Maternal/Newborn ATI Final REVIEW
Questions with Accurate Answers
What is the fourth stage of labor and when does it start? - ANSWERSPostpartum
period- starts after the delivery of the placenta
What are the greatest risks during the postpartum period? - ANSWERSHemorrhage
Shock
Infection
When is RH immune globulin (RhoGAM) administered to post partum women? -
ANSWERSAdministered 72 hours for women who are Rh-negative and gave birth to
infants who are Rh-positive
This prevents sensitization to Rh in future pregnancies
What is included in the postpartum nursing assessment? - ANSWERSMonitoring vital
signs
Assessing uterine firmness & location in relation to umbilicus
Uterine position in relation to midline (if deviated, assist mom in emptying bladder)
Amount of vaginal bleeding (lochia)
How often should vitals be monitored after delivery? - ANSWERSEvery 15 min for the
first hour
Every 30 minutes for second hour
Every 4-8 hr depending on remaining medication regimen
This occurs with contractions of the uterine smooth muscle, whereby the uterus returns
to its pre-pregnant state - ANSWERSInvolution
Defined as blood flow from the uterus during postpartum period - ANSWERSLochia
This type of lochia is bright red in color, bloody consistency, fleshy odor, may contain
small clots - ANSWERSLochia rubra
This type of lochia is pinkish brown in color & serosanguineous consistency -
ANSWERSLochia serosa
This type of lochia is yellowish, white creamy color, fleshy odor - ANSWERSLochia alba
When is colostrum present in the new mother's breasts? - ANSWERSDuring pregnancy
and 2-3 days immediately after birth
,Defined as an infection in a milk duct of the breast with concurrent flulike symptoms -
ANSWERSMastitis
What are therapeutic and approved holding positions when breast feeding? -
ANSWERSCradle hold
Side-lying hold
Football hold
What does breast feeding cause the release of? What does this prevent? -
ANSWERSBreast feeding causes the release of oxytocin which stimulates uterine
contractions (will prevent hemorrhage)
What are normal lab values in the post partum period? - ANSWERSIncreased Hct &
Hgb up to 72 hours
Leukocytosis (WBC count up to 20,000-25,000 for the first 10-14 days, without
presence of infection)
Increased coagulation factors
Increased fibrinogen
A medical condition during pregnancy defined as excessive nausea and vomiting that is
prolonged past 12 weeks of gestation. Results in weight loss & electrolyte imbalance -
ANSWERSHyperemesis gravidarum
What are nursing responsibilities when caring for a patient diagnosed with hyperemesis
gravidarum? - ANSWERSMonitor client's I&O
Assess client's skin turgor/mucous membranes
Monitor vital signs
Monitor client's weight
Have client remain NPO for 24-48 hours
This medical condition occurs during pregnancy due to inadequacy in maternal iron
stores and consuming insufficient amounts of dietary iron - ANSWERSAnemia
This medical condition is defined as an impaired tolerance to glucose with the first onset
or recognition during pregnancy - ANSWERSGestational diabetes mellitus
What is the ideal blood glucose level during pregnancy? - ANSWERS70-110mg/dL
What are the clinical manifestations of hypoglycemia? - ANSWERSNervousness
Headache
Weakness
Irritability
Hunger
Blurred vision
Tingling of mouth/extremities
, What are the clinical manifestations of hyperglycemia? - ANSWERSThirst
Nausea
Abdominal pain
Frequent urination (diuresis)
Flushed dry skin
Fruity breath
What are the glucose levels that diagnostically, indicate gestational diabetes mellitus? -
ANSWERSBlood glucose screening of 130-140mg/dL or greater, indicating 3-hr oral
glucose test is indicated
This disorder begins after the 20th week of pregnancy where BP s elevated at 140/90
mm Hg or greater recorded at least twice, 4-6 hours apart within a 1 week period -
ANSWERSGestational hypertension (GH)
This disorder is defined as gestational hypertension with the addition of proteinuria
greater than 1+ - ANSWERSMild preeclampsia
This disorder is defined as maternal BP of 160/100 mm Hg or greater, protenuria
greater than 3+, oliguria, elevated Cr greater than 1.2mg/dLm visual disturbances,
hyperreflexia, pulmonary/cardiac involvement, extensive peripheral edema, hepatic
dysfunction & thrombocytopenia - ANSWERSSevere preeclampsia
This disorder is defined as severe preeclampsia symptoms along with the onset of
seizure activity or coma - ANSWERSEclampsia
This syndrome of pregnancy is a variant of gestational hypertension in which
hematologic conditions coexist with severe preeclampsia involving hepatic dysfunction -
ANSWERSHELLP syndrome
H- hemolysis (anemia and jaundice)
EL- elevated liver enzymes (Elevated ALT/AST, nausea/vomiting)
LP- low platelets (thrombocytopenia, DIC)
What are antihypertensive medications that are approved to be taken during
pregnancy? - ANSWERSMethyldopa (Aldomet)
Nifedipine (Adalat, Procardia)
Hydralazine (Apresoline, Nesopresol)
Labetalol (Normodyne)
AVOID ACE INHIBITORS & ARBs
What is an anticonvulsant medication used during pregnancy? - ANSWERSMagnesium
sulfate
What are signs of magnesium sulfate toxicity? - ANSWERSAbsence of patellar deep
tendon reflexes
Urine output less than 30mL/hr
Questions with Accurate Answers
What is the fourth stage of labor and when does it start? - ANSWERSPostpartum
period- starts after the delivery of the placenta
What are the greatest risks during the postpartum period? - ANSWERSHemorrhage
Shock
Infection
When is RH immune globulin (RhoGAM) administered to post partum women? -
ANSWERSAdministered 72 hours for women who are Rh-negative and gave birth to
infants who are Rh-positive
This prevents sensitization to Rh in future pregnancies
What is included in the postpartum nursing assessment? - ANSWERSMonitoring vital
signs
Assessing uterine firmness & location in relation to umbilicus
Uterine position in relation to midline (if deviated, assist mom in emptying bladder)
Amount of vaginal bleeding (lochia)
How often should vitals be monitored after delivery? - ANSWERSEvery 15 min for the
first hour
Every 30 minutes for second hour
Every 4-8 hr depending on remaining medication regimen
This occurs with contractions of the uterine smooth muscle, whereby the uterus returns
to its pre-pregnant state - ANSWERSInvolution
Defined as blood flow from the uterus during postpartum period - ANSWERSLochia
This type of lochia is bright red in color, bloody consistency, fleshy odor, may contain
small clots - ANSWERSLochia rubra
This type of lochia is pinkish brown in color & serosanguineous consistency -
ANSWERSLochia serosa
This type of lochia is yellowish, white creamy color, fleshy odor - ANSWERSLochia alba
When is colostrum present in the new mother's breasts? - ANSWERSDuring pregnancy
and 2-3 days immediately after birth
,Defined as an infection in a milk duct of the breast with concurrent flulike symptoms -
ANSWERSMastitis
What are therapeutic and approved holding positions when breast feeding? -
ANSWERSCradle hold
Side-lying hold
Football hold
What does breast feeding cause the release of? What does this prevent? -
ANSWERSBreast feeding causes the release of oxytocin which stimulates uterine
contractions (will prevent hemorrhage)
What are normal lab values in the post partum period? - ANSWERSIncreased Hct &
Hgb up to 72 hours
Leukocytosis (WBC count up to 20,000-25,000 for the first 10-14 days, without
presence of infection)
Increased coagulation factors
Increased fibrinogen
A medical condition during pregnancy defined as excessive nausea and vomiting that is
prolonged past 12 weeks of gestation. Results in weight loss & electrolyte imbalance -
ANSWERSHyperemesis gravidarum
What are nursing responsibilities when caring for a patient diagnosed with hyperemesis
gravidarum? - ANSWERSMonitor client's I&O
Assess client's skin turgor/mucous membranes
Monitor vital signs
Monitor client's weight
Have client remain NPO for 24-48 hours
This medical condition occurs during pregnancy due to inadequacy in maternal iron
stores and consuming insufficient amounts of dietary iron - ANSWERSAnemia
This medical condition is defined as an impaired tolerance to glucose with the first onset
or recognition during pregnancy - ANSWERSGestational diabetes mellitus
What is the ideal blood glucose level during pregnancy? - ANSWERS70-110mg/dL
What are the clinical manifestations of hypoglycemia? - ANSWERSNervousness
Headache
Weakness
Irritability
Hunger
Blurred vision
Tingling of mouth/extremities
, What are the clinical manifestations of hyperglycemia? - ANSWERSThirst
Nausea
Abdominal pain
Frequent urination (diuresis)
Flushed dry skin
Fruity breath
What are the glucose levels that diagnostically, indicate gestational diabetes mellitus? -
ANSWERSBlood glucose screening of 130-140mg/dL or greater, indicating 3-hr oral
glucose test is indicated
This disorder begins after the 20th week of pregnancy where BP s elevated at 140/90
mm Hg or greater recorded at least twice, 4-6 hours apart within a 1 week period -
ANSWERSGestational hypertension (GH)
This disorder is defined as gestational hypertension with the addition of proteinuria
greater than 1+ - ANSWERSMild preeclampsia
This disorder is defined as maternal BP of 160/100 mm Hg or greater, protenuria
greater than 3+, oliguria, elevated Cr greater than 1.2mg/dLm visual disturbances,
hyperreflexia, pulmonary/cardiac involvement, extensive peripheral edema, hepatic
dysfunction & thrombocytopenia - ANSWERSSevere preeclampsia
This disorder is defined as severe preeclampsia symptoms along with the onset of
seizure activity or coma - ANSWERSEclampsia
This syndrome of pregnancy is a variant of gestational hypertension in which
hematologic conditions coexist with severe preeclampsia involving hepatic dysfunction -
ANSWERSHELLP syndrome
H- hemolysis (anemia and jaundice)
EL- elevated liver enzymes (Elevated ALT/AST, nausea/vomiting)
LP- low platelets (thrombocytopenia, DIC)
What are antihypertensive medications that are approved to be taken during
pregnancy? - ANSWERSMethyldopa (Aldomet)
Nifedipine (Adalat, Procardia)
Hydralazine (Apresoline, Nesopresol)
Labetalol (Normodyne)
AVOID ACE INHIBITORS & ARBs
What is an anticonvulsant medication used during pregnancy? - ANSWERSMagnesium
sulfate
What are signs of magnesium sulfate toxicity? - ANSWERSAbsence of patellar deep
tendon reflexes
Urine output less than 30mL/hr
