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Repro exam 2
exam 2
| Question | Answer |
|---|---|
| Following the 3rd stage of labor, what is the nurse’s priority action? | Administer Oxytocin via the IV infusion bag |
| A 8 week postpartum female presents to the ER with signs of a seizure. What is the diagnosis? | Eclampsia |
| A nurse is about to give oxytocin. What should she assess first before giving it? | Resting tone |
| A mother is giving birth to a baby weighing 8 lb 6 oz. What are the complication risks? Select all that applies. | Shoulder dystocia, Cesarean delivery, Neonatal hypoglycemia |
| A picture of a FHR strip is showing decelerations. The picture depicts a fetal baseline with no determined pattern and that dips a little bit up and down at a semi-rounded angle but not at an alarming height. What event is causing this? | Uteroplacental insufficiency |
| How should a nurse treat a mother’s hypotension? Select all that applies. | Turn her on left side, Give oxygen, Give fluids |
| A pregnant female presents with 7cm dilation, 50% effacement, mild contractions occurring every 5 minutes, and -1 station. What stage of labor is she in? | 1st stage, active |
| A woman with a long history of opioid abuse is about to be given a drug for pain. What would raise alarm bells to the nurse? | Butorphanol |
| A 14 week pregnant woman with minor spotting says she has not had a period. She also took a positive pregnancy test. What should the nurse’s priority action be? | Do an ultrasound to determine gestation |
| A 12 week postpartum female presents to the ER with a BP of 142/92. What is the nurse’s rationale for this? | Chronic hypertension |
| A woman had a really high blood glucose two times during a 3 hour Glucola test? What is the nurse’s first course of action? | Dietary modifications |
| What objective sign showcases adequate primary and secondary powers of labor? | Fetal Descent |
| Pt at 36 weeks gestation with gestational diabetes, what will the nurse expect next? | Non stress test twice a week |
| Medical nutritional therapy is used for what in gestational diabetes? | Provide adequate nutrition, prevent DKA, and promote euglycemia |
| Woman concerned diagnoses of GDM and dietary restriction. Nurse response is? | “let’s consult dietitian.” |
| Woman at 32 weeks gestation, the primary goal is? | Optimal pregnancy outcomes |
| The first intervention for 2 abnormal sugar tests is? | Dietary modification before drugs |
| A pregnant woman is scheduled a 1 hour glucose test, what statement by the patient indicates further teaching is needed? | “I need to fast 8 hours prior to the test.” |
| Mom is experiencing perinatal loss, the nurse should respond with what? | Making memories, involve the family in grief support, and get the Chaplin if desired |
| Some spotting, no cervical dilation is which miscarriage ? | Threatened |
| Cervix is open, moderate vaginal bleeding is which miscarriage? | Inevitable |
| Fetus passed, placenta still inside, more concern for hemorrhage NOT infection is which miscarriage? | Incomplete |
| The mother membranes ruptured 12 hrs ago, the fetal heart rate is 180. What maternal vital would the nurse assess? | Temperature (indicates infection) |
| A fetal heart rate drops to it’s lowest point as the mother's contraction reached it’s highest point and returns to baseline indicates? | Early decelerations |
| Mild/moderate variability indicates what? | Nuchal cord (cord compression) |
| A woman is in the active phase of the first stage of labor and her membrane ruptured the primary nursing intervention is to? | Assess fetal heart rate every 30 mins |
| Before you give pain medications, what should you check? | Dilation measurements |
| Buterpernol (narcotic) in women addicted to opioids should be? | HOLD |
| Woman complained of rectal pressure, the nurse should conduct what FIRST? | Vaginal exam |
| Woman is 8 cm dilated and on IV Pitocin, would you give an analgesic? | NO, she’s too close to delivering, analgesic could cause respiratory depression |
| Two hours after receiving an epidural the nurse should monitor mom? | Bladder distention |
| Woman comes in with last menstrual period one week ago, what presumptive signs would the nurse ask? | Breast tenderness and Amenorrhea |
| Looking at the weight gain (BMI 20, Wt 128 → Wt 143) and lab values (HGB 11 → 10.7, Glucose neg → Glucose trace positive) = indicates what? | Physiological Anemia |
| A pregnant woman has a trend systolic blood pressure of 148 then to 155, the next assessment the nurse would test for is? | Urine protein |
| A woman 13 weeks postpartum that received magnesium sulfate during labor, had elevated blood pressure of 140/90, this would indicate she has? | Chronic HTN |
| Healthy People 2030 is trying to reduce what? | Infant mortality/distress |
| Preterm birth (PTB) is defined as what? | Birth between 20–37 weeks |
| What is a prevention strategy for preterm birth mother regrading their weight before pregnancy ? | Get to a healthy weight before pregnancy |
| What in maternal obstetric history would be most concerning to the nurse? | Weight gain of 40 lbs in previous pregnancy but normal BMI in current pregnancy |
| What temp would be the most concerning by the nurse? | Maternal temperature of 100.5 after 3 days |
| Woman is 34 weeks gestation and actively progressing in labor, which action would the nurse anticipate? | Administer magnesium sulfate every 2 hours |
| If patient is on magnesium sulfate, what are the main concerns? | Respiratory distress and Hemorrhage |
| What should the nurse instruct mom to watch for as signs of preterm labor? | Low backache, menstrual-like cramps, pelvic pressure, intestinal cramps |
| Mom has come to sign up for prenatal class but complains of low backache, pelvic pressure, and inability to sleep for 8 hrs. The nurse’s main concern is? | assess for preterm labor |
| Mom complains of low backache, pelvic pressure, and inability to sleep for 8 hours. The nurse’s main concern is? | Assess for preterm labor |
| Which woman is at higher risk for postpartum infection? | Woman in labor lasting 28 hours |
| Priority action in suspected complication during labor? | Assess the FHR |
| Woman has placenta previa at 27 weeks, anticipated risk factors? | Future cesarean births and vaginal bleeding during dilation |
| What is the Rationale for using betamethasone (steroid)? | Fetal lung development/surfactant |
| A laboring woman present with green-yellow vaginal discharge, the nurse anticipates which fetal complication? | Respiratory distress |
| After delivering a baby with shoulder dystocia, the nurse knows the mom is at risk for | Postpartum hemorrhage |
| A fetus presents with shoulder dystocia the First intervention for shoulder dystocia? | McRoberts maneuver |
| A woman had a 4th degree episiotomy. The nurse say that the Fundus is firm but slow continuous leakage of blood is indicative? | An unrepaired laceration |
| What Modifiable risk factors that prevent preterm labor? | Consistent prenatal care, Pregnancy planned after 18 months |
| What is the loss weeks for miscarriage? | Loss of fetus at <20 weeks’ gestation |
| If there are BP problems with the mom (BP too high and doesn’t come down) the next assessment the nurse should do is? | a urinalysis to check for protein in the urine |
| The pregnant woman came in complaint of headache, spots in vision, elevated BP. This indicates? | Preeclampsia with severe features |
| MAGNESIUM SULFATE is what type of medication and why is it given? | CNS depressant (neuro protection), muscle relaxant (slows contractions), prophylactic prevention of seizures in a pt with preeclampsia |
| What are the strict I & O guidelines for a patient on magnesium sulfate? | Fluid intake 100–125 mL/hr; Minimum urine output 30 mL/hr; Monitor for fluid volume overload |
| What urine output indicates magnesium sulfate toxicity? | Urine output <30 mL/hr or <100cc/4hr |
| What are the signs of Magnesium Sulfate Toxicity? | (BURP) Blood pressure decreased, Urine output <100cc/4hr or <30 mL/hr, Respiratory rate <12/min, Patellar reflexes absent, Mg level >8 mEq/dl, Muscle weakness, Slurred speech |
| What is the best fetal presentation for vaginal birth? | Vertex (head); Need to be face down head first same as wanting them in occipital anterior position |
| What indicates TRUE labor? | Progression of cervical dilation |
| if membrane ruptures in the active phase, the nurse must? | assess FHR q30 mins |
| What characterizes the 1st stage Active Phase of labor? | 4–7 cm dilated (1 cm per hour), mild contractions q5 mins, -1 station, 50% effacement |
| With Oxcitocin , always do what with it? | piggybacked |
| Whats the main thing in the 1st Stage forComfort Measures ? | counterpressure ( hold pressure on their back) |
| Before giving regional Anesthesia how much to hydrate | Pre-hydrate 500-1000 mL of LR over 20-30 mins |
| What is important during the Transition Phase of labor for pain meds like epidural? | Always check dilation before administering pain medications; Too late for epidural at this stage because it can cause respiratory depression; Tell pt they’re real close and doing great |
| Woman complained of rectal pressure, the nurse should conduct what FIRST? | perform a vaginal exam |
| What amount of blood loss defines postpartum hemorrhage mL for vaginal birth? | Greater than 500 mL for vaginal birth |
| What amount of blood loss defines postpartum hemorrhage mL C-section? | greater than 1000 mL for C-section |
| Uteroplacental insufficiency is ? | bradycardia in a FHR strip |
| Mild/moderate variability is ? | nucha cord compression |
| For EPIDURAL ANESTHESIA OR ANALGESIA (BLOCK), after the mom receives it, it is important for the nurse to monitor for what ? | bladder distention q2hrs. |
| Naloxone Used? | if RR is <12/min or O2 is <90% |
| so it is important to check fetal tracing first before giving what ? | giving epidural |
| What is the rationale for using betamethasone? | fetal lung development/surfactant |
| Betamethasone dosing? | – 12mg IM, two doses 24 hours apart |
| After recovery, how often should fundal massage be performed to assess/prevent hemorrhages? | Every 15 minutes |
| If you see the head come out, what should you get ready to do? | Suction |
| When should propofol be given? | If H/H is low |
| What is the intervention if baby presents with shoulder dystocia is ? | brings knee to chest to increase pelvic outlet so…….McRobert Maneuver |
| For Prolapse of Umbilical Cord what should the nurse do and not do ? | elevate presenting part, put umbilical cord back in the vagina Do NOT remove your hand once you are elevating the presenting part until birth occurs. |
| High BP Present before pregnancy or diagnosed before 20 weeks Persist longer than 12 weeks PP is what? | Chronic HTN |
| What to give for Magnesium Toxicity? | Calcium Gluconate |
| Which Miscarriage is HIGH RISK FOR SEPSIS? | Missed Miscarriage |
| Which Miscarriage is HIGH RISK FOR HEMORRHAGE? | Incomplete Miscarriage |
| What is any loss of pregnancy before 20 weeks’ gestation ? | Spontaneous abortion (miscarriage) |
| After miscarriage If Rh negative and unsensitized → give Rhogam within? | 72 hours |
| With soaking 2 pads per hour for 2 hours you need to start what for the patient? | large-bore IV access cause of blood loss |
| Hypertension + Proteinuria = ? | Preeclampsia |
| What’s the The 5 P’s of Labor? | Power, Passage, Passenger, Psyche, Positions |
| What is VEAL CHOP | • Variable = cord compression • Early = head compression • Acceleration = okay Oxygenation • Late = perfusion |Placenta insufficiency |
| Can Nifedipine and magnesium sulfate or terbutaline be used together ? | no |
| HTN w/o proteinuria develops after week 20 of pregnancy over 140/90 is ? | Gestational Hypertension |
| Magnesium Sulfate therapeutic range? | Therapeutic level: 4–7 mEq/L |
| A nurse is about to look at a FHR strip. What is the order of importance to look for? | Obtain FHR Baseline Determine variability Assess accelerations Access deceleration Determine uterine contraction Before Viewing Any Data, Check Before=Baseline Viewing=Variability Any =Accelerations Data =Decelerations Check =Contractions |
| What is a woman who had a cesarean delivery most at risk for? | Postpartum hemorrhage |
| A postpartum woman with Disseminated Intravascular Coagulation disorder is in the hospital. What sign/symptom should let the nurse know she has DIC? | Red tinged blood at the IV site |
| A woman postpartum from a cesarean delivery is switched from the operating bed to a recovery bed. She starts to have steady vaginal bleeding. What should the nurse do? | Massage the fundus |
| Who out of all this nurse’s patients is most at risk for postpartum hemorrhage? | A G2P1 patient on Magnesium Sulfate for the last 12 hours |
| What should the nurse teach the patient receiving maintenance tocolytics? | This doesn’t help to prevent preterm birth or resolve neonatal outcomes |
| A 16 hour postpartum woman experiences a saturated pad after 45 minutes. What should the nurse do? | Massage fundus |
| Interventions for Late Decels? | • L lateral / elevate legs • IV bolus • Stop pit / give tocolytics • Administer O2 10 L/min |
Created by:
fsanoe