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OB Final 2011
OB Final Study Guide 2011
| Question | Answer |
|---|---|
| Family center care includes mom and | husband and kids, whole family |
| Nurse does not give 6am seizure meds at 10am pt ambulates and falls. The nurse is sued for? | malpractice |
| describe evidenced based practice | questions why something is effective and is there a better approach |
| why was family centered maternity care developed | in response to parents requests that infants be with them |
| WIC provides | supplemental food supplies to low income women who are pregnant or nursing |
| a nursing process that is controlled and directed toward finding solution or options is called | critical thinking |
| write a correct NI for giving pt 100ml every 2 hrs | Provided 100 ml of fluid of choice every 2hrs while awake |
| process of determining outcomes and intervention of care is which stage of the nursing process | planning |
| what kind of delivery is a nurse midwife qualified to perform | vaginal |
| give examples of a independent nursing function | teaching (prenatal care) |
| what is a therapeutic nursing response to “I am afraid to have a cesarean” | “what concerns you most about a cesarean” |
| how can a nurse best assist a family to cope with stress | helping to identify family strengths |
| what type of family does a 3 year old with 2 adoptive moms belong to | same sex parents |
| what do families that deal well with stress believe about stress | that some stress is normal |
| NI: an appropriate goal for a patient with a different ethnic background | adapt ethnic practices to health needs |
| 5 functions of nursing process and family | affective, economic, healthcare, reproductive, socialization |
| non traditional families included | multigenerational, same sex |
| fertilization most likely takes place in the | fallopian tubes |
| what supplement may prevent neural tube defects | folic acid |
| what is one of the things you should do for your patient, as their advocate | ensure access to available resources |
| what kind of disorders are men more commonly affected by | X linked disorders |
| female chromosome | XX |
| Trisomy 21 Syndrome's common name | Down's Syndrome |
| what is one female secondary sexual characteristic (and usually the first to develop) | breast development |
| if a womens menstruation occurs every 28 days, what day will she most likely ovulate | at 14 days |
| what shape can you use to describe a non pregnant uterus with | pear |
| if menstruation began on October 5 and normally a 28 day cycle ovulation will occur when | Oct 19 |
| breastfeeding pt with warm, red, painful breast, temp, & flu like symptoms NI? | notify HCP |
| what are the phases of a normal ovarian cycle | Ovulatory, follicular, luteal |
| the part of the uterus that renews monthly in the absence of pregnancy | endometrium |
| twins that are from 2 different ova and may be different sexes are what kind of twins | dizygotic twins |
| what is the configuration of the umbilical cord vessels | 2 arteries and 1 vein |
| what does cephalocaudal growth pattern mean | the brain develops first |
| what is the purpose of the foramen ovale | to shunt blood from the right atrium to the left atrium |
| what is the function of the ductus arteriosus | carry blood from pulmonary arteries to the descending aorta |
| a pregnant women at 20 weeks gestation fundal measures 20cm even w/umbilicus, is this normal growth | yes |
| what is the appropriate NI for pt in 3 trimester complaining of feeling dizzy and agitated while taking vitals | have patient turn to her left side and recheck BP in 5 minutes |
| “I'll eat 2 large meals a day with frequent protein snacks” Does this patient understand teaching about ways to avoid morning Nausea? | No, needs additional teaching |
| vascular volume increases during pregnancy 30 – 50%, why? | to provide adequate perfusion to the placenta |
| why do mom's visit HCP every 4 weeks in first trimester | to monitor condition of mom and fetus |
| what is a good therapeutic response to a mom who fears something happening to her baby | tell me about your concerns |
| step in maternal role attachment that relates to mom giving up certain aspects of her previous life | grief work |
| what is an example of a man trying on fathering behaviors | coaching little league ball |
| why might an Asian woman refuse to meet your eyes while you are teaching her | cultural beliefs |
| a women who has female genitalia mutilation is at risk for | obstructed labor, laceration, hemorrhage, infection |
| can you delegate elevating a breast lumpectomy patient's arm to promote lymph node drainage to CNA | yes |
| what is the grava of a women with first pregnancy, term, living, 2nd, preterm, living 3rd miscarriage, 4th current pregnancy | G 4 P1112 |
| do you give a drug for the sole purpose of fetal therapy | No |
| Non reassuring pattern of the fetal HR is noted and mother is left side lying change her position the right. | |
| Nurse’s should teach the woman and her support person (about delivery procedures; initially) | about the monitoring equipment and discuss any questions they have related to electronic monitoring. |
| Contractions are 4 to 5 min. apart, and last for 30 sec. in active labor nurse’s should ask assessment questions when? | when the contraction is over. |
| Best time to teach non pharmacological pain control methods | is the latent phase. |
| Method of pain management that would be safest for a Gravida 3 Para 2002 admitted at 8 cm is | breathing and relaxation techniques. |
| Nerve block used in labor that provides anesthesia to the lower vagina and perineum is | a pudendal. |
| NI after epidural narcotic | Monitor respirations hourly |
| the least favorable maternal position is | supine |
| the first type of breathing technique is | slow paced |
| Labor pain in the back- have support person | apply firm pressure to the lower back. |
| Excessive anxiety in labor heightens the woman’s sensitivity to pain by | increasing muscle tension. |
| 24 year old G2 P1001 who is in active labor at 39 weeks prenatal data most important is | positive result for Group B strep. |
| A patient with leaking of fluid at 34 weeks requires | immediate notification of HCP. |
| A 22 year old G3 P2002 at 38 weeks and contractions every 3 min., who is requesting to use the bathroom to have a bowel movement | should be assessed first. |
| Factors for treatment modality are | personal and family history, financial resources, and maternal age. |
| 4P's of labor | Powers, Passage, Passenger, and Psyche |
| Fetal factors that regulate HR | autonomic nervous system, Baroreceptors, chemoreceptors, and adrenal glands |
| Amnitomy care | monitor fetus for non reassuring signs |
| oxytocin set up | secondary infusion and controlled by infusion pump |
| cervix prep for induction | prostaglandin |
| why use a urinary catheter during a focepts birth | because full bladder reduces room in pelvis |
| medium episiotomy, NI | apply cold packs promptly |
| NI targeted toward prevent hemorrhage after C section | access fundas regularly for firmness |
| fundus levels at umbilicus, firm, midline, 24 hrs after cesarean | document normal finding |
| 3hrs post partum, difficulty urinating, finally urinates 100mL, the next NI should be to? | reassess fundal height |
| what can aid in episiotomy healing | warm sits bath |
| prevent breast engorgement | wear well fitted bra |
| s/s new mom should report | reappearance of red locia |
| father reluctant to spoil newborn, does not pick up baby when he cries. NI? | explain baby cries to communicate |
| parent care for newborn | give positive feed back |
| what do surfactants do in the lungs? | keeps aveoli open between breaths |
| why does the foramen ovale close | because pressure in Left atrium is higher than right |
| brown fat is to? | maintenance of temperature |
| prevent jaundice | regular and adequate breastfeeding |
| why infection signs are subtle in newborn? | because leukocyte and inflammatory signs are immature |
| infant shoulder discotia, asses for? | clavicle fracture |
| what newborn reflex helps with breastfeeding | rooting |
| where is the best site to do a glucose determination on an infant | lateral heel |
| newborn axillary temp 35.9 (96.6), NI? | place in a radiant warmer |
| steps to returning an infant to mom | mom read printed band and verify match to baby |
| site for hep B injections | vatus lateralis |
| why do you need to support a baby's head? | muscles to weak to support |
| what is a normal circumcision assessment | development of yellow crust |
| What can a mom cause by breastfeeding for only 5 minutes on each breast | cause frequent hunger ??? |
| what should a mom do who cannot breastfeed her baby right away but, wants to once baby is able? | use breast pump to maintain lactation |
| When should a mom be given an anlgesic so that the baby gets less of the medication? | less will reach baby if taken right after breastfeeding |
| how best to asses diet | ask about previous day |
| alcohol use and pregnancy | avoid entirely throughout pregnancy |
| when presenting a child with an anomaly, what should you do to? | emphasize normal aspects of the baby |
| Amniotomy shows green fluid with a mild odor | monitor the fetus closely for non-reassuring signs. |
| Oxytocin | is a secondary infusion controlled by a pump |
| For cervical prepreation for delivery use? | can use prostaglandin gel |
| Why is a urinary catheter needed for a forceps delivery? | A full bladder reduces the available room. |
| During the recovery phase of a median episiotomy the nurse should | apply cold packs to peri-area promptly. |
| Best method to prevent post partum hemorrhage | assess uterine firmness regularly |
| Checking the fundus for a mom who delivered 24 hours ago- the fundus is at midline and at level of umbilicus and firm- What to document? | DOCUMENT that it is normal. |
| Woman 3 hours post partum has difficulty urinating- | ASSESS height of fundus. |
| Woman is 24 hours post partum with episiotomy | how do you help with the healing? Warm sitz baths. |
| Prevention of breast engorgement? | Wear a well fitting bra/binder constantly. |
| New mom should report | reappearing of red lochia after it has changed to serous. |
| A new father is reluctant to pick up newborn because he does not want to spoil it. | Teach that newborns cry to communicate their needs. |
| Best nursing encouragement for new parents | Positive Feedback |
| Primary purpose fo surfactant- | keep alveoli partially open between breaths |
| The foramen ovale closes because the- | ressure of the left atrium is greater than the right. |
| Brown fat is used for | to maintain temperature. |
| To prevent jaundice | frequent breast or bottle feedings. |
| Infection in the newborn has subtle signs, why? | Leukocytes and inflammatory responses are immature. |
| 9 lb 11 oz baby delivered vaginally with shoulder dystocia, what to assess for? | Clavicle fractures. |
| What is the newborn reflex that teaches mom how to feed? | Rooting. |
| The best location for blood glucose testing on infant | lateral surface of the heel. |
| Infant axillary temp is 35.9 (96.6), what to do? | Place in warmer. |
| Correct site for Hep b injection- | vastus lateralis |
| Must support newborns head, why? | Baby’s muscles are to weak |
| Normal circumcision assessment | development of yellow crust |
| Mom wants to nurse only five minutes on each side to avoid nipple soreness, what can you teach her? | Teach her that limiting time can cause frequent infant hunger due to not getting rich milk. |
| Mom has a baby at 29 wks, what to do about breastfeeding? | She can pump to maintain lactation until nursing is possible. |
| Mom is concerned about taking medications since she is breastfeeding. What to teach? | Teach her to take meds just after breastfeeding. |
| Important dietary assessment question to ask pregnant adolescent | What did you eat yesterday? |
| Alcohol during pregnancy | NO NO NO NO NO NO NO NO NO NO NO NO! |
| When presenting an infant with an anomaly to parents, what should you do? | Emphasize normal aspects first. |
| Mom of stillborn baby is angry with the doctor | THIS is a normal grieving response. |
| Main goal when dealing with battered women- | emphasize that they have the right not to be hurt. |
| What is the difference between an inevitable and a threatened abortion? | Ruptured membranes |
| Mom is receiving methotrexate, what dietary teaching is needed? | Avoid taking a vitamin with folic acid. |
| Intrapartal care for sever preeclampsia | promote placental blood flow and prevent maternal injury. |
| What causes clonus? | An irritable CNS |
| Name of the test for gestational diabetes- | glucose challenge test. |
| Best evaluation for client administration of insulin- | client is able to accurately withdraw, mix and inject. |
| What warning sign to watch for in pregnant woman with LUPUS? | Increased BP |
| Teaching for pregnant woman with chickenpox | report cough and dyspnea immediately. |
| HIV med for pregnancy | Zidovudine |
| TB med for pregnancy- | Isoniazid, rifampin |
| Nursing assessment for infection | cloudy amniotic fluid |
| Monitoring for admin of mag sulfate | hourly vs, heart and lung sounds |
| Drop in FHR possible | prolapsed cord. |
| Male or female condoms protect against | STD’s. |
| Coitus interruptus, breast feeding, and natural family planning | are not the most reliable. IUD is the most reliable. |
| Thrombophlebitis, liver tumor, and possible pregnancy should not receive | oral contraceptives. |
| Family planning, NI | educate couples on the various methods of contraception. |
| Informed consent concerning contraceptive is important because | it may have potentially dangerous side effects. |
| cervical cap contraindicated in | Toxic shock syndrome |
| Diet of pregnant woman should be composed of what kind of carbs | complex carbs. |
| Increase absorption of iron by taking with | with orange juice |
| Folates | green leafy vegetables |
| Pica | ingestion of nonfood substances |
| Legumes | calcium |
| Determine the cultural influence on a client’s diet by identifying | the food preferences and methods of food prep. common to that culture |
| Week 28 and weigh gain of 17 lbs. | is normal |
| Primary reason for evaluating (AFP) level | is to determine neural tube deficits |
| Nurse’s role in diagnostic testing | is to provide information about the tests. |
| Nursing intervention necessary before a second-trimester transabdominal ultrasound | is to instruct the client to drink 1 to 2 quarts of water. |
| Purpose of amniocentesis for the client hospitalized at 34 weeks with pregnancy induced hypertension | is determination of fetal lung maturity. |
| As the uterus contracts during labor, maternal-fetal exchange of oxygen and waste products | diminishes as the spiral arteries are compressed. |
| Pregnant woman can usually tolerate the normal blood loss associated with childbirth because | they have increased blood volume. |
| Essential part of nursing care for the laboring woman is helping the woman | to manage the pain. |
| Gravida 3 para 2 whose longest previous labor was 4 hours should go to the hospital | the soonest after labor begins. |
| A woman who is Gravida 3 Para 2002 enters the intrapartum unit. Most important nursing assessment is | fetal HR, maternal VS, and nearness to birth (SVE, contractions, bleeding). |
| A woman who is in second-stage labor is almost ready to give birth if | the vulva bulges and encircles the fetal head. |
| A woman who is touching her infant with the fingertips and talking to him softly in high-pitched tones, the nurse should document this evidence | of normal early maternal infant attachment behavior. |
| Contraindication for application of internal monitoring devices is | unruptured membranes. |
| Finding of beat-to-beat variability can be determined by | electronic fetal monitoring. |
| Most appropriate method of intrapartum fetal monitoring when a woman has a history of hypertension during pregnancy is | continuous electronic fetal monitoring. |
| If you cannot get accurate assessment of the actual intrauterine pressure, what should you use | use a intrauterine pressure catheter |
| If fetal HR baseline increases 1 to 20 beats/min. after vibro-acoustic stimulation the fetus is showing | a reassuring response. |
| Non reassuring pattern of the fetal HR is noted and mother is left side lying change her position the right. | |
| Nurse’s should teach the woman and her support person | about the monitoring equipment and discuss any questions they have related to electronic monitoring. |
| Contractions are 4 to 5 min. apart, and last for 30 sec. in active labor nurse’s should ask assessment questions | when the contraction is over. |
| Best time to teach non pharmacological pain control methods | is the latent phase. |
| Method of pain management that would be safest for a Gravida 3 Para 2002 admitted at 8 cm is | breathing and relaxation techniques. |
| Nerve block used in labor that provides anesthesia to the lower vagina and perineum is | a pudendal. |
| NI after epidural narcotic | Monitor resp. hourly |
| the least favorable maternal position is | supine |
| the first type of breathing technique is | slow paced |
| Labor pain in the back- have support person | apply firm pressure to the lower back. |
| Excessive anxiety in labor heightens the woman’s sensitivity to pain by | increasing muscle tension. |
| 24 year old G2 P1001 who is in active labor at 39 weeks prenatal data most important is | positive result for Group B strep. |
| A patient with leaking of fluid at 34 weeks requires | immediate notification of HCP. |
| A 22 year old G3 P2002 at 38 weeks and contractions every 3 min., who is requesting to use the bathroom to have a bowel movement | should be assessed first. |
| Factors for treatment modality are | personal and family history, financial resources, and maternal age. |
| 4P's of labor | Powers, Passage, Passenger, and Psyche |
| Fetal factors that regulate HR | autonomic nervous system, Baroreceptors, chemoreceptors, and adrenal glands |
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