OB HESI Study Guide Questions and Answers Rated A

OB HESI Study Guide Questions and Answers Rated A What is the primary function of uterine contraction after the delivery of the infant and placenta? Name 4 tocolytics 1. Indometacin 2. Nifedipine 3. Magnesium Sulfate 4. Terbutaline Name the 4 P's of Labor 1. Passageway 2. Passenger 3. Powers 4. Psyche The fetus of a pregnant patient is presenting in transverse lie. After notifying the HCP what should the nurse do? Prepare to assist with external version or prep for a cesarean section delivery The nurse is assisting with delivery of a pregnant patient who has been induced and is now in hypertonic labor. The fetal heart rate drops suddenly. What should the nurse prepare to do? Decrease oxytocin A patient at 38 weeks' gestation is reporting continuous, heavy vaginal discharge & pelvic pressure. A nitrazine test confirms PROM with no sign of infection. After being admitted which nursing intervention would be of the HIGHEST priority? Administer antibiotics per order A nonsmoking patient, pregnant for the first time at 28 years of age & expecting twins, is at 36 weeks' gestation & complaining of backache & painful uterine contractions. After examination the patient has no cervical dilation or pooling of fluid. What is the BEST course of action? Send the patient home for bed rest & hydration with orders to return if the water breaks or contractions worsen A patient at 31 weeks' gestation in preterm labor is given magnesium sulfate. What must the nurse report as part of the patient's care? Respiratory depression, hypotension, absent tendon reflexes The fetus of a multigravida patient has died. Photographs are taken of the fetus according to organizational policy & when the patient is informed that pictures are available, she angrily responds no & bursts into tears. How should the nurse respond? Explain that the hospital will keep the photos in case she changes her mind. During labor the fetus begins to deliver but instead of continuing to emerge, it retracts into the vagina. What should the nurse try FIRST? McRoberts maneuver The membranes of a pregnant patient have ruptured & the umbilical cord is hanging out of the vagina. What should the nurse do? Place the patient in bed, call for help, & hold the presenting part off of the cord A pregnant patient near term has sustained blunt trauma to the abdomen from a MVC. The patient goes into labor but then complains of severe pain in the back and shoulder. What should the nurse suspect is occurring with this patient? Uterine rupture At 31 weeks' gestation, a patient with a history of preterm birth reports cramps, vaginal pain, & low, dull backache accompanied by vaginal discharge & bleeding. The cervix is 2.1 cm long; there is fetal fibronectin in her cervical secretions, & the cervix is dilated 3 to 4 cm. For what should the nurse prepare this patient? Hospitalization, tocolytic therapy, & IM corticosteroids After 12 hours of active labor, a pregnant patient is only dilated 6 cm. What should the nurse consider doing for this patient? Reassess the fetal presentation and position A patient whose membranes have prematurely ruptured is discharged to home care. Which action should the nurse include in the patient's teaching plan? Monitoring temperature twice a day The nurse is concerned that a pregnant patient is at risk for preterm labor. What medical risk factors did the nurse most likely assess in this patient? Obesity Diabetes Dehydration High blood pressure While in labor a patient with a prior history of cesarean birth complains of light-headedness & dizziness. The nurse assess the patient & notes an increase in pulse & decrease in blood pressure from the vital signs 15 min prior. What might the nurse consider as a possible cause for the symptoms? Uterine rupture A pregnant patient is diagnosed wit placenta increta. What are the maternal & fetal implications for this placental abnormality? Fetal death Hemorrhage Uterine rupture Possible hysterectomy At 35 weeks' gestation, a patient experiences preterm labor. Tocolytics are administered & the patient is on bed rest at home. What should the nurse teach this patient. Fetal kick counts should be 10/hour, call if under 3 are felt After an hour of administering oxytocin intravenously, a patient's contractions are 100 seconds in length. What should the nurse do FIRST? Discontinue the oxytocin infusion The nurse-midwife tells a pregnant patient that she has developed dystocia. How should the nurse explain this term to the patient? Difficult or abnormal labor A patient in labor is experiencing extreme dyspnea & the nurse suspects the development of an amniotic fluid embolism. What interventions are priorities for this patient? Call for help Apply 02 Measure VS Assist with cesarean section at the bedside The fetus of a pregnant patient is in an occiput posterior position. How will this patient's labor differ from others? Experience of additional back pain A patient with preterm labor is receiving terbutaline. For what should the nurse assess while the patient is receiving this medication? Onset of tachycardia A patient at 28 weeks' gestation is being assessed for preterm labor. Which finding indicates that preterm labor is occurring? Fetal fibronectin is present in vaginal secretions During labor, a patient at 41 weeks' gestation asks why the amniotic fluid is green in color. What should the nurse respond? "This is meconium-stained fluid from the baby" Within 24 hours of delivery, the postpartum patient complains of pain in the pelvic region. Comfort measures & medication fail to eliminate the pain. Her pulse is rapid, & BP, hematocrit, & hemoglobin are low. The fundus is firm & lochia is dark red & flowing in only moderate amounts without pooling. What should the nurse suspect is occurring with the patient? Deep pelvic hematoma Which postpartum patient should the nurse suspect of having endometritis? Patient with diabetes who delivered vaginally & develops tachycardia & a feverof 101.7 degrees on the third postpartum day. The next day, the patient appears ill; fever is 102.9 degrees; WBC is 31,500 cells/mm3; blood cultures are negative. The nurse is caring for a postpartum patient who is receiving IV antibiotics & supportive care for endometritis. Which finding should the nurse report immediately? Steadily decreasing volume of urine A postpartum patient received corticosteroids during pregnancy, delivered by cesarean & subsequently developed endometritis. The incision is red, warm, & very sensitive to touch, & remains febrile despite antibiotic therapy. What is the most important aspect of post hospital care to teach the patient? Wound care and hand washing A patient develops mastitis three weeks after delivery. What part of self-care should the nurse instruct as being the most important? Breast-feed or otherwise empty the breasts every one to two hours A postpartum patient develops cystitis & does not want to drink more fluids because it burns when she voids. What should the nurse respond to this patient's issue? Teach that voiding large volumes of fluids that acidify the urine can actually reduce the burning & irritation Which clinical manifestation in a patient with DVT should the nurse report immediately? Dyspnea Two weeks after their baby is born, the spouse is concerned that the patient is extremely talkative & energetic, is only sleeping for a few hours each night, & forgets to eat. The patient is also neglecting her appearance & unaware that a baby has needs. What health problem should the nurse suspect the patient is experiencing? Postpartum psychosis The nurse is planning care to assist a patient & spouse through the unexpected death of their newborn. Which interventions should the nurse use to support the couple at this time? Provide lock of hair Provide a photo of the baby Encourage to name their baby What is the most frequent reason for postpartum hemorrhage? Uterine atony A postpartum patient calls for the nurse because she is having a very heavy lochia flow containing large clots. What should be the nurse's FIRST action? Palpate fundus The nurse assesses the patient who is one hour postpartum & observes a heavy, steady gush of bright red blood from the vagina in the presence of a firm fundus. What is the most likely cause of the signs & symptoms? Lacerations The nurse is caring for a patient within the first four hours of her cesarean birth. Which nursing intervention would be appropriate to prevent thrombophlebitis? Ambulate as soon as vital signs are stable The nurse is reviewing a medical record or a patient who just delivered a newborn & is concerned that the patient is at risk for an intrapartal infection. Which information caused the nurse to have this concern? Urinary catheterization Use of forceps for the birth Prolonged rupture of membranes On examining a patient who gave birth five hours ago, the nurse finds that the patient has completely saturated a perineal pad within 15 min. Which action by the nurse should be implemented FIRST? Assess the fundus When assessing a postpartum patient who was diagnosed with a cervical laceration which has been repaired, what sign should the nurse report as a possible development of hypovolemic shock? Weak and rapid pulse The nurse has attempted to massage a boggy uterus to firm state without success. The next intervention the nurse should anticipate is the administration of what medication Oxytocin When assessing the patient for postpartum hemorrhage what should the nurse monitor every hour? Pad count A postpartum patient is being evaluated for depression. Which manifestations would the nurse assess in this patient? Tearful Lack of motivation Sadness and Anxiety When diagnosed with a DVT, the nurse knows the patient will be treated with which medication? Anticoagulants When providing care for a postpartum patient at a six-week checkup, which behavior would alert the nurse the patient may have postpartum psychosis Restless and agitated, concerned with self The nurse observes a mother with her two-week infant & becomes concerned. Which behavior should the nurse bring to the attention of the HCP? Nonresponsive to the infant crying List 3 factors for preeclampsia/eclampsia. Family history/Personal history Extremes in age (very old/very young) American descent Twelve hours after delivery, the fundus of a patient who has just delivered her fifth child after 14 hours of labor is two fingers above the umbilicus & her uterus feels soft and spongy. What should the nurse do first? Gently massage the fundus until it tones up A patient has just delivered her second child and will breast-feed. The patient does not want to become pregnant again until her second child is at least 2 years old. When should the nurse counsel the patient to begin birth control? As soon as she resumes sexual activity Before delivery a pregnant patient's hemoglobin was 14g/dL and a hematocrit of 42%. Which postpartum measurements should the nurse report? Hemoglobin 9g/dL and hematocrit 32% in a woman who has given birth by cesarean A patient has just delivered a baby. Her prelabor vital signs were T-98.8 B/P-P-R 120/70, 80, 20. Which combination of findings during the early postpartum period should be reported immediately? The nurse is discharging a new mother and notes she is not rubella-immune and administers the rubella vaccine. The patient will breast-feed her infant and plans to get pregnant again as soon as possible. What is the most important information the nurse should give her about this immunization? Warn her not to attempt another pregnancy for at least 3 months During a postpartum examination on the day of delivery, a patient complains that she is still sore that she can't sit comfortably. The nurse examines her perineum and finds the edges of the episiotomy approximated without signs of a hematoma. Which intervention will be most beneficial at this point? Place an ice pack What is the process by which the reproductive organs return to the nonpregnant size and function? Involution What is the primary function of uterine contractions after the delivery of the infant and placenta? Seal off the blood vessels at the site of the placenta While educating a class of postpartum patients before discharging them home after delivery, one woman asks, "when will I stop bleeding?" How should the nurse respond? The bleeding may slowly decrease over the next one to three weeks, changing color to a white discharge, which may continue for up to six weeks The nurse is caring for a patient on postpartum day 1. Before assessing her uterus, where should the nurse anticipate she will locate the fundus? 1 cm below the umbilicus