MATURNITY OB/ HESI EXAM REVIEW
QUESTIONS AND ANSWERS
Why are preterm babies more prone to bleeding? - answer-their blood is deficient in
prothrombin a factor of blood clotting mechanism. Fragile capillaries of the head are
susceptible for injury during birth causing intracranial hemorrhage
Is drooling normal in newborns? - answer-the salivary glands do not secrete saliva until
the infant is 2-3 months old. Drooling in newborns is considered a sign of pathological
disturbance and needs to be reported
Nursing care for hydrocephalus/ vp shunt? - answer-observe for signs of increased
intracranial pressure (icp) and of infection. Pain control management
Bacterial infection is life threatening. Position infant on opposite side of operation
Signs of infection with hydrocephalus/ vp shunt? - answer-signs of infection is vital signs
increase. Poor feeding, pupil dilation, decrease levels of consciousness, and seizures.
Pt instruction for pseudomenstration? - answer-a thin white or blood-tinged mucus, may
be discharged from vagina. This discharge is caused by hormonal withdrawal from the
mother at birth
Newborn tub baths? - answer-are acceptable. The infant need only be bathed 2-3 times
a week using plain warm water during neonatal period. The bath is a excellent time to
provide basic hygiene and to observe the naked newborn behavior, muscle activity, and
general well being. Wash baby head to toe. Water should be 100 prevent chilling baby.
Wrap baby in towel to wash hair so baby doesn't get cold
Priority nursing intervention for neonatal abstinence syndrome? - answer-provide a
quite environment with swaddling, reduction of external stimuli, and close observations
for seizures
Caput succedaneum? - answer-swelling or edema of the newborn scalp that crosses
the suture lines;
Chignon? - answer-newborn scalp edema created by vacuum extractor
Cephalohematoma? - answer-subperiosteal swelling containing blood, found on the
head of some newborns, the swelling doesn't cross the suture lines and therefore often
appears unilateral; usually disappears within a few weeks to 2 months without treatment
Vital sign hypovolemic shock? - answer-increased respiration and heart rate, increase
of o2 content, tachycardia, and bp falls
,Signs of post maturity in post term newborn? - answer-asphycia caused by chronic
hypoxia, meconium aspiration, poor nutrient status, depleted glycogen reserves cause
hypoglycemia, increase in red blood cells production, birth defects, and seizures
How to evaluate uterus in pp period/ what to do if fundus is "boggy"? - answer-palpate
the fundus if it feels boggy/soft it should be massage until firm but it shouldn't be overly
massage
Discharge instruction for postpartum moms should report? - answer-fevers over 100.4
Persistent lochia rubra or lochia that has a foul oder
Bright red bleeding particularly if the lochia has changed to serosa or alba
Prolonged afterpains
Signs of uti
Pain redness or tenderness in the calf
Feeling depressed
What should be assessed if uterus is boggy and to r? - answer-? If bladder is full or
distended if so have the patient urinate and massage uterus
What is mastitis? - answer-- inflammation and infection of breast tissue,usually occurs
2-3 weeks after birth. Organisms from skin/infant mouth enter small cracks in the
nipples.
Signs and symptoms of mastitis? - answer-are redness/ heat, tenderness, edema/
heaviness in breast and purulent drainage.
Treatment of mastitis? - answer-antibiotics are given, and remove milk from the breast.
Mild analgesics are given to make the mother comfortable. The mother can usually
continue to breast feed.
Pt. Teaching of mastitis? - answer-wash hands before breastfeeding, maintain breast
cleanliness, expose breast to air, ensure correct newborn latch on and removal,
encourage the newborn to empty the breast, breast feed from the uninfected side first,
report redness and fever. Apply ice packs or moist heat to relieve discomfort.
Pt teaching for engorgement? - answer-wear a tight bra. Feed frequently if breast
feeding. Apply cold compresses and warm compresses for discomfort.
What is endometritis and when does it occur? - answer-presence of tissue that
resembles endometrium outside the uterus. It is inflammation of the inner lining of the
uterus. The lesions may cause pain pressure and inflammation to adjacent organs as
they build up and slough during menstrual cycles. Occurs in the postpartum period
usually after the first day you see fever. Tearing of the tissue causes this
How to prevent thrombophlebitis after birth or cesarean? - answer-use pneumatic
compression devices on the lower extremities or prophylactic heparin for women
, undergoing cesarean or who is on bed rest. Early ambulation or range of motion
exercises are valuable aids to preventing thrombus. If stirrups are used during birth they
should be padded to prevent pressure to the popliteal angle.
What is subinvolution? - answer-a slower than expected return of the uterus to its non-
pregnant condition. Infection and retained fragments of the placenta are the most
common cause.
Signs of subinvolution is the following? - answer-• fundal height greater than expected
for the amount of time after birth
• persistence of lochia rubra or a slowed progression through all three phases
• pelvic pain, heaviness, fatigue
Treatment for subinvolution is the following:
• methylergonovine (methergine) to maintain firm uterine contraction
• antibiotics for infection
• dilation of the cervix and curettage to remove fragments of the placenta from uterine
wall
What is cephalohematoma/ what is the baby at risk for? - answer-lump on side of head.
Blood under the scalp. Can cause jaundice because of the breakdown of rbc's so if the
bilirubin is too high- greater than 12 and increases by 5 in 24 hours place the infant
under uv lights this could cause brain damage
What is molding? - answer-of the head occurs as result of parietal bones overriding
each other as the head passes through the birthing canal
What are the normal reflexes/ when should they be gone? - answer-moro reflex- 3-6
months, tonic neck 5-7 months, palmer grasps 4 months, babinski variable, root
response 3-4 months, sucking 7-12 months
What are the normal vital signs/ in what order should the nurse obtain vital signs? -
answer-hr. 110-160, resp rate- 35-60, temp 97.7-100, bp 80/50 blood sugar 40-90
Respirations first, pulse 2nd, temp 3rd.
How to use a bulb syringe? - answer-keeps airway clear of mucous
Compress the syringe insert the narrow portion into side of infants mouth suction mouth
first to prevent aspiration, release the pressure of the ball and listen to the sound of
mucous being suction, remove the syringe empty contents, compress again insert into
nostril, release pressure remove and empty
What will be the result of untreated hyperbilirubinema? - answer-jaundice the bilirubin
rises rapidly, because of the breakdown of the red blood cells so if the bilirubin is too
high greater than 12 and increase by 5 in 24 hours place infant under uv lights this can
cause brain damage
QUESTIONS AND ANSWERS
Why are preterm babies more prone to bleeding? - answer-their blood is deficient in
prothrombin a factor of blood clotting mechanism. Fragile capillaries of the head are
susceptible for injury during birth causing intracranial hemorrhage
Is drooling normal in newborns? - answer-the salivary glands do not secrete saliva until
the infant is 2-3 months old. Drooling in newborns is considered a sign of pathological
disturbance and needs to be reported
Nursing care for hydrocephalus/ vp shunt? - answer-observe for signs of increased
intracranial pressure (icp) and of infection. Pain control management
Bacterial infection is life threatening. Position infant on opposite side of operation
Signs of infection with hydrocephalus/ vp shunt? - answer-signs of infection is vital signs
increase. Poor feeding, pupil dilation, decrease levels of consciousness, and seizures.
Pt instruction for pseudomenstration? - answer-a thin white or blood-tinged mucus, may
be discharged from vagina. This discharge is caused by hormonal withdrawal from the
mother at birth
Newborn tub baths? - answer-are acceptable. The infant need only be bathed 2-3 times
a week using plain warm water during neonatal period. The bath is a excellent time to
provide basic hygiene and to observe the naked newborn behavior, muscle activity, and
general well being. Wash baby head to toe. Water should be 100 prevent chilling baby.
Wrap baby in towel to wash hair so baby doesn't get cold
Priority nursing intervention for neonatal abstinence syndrome? - answer-provide a
quite environment with swaddling, reduction of external stimuli, and close observations
for seizures
Caput succedaneum? - answer-swelling or edema of the newborn scalp that crosses
the suture lines;
Chignon? - answer-newborn scalp edema created by vacuum extractor
Cephalohematoma? - answer-subperiosteal swelling containing blood, found on the
head of some newborns, the swelling doesn't cross the suture lines and therefore often
appears unilateral; usually disappears within a few weeks to 2 months without treatment
Vital sign hypovolemic shock? - answer-increased respiration and heart rate, increase
of o2 content, tachycardia, and bp falls
,Signs of post maturity in post term newborn? - answer-asphycia caused by chronic
hypoxia, meconium aspiration, poor nutrient status, depleted glycogen reserves cause
hypoglycemia, increase in red blood cells production, birth defects, and seizures
How to evaluate uterus in pp period/ what to do if fundus is "boggy"? - answer-palpate
the fundus if it feels boggy/soft it should be massage until firm but it shouldn't be overly
massage
Discharge instruction for postpartum moms should report? - answer-fevers over 100.4
Persistent lochia rubra or lochia that has a foul oder
Bright red bleeding particularly if the lochia has changed to serosa or alba
Prolonged afterpains
Signs of uti
Pain redness or tenderness in the calf
Feeling depressed
What should be assessed if uterus is boggy and to r? - answer-? If bladder is full or
distended if so have the patient urinate and massage uterus
What is mastitis? - answer-- inflammation and infection of breast tissue,usually occurs
2-3 weeks after birth. Organisms from skin/infant mouth enter small cracks in the
nipples.
Signs and symptoms of mastitis? - answer-are redness/ heat, tenderness, edema/
heaviness in breast and purulent drainage.
Treatment of mastitis? - answer-antibiotics are given, and remove milk from the breast.
Mild analgesics are given to make the mother comfortable. The mother can usually
continue to breast feed.
Pt. Teaching of mastitis? - answer-wash hands before breastfeeding, maintain breast
cleanliness, expose breast to air, ensure correct newborn latch on and removal,
encourage the newborn to empty the breast, breast feed from the uninfected side first,
report redness and fever. Apply ice packs or moist heat to relieve discomfort.
Pt teaching for engorgement? - answer-wear a tight bra. Feed frequently if breast
feeding. Apply cold compresses and warm compresses for discomfort.
What is endometritis and when does it occur? - answer-presence of tissue that
resembles endometrium outside the uterus. It is inflammation of the inner lining of the
uterus. The lesions may cause pain pressure and inflammation to adjacent organs as
they build up and slough during menstrual cycles. Occurs in the postpartum period
usually after the first day you see fever. Tearing of the tissue causes this
How to prevent thrombophlebitis after birth or cesarean? - answer-use pneumatic
compression devices on the lower extremities or prophylactic heparin for women
, undergoing cesarean or who is on bed rest. Early ambulation or range of motion
exercises are valuable aids to preventing thrombus. If stirrups are used during birth they
should be padded to prevent pressure to the popliteal angle.
What is subinvolution? - answer-a slower than expected return of the uterus to its non-
pregnant condition. Infection and retained fragments of the placenta are the most
common cause.
Signs of subinvolution is the following? - answer-• fundal height greater than expected
for the amount of time after birth
• persistence of lochia rubra or a slowed progression through all three phases
• pelvic pain, heaviness, fatigue
Treatment for subinvolution is the following:
• methylergonovine (methergine) to maintain firm uterine contraction
• antibiotics for infection
• dilation of the cervix and curettage to remove fragments of the placenta from uterine
wall
What is cephalohematoma/ what is the baby at risk for? - answer-lump on side of head.
Blood under the scalp. Can cause jaundice because of the breakdown of rbc's so if the
bilirubin is too high- greater than 12 and increases by 5 in 24 hours place the infant
under uv lights this could cause brain damage
What is molding? - answer-of the head occurs as result of parietal bones overriding
each other as the head passes through the birthing canal
What are the normal reflexes/ when should they be gone? - answer-moro reflex- 3-6
months, tonic neck 5-7 months, palmer grasps 4 months, babinski variable, root
response 3-4 months, sucking 7-12 months
What are the normal vital signs/ in what order should the nurse obtain vital signs? -
answer-hr. 110-160, resp rate- 35-60, temp 97.7-100, bp 80/50 blood sugar 40-90
Respirations first, pulse 2nd, temp 3rd.
How to use a bulb syringe? - answer-keeps airway clear of mucous
Compress the syringe insert the narrow portion into side of infants mouth suction mouth
first to prevent aspiration, release the pressure of the ball and listen to the sound of
mucous being suction, remove the syringe empty contents, compress again insert into
nostril, release pressure remove and empty
What will be the result of untreated hyperbilirubinema? - answer-jaundice the bilirubin
rises rapidly, because of the breakdown of the red blood cells so if the bilirubin is too
high greater than 12 and increase by 5 in 24 hours place infant under uv lights this can
cause brain damage
