OB/Peds Final Exam Latest Update 2023/2024 Actual Exam Questions 100% Correct

OB/Peds Final Exam What is antepartum? (ANS- time between conception and onset of labor What is placenta previa? (ANS- placenta implants over cervical os What are clinical manifestations of placenta previa? (ANS- -Vaginal bleeding (painless, bright red in second or third trimester, spontaneous cessation then recurrence) What is the nursing management of placenta previa? (ANS- -Monitoring of maternal-fetal status •Vaginal bleeding; pad count •Avoidance of vaginal exams •FHR -Support and education: fetal movement counts, effects of prolonged bed rest (if necessary); signs and symptoms to report -Preparation for possible cesarean birth What is abruptio placentae? (ANS- •Separation of placenta leading to compromised fetal blood supply What is the nursing assessment for abruptio placentae? (ANS- -Bleeding (dark red) -Pain (knife like), uterine tenderness, contractions -Fetal movement and activity (decreased) -FHR -Laboratory and diagnostic testing: CBC, fibrinogen levels, PT/aPTT, type and cross-match, nonstress test, biophysical profile What is the nursing management for abruptio placentae? (ANS- -Tissue perfusion: left lateral position, strict bed rest, oxygen therapy, vital signs, fundal height, continuous fetal monitoring-Support and education: empathy, understanding, explanations, possible loss of fetus, reduction of recurrence Watch for DIC What is preeclampsia? (ANS- pregnancy induced hypertension How do you manage mild preeclampsia? (ANS- -Bed rest, daily BP monitoring, and fetal movement counts -Hospitalization; IV magnesium sulfate during labor How do you manage severe preeclampsia? (ANS- -Hospitalization; oxytocin and magnesium sulfate; preparation for birth What is gestational diabetes? (ANS- diabetes during pregnancy What is magnesium sulfate used for? (ANS- -Used to stop preterm labor by relaxing the smooth muscle of the uterus and suppresses contractions. -Also used to lower BP and depress the CNS if gestational HTN is present. ***Given for mild and severe preeclampsia*** What is an ectopic pregnancy? ( ANS- A pregnancy in which the fertilized egg implants outside the uterus. What is vaginal bleeding? (ANS- any discharge of blood from the vagina. It can happen any time from conception (when the egg is fertilized) to the end of pregnancy. Some women have vaginal bleeding during their first 20 weeks of pregnancy. What does vaginal bleeding put you at risk for? (ANS- Anemia, shock What are S/S of vaginal bleeding? (ANS- Increased HR and Low BP What is lightening during pregnancy? (ANS- happens during weeks 38-40 (baby drops into pelvis) What is quickening? (ANS- fetal movement 16-20 wks What are the psychosocial implications of pregnancy? (ANS- anxiety, stress, depression, marital dissatisfaction, and social support What is intrapartum? (ANS- labor and delivery of the fetus What is a cesarean section? (ANS- surgical delivery of a baby by making an incision through the abdomen and into the uterus What is the pre op care for a c-section? (ANS- -a blood test will be carried out to check for a lack of red blood cells -antibiotics -anti-emetics -antacids -Insert foley catheter -Aseptic technique What is the post op care for a c-section? (ANS- -assess fundus -have the mom and baby bond while in the PACU -encourage breastfeeding -monitor vitals -monitor for infection -administer pain meds, fluids, pitocin -monitor I/O's What is a prolapsed umbilical cord? (ANS- When the umbilical cord presents first and gets squeezed between the vaginal wall and the baby's head. How do you interpret the fetal monitor and what is it? (ANS- -Handheld vs. electronic; intermittent vs. continuous; external vs. internal ELECTRONIC FETAL MONITORING: •Uses a machine to produce a continuous tracing of the FHR •Produce a graphic record of the FHR pattern •Primary objective -To provide information about fetal oxygenation and prevent fetal injury from impaired oxygenation -To detect fetal heart rate changes early before they are prolonged and profound What are the 5P's? (ANS- •Passageway (birth canal: pelvis and soft tissues) •Passenger (fetus and placenta) •Powers (contractions) •Position (maternal) •Psychological response What is postpartum? (ANS- •The period of time following the delivery of the child during which the body tissues, especially the reproductive system reverts back to the pre-pregnant state, both anatomically and physiologically. How do you assess the fundus postpartum? (ANS- qposition of fundus in relation to the umbilicus •If palpable above level of umbilicus or to the right - full bladder •Encourage woman to void before assessment •Poorly contracted uterus: boggy or very soft in the abdomen Uterus •At delivery fundus is at the umbilicus •1-2 hours: midway between umbilicus and symphysis pubis •12 hours: 1 cm above or at umbilicus • After that the height of the uterine fundus •decreases (involutes) by approximately 1 cm per day. -MASSAGE THE FUNDUS