RN ATI MATERNAL NEWBORN PROCTORED EXAM (VERSION 9)

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? • A client’s emotional and physical condition (unwanted pregnancy, adolescent pregnancy, history of depression, difficult pregnancy and birth) • The newborn’s physical condition (prematurity, congenital anomalies) after birth can affect the family’s bonding process. • Culture, age, and socioeconomic level are factors that can influence the bonding process. Bonding can be delayed secondary to maternal or neonatal factors A nurse is providing community education regarding risk factors for ovarian cancer. Identify five (5) risk factors associated with the development of ovarian cancer. (Review the Med Surg RM) • Age greater than 40 years • Nulliparity or first pregnancy after 30 years of age • Family history of ovarian, breast, or genetic mutation for hereditary nonpolyposis colon cancer (HNPCC) • BRCA1 or BRCA2 gene mutations • Diabetes mellitus • Early menarche/late menopause • History of dysmenorrhea or heavy bleeding • Endometriosis • High‑fat diet (possible risk) • Hormone replacement therapy • Use of infertility medications • Older adult clients following surgery for cancer What are risks/possible complications/contraindications for the use of intrauterine contraceptive devices? • Best used by women in a monogamous relationship due to the risks of STIs • Can cause irregular menstrual bleeding • Risk of bacterial vaginosis, uterine perforation, or uterine expulsion • Must be removed in the event of pregnancy • Active pelvic infection, abnormal uterine bleeding, severe uterine distortion; for copper IUD also Wilson’s diseases and copper allergy A pregnant client has a history of giving birth to one set of twin boys, one term girl and 2 early spontaneous abortions. What is her gravida and para? G P = TPAL G5, P1123 What are five (5) risk factors that affect female fertility? AGE greater than 35 years can affect fertility. DURATION OF INFERTILITY:More than 1 year of coitus without contraceptives. For women over the age 35 or who have a known risk factor, the recommendation is for 6 months. MEDICAL HISTORY: Atypical secondary sexual characteristic, such as abnormal body fat distribution or hair growth, is indicative of an endocrine disorder. Assessment should include hormonal and adrenal gland disorders, as these can contribute to infertility. SURGICAL HISTORY: Particularly pelvic and abdominal procedures. OBSTETRIC HISTORY: Past episodes of spontaneous abortions. Other obstetric assessments should include an evaluation of hormone levels throughout the client’s cycle. This can provide information about anovulation, amenorrhea, and premature ovarian failure. GYNECOLOGIC HISTORY: Abnormal uterine contours or any history of disorders that can contribute to the formation of scar tissue that can cause blockage of ovum or sperm. SEXUAL HISTORY: Intercourse frequency, number of partners across the lifespan, and any history of STIs 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? • A tub bath should not be given until the circumcision is healed. Until then, warm water should be trickled gently over the penis. • Notify the provider if there is any redness, discharge, swelling, strong odor, tenderness, decrease in urination, or excessive crying from the newborn. • Tell the parents that a film of yellowish mucus can form over the glans by day two, and it is important not to wash it off. • Teach the parents to avoid using premoistened towelettes to clean the penis because they contain alcohol A nurse is providing discharge teaching to a new parent regarding cord care. What information should be provided? • Before discharge, the cord clamp is removed. • Prevent cord infection by keeping the cord dry, and keep the top of the diaper folded underneath it. • Sponge baths are given until the cord falls off, which occurs around 10 to 14 days after birth. Tub bathing and submersion can follow. • Cord infection (a complication of improper cord care) can result if the cord is not kept clean and dry. • Monitor for manifestations of a cord that is moist and red, has a foul odor, or has purulent drainage. • Notify the provider immediately if findings of cord infection are present