RN CAPSTONE MATERNALNEWBORN –LATEST STUDY GUIDE

The nurse is assessing a new mother's efforts to bond with her newly born infant. Identify three (3) factors that can impact effective bonding between mother and infant? 1) Mother’s physical and emotional condition 2) Baby's physical condition 3) Family being prepared for the baby The client enters the obstetrical clinic for birth control information on using a diaphragm. What five (5) instructions would be provided by the nurse to explain use of the diaphragm? 1) A client should be properly fitted with a diaphragm by a provider 2) Replaced every 2 years and refitted for a 20% weight fluctuation, after abdominal or pelvic surgery, and after every pregnancy 3) Requires proper insertion and removal. Prior to coitus, the diaphragm is inserted vaginally over the cervix with spermicidal jelly or cream that is applied to the cervical side of the dome and around the rim. The diaphragm can be inserted up to 6 hours before intercourse and must stay in place 6 hours after intercourse but for no more than 24 hrs 4) Spermicide must be reapplied with each act of coitus 5) A client should empty her bladder prior to insertion of the diaphragm. A nurse is caring for a client who was diagnosed with group B streptococcus during her initial screening. What effects can this infection have on her pregnancy? Premature rupture of membranes, preterm labor & delivery, chorioamnioitis, infections of urinary tract, maternal sepsis. What are five (5) risk factors that affect female fertility? 1) Age greater than 35 2) Weight 3) Substance use 4) STDs 5) Surgical history A nurse is providing education to a new mother regarding storage of breast milk. Identify five (5) teaching points to discuss with the new mother regarding storage of breast milk. .clean wide-mouthed lid with tight lid At room temp for 8-10 hrs Refrigerator -24 hrs,Freezer -20 degrees C for three months-STORE MILK IN THE BACK OF THE MAIN BODY OF THE REFRIGERATOR MILK CAN BE STORED IN AN INSULATED COOLER BAG FOR 24HRS- KEEP ICE PACKS IN CONTACT WITH MILK CONTAINERS AT ALL TIMES,LIMIT OPENING OF THECOOLER BAG Thawed,Previously frozen in refregirator 40 degrees F UPTO 1 day THAWED MILK SHOULD NOT BE WARMED IN ANY OTHER WAY EXCEPT PUTTING MILK IN BOTTLE AND PLACING IN WARM WATER NB ;NEVER REFREEZE BREASTMILK AFTER IT HAS BEEN THAWED IF THE BABY HAS LEFTOVER MILK FROM FEEDING BOTTLE- USE WITHIN 2 HRS AFTER BABY IS DONE FEEDING THEN DISCARD. A nurse is providing care for an uncircumcised male newborn and his mother. What information should be provided during discharge regarding bathing of the penile area of the newborn male? Wash with soap and water and rinse the penis To prevent constriction do not force back the foreskin What is the recommended weight gain in the first, second and third trimesters? 1st trimester: 1-2 kg (2.2 – 4.4 lbs) 2nd and 3rd trimester: 0.4 kg ( 1lb) per week What are six (6) emotional responses the nurse would assess for if a mother is experiencing postpartum depression? 1) Feeling loss, irritability 2) Intense mood swings 3) Anxiety 4) Guilt 5) Inadequacies feelings 6) Decrease appetite What would the nurse teach to the postpartum mother before administering the Rho(D) Immune Globulin? Educate the mother that all Rh-negative mothers who have newborns who are Rh-positive must be given Rho(D) immune globulin administered IM within 72 hr of the newborn being born to suppress antibody formation in the mother. Infants who are Rh0positive are given Rho(D)Immune globulin to prevent sensitization in future pregnancies. A nurse is instructing a newly diagnosed client with fibrocystic breast tissue disorder about diet. What should the nurse instruct the client to avoid in their diet? (Review the Med Surg RM) a. Alcohol b. Caffeine C. Milk d. Orange juice What are five (5) adverse effects noted with epidural analgesia administration during labor? 1) Maternal Hypotension 2) Fetal Bradycardia 3) Bladder distention 4) Loss of bearing down reflex 5) Respiratory depression What should the nurse teach the client about depot medroxyprogesterone acetate as a method of contraception? Start injection during the first 5 days of the patient’s menstrual cycle and every 11 – 13 weeks afterwards; For postpartum on-breastfeeding patients injections should be given 5 days of delivery, for breastfeeding women within 6 weeks; advise clients to keep up with follow-up appointments; maintain adequate intake of calcium and vitamin D A nurse is preparing to administer a rubella vaccination. What are contraindications to this immunization? (Pharmacology Review Module) Pregnancy, immunocompromised household members, hypersensitivity, gelatin allergy What are the indications for prescribing hormone replacement therapy (HRT) for a menopausal client? (Review Pharmacology Module) Indications can range from relieving vasomotor symptoms, improving urogenital symptoms (long- term therapy), to preventing osteoporosis .....................................................................................................CONTINUE