Ob Ati Review Questions And Answers Graded A+

OB ATI REVIEW QUESTIONS AND ANSWERS GRADED A+ When is RhoGAM administered? 28 wks and following delivery Test used to assess for lung maturity, detect congenital abnormalities and diagnose fetal hemolytic dx; RhoGAM is advised after this procedure due to the potential of fetal RBCs entering the maternal blood circulation; possible complication includes pre-term labor and miscarriage therefore report if pt is having any abdominal tightness following procedure; ultrasound should be done prior to procedure to locate a pocket of fluid Amniocentesis What are late decelerations indicative of? Uteroplacental insufficiency Five components of the APGAR score HR, RR, color, reflexes, and muscle tone If a mother is abusing this illicit drug, the nurse can suspect vasoconstriction rt/t abruptio placentae Cocaine Pt with this should eat to taste to avoid nausea, eat a healthy snack at bedtime, alternate liquids and solids q2h, and eat protein following a sweet snack to prevent excessive nausea and vomiting Hyperemesis gravidarum At this time during pregnancy, a GBS culture is taken 35-37 wk At this time during pregnancy, a glucose test is performed 28 wk At this time during pregnancy, a rubella titer is taken 6 wk This contraceptive in contraindicated for pts who have a family or personal hx of osteoporosis since it causes a decrease in bone mineral density Medroxyprogesterone acetate (Depo provera) This contraceptive in contraindicated for pts who have cardiovascular dx, breast cancer, estrogen-dependent tumors, and poor liver fxn Combined estrogen-progestin oral contraceptives (COC) This contraceptive in contraindicated for pts who have multiple sexual partners, have never been pregnant, or who have pelvic inflammatory dx Intrauterine device (IUD) This transdermal contraceptive in contraindicated for pts who have HTN or thromboembolitic disorders Norelgestromin (Ortho Evra) Bath water for a baby should be set no higher than ____ 120 F A postpartum mother who is breastfeeding should increase her caloric intake by ___ 330/day A perineal pad should be changed around ____ 4x/day Nagele's rule -3 mo, +1 yr and 7 days A ____ oxytocin-stimulated contraction test is an adverse result and should be reported to the provider Positive A ____ nonstress test ensures a healthy well-being of the baby Reactive This barrier contraceptive should be replaced q2y, be left in 6 hours after intercourse, use a water-based lubricant (oil can weaken the rubber), and the bladder should be emptied prior to insertion Diaphragm A pt using jet hydrotherapy during labor is contraindicated for this type of fetal heart monitoring Internal electrode The posterior fontanel should be _____ than the anterior fontanel Smaller If a baby is circumcised using the clamp method, ____ should be placed around the glans of the penis during diaper changes, sterile gauze should be gently applied if bleeding occurs, and exudate should not be wiped off Petroleum jelly This is indicative of hepatic involvement and a sign of severe preeclampsia; if left untreated it could be fatal to mother and baby Epigastric pain A test that assess five variables; fetal breathing, fetal movement, fetal tone, amniotic fluid volume, and fetal reaction Biophysical profile This refers to a systemic infection from bacteria in the bloodstream that occurs during the first month after birth; s/sx include nasal flaring, temperature instability, tachypnea, hypotonia, lethargy and irritability Neonatal sepsis Abnormally small amount of amniotic fluid, 500 mL at term; associated with congenital abnormalities such as renal agenesis and intrauterine growth restriction Oligohydramnios This is a common bacterial STD where 80% of all cases are asymptomatic. It can be spread to a baby during birth and can lead to and premature ROM Gonnorhea A serious condition of pregnancy in which the blood pressure rises to 140/90 mm Hg or higher accompanied by proteinuria; s/sx includes pitting edema of the ankles, blurred vision, 3+ DTR, photophobia, oliguria and epigastric pain Preeclampsia Age range at which solid foods can be introduced to the baby 4-6 mo Medicine that's a bronchodilator that's also used in premature labor; relaxes the utereus; adverse rxn includes hypokalemia, hypoTN and hyperglycemia; admnistered subcu q4h for 24h. Brethine This type of pressure relieves back pain r/t fetal posterior position while the pt is in labor Sacral counterpressure A car seat should be put in at a ___ degree angle for the newborn 45 Inflammation of the breast; s/sx include unilateral breast pain with tenderness, sudden onset of fever, chills, and body aches Mastitis Fungal infection that can cause the breast to have a rash with pink, shiny nipples with burning and stinging pains during or after breastfeeding Candidiasis Chest wall under the sternum moves inward during inspiration; sign of respiratory distress in the newborn and require intervention Substernal retractions Light, continuous-stroking massage movement applied with fingers and palms in a slow and rhythmic manner during contractions paired with breathing; relieves contraction pain Effleurage This drug is an opioid antagonist, used to treat opioid overdose ie: respiratory depression Narcan Swab vaginal area, rub on slide, under microscope it should look like a fern; positive indicates ROM Ferning test Type of circumcision; avoid cleaning site with soap and water, change the diaper q4h, don't wipe away exudate, and rim should fall off within a week Plastibell device T:36.5-37.2 (ax), P: 120-160, R: 30-60, length:45-55 cm, and weight: 2.5-4 kg Normal vitals A baby should breastfeed ____ min on each breast 15-20 Blockage of the pulmonary artery by foreign matter or by a blood clot; pt should remain in bed to decrease risk of occurrence, avoid massaging leg, apply warm compresses to the calves, and receive IV heparin therapy Pulmonary embolism ____ accelerations during a 20 min nonstress test is reassuring 2+ This culture believes in postponing bathing for up to 14 days postpartum, protecting the baby's hands and feet from cold air, allowing bed rest for 3 days postpartum for the mother, and drinking warm beverages Hispanic A car seat should be rear facing until the child is ___ of age or 20 lb 2 yo If a newborn's bilirubin levels are ___ they should receive phototherapy 8 mg/dL A corticosteroid whose purpose is to release surfactant and therefore enhance fetal lung maturity; mother should receive 12 mg IM 24 hrs apart Betamethasone These decelerations are caused by compression of the fetal head; an expected finding during the transition phase of labor progression require no further nursing intervention. Early decelerations These decelerations are caused by cord compression, noted as V-shaped on the monitoring strip; change the mother's position; if pitocin is infusing, stop infusion, alert physician Variable decelerations These decelerations are an abrupt FHR decreases of at least 15 bpm from baseline that last longer than 2 minutes but less than 10 minutes; fatal Prolonged decelerations These decelerations are due to uteroplacental insufficiency; nurse should change pt position, dc ocytocin, administer oxygen (8-10 L via face mask), and deliver the newborn if interventions are not helping Late decelerations This type of pressure lifts the occiput of the newborn off the spinal nerves and provides relief for the pt Counter pressure A pt who has this dx should have a fasting glucose level between 60-90 mg/dL, eat 3-5x/ day, eat foods high in fiber, and eat the least amount of carbs at breakfast DM I 1. Palpate the fundus to identify fetal part 2. Determine the location of the fetal back 3. Palpate for fetal part presenting at the inlet 4. Identify the attitude of the head Leopold manuevers What does ABC stand for when weighing priority for nursing interventions? Airway, breathing, circulation Pain relief and relaxation during labor; labor pain; postoperative pain after C-section; can precipitate withdrawal symptoms if pt has opioid dependency Nubain Maternal alpha serum protein test performed around 16-20wks for screening purposes; elevated levels may indicate neural tube defect (NFT) (conduct ultrasound to diagnose) MSAFP Hormone produced by the posterior pituitary gland; stimulates uterine contractions; given to pts to induce labor and if they have a flaccid uterus or excessive vaginal bleeding Oxytocin Abnormally low blood sugar level; expected findings include an irregular RR, lethargy, difficulty feeding, and jitteriness Hypoglycemia A regional pain-relieving drug is delivered continuously through a catheter into a small space in the lower spine; adverse effect is severe hypoTN and tinnitus Epidural analgesia If this is found in a newborn following a circumcision, the provider should be notified because it's indicative of infection Swelling ____ in the mother after a SROM is an indicator of infection Tachycardia Expected range of platelets 150,000-400,000 A partial or complete occlusion of a superficial or deep vein by thrombus with inflammatory changes; assess with measuring calf sizes (unilateral edema) Thrombophlebitis Test used to assess for fetal blood type and RBC count if there is a r/o isoimmune hemolytic anemia Cordocentesis Test that detects the presence and amount of fetal blood in the maternal circulation when there's a r/o Rh isoimmunization Kleihauer-Betke test Moderate to severe cramp-like pains that are related to the uterus working harder to remain contracted and/or to the increase of oxytocin that is released in response to infant suckling; more common in multiparas Afterpains Condition in which the placenta is implanted in the lower segment of the uterus instead of the upper part; pt has painless vaginal bleeding Placenta previa Premature separation of the implanted placenta; pt has painful vaginal bleeding and late decelerations Abruptio placentae Stage of labor that includes the latent, active, and transition phases; nurse should monitor vitals and contractions and assess FHR and cervical dilation from 0-10 cm First Phase of labor in which pt is dilated 0-3 cm Latent Phase of labor in which pt is dilated 4-7 cm Active Phase of labor in which pt is dilated 8-10 cm Transition Stage of labor that includes complete dilation and effacement to the actual delivery of the baby Two Stage of labor that includes the delivery of the placenta Three Stage of labor that is postpartum; recovery lasting 1-4 hr Four Used in labor and delivery to stop preterm labor and to prevent seizures in women with severe preeclampsia; assess for toxicity with absent DTR and extremely low RR, counteract toxicity with calcium gluconate Magnesium sulfate Medicine used in l&d pts to slow down uterine contractions and stop preterm labor Nifedipine Lochia that is bright red; lasts 1-5 days postpartum Rubra Lochia that is pinkish-brown; lasts 4-10 days postpartum Serosa Lochia that is light yellow-cream color; lasts 10-21 days postpartum Alba Normal range of newborn glucose 40-150 mg/dL Normal hgb level 12 g Normal hct level 35% Baby is considered pre-term if they're born at less than ___ wk 36 Normal newborn BP 60-90/20-60 Normal newborn HR 110-160 Normal newborn RR 30-60 Normal WBC count Normal serum albumin level 3.4-5.4 Normal BUN level 10-20 Normal Cr level 0.6-1.1