Maternal Newborn Capstone questions and answers well illustrated.

Maternal Newborn Capstone questions and answers well illustrated. hyperbilirubinemia d/t Rh incompatibility - correct answers.If the Rh-negative client has been exposed to Rh-positive fetal blood, she will produce antibodies against Rh factor. These antibodies can cross the placenta and destroy the red blood cells of the Rh-positive fetus. This accelerated rate of red blood cell destruction results in the increased release of bilirubin. The newborn's serum bilirubin level can rise quickly. -Hydrops fetalis is the most severe form of Rh incompatibility and can be prevented by the administration of Rho (D) immunoglobulin. Displaced uterus - correct answers.Displacement of the uterus (above the umbilicus and displaced to the right) is a sign of bladder distention. The nurse should assist the client to void then reassess the fundus. Hyperbilirubinemia with a newborn - correct : phototherapy -maintain an eye mask over the newborn's eyes to protect the corneas and retinas. -the newborn should be undressed during the therapy with the exception of a male newborn who should have the genitals covered. -avoid applying lotions/ointments to the skin during phototherapy because they absorb heat that can cause burns. -the nurse should turn off the phototherapy lights before drawing blood for testing. Uncomplicated gestational hypertension - correct answers.S/S: -BP 140/90 and above -BP will return to normal after pregnancy -without edema or proteinuria Edema, proteinuria, headaches, blurred vision, hyperreflexia, hepatic involvement, occurs when gestational hypertension is associated with pre-eclampsia, eclampsia and/or HELLP syndrome. Gestational HTN - correct answers.Diagnostics -dipstick testing for urine for proteinuria -24 hr urine collection for creatinine clearance and protein TX: magnesium sulfate (therapeutic range: 4- 8 mg/dl) Nursing intervention: -administer mag bolus, inform pt they will feel flushed, hot, and sedated -Monitor DTRs (first sign toxicity), BP, P, RR, LOC, urine output, visual disturbances, headache, epigastric pain, uterine contractions, FHR and activity. Pt. Edu: • Maintain on bed rest and encourage the side-lying position • Promote diversional activities • Avoid foods that are high in sodium • Avoid alcohol and limit caffeine • Instruct to increase fluid intake to 8 glasses/day • Maintain a dark quiet environment to avoid stimuli that may precipitate a seizure • Maintain a patent airway in the event of a seizure • Administer antihypertensive medications if prescribed Ovarian Cancer - correct answers.Risk Factors: -use of infertility meds -age 40 years -endometriosis -nulliparity -previous breast cancer -family hx of breast/ovarian cancers -early menarche -late onset menopause Episiotomy Care - correct answers.-apply ice pack and cool water sitz baths are used during the first 24 hours to reduce edema and promote comfort. hazel compresses to reduce edema -the nurse should also instruct the client on the use of rx anesthetic creams, sprays, and ointments. -The use of a squeeze bottle of antiseptic solution to cleanse the perineal area after voiding reduces the risk of infection. -post 24 hours the use of heat, such as warm sitz bath, promotes circulation, comfort, and tissue repair. -the use Stations - correct answers.-3 ( -2 ( -1 ( 0 station (the lowermost portion of the fetus is at the level of the ischial spines) +1 ( +2 ( +3 ( Raloxiphine - correct to prevent and treat bone loss (osteoporosis) in women after menopause. It is not used for migraines, hypertension, or heart disease. DVT Risk Factors - correct answers.-Cesarean birth doubles the risk for deep-vein thrombosis. -pregnancy -operative vaginal birth -pulmonary embolism -immobility -obesity -smoking -multiparity -age greater than 35 years -history of thromboembolism -diabetes mellitus. VEAL CHOP - correct answers.V- Variable C- Cord Comphression E- Early Decels H- Head Compression A- Accelerations O - OK L-Late Decels P - Placenta ---Late decelerations are associated with insufficient placental perfusion which requires immediate intervention to restore adequate blood flow. Changing the client's position will displace the weight of the uterus off of the vena cava and thus increase maternal circulation to the placenta.