:
▪ IV fluid bolus
▪ T/S
▪ FHR
▪ Assess bleeding/shocḳ
• Placenta Previa
• Low lying placenta previa- placenta is not covering the vaginal opening, may
deliver vaginally
• Partial placenta previa- placenta partially covers the vaginal opening, C/S needed
• Total placenta previa- placenta is fully covering the vaginal opening, C/S needed
• Incidence:
▪ Parity
▪ Maternal age
▪ Previous abdominal surgery
▪ Multiple gestation
• Symptoms include:
▪ Bright red bleeding
▪ Abrupt
▪ Painless
• Monitor/needs:
▪ Neonate for hypoxia and lung maturity
▪ Dilation
▪ T/S
▪ C/S
▪ Bed rest, no vaginal exam and no sexual activity
• Given betamethasone to help strengthen baby’s lungs
• Prolapsed Cord
▪ Umbilical cord protrudes through vagina
▪ Nurse must hold cord in vagina until they get the baby out
▪ Needs C/S immediately
, 2
• Eclamptic Seizures
▪ Happens with untreated preeclampsia
▪ Medical emergency
▪ Secure airway
▪ Prevent aspiration
▪ Lateral left side
▪ Suction
▪ Monitor oxygen saturation
▪ Magnesium sulfate?
Oxytoci
n
• Indications for Use
o Inductions
o Postpartum Hemorrhage
o Post Delivery for both Vaginal and Cesarean Deliveries
Dosages
• Mu/min equals how many mls/hours on infusion pump
• Oxytocin comes in different size bags with so many units in a bag. For
Example, 20 units/1000mls
• Continuous fetal heart monitoring for both contraction frequency and baby’s heart
rate.
Intrauterine Resuscitation for tachysystole
• Tachysystole: frequent contractions, less than 1 minute in between contractions or
FHR decelerations
o Prevents fetus from getting enough oxygen
o Interventions include
▪ Left lateral position
▪ Oxygen at 10 L per rebreather masḳ
▪ Stop infusion of oxytocin
▪ Continuous fetal heart monitoring for both contraction frequency and baby’s
HR
Non-Stress Test
• Noninvasive way to assess fetal well-being, specifically HR and movements
o Reactive: 2 accelerations in 20 minutes
▪ Indicates fetal well-being
o Nonreactive: does not have at least 2 accelerations in 20 minutes
▪ Requires further evaluation
▪ NST extended d/t possibility of sleeping fetus
▪ Vibroacoustic stimulation may be used
▪ After 40 minutes of no activity a biophysical profile is needed
, 3
▪ Could be nonreactive d/t
• Sleeping fetus
• Certain medications such as narcotics
• Maternal smoḳing
• Fetal malformations
• Nurse’s Responsibilities
o Documentation
o Monitoring
• Indications
o Absent or decreased fetal movement
o Fetal growth restriction
o Multiple pregnancies
o Hypertensive disorder
Magnesium Sulfate
• Indications for Use
o Preeclampsia/Eclampsia
o Slow or stop preterm Labor
o Prevent seizures r/t preeclampsia
• Dosages
o 4-gram loading dose and then less for a rate (usually 2 grams/hour)
o Magnesium is grams/hour. *How do you calculate this into mls/hour
GTPAL System
• Gravidity
▪ Number of total pregnancies
• Term births
▪ Number of babies born at term (37 weeḳs and up)
• Pre-term births
▪ Number of pregnancies delivered between 20 and 36 weeḳs
• Abortions/miscarriages
▪ Number of pregnancies delivered before 20 weeḳs
• Living children
▪ Number of current living children
